General Medical Information Research Articles

Exploring and prioritizing content to include in a medication self-management toolkit for persons with spinal cord injury/dysfunction: A concept mapping approach.

Adults with spinal cord injury/dysfunction (SCI/D) face challenges with medications they take to manage their secondary conditions (e.g., pain, urinary tract infections, autonomic dysreflexia). With many healthcare providers typically involved in care, there are additional challenges with care fragmentation and self-management. Prior research emphasized the desire for more support with medication self-management among this population. To explore what content should be included in a medication self-management resource (i.e., toolkit) for adults with SCI/D, as well as considerations for delivery from the perspectives of adults with SCI/D, caregivers, healthcare providers, and representatives from community organizations. A concept mapping study was conducted. Participants took part in one or more of three activities: brainstorming; sorting and rating; and mapping. Participants generated ideas about the content to include in a medication self-management toolkit. Participants sorted the statements into conceptual piles and assigned a name to each. All statements were rated on a five-point Likert-type scale on importance and realistic to include in the toolkit. Participants decided on the final cluster map, rearranged statements, and assigned a name to each cluster to create visual representations of the data. Forty-four participants took part in this study. The final map contained eight clusters: 1) information-sharing and communication; 2) healthcare provider interactions and involvement; 3) peer and community connections; 4) supports and services for accessing prescription medications and medication information; 5) information on non-prescription medication and medication supplies; 6) safety and lifestyle considerations; 7) general medication information; and 8) practical information and strategies related to medication-taking. Safety and lifestyle considerations was rated as the most important and realistic to include in the toolkit. Given the limited tools to help adults with SCI/D with managing their medications, there is great potential to better support this population across all areas of medication self-management.

Ophthalmic diseases in meningitis within the pediatric population

ObjectifLa méningite peut se solder par des complications ophtalmiques chez les enfants. Or, ces retombées visuelles ont été peu étudiées dans les pays industrialisés. La présente étude a pour objectif de mettre au jour les séquelles oculaires et neuro-ophtalmiques éventuelles de la méningite au sein d'une population pédiatrique dans un hôpital de soins tertiaires pour enfants. NatureOn a réalisé un examen rétrospectif des dossiers de tous les enfants qui ont reçu un diagnostic de méningite entre 2006 et 2015 à l'Hôpital de Montréal pour enfants. L’étude a reçu l'approbation du comité d’éthique du Centre universitaire de santé McGill et respectait les principes de la Déclaration d'Helsinki. MéthodesAprès extraction des dossiers médicaux des enfants qui ont eu une méningite, on a retenu les patients qui ont fait l'objet d'une consultation en ophtalmologie. Les données démographiques et les antécédents médicaux pertinents, de même que les résultats des examens oculaires et de l'imagerie, ont été notés. La proportion d'anomalies oculaires a été calculée et analysée. RésultatsAinsi, 72 des 861 patients (8,4 %) qui ont eu une méningite ont fait l'objet d'une consultation en ophtalmologie, dont 46 qui répondaient aux critères d'inclusion; de ce nombre, 31 patients (67,4 %) présentaient des anomalies oculaires, qui touchaient le plus fréquemment l'acuité visuelle (8 patients sur 32), les mouvements extraoculaires et l'alignement (14 patients sur 28), le nerf optique (10 patients sur 41), la réactivité pupillaire (4 patients sur 35) et la cellulite périorbitaire/orbitaire (4 patients sur 46). Les enfants plus âgés étaient plus susceptibles de présenter des anomalies ophtalmologiques. ConclusionNotre étude met en relief les anomalies oculaires découvertes chez des enfants qui ont eu la méningite et qui ont été soignés dans un centre de soins tertiaires dans un pays à indice de développement sociodémographique élevé. Les complications risquent de perdurer. Les ophtalmologistes traitants doivent être bien au fait du risque d'anomalies oculaires associées à la méningite, ce qui nous amène à recommander que les professionnels de la santé soient mieux sensibilisés à cette éventualité.

Evaluation of Replies to Voice Queries in Gynecologic Oncology by Virtual Assistants Siri, Alexa, Google, and Cortana

Women that receive news that they have a malignancy of gynecologic origin can have questions about their diagnosis. These questions might be posed as voice queries to the virtual assistants Siri, Alexa, Google, and Cortana. Because our world has increasingly adopted smart phones and standalone voice query devices, this study focused on the accuracy of audible replies by the virtual assistants (VAs) Siri, Alexa, Google, and Cortana to voice queries related to gynecologic oncology. Twenty-one evaluators analyzed VA audible answers to select voice queries related to gynecologic oncology. Questions were posed in three different ways for each voice query in order to maximize the likelihood of acceptability to the VAs in a 24-question panel. For general queries that were not related to gynecologic oncology, Google provided the most correct audible replies (83.3% correct), followed by Alexa (66.7% correct), Siri (45.8% correct), and Cortana (20.8% correct). For gynecologic oncology-related queries, the accuracy of the VAs was considerably lower: Google provided the most correct audible replies (18.1%), followed by Alexa (6.5%), Siri (5.5%), and Cortana (2.3%). There was a considerable drop in the accuracy of audible replies to oral queries on topics in gynecologic oncology relative to general queries that were not related to gynecologic oncology. There is considerable room for improvement in VA performance, so that caution is advised when using VAs for medical queries in gynecologic oncology. Our specific findings related to gynecologic oncology extend the work of others with regard to the low usability of general medical information obtained from VAs, so that reliance on conversational assistants for actionable medical information represents a safety risk for patients and consumers.

Should Medical Insurance Review Serve the Patient's Best Interests? Examples and Considerations Illustrated by Behavioral Health Cases.

Physician medical directors working for health care insurance companies conduct utilization reviews, participate in quality-of-care reviews, and adjudicate appeals. As a result, they have access to substantial and important clinical information. The medical director may have both current and historical information that can assist the treatment team in providing care. Sharing this information with a patient's current health care provider(s) is problematic due to concerns about patient privacy and the insurer's goal of not assuming legal liability for patient care. While this paper considers legal issues, it predominantly addresses the ethical responsibilities of medical directors who have valuable information unavailable to or unrecognized by the treatment team. Although it is important to consider sharing general medical information, this paper emphasizes the sharing of behavioral health information, which can be highly sensitive but also pertinent to psychiatric and other medical treatment choices. We suggest that clinical information should flow from insurer to provider when the insurer has information that will benefit the patient or prove crucial to optimal care rather than just flow from provider to insurer for the purposes of claims payments. To support and secure that flow, the paper outlines procedures for determining the need to share information, the means of providing that information, ways to separate liability, and processes for protecting privacy.

AGE CHANGES OF THE LIVER

The purpose of the research is to analyze the results of scientific works devoted to the study of age-related changes in the liver and aging under the influence of various harmful factors.
 Research material and methods. Analytical and bibliosemantic methods were used in the research. The search for scientific information on the topic of age-related changes in the liver and general scientific medical information was conducted using PubMed and Web of Science databases.
 The results. The analysis of literary sources made it possible to establish that in the course of life, the human body undergoes a number of changes that lead to its aging. Physiological aging of the body is accompanied by irreversible functional and organic restructuring of all systems and organs, including the liver. The most common cause of diffuse changes in the liver parenchyma in elderly patients is steatosis, in the development of which mitochondrial dysfunction plays an important role. The problem of bad habits is also acute, because they inevitably accelerate the aging process in the liver itself and cause pronounced diffuse changes. This list includes alcohol consumption, smoking, and poor nutrition. Hereditary diseases are a separate direction of age-related changes in the liver. Without proper therapy, they accelerate the aging of the liver and the appearance of new chronic diseases associated with them.
 It was also established that scientists have always sought to find reasons that affect the shortening of life, the mechanisms of liver aging, and the development of its age-related pathology. Along this path, hundreds of hypotheses have arisen that explain the essence of aging by the action of some single factor, say, a violation in one or another link of life support. One of the first synthetic theories of aging, based on the action of a complex system of factors, is the adaptive and regulatory function of the liver.
 This theory is called adaptive because it sees the basis of aging in the reduction of the body's adaptive capabilities with age; and regulatory – because the shifts that occur are explained by a change in the mechanisms of regulation of exchange and function. According to the adaptation-regulatory theory, along with aging, a destructive process, the process of vitauktu (from vita - life, auktum - to increase) develops, aimed at stabilizing the viability of the liver and the body as a whole. This idea determined the tactics and strategy for solving this problem – to slow down the pace of aging and optimize the aging process and the adaptive capabilities of the body as much as possible.
 Conclusions. For the treatment and prevention of liver diseases, against the background of inevitable aging, it is advisable to use drugs with a multidirectional effect on various links of the pathogenesis of liver lesions. Systematic implementation of preventive measures will allow older people to maintain good health and work capacity for many years.

The Utilization and Limitation of Genetic Information in Insurance: Improvement Plan of China’s“Genetic Non-discrimination Act”

According to current Chinese law, insurance companies cannot use genetic information for medical, disease, disability, care and medical accident insurance. Nevertheless, this approach has not effectively solved the problem of “genetic discrimination” in China. Genetic information plays a vital role in insurance. The theory that genetic information can be used in insurance is based on risk classification and price equilibrium principle. Adverse selection can be avoided by dividing genetic information into different risk classes. This is an inevitable requirement of the insurer's right to know. For the consideration of social and public interests, commercial insurance should undertake a reasonable social relief function, but it is necessary to clarify the limitations of the social relief function of commercial insurance, and commercial insurance and social insurance cannot be equated. In terms of the characteristics of genetic information itself, there is no substantial difference between it and general medical information. Insurance covers uncertain risks, and with the progress of technology, the accuracy of genetic testing has also been improved. Therefore, theoretically speaking, it is not necessary to completely prohibit insurers from using genetic information in the insurance field. Therefore, in the future, China's legislation on genetic discrimination should be changed from completely prohibiting the use of genetic information by insurers to conditionally restricting the use of genetic information by insurers. First of all, the way to obtain genetic information by the insurer should be clarified, and the insurer should be prohibited from forcing the insured to carry out predictive genetic testing. The insurance applicant only must inform the specific genetic testing results. Secondly, it is necessary to set conditions for the insurer to use genetic information. The insurer can only use genetic information in personal insurance that meets a certain amount of money, and the use of genetic information must meet legal procedures and obtain the consent of the insured. In addition, it is also necessary to strengthen the regulation of the gene testing industry, formulate strict market access rules, and establish a gene consultant system to make up for the inferior position of the insured in the profession. Finally, improve the rescue of the insured, let professionals participate in the settlement of disputes, and increase the severity of punishment for the illegal use of genetic information by insurance companies.

Understandability and Actionability of Available Video Information on YouTube Regarding Hemophilia: A Cross-Sectional Study.

Introduction With the advent of revolutionary information technology, most general medical information can be accessed by the community at large. However, the factual nature of information, its understandability, and actionability ofdiseases like Hemophilia are unknown to the general population. Hence the present study has been envisaged to assess the understandability and actionability of available video information on YouTube about Hemophilia. Methods A cross-sectional study was performed using the Patient Education Materials Assessment Tool for Audiovisual materials (PEMAT-AV) to assess the understandability and actionability of 50 videos shown by order of relevance utilizing three independent assessors. An online google survey was prepared using the PEMAT questionnaire as a basis and results were recorded and saved as a Microsoft Excel sheet for analysis. Data was analyzed using either Microsoft Excel or an online calculator as the case may be. Results A total of 50 short videos on Hemophilia were assessed by three independent assessors using PEMAT. The data so obtained was rechecked by an independent reviewer before data analysis. Three videos were excluded due to non-English language whileonly two videos out of 50 showed 100% average understandability and actionability. Average understandability and actionability scores range between 34 to 100 percent and 11.1 to 100 percent, respectively. Most videos have higher average understandability than actionability (P value=0.003). Conclusion Our study shows there are only a few high-quality short videos available as audio-visual patient education materials on YouTube about Hemophilia. There is a great need to develop content that is beneficial to patients as patient educational material.

General Surgery Clinical Information Management System Based on Intelligent Data Management.

In order to improve the effect of surgical clinical information management, this paper combines the intelligent data management technology to construct the general surgery clinical information management system. Based on the design and development of general surgery clinical medical case information management system, this paper studies the mutual conversion between XML data and relational data, and designs a clinical medical case information management system based on the design idea of layered architecture. The clinical medical case information management system mainly adopts the modular design idea and adopts a digital microscopic image storage mode based on HDFS architecture. After building the system function structure, the system effect is verified by simulation test. From the experimental statistical results, it can be seen that the general surgery clinical information management system based on intelligent data management proposed in this paper has a good effect.

Management of Helicobacter pylori among medical doctors working in Khartoum, Sudan 2019: a cross-sectional study.

Various international guidelines have been developed regarding Helicobacter pylori (H. pylori) management, as it is infecting more than half of the world's population. Sudan's health system lacks guidelines regarding H. pylori management, leading to a discrepancy in practice. Investigating the current approach could be a step forward in the formulation of a national consensus in the management of H. pylori. A cross-sectional study was conducted among medical doctors currently working in Khartoum, Sudan. Participants were enrolled from platforms of medical associations through an online questionnaire. The questionnaire was scored out of 25 points, and scoring 13 or above considered a good approach. Data analysis was carried out using Statistical Package for Social Sciences (SPSS). A total of 358 medical doctors participated in the study. The mean (±SD) score was 12.9(±4.5). Those who were using textbooks, campaigns, symposiums or general medical information to their primary Source of knowledge significantly scored higher. The most selected indication for both diagnosis (76.8%) and treatment (67.6%) was an active peptic ulcer. Stool antigen test (SAT) was the most preferred test (70.7%). The majority of respondents selected triple therapy (82.1%) as a first-line regimen. Only 37.7% confirmed the eradication after four weeks of stopping the treatment. They ensure eradication mainly through SAT (29%). A suboptimal approach was noted among medical doctors of Khartoum, Sudan, regarding H. pylori management. Efforts should be invested in forming national guidelines and the implementation of continuous medical education programs.

Medical information seeking practices among medical students in Kenya: A descriptive cross-sectional study

Purpose: Many medical schools in low- and middle-income countries (LMICs) have adopted a problem-based learning (PBL) approach. PBL requires medical students to independently access and correctly interpret medical information. There is paucity of information on how students in LMICs retrieve medical information and apply Evidence Based Medicine (EBM) principles. Methods: A cross-sectional survey was carried out among medical students in their clinical years at Moi University School of Medicine (MUSOM), a large medical school in Kenya between August and November 2016.Results: Authors analyzed results of 206 clinical year medical students at MUSOM (response rate of 84%). Standard textbooks (47.8%) and lecture slides (20.9%) were the most preferred sources of general medical information. Medscape®, a free mobile medical information application, was the most utilized drug information source. Sources which directly link to primary biomedical literature such as PUBMED and HINARI were used by 14.1% and 7.8% of students respectively. A quiz testing key clinical epidemiology concepts was also performed with a mean score of 49% (SD, 23.8).Conclusion: There is preference for standard textbooks. Low scores on the clinical epidemiology quiz, coupled with most students endorsing limited understanding of key EBM concepts emphasizes the need for broader EBM training.

Rate-Dependent Depression: A Predictor of the Therapeutic Efficacy in Treating Painful Diabetic Peripheral Neuropathy.

We investigated the application of rate-dependent depression (RDD) of the Hoffmann (H) wave as a predictor of treatment efficacy in patients with painful diabetic peripheral neuropathy (DPN). General medical information, scales, and nerve conduction data were collected from 73 healthy subjects, 50 subjects with type 2 diabetes and painless DPN, and 71 subjects with type 2 diabetes and painful DPN. The left tibial nerve was stimulated, and RDD was calculated by the decline in amplitude of the third H wave relative to the first one. Gabapentin treatment was initiated after baseline evaluation, and the RDD and visual analog scale (VAS) score were both evaluated regularly during the 2-week study period. At baseline, the painful DPN group exhibited significant RDD impairment across all stimulation frequencies. Gabapentin treatment significantly reduced the VAS score and restored RDD during the 2-week observation period. RDD was found to be an independent factor of minimal VAS score improvement, such that the benefit increased by 1.27 times per 1% decrease in the RDD value. In conclusion, this study demonstrates that diabetes-induced loss of RDD can be modified by gabapentin and suggests that RDD may be valuable for predicting the initial efficacy of gabapentin therapy in patients with painful DPN.

Association of acidic urine pH with impaired renal function in primary gout patients: a Chinese population-based cross-sectional study

BackgroundPatients with gout frequently have low urinary pH, which is associated with the nephrolithiasis. However, the specific distribution of urinary pH and potential relationship of acidic urine pH to broader manifestations of kidney disease in gout are still poorly understood.MethodsA 2016–2020 population-based cross-sectional study was conducted among 3565 gout patients in the dedicated gout clinic of the Affiliated Hospital of Qingdao University to investigate the association between low urinary pH and kidney disease. We studied patients that we defined to have “primary gout”, based on the absence of > stage 2 CKD. All subjects underwent 14 days of medication washout and 3-day standardized metabolic diet. We obtained general medical information, blood and urine biochemistries, and renal ultrasound examination on the day of the visit. The primary readouts were urine pH, eGFR, nephrolithiasis, renal cysts, microhematuria, and proteinuria. Patients were assigned into 5 subgroups (urine pH ≤5.0, 5.0 <pH≤ 5.5, 5.5 <pH< 6.2, 6.2 ≤pH≤ 6.9, and pH >6.9), aligning with the clinical significance of urine pH.ResultsOverall, the median urine pH and eGFR of all patients was 5.63 (IQR 5.37~6.09), and 98.32 (IQR 86.03~110.6), with acidic urine in 46.5% of patients. The prevalence of nephrolithiasis, microhematuria, and proteinuria were 16.9%, 49.5%, and 6.9%, respectively. By univariate analysis, eGFR was significantly associated with age, sex, duration of gout, tophus, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, serum utare, hypertension, diabetes, and urine pH. On multivariable analysis, eGFR was associated with age, sex, diastolic blood pressure, serum uric acid, hypertension, diabetes, and urine pH. Acidic urine pH, especially urine pH < 5.0, was significantly associated with the prevalence of kidney disease, including > stage 1 CKD, nephrolithiasis, kidney cyst, and microhematuria. Patients with 6.2 ≤ urine pH ≤ 6.9 and SU ≤ 480 μmol/L had the highest eGFR with the lowest prevalence of nephrolithiasis, microhematuria, and proteinuria.ConclusionsApproximately half of gout subjects had acidic urine pH. Urine pH < 5.0 was associated with significantly increased nephrolithiasis, renal cyst, microhematuria, and proteinuria. The results support prospective clinical investigation of urinary alkalinization in selected gout patients with acidic urine pH.

Web-based sensitivity training for interacting with facial paralysis.

Previous research has shown that observers tend to form inaccurate and negatively biased first impressions of people with facial paralysis (FP). It has been hypothesised that this may be ameliorated by encouraging people to focus on channels of expression other than the face. This was tested in a web-based study of 466 participants. Participants in the Trained Condition received tips for perceiving expressiveness in individuals with FP, while those in the Untrained Condition received general medical information about FP. We observed no significant differences between groups for accuracy of emotion recognition, but a significant effect of the training upon perception of emotional intensity. These results show that attending to non-facial cues may improve social perception and reduce bias.

A New Time-Window Prediction Model For Traumatic Hemorrhagic Shock Based on Interpretable Machine Learning.

ABSTRACTEarly warning prediction of traumatic hemorrhagic shock (THS) can greatly reduce patient mortality and morbidity. We aimed to develop and validate models with different stepped feature sets to predict THS in advance. From the PLA General Hospital Emergency Rescue Database and Medical Information Mart for Intensive Care III, we identified 604 and 1,614 patients, respectively. Two popular machine learning algorithms (i.e., extreme gradient boosting [XGBoost] and logistic regression) were applied. The area under the receiver operating characteristic curve (AUROC) was used to evaluate the performance of the models. By analyzing the feature importance based on XGBoost, we found that features in vital signs (VS), routine blood (RB), and blood gas analysis (BG) were the most relevant to THS (0.292, 0.249, and 0.225, respectively). Thus, the stepped relationships existing in them were revealed. Furthermore, the three stepped feature sets (i.e., VS, VS + RB, and VS + RB + sBG) were passed to the two machine learning algorithms to predict THS in the subsequent T hours (where T = 3, 2, 1, or 0.5), respectively. Results showed that the XGBoost model performance was significantly better than the logistic regression. The model using vital signs alone achieved good performance at the half-hour time window (AUROC = 0.935), and the performance was increased when laboratory results were added, especially when the time window was 1 h (AUROC = 0.950 and 0.968, respectively). These good-performing interpretable models demonstrated acceptable generalization ability in external validation, which could flexibly and rollingly predict THS T hours (where T = 0.5, 1) prior to clinical recognition. A prospective study is necessary to determine the clinical utility of the proposed THS prediction models.

The characteristics and risk factors of healthcare-seeking men with lower urinary tract symptoms in China: Initial report from the POInT group.

To investigate the clinical characteristics of health care-seeking men presenting with lower urinary tract symptoms (LUTS) in China and to reveal risk factors for symptom severity. This multicenter, hospital-based, cross-sectional study recruited 1477 eligible male subjects, who were at least 45 years, seeking health care at 9 participating hospitals across the mainland China. The general medical information and subjective symptoms were recorded, followed by the measurement of prostate volume, urodynamic indices, and laboratory tests for kidney function, plus glucose/lipid metabolism. Univariate and multivariate linear regression were employed for the detection of risk factors for symptom severity. The proportion of mild, moderate, and severe LUTS was 14.6%, 32.6%, and 52.8%, respectively, with 62.2% reporting the triple combination of storage, voiding, and postmicturition symptoms. Median prostate volume was 44.6 ml, and 71.1% were experiencing comorbidities. Thirteen independent risk factors for LUTS severity were identified, namely, nocturnal voiding episodes and the presence of straining and weak steam; the triple combination of symptom subtypes; general and nocturia quality of life; Qmax and bladder outlet obstruction index; and numbers of comorbidities, hypertension, estimated glomerular filtration rate, and cholesterol and glycosylated hemoglobin. The majority of health care-seeking LUTS men present with moderate-to-severe and overlapping symptoms, with a high prevalence of both lower urinary tract dysfunction and systemic comorbidities. The evidence from both urological and nonurological independent risk factors demonstrate the multifactorial nature of LUTS, for which a multidisciplinary management is essential.

Incidence and Risk Factors for Venous Thromboembolism Following 2462 Major Abdomino-Pelvic Surgeries in Tertiary Hospital.

PurposeTo determine the incidence and risk factor of postoperative venous thromboembolism (VTE) in Thai populations and to evaluate morbidity, mortality, bleeding complications and the benefit of thromboprophylaxis in real-world practice.Patients and MethodsWe performed a retrospective, single-center, cohort study of patients from all age groups who underwent elective open or laparoscopic major abdomino-pelvic surgery between January 2008 and December 2018 at Chulabhorn Hospital, Bangkok, Thailand. We collected general medical information and specific data based on items from the Caprini risk scoring system.ResultsA total of 2462 major abdomino-pelvic surgeries were included. The study population consisted of 742 males (30.1%) and 1720 females (69.9%) aged 54.59 ± 13.27 years. The incidence of VTE in Thai patients that underwent major abdominal surgery was 0.48%. The most frequent influencing factor for VTE was a history of pulmonary embolism, which increased the risk of VTE 98.28-fold, whereas a history of deep vein thrombosis increased the risk of VTE by 12.34-fold. Other factors influencing VTE development were obesity, anticoagulant use, postoperative chemotherapy, preoperative chemotherapy, endometrium cancer, tumor-node-metastasis (TNM) stage 4 and American College of Chest Physicians (ACCP) class 4. Protective factors included no history of VTE, laparoscopic surgery, TNM stage 0 and benign disease and BMI<30. VTE significantly increased mortality whereas following ACCP guideline reduced mortality.ConclusionPost-operative VTE incidence in Thai patients undergoing major abdomino-pelvic surgery was lower compared with Western patients. Factors influencing for VTE were history of VTE, anticoagulant use, postoperative chemotherapy, preoperative chemotherapy, endometrium cancer, TNM stage 4 and ACCP class 4. Following ACCP guideline reduced the incidence of mortality.

Analysis of Injection of Xuesaitong (lyophilized) in 30097 cases in real world

To investigate the extensive application of Injection of Xuesaitong(lyophilized) in clinical real world study, and provide basis for clinical guidance on rational drug use and improvement of drug instructions. A prospective, multi-center, large-sample hospital centralized monitoring method was adopted to collect the general information and medication information of all patients who received Injection of Xuesaitong(lyophilized) during the study period in the respective monitoring units. Data analysis was performed using SAS 9.1 software. This study included 79 hospitals, with 30 097 patients being recruited. The patients who met the indications for stroke and hemiplegia accounted for 31.18%, those who experienced indications of chest pain and heartache accounted for 23.15%, and patients with central retinal vein occlusion indication accounted for 0.53%. The minimum single dose of Injection of Xuesaitong(lyophilized) was 20 mg, the maximum single dose was 1 000 mg, and the average single dose was(383.31±78.10) mg. 69.96% of the patients used 0.9% sodium chloride as the menstruum, 28.78% of the patients used 5% glucose as the menstruum, and 0.19% of the patients used 10% glucose as the menstruum. The minimum time for Injection of Xuesaitong(lyophilized) to dissolve is 0 min, 120 min maximally, and(14.26±13.73) min on an average basis. Patients using Injection of Xuesaitong(lyophilized) by intravenous drip accounted for 99.93%, with a slowest drip rate of 10 drops per min, fastest drip rate of 80 drops per min, and an average of(43.91±10.77) drops per min. Injection of Xuesaitong(lyophilized) was used for a minimum of 1 day and a maximum of 80 days, with an average of(8.22±5.12) days. Combined use with other injections accounted for 80.67%, 47.14% of them flushed the tube and 3.31% of them replaced infusion sets. The study found 40 cases of adverse reactions in patients with Injection of Xuesaitong(lyophilized), with an overall incidence of 0.13%(0.09% to 0.17%) for adverse reactions. In the real world application, the usage of Injection of Xuesaitong(lyophilized) basically meets the requirement of drug instructions in terms of indications, dosages, and methods of administration. However, it still needs to be improved in standardizing the selection of the menstruum, drip rate, course of treatment, and the combined usage of medicine.

Analysis of clinical application characteristics of Xingnaojing Injection in treating cerebral hemorrhage in real world

To explore the population characteristics and clinical application characteristics of patients with cerebral hemorrhage treated with Xingnaojing Injection in real world. The model was established by Apriori algorithm, and the general information and medication information of 8 369 patients with cerebral hemorrhage treated with Xingnaojing Injection were analyzed by using Clementine 12.0 in the databases of information systems of 33 class Ⅲ grade A hospitals in China. The results showed that among the 8 369 patients with cerebral hemorrhage treated with Xingnaojing Injection, the median age was 59 years old. And the male to female ratio was about 1.74∶1. Most of them did manual labor(31.26%), and were hospitalized in winter(27.46%), especially during the Cold Dew(5.1%). The majority of the patients were in a stable condition(50.94%), and preferred neurosurgery department(48.82%). 29.03% of patients were hospitalized for 15-28 days, and 42.47% of patients spent 10 000-50 000 Yuan of hospitalization expenses. The single dose of Xingnaojing Injection was 10-20 mL at most(46.03%). And the course of medication was mostly 3 days or less(68.60%). Lidocain was the most frequently used Western medicine in drug combination(5.05%), and Huayu Tongmai Ji was the most frequently used traditional Chinese medicine in drug combination(10.73%). The most frequently used one type of traditional Chinese medicine combined with one type of Western medicine was Huayu Tongmai Ji + Dexamethasone(8.08%). The most frequently used two Western medicines in drug combination were Omeprazole + Dexamethasone(5.07%). Prilosec + Dexamethasone + Lidocaine(3.35%) were three Western drugs with the most frequent combination. When the dosage was 10-20 mL and the number of days of treatment was &gt; 15 days, the largest number of the patients was cured and improved(44.78%, 45.85%). The results showed that cerebral hemorrhage patients treated with Xingnaojing Injection were mostly middle-aged and elderly people, with more males than females. Brain hemorrhage often occurred in winter and spring. Xingnaojing Injectiont was often combined with glucocorticoids, proton pump inhibitors and cardiovascular drugs to prevent cerebral hemorrhage complications. The clinical medication met the guidelines for the treatment of cerebral hemorrhage. Some patients had over-treatment use, which can provide a reference for clinicians in treating cerebral hemorrhage.

Internet access, usage and trust among medical professionals in China: A web-based survey

ObjectivesSocial media has changed methods of communication in the medical profession. As part of a “doctor as communicator” strategy, Chinese medical professionals are actively embracing social media, which may have an impact on tense physician-patient relationships in China. This paper aims to examine a pattern of Internet access, Internet usage, and trust among Chinese medical professionals and further explores the reasons for these relationships on an individual level. DesignsA web-based questionnaire was designed, based on a media literacy model, and was divided into 3 dimensions: public information, general medical information, and specialty information. After a two-round pilot study, 1001 physicians were included. Additionally, 4 interviewees were chosen to participate in in-depth interviews and content analysis was performed. Data were analyzed using SPSS 25.0. ResultsFindings showed that new media has become a major approach for medical professionals in China to retrieve and get access to various information. However, they still trust traditional media (n = 1001, P < 0.01) and professional journals more (n = 1001, P < 0.01). Internet access, usage, and trust were positively correlated (r = 0.185–0.344, P < 0.01). Regarding usage habits, 47.66% of the participating physicians would practice science popularization through their new media accounts and 71.23% would forward approved health information within their professional realm. A validated instrument can be provided for further related studies. ConclusionsScience popularization is a specific usage of new media among Chinese medical professionals, through which they have achieved new authority and empowered communication because of self-media. To some extent, physician-patient relationships in China can be improved because this online interaction is conducive to building harmonious and lasting offline physician-patient relationships.

Medical Tourism Websites with an Approach to Information Content: A Systematic Review

Background: The information content of medical tourism websites could influence the decisions patients and their families make regarding medical centers. This study aimed to investigate the information content of medical tourism websites. Methods: This systematic review was carried out in 2017. Key terms used for searching consisted of, but not restricted to, medical tourism, information content, information needs, and medical tourism website. The terms were searched on PubMed, Science Direct, Web of Science, Embase, ProQuest and Cochrane. One hundred and ninety-two articles out of 1185 retrieved were duplicated and removed from the study. Titles and abstracts of the remaining identified studies were scanned considering the aim of the study. Finally, 31 relevant studies were included in the study. Results: The information content of medical tourism websites can be grouped into three main categories including general information (with six subgroups), medical information (with eight subgroups) and tourism information (with one subgroup). The subgroups include information about medical centers, target country, costs and insurance, contact details, website information, photo galleries, the quality of services, trustworthiness, the quality of supportive services, risks, patient rights, physicians and their specialties, and patient instructions for receiving medical and tourism services. Conclusion: The medical tourism websites should provide a wide range of information. Considering the important role of medical tourism websites in meeting patients’ information needs, the relevant bodies should improve the information content of medical tourism websites to help patients to make their decisions reliably.