Journal of the Chinese Medical Association : JCMA
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Observational Study
Differences in end-of-life care and outcomes in palliative consultation-eligible patients with and without do-not-resuscitate orders - A propensity score matched study.
The primary objective of palliative care, not synonymous with end-of-life (EOL) care, is to align care plans with patient goals, regardless of whether these goals include the pursuit of invasive, life-sustaining procedures, or not. This study determines the differences in EOL care, resource utilization, and outcome in palliative care consultation-eligible emergency department patients with and without do-not-resuscitate (DNR) orders. ⋯ The palliative care consultation-eligible emergency department patients with DNR compared with those without DNR experienced worse outcomes, greater pain control, more endotracheal extubations, shorter duration of hospital stay, more critical discharge to home, more hospice referrals, and 23.3% reduction in total expenditure. There were fewer deaths in the ICU among them as well.
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Inflammatory bowel disease (IBD) is a chronic inflammatory disease associated with complicated interaction between immune, gut microbiota, and environmental factors in a genetically vulnerable host. Dysbiosis is often seen in patients with IBD. We aimed to investigate the fecal microbiota in patients with IBD and compared them with a control group in Taiwan. ⋯ Compared with the healthy control, the IBD group showed dysbiosis with a significant decrease in both richness and diversity of gut microbiota.
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To assess the efficacy and safety of perimysium dissection for posterior shoulder myofascial pain. ⋯ US-guided perimysium dissection is an easy, safe, and effective injection method to manage posterior myofascial shoulder pain.
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Lifestyle modification is suggested for patients with coronary artery disease (CAD), but the impact of adherence to a healthy lifestyle remains undetermined. The aim of this study is to investigate the association of adherence to a healthy lifestyle with future outcomes and biochemical markers in CAD patients. ⋯ Adherence to a healthy lifestyle is independently associated with a lower risk of future adverse events in CAD patients and plays an important role in secondary prevention in the era of interventional cardiology.
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Editorial Comment
Is one-minute difference in operation time meaningful?