Journal of the Chinese Medical Association : JCMA
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Observational Study
Clinical outcomes in ventilator-associated pneumonia patients with and without chronic obstructive pulmonary disease: A retrospective observational study.
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Critically ill patients with COPD exacerbations may require invasive mechanical ventilation (IMV). Ventilator-associated pneumonia (VAP) commonly occurs in the intensive care unit (ICU) and is usually associated with high mortality. Current studies on the association between COPD and VAP are limited. This work compared the causes and clinical outcomes of VAP in patients with and without COPD in Taiwan. ⋯ Our study revealed that COPD was not associated with worse clinical outcomes in patients with VAP. No significant differences in bacterial cause were observed between the two groups.
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Limited knowledge exists regarding the interrelations between sleep quality and resilience within the demographic of healthy, community-residing middle-aged and older adults, with a particular dearth of information regarding sex-specific associations. This study aimed to examine the sex-specific associations between sleep quality, resilience, and biomarkers in community-dwelling middle-aged and older adults. ⋯ This study highlights the association between sleep quality and resilience in older adults. Good sleep quality is related to better resilience, but greater depressive symptoms are also linked to poorer resilience in both sexes. Nevertheless, the low habitual sleep efficiency and frequent use of sleeping medications in women but not men with poor sleep quality highlight the need to explore sex-specific approaches to address the interplay of sleep quality, resilience, and other factors (such as depressive symptoms) in healthy aging.
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Coronavirus disease 2019 (COVID-19) causes persistent symptoms, including brain fog. Based on limited research on the long-term consequences of mild COVID-19, which has yielded inconsistent results, we investigated which cognitive functions were most affected by COVID-19 in nonhospitalized Asian patients with long-term COVID and subjective cognitive complaints. ⋯ Nearly 70% of patients with subjective cognitive complaints and long COVID had objective cognitive impairments. A comprehensive evaluation is essential for these patients, even when they present with mild symptoms.
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The wide-awake local anesthesia no tourniquet (WALANT) technique, which is based on the local infiltration of lidocaine and epinephrine, is widely used in hand and wrist surgery. However, few studies have been conducted on the cost-benefit analysis of phalanx fracture surgery using the WALANT technique. This study aimed to investigate the clinical condition, as well as the time spent for anesthesia and operation. We also performed an economic analysis to compare general anesthesia, local anesthesia with a tourniquet, and the WALANT technique for plate fixation of phalanx fractures. ⋯ Open reduction with plate fixation of phalanx fractures using the WALANT technique or local anesthesia was cost-effective compared with general anesthesia. Patients who underwent phalanx fracture surgery using the WALANT technique experienced less pain on the first postoperative day because of the adequate tumescent technique and not using a tourniquet during surgery.
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Despite numerous surveys on traditional Chinese medicines (TCMs) and their impact on people in Taiwan, only a few directly assessed the perspectives of the users and their experiences with the practice. In this study, we aimed to explore the attitudes, experiences, and understanding of TCMs, and also to identify the TCMs that are commonly preferred among people in Taiwan. ⋯ People in Taiwan who participated in the survey had a relatively positive impression of and experience with TCMs, but there were still some knowledge gaps that need to be filled with additional information. It is essential to strengthen the publicity and education about TCMs and improve the public's understanding and correct use of TCMs.