Medicine
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Acute renal colic is one of the most common urological emergencies. While previous randomized controlled trials (RCTs) and pairwise meta-analyses only looked at the efficacy of 1 or 2 analgesics. It is not fully understood that the comprehensive ranking of the effectiveness and safeness of analgesics from these published articles. Therefore, this network meta-analysis (NMA) aims to compare and rank the different analgesics for treatment of acute renal colic. ⋯ This is the first systematic review to use the NMA to comprehensively compare and rank analgesics for relieving pain of acute renal colic in adults based on most important factors deciding the choice of initial analgesia, and the results can provide implications for clinical practice and further research.
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To investigate the features and prognosis of the elderly patients with pancreatic neuroendocrine tumor (pNET). The patients diagnosed with pNETs between 2004 and 2014 were identified from the Surveillance Epidemiology and End Results database. The ethical approval was waived because the present study was analysis of the data from Surveillance Epidemiology and End Results database. ⋯ Distant metastatic elderly patients underwent primary site surgery had better CSS and OS than the patients without surgery. The elderly patients have increased possibility of poorly differentiated tumor, and decreased proportion of Black patients, surgery of primary site, number of removed lymph node and married status. Worse differentiation and tumor metastasis were independent risk factors for both CSS and OS, while primary tumor located in body/tail of pancreas, female patients, surgery of tumor primary site, and being married were protective factors.
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The nasopharyngeal airway is an important equipment in airway management, a correct placement is crucial for its effectiveness. We measured the nares-to-epiglottis distance (NED) and examined the correlations of the optimal insertion length (NED-1) with patient characteristics and various external facial measurements. We aimed to develop a simple method for estimating the optimal insertion length and to help select an appropriate nasopharyngeal airway. ⋯ The regression lines of the optimal insertion length versus PTD showed the best fit to the equality line. The measurements of PTD showed the minimal differences from NED-1 and with the most patients showing <1 cm differences from NED-1. The optimal insertion depth of nasopharyngeal airway can easily be predicted by the distance from philtrum-to-ear tragus, and a nasopharyngeal airway of an appropriate size can be selected accordingly.
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The rate of preterm birth has been increasing worldwide. Most preterm babies are at increased risk of central nervous system impairments as well as respiratory and gastrointestinal complications. The aim of this study was to investigate the trends in preterm birth and associated factors contributing to preterm delivery in Taiwan. ⋯ Overall, the proportion of preterm deliveries increased by 11.1% (from 8.2% in 2001 to 9.1% in 2011). Multiple logistic regression analyses showed that nulliparity, multiple births, maternal medical complications, maternal age <20 years or ≥40 years, and medical indication for earlier delivery were positively associated with an increased risk of preterm delivery. Nulliparous women aged younger than 20 years and older than 40 years should be recognized as at-risk for preterm birth.
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In the present study, we aimed to investigate the association between gestational diabetes mellitus (GDM) and the oral microbial imbalance in the second trimester of pregnancy. Three hundred thirtyone women in the second trimester of pregnancy who underwent prenatal examinations at the Third Affiliated Hospital of Soochow University from February 2018 to August 2018 were included in this study. Personal parameters including the age, education level, and body mass index (BMI) at 28 weeks of gestation were recorded. ⋯ The detection rate of tuberculosis bacilli, Black-pigmented bacteria, and Capnocytophaga in pregnant women with GDM was higher than those in nondiabetic pregnant women (P = .000, P = .026, and P = .030, respectively). In addition, pregnant women with GDM had fewer oral streptococci (P = .000) and lactobacilli (P = .000) and more oral anaerobic bacteria (P = .000), tuberculosis bacilli (P = .000), Black-pigmented bacteria (P = .007), Capnocytophaga (P = .000), and actinomycetes (P = .000). The detection rate and the number of oral bacteria in pregnant women with GDM were higher than those in nondiabetic pregnant women in the second trimester of pregnancy.