Medicine
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To investigate the predictive value of arterial blood lactate (Lac)/serum albumin (Alb) ratio (Lac/Alb) on myocardial injury in elderly patients with severe community-acquired pneumonia (SCAP). Seventy-two elderly SCAP patients hospitalized in the intensive care unit (ICU) of the emergency department of Hebei General Hospital from March 2020 to March 2021 were included, and the general data and arterial blood Lac and serum Alb levels were collected, and Lac/Alb values were calculated. The patients were divided into myocardial injury group (n = 25) and nonmyocardial injury group (n = 47) according to whether the myocardial injury occurred during their ICU stay, and the predictive value of Lac/Alb on myocardial injury in elderly patients with SCAP was assessed using receiver operating characteristic curve and area under the curve. ⋯ Neutrophils, neutrophil/lymphocyte ratio, serum creatinine, Lac, and Lac/Alb showed a weak positive correlation with myocardial injury in patients (all P < .05). The area under the curve of Lac/Alb for predicting myocardial injury in elderly patients with SCAP was 0.737 (95% confidence interval 0.620-0.834), and the sensitivity and specificity of the prediction with 1.21 as the cutoff value were 60.00% and 78.72%, respectively. Lac/Alb has an excellent predictive value for myocardial injury in elderly SCAP patients.
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Resurfacing arthroplasty using the J&J DePuy ASR system was withdrawn from surgical treatment due to the necessity of frequent revision procedures after its application. There have been many studies concerning treatment of acetabular bone loss using different operating techniques. However, we felt that data of custom - made implant usage in such cases is highly insufficient, and there is lack of evidence on its application in treatment of loosening of the previous implant. The aim of the study was to evaluate the effectiveness of surgical treatment with a custom-made implant in a patient with extensive acetabular bone loss after aseptic loosening of the acetabular component of the J&J DePuy ASR surface prosthesis in the early period of observation. ⋯ The use of an individual custom-made implant in extensive acetabular bone loss after aseptic loosening of the acetabular component of the J&J DePuy ASR surface prosthesis in patients is an effective method of surgical treatment.
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The copy-and-paste feature is commonly used for clinical documentation, and a policy is needed to reduce overdocumentation. We aimed to determine if the restricted use of copy and paste by doctors could improve inpatient healthcare quality. Clinical documentation in an inpatient dataset compiled from 2016 to 2018 was used. ⋯ The discharge note completion rate initially decreased and not affected long term after restriction policy. Appropriate policies to restrict the use of copying and pasting can lead to improvements in inpatient healthcare quality. Prospective research with cost analysis is needed.
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Vaccination can have a substantial impact on mitigating COVID-19 outbreaks. However, the vaccine rollout rates associated with the gross domestic product (GDP) and few deaths are required for verification. Three hypotheses were made: 1. the inflection point (IP) days on the cumulative number of confirmed cases (CNCCs) in 2021 are improved (i.e., shorter than 2021); 2. the vaccinations are associated with national GDP and fewer deaths; and 3. the association is weak between vaccinations and CNCC IP based on the argument that vaccinations are limited to protection against milder infection. ⋯ Our results indicate that vaccination has a significant effect on mitigating COVID-19 outbreaks, even with limited protection against infection. Continued compliance with nonpharmaceutical interventions is essential to the fight against COVID-19 in the future.