Medicine
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High intra-abdominal pressure (IAP) is associated with acute kidney injury (AKI). However, the relationship between intra-abdominal hypertension (IAH) and AKI in medical septic patients is still inconclusive. This prospective cohort study enrolled patients admitted in the Medical Intensive Care Unit from April 2020 to February 2021. ⋯ A total of 52 patients (65.8%) developed the primary outcome (i.e., a composite outcome including AKI, treatment with kidney replacement therapy, or death). On Cox proportional-hazards model between IAH and outcomes, after adjustment for multiple covariates, IAH was associated with a composite outcome (hazard ratio [HR], 6.5; 95% confidence interval [CI], 2.3-18.6; P < .005) and the development of AKI (HR, 6.5; 95% CI, 2.3-18.8; P < .005). IAH was associated with a composite outcome of AKI, treatment with kidney replacement therapy, or death in medical septic patients. thaiclinicaltrial.org, Identifier: TCTR20200531001, Registered May 24, 2020.
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The motions of the shoulder are mainly carried out through the glenohumeral joint, but are also assisted by the scapulothoracic joint. Therefore, changes in the biomechanics of the thoracic spine and scapula affect the function of the shoulder. However, there is limited information on the biomechanical and functional characteristics of the shoulder complex and thoracic spine in patients with subacromial impingement syndrome (SIS). ⋯ Patients with SIS showed reduced shoulder ROM and end-range extension of the thoracic spine compared to healthy individuals, and the scapula was in a more anterior-tilted, protracted, and downward rotated position. In addition, it showed lower external rotation and abduction strength. These results suggest the need for interventions to improve the limited thoracic extension and altered scapular position, which may affect shoulder ROM and muscle strength in the rehabilitation of patients with SIS.
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Randomized Controlled Trial
Effect of nursing intervention based on continuity model on psychological stress state of patients with rheumatoid arthritis.
To explore the effect of nursing intervention based on continuity model on psychological stress state of patients with rheumatoid arthritis (RA). A total of 128 patients with RA in our hospital from January 2015 to January 2017 were selected and divided into 2 groups by random number table method, 64 cases in each group. The control group received routine nursing, and the observation group received nursing intervention based on continuity model. ⋯ After receiving nursing intervention, the psychological stress scores of somatizations, anxiety and depression of all patients were significantly lower than before nursing, and the above scores of the observation group were significantly lower than those of the control group (all P < .05). After nursing, the positive coping score, negative coping score and quality of life score of all patients were significantly higher than those before nursing, and the above scores of the observation group were significantly higher than those of the control group (all P < .05). Nursing intervention based on continuity model can promote the recovery of physical function, improve psychological stress and negative emotions, and improve the quality of life of patients with RA, which is worthy of clinical application.
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The intestinal flora is closely related to the pathogenesis of nonalcoholic fatty liver disease (NAFLD). This study intends to systematically evaluate the efficacy and safety of probiotics in the treatment of NAFLD through a meta-analysis of published randomized controlled trials. ⋯ This study shows that the use of probiotics therapy has a good regulating effect on liver function, steatosis, blood glucose level, insulin level and blood lipid level in NAFLD patients.
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Focal segmental glomerulosclerosis (FSGS) describes a renal histologic lesion with diverse causes and pathogenicities. Monogenic abnormalities which are associated with impaired function of podocyte could result in FSGS. Most of genetic FSGS do not respond to immunosuppressive agents and often develop end-stage kidney disease. We reported a case of FSGS caused by myosin1e (MYO1E) mutation, alleviated by cyclosporine A (CsA) and low-dose glucocorticoid. ⋯ MYO1E autosomal recessive mutation was a rare FSGS causative mutation that might benefit from CsA treatment. However, the long-term effect of CsA on FSGS caused by this mutation should be investigated in the future.