Medicine
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Randomized Controlled Trial
The application effect of autologous platelet-rich plasma combined with negative pressure sealing drainage technology in pressure ulcer wound repair.
This study aimed to evaluate the efficacy of combining autologous platelet-rich plasma (PRP) with negative pressure wound therapy (NPWT) for the repair of pressure ulcers. We included 90 patients with pressure ulcers from General Technology Gemstone Flower Healthcare Jilin City Hospital of Chemical Industry between January 2021 and December 2023. Patients were randomly assigned to either a control group or an observation group, with 45 patients in each. ⋯ Two weeks post-surgery, the observation group had significantly lower levels of C-reactive protein, erythrocyte sedimentation rate, and white blood cell count, as well as reduced numerical rating scale and Pressure Ulcer Scale for Healing scores (P < .05). The incidence of complications was 6.67% (3/45) in the observation group compared to 33.33% (15/45) in the control group, with a significant difference (P < .05). Combining autologous PRP with NPWT significantly improves clinical outcomes, reduces inflammatory responses, decreases pain, accelerates wound healing, and lowers complication rates in patients with pressure ulcers.
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Comparative Study Observational Study
Comparison of clinical characteristics, microvascular complications and inflammatory markers in type 2 diabetic patients under insulin versus metformin treatment: A cross-sectional study at Karbala Diabetic Center, Iraq.
Type 2 diabetes mellitus (T2DM) is a major global health issue associated with chronic inflammation, which contributes to both disease progression and its complications, including cardiovascular and microvascular disorders. Key inflammatory markers such as tumor necrosis factor-alpha, interleukin-6 (IL-6), E-selectin, and P-selectin are elevated in T2DM patients and are implicated in the development of these complications. Understanding how treatments such as insulin and metformin affect these markers is crucial for improving therapeutic strategies in T2DM. ⋯ Conversely, sE-selectin levels were 1.5-fold higher in the insulin group, and sP-selectin levels were 1.4-fold higher in the metformin group. This study highlights distinct differences in inflammatory markers and systemic complications between T2DM patients treated with insulin and those treated with metformin alone. Further research is needed to explore the mechanisms underlying these observations and optimize treatment strategies for T2DM patients.
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Comparative Study Observational Study
Comparison of prognosis after transurethral resection of bladder tumor between solitary and multiple bladder cancers.
This study investigates the difference in overall survival rates after transurethral resection of bladder tumor between solitary and multiple bladder cancers, aiming to provide guidance for clinical practitioners. A retrospective analysis was conducted on 133 patients with bladder cancer who underwent transurethral resection of bladder tumor from April 2017 to October 2023, of which 112 patients had complete clinical and follow-up data. Clinical and follow-up data were collected, and the overall survival rates after surgery were compared between solitary and multiple bladder cancers. ⋯ Univariate and multivariate regression analyses revealed that the number of bladder tumors is a risk factor for overall survival after bladder cancer surgery (P = .004). Multiple bladder cancers have a higher pathological grade, larger tumor diameter, and poorer prognosis after transurethral resection of bladder tumor compared to solitary bladder cancers. The number of bladder tumors is an independent risk factor for overall survival after bladder cancer surgery.
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Observational Study
Treatment and long term follow-up results in patients with pulmonary vascular thrombosis related to COVID-19.
Pulmonary embolism is a complication of COVID-19 infection. The aim of this study is to assess prognosis and treatment response, including incidences of chronicity, relapse, and mortality among outpatients diagnosed with COVID-19-related pulmonary embolism between 2020 and 2022. A total of 101 patients with pulmonary embolism, started on anticoagulation during or within a month of COVID-19 infection, were included after testing positive by PCR. ⋯ Specific pulmonary artery blockage value was found to be higher in patients with chronic thromboembolic pulmonary hypertension compared to those who demonstrated a response to pulmonary embolism treatment (P = .009). No adverse effects of anticoagulant therapy were observed during course of treatment. Over 24-month follow-up period, mortality, relapse, chronic thromboembolic hypertension and thromboembolic disease was observed in 2%, 2.2%, 4.9%, and 9.9% of patients, respectively.
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Observational Study
Ultrasound-guided popliteal sciatic nerve block for surgical anesthesia in wound care patients with ongoing anticoagulant/antiaggregant therapy: A single-center, prospective study.
Ultrasound-guided peripheral nerve blocks may be a good alternative in patients under antithrombotic drugs. We evaluated the efficacy of ultrasound-guided popliteal sciatic nerve block in patients undergoing lower extremity wound debridement of whom antithrombotic drugs could not be stopped. We focused on hemorrhagic complications related to sciatic nerve block. ⋯ Mean block onset time was 16.27 ± 5.69 minutes. Mean postoperative analgesia time was 19.5 ± 11.22 hours. Sciatic nerve block under ultrasound guidance using in-plane technique was safe and provided sufficient surgical anesthesia and postoperative analgesia for lower extremity wound debridement surgery in patients on antithrombotic drugs.