Medicine
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One of the main characteristics of COVID-19 is the high incidence of venous thromboembolism, particularly pulmonary embolism. Anticoagulation therapy is the primary treatment for pulmonary embolism. Heparin-induced thrombocytopenia (HIT) is an antibody-mediated adverse reaction to heparin that occurs during its use of heparin drugs. The main clinical manifestation is a decrease in platelet count, which can lead to the formation of arterial and venous thrombosis and, in severe cases, even death. Herein, we present a case of HIT that occurred during anticoagulation therapy for COVID-19, complicated by pulmonary embolism. ⋯ Clinicians should remain vigilant to venous thromboembolism for COVID-19 patients even after recovery. During anticoagulant therapy, if thrombocytopenia occurs, HIT should be considered due to its high mortality rate. The 4T scoring system was used for the initial assessment. HIT antibodies can be detected, if necessary, to assist in diagnosis and reduce the occurrence of severe HIT. In the future, by detecting certain biomarkers, we can screen out patients with HIT who are more prone to thrombotic events, thereby minimizing the risk of bleeding caused by anticoagulation.
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Hypertension is a serious health concern, especially in developing countries, and assessing people's knowledge, attitudes, and practices (KAP) is important for its awareness and management. This cross-sectional study aimed to assess the KAP on hypertension among students and staff from the Health Sciences and Veterinary Medicine Faculty of the University of Namibia. A cross-sectional study design was conducted on adult participants who completed the KAP questionnaire while resting, and thereafter their blood pressure (BP) was measured. ⋯ Only approximately 39% of the participants regularly monitored their BP. Just above 50% of the participants regularly engaged in physical activities and made dietary modifications to maintain a healthy heart. It is important to host regular hypertension campaigns among health science personnel, as this would help refresh and improve their KAP in prevention and management.
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Many factors can affect delivery mode decisions. Therefore, this study aimed to explore the effects of maternal age, physician's sex, region, income, and hospital type on cesarean section (C/S) delivery rates between 2008 and 2018 in Taiwan. In this population-based cross-sectional study, data were extracted from the Taiwan National Health Insurance Research Database (2 million individuals). ⋯ In conclusion, this study revealed a significant increase in C/S rates over the past decade, which was influenced by multiple factors. Maternal age, physician's sex, income status, location, and type of hospital may influence C/S rates. Analyzing these relationships can inform the development of strategies aimed at reducing future C/S rates, and targeted interventions may reduce the C/S rates.
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Observational Study
Prevalence and risk factors of cognitive frailty in patients with cardiovascular disease: A hospital-based cross-sectional study.
The prevalence of the cognitive frailty is increasing in China. Screening for this condition is crucial for its early detection, prevention, and treatment. This study was designed to explore the incidence of cognitive frailty among hospitalized elderly patients suffering from cardiovascular disease. ⋯ In terms of specific cardiovascular diseases, the prevalence of cognitive frailty was 28.5% in coronary heart disease, 20.5% in arrhythmia, 36.8% in valvular disease, 53% in heart failure, and 13.7% in hypertension. The multivariable analysis showed that age (OR = 1.13, 95% CI: 1.10-1.15, P < .001), anxiety (OR = 1.01, 95% CI: 1.03-1.11, P = .001), female sex (OR = 1.83, 95% CI: 1.10-1.16, P < .001), education level (college and above, OR = 0.27, OR = 0.12-0.64, P = .003), polypharmacy (OR = 2.29, 95% CI: 1.62-3.23, P < .001), comorbidity (OR = 1.93 95% CI: 1.37-2.71, P < .010), region (rural, OR = 1.77, 95% CI: 1.36-2.30, P < .001), sarcopenia (OR = 1.60, 95% CI: 1.16-2.19, P = .004), and nutritional status (risk of malnutrition, OR = 1.66, 95% CI: 1.17-2.35, P = .004; malnutrition exists, OR = 3.24, 95% CI: 1.85-5.83, P < .001) were independently associated with cognitive frailty. The prevalence of cognitive frailty was 33.9% in hospitalized elderly cardiovascular patients in Guangzhou. heart failure, hypertension, age, anxiety, female sex, education level, polypharmacy, comorbidity, region, sarcopenia, and nutritional status were independent risk factors for cognitive frailty.
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The aging population has become a severe public health issue both in China and globally. Over 180 million elderly people in China have chronic diseases, with 75% of them suffering from 2 or more chronic diseases, posing significant threats to their independence and quality of life, and imposing immense mental and disease burdens on patients and their families. So our research analyzes the influencing factors based on the current acceptance status of advance care planning (ACP) among elderly patients with chronic diseases. ⋯ Factors influencing ACP acceptance included fear of death, whether the patient had cared for a dying relative, duration of chronic illness, presence of complications, natural acceptance, and religious beliefs (P < .05). The acceptance level of ACP among elderly patients with chronic diseases is moderately high. Medical staff should provide more choices to enhance the life value of elderly patients with chronic diseases based on fully respecting their wishes.