Medicine
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Observational Study
Sex disparity of DAPT noncompliance in patients with left main stem PCI with DES.
This retrospective study aims to explore the sex disparity in dual antiplatelet therapy (DAPT) noncompliance among left main stem percutaneous coronary intervention (PCI) patients with drug-eluting stent (DES) and identify predictors associated with non-adherence. Data were collected from the medical records of 1585 patients, including 1104 males and 481 females, who underwent left main stem PCI with DES. Baseline characteristics, angiographic features, and DAPT compliance rates at 1 month and 12 months were analyzed. ⋯ Angiographic characteristics, including lesion location and Syntax score, had no consistent association with DAPT noncompliance. This study highlights sex disparity in DAPT noncompliance among patients undergoing left main stem PCI with DES. Comorbidities, socioeconomic status, smoking status, and prior coronary artery disease history were identified as predictors of non-adherence.
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This study aimed to establish an effective predictive model for postoperative delirium (POD) risk assessment after total knee arthroplasty (TKA) in older patients. The clinical data of 446 older patients undergoing TKA in the Orthopedics Department of our University from January to December 2022 were retrospectively analyzed, and the POD risk prediction model of older patients after TKA was established. Finally, 446 patients were included, which were divided into training group (n = 313) and verification group (n = 133). ⋯ The area under receiver operating characteristic curve of the model group and the validation group were 0.954 and 0.931, respectively. The calibration curve of the prediction model has a high consistency between the 2 groups. The occurrence of POD was associated with age, educational level, American Society of Anesthesiologists grade, accompaniment of chronic obstructive pulmonary disease, accompaniment of cerebral stroke, postoperative hypoxemia, long operation time, and postoperative pain in TKA patients.
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Case Reports
Complete dislodgement of a mechanical valve prosthesis: A rare but potentially life-threatening event: a case report.
Complete dislodgement of a mechanical valve is extremely uncommon as a long-term issue after getting a substitute mitral valve, and this report details an incident of complete detachment of a mechanical valve. ⋯ A crucial aspect is comprehending the structure of the prosthetic valve itself. The use of transthoracic echocardiography and real-time 3-dimensional transesophageal echocardiography provides additional structural and functional details, enhancing support for potential life-saving interventions. Echocardiography plays a significant role in evaluating the morphology and function of prosthetic valves.
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Emergency surgeries are linked with increased morbidity and reduced life expectancy, often associated with low socioeconomic status, limited access to healthcare, and delayed hospital admissions. While the influence of socioeconomic status on elective surgery outcomes is well-established, its impact on emergency surgeries, including ostomy creation and closure, is less clear. This study aimed to explore how the pandemic and socioeconomic status affect emergency ostomy procedures, seeking to determine which has a greater effect. ⋯ A high socioeconomic status was significantly associated with early hospital admission for ostomy closure, and lower probability of mortality. More metastases and perforations were observed during the pandemic period and mortality was increased during pandemic and in patients without ostomy closure. The socioeconomic status lost its effect in cases of emergency ostomy creation and had no impact on length of hospital stay in either the pre-pandemic or pandemic period.
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To identify the relationship between leadership and work readiness in a cohort of new head nurses in China. This cross-sectional study enrolled 225 newly appointed head nurses in public tertiary hospitals in China, which were selected using convenience sampling. Data were collected using online questionnaires that included a sociodemographic characteristics form, the Nursing Managers Leadership Scale (NMLS), and the New Nurse Leaders' Job Readiness Scale (NNLJRS). ⋯ This study found that the leadership and work readiness of the new head nurses still needed improvement. A significant relationship was found between these 2 variables, and charisma, affinity, coordination ability, and motivational ability in the leadership ability of the new head nurses facilitated the level of work readiness. Nursing administration should create a leadership development series program focusing on the development of charisma, affinity, coordination ability, and motivational ability to support the work readiness of new nurse managers and help them with role transition.