Medicine
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Observational Study
Does type II diabetes mellitus increase the morbidity of patients with diverticulitis?
Diverticular disease is a common condition that has numerous complications. Understanding the impact of diabetes mellitus (DM) on these complications, especially diverticulitis, is crucial for optimizing patient care. This study aimed to determine the relationship between type II DM and the complications of colonic diverticulitis. ⋯ A greater incidence of complications and a higher category of Hinchey classification were associated with DM compared to nondiabetics. Additionally, diabetics underwent more surgical interventions and had longer hospital stays. Diabetics with diverticulitis require particular care to prevent severe complications.
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This study aimed to elucidate the resistance trends of P. aeruginosa isolates from 2005 to 2023 in Zhejiang Province, emphasizing the impact of Coronavirus disease 2019 (COVID-19) on antimicrobial resistance patterns and clinical management. We retrospectively analyzed 7326 P. aeruginosa isolates collected from diverse clinical sources in a tertiary hospital in Zhejiang Province from 2005 to 2023. Identification and antibiotic susceptibility testing of each isolate were performed using the VITEK-32 automated system and the disk diffusion method, following Clinical and Laboratory Standards Institute guidelines. ⋯ This study identifies significant, evolving resistance patterns in P. aeruginosa over a 19-year period, with marked increases in resistance to critical antibiotics, including carbapenems (imipenem, meropenem), quinolones (levofloxacin, ciprofloxacin), and certain β-lactams (piperacillin). These findings underscore an urgent need for dynamic, tailored infection control measures, emphasizing the importance of robust antibiotic stewardship programs, localized treatment guidelines, and proactive monitoring of resistance trends. Implementing these strategies is essential to effectively counter the challenges posed by multi-drug resistant P. aeruginosa, improve patient outcomes, and sustain the efficacy of vital antibiotic therapies.
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To improve the management level of general anesthesia during bronchoscopy in the children with diffuse alveolar hemorrhage (DAH). A retrospective study was conducted in the children with DAH who had performed bronchoscopy under general anesthesia with spontaneous respiration by face mask ventilation initially from June 2021 to June 2022 in our hospital. (1) Thirty-four children who had underwent 38 bronchoscopy procedures were included. (2) General anesthesia induction was performed by bolus of propofol intravenous in all the procedures. For maintaining anesthesia, combination use of propofol and remifentanil intravenously infusion were given in 31 procedures (81.6%) and propofol intravenously infusion alone was given in the rest 7 procedures (18.4%). ⋯ Intraoperative hypercapnia also occurred in 16 procedures (42.1%). Two procedures (5.3%) were complicated by severe pulmonary hemorrhage. General anesthesia with spontaneous respiration by face mask ventilation is feasible and relatively safe for the children with DAH undergoing bronchoscopy, whereas the anesthetic protocol still needs to be improved.
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Observational Study
Factors impacting the efficacy of the retrograde autologous priming in isolated coronary artery bypass surgery.
During retrograde autologous priming (RAP), some patients develop hypotension and hemodynamic instability, which impedes the procedure. This study aimed to demonstrate the effects of RAP on transfusion requirements and the development of hemodynamic instability. Overall, 443 patients who were operated upon for coronary artery bypass surgery (CABG) between January 2017 and December 2022 were enrolled and examined, including 162 who underwent RAP (RAP group) and 281 who did not (non-RAP group). ⋯ In the receiver operating characteristic (ROC) curve analysis, the cutoff values for BSA and CVP were found to be 1.73 (sensitivity = 84.2%, specificity = 80.3%, the area under the ROC curve [AUC] = 0.905) and 4.5 (sensitivity = 97.7%, specificity = 99.7%, AUC = 0.994), respectively. Our finding suggest that RAP is associated with a reduction in the requirement in blood transfusion during both intra-and postoperative periods, as well as a decrease in postoperative drainage. Additionally, the risk of hemodynamic instability during RAP appears to be minimal in patients with a body surface area (BSA) >1.73 and a baseline CVP exceeding 4.5.
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The aim of this study was to retrospectively investigate the effect of Crinone vaginal gel on pregnancy outcomes in women undergoing natural cycle (NC) frozen embryo transfer (FET) and to obtain the most suitable population for its routine application. ⋯ This study demonstrated that the Crinone could protect women against spontaneous abortion, especially in patients who do not need HMG or in combination with Femoston.