Brit J Hosp Med
-
Aims/Background Severe postpartum haemorrhage (PPH) is a dangerous condition, characterized by rapid progression and poor prognosis. It remains the leading preventable cause of maternal death worldwide. This study aimed to investigate the risk factors for severe PPH and establish a prediction model to identify severe PPH early, allowing for early intervention reduce maternal death. ⋯ Clinical decision curve analysis (DCA) confirmed a significant threshold exceeding 0.9, signifying a substantial net benefit and model precision. Conclusion Parity ≥2 times, abortion ≥2 times, in vitro fertilisation, gestational week at delivery, abnormal foetal position, caesarean delivery, pregnancy with anaemia, and hypertensive disorders of pregnancy are independent risk factors for severe PPH. The predictive model established in this study accurately predicts the occurrence of severe PPH and has significant value for clinical application.
-
Aims/Background Implementing effective nursing management is particularly critical in the case of elderly gastric cancer (GC) patients receiving chemotherapy, who are more vulnerable to risk events. Therefore, this study explored the effect of intensive nursing management on quality of life (QoL) and mental health in elderly GC patients receiving chemotherapy. Methods A total of 155 elderly patients with GC undergoing chemotherapy in Central Hospital Affiliated to Shandong First Medical University from July 2021 to July 2023 were selected as the study subjects. ⋯ After management, in comparison with the reference group, the observation group showed significantly higher scores in each dimension of QLQ-C30, as well as significantly lower scores in PHQ-9 and MDASI-C (p < 0.001). The incidences of gastrointestinal reaction, myelosuppression, neurotoxicity, and hepatorenal damage were lower in the observation group than in the reference group (45.95% vs 70.37%, 40.54% vs 65.43%, 35.14% vs 53.09%, and 33.78% vs 51.25%, respectively; p < 0.05). Conclusion The application of intensive nursing management in treating elderly GC patients during chemotherapy effectively improves their physical and mental states, ameliorates clinical symptoms and enhances the QoL, showing certain clinical application value.
-
Aims/Background The purpose of this study is to investigate the risk factors for gestational diabetes mellitus (GDM) during pregnancy and its impact on neonatal birth outcomes. Methods A total of 2010 cases of mothers with GDM who underwent routine prenatal examinations and delivered at The Fourth Hospital of Shijiazhuang from June 2021 to April 2022, and their newborns were selected as the GDM group. For comparison, 2087 cases of mothers with normal glucose tolerance (NGT) and their newborns during the same period were selected as the NGT group. ⋯ Conclusion The risk factors for GDM include advanced maternal age, being underweight, overweight, or obese prior to pregnancy, irregular eating habits, dietary nutritional deficiencies, and lack of prenatal exercise. The incidence of adverse pregnancy outcomes is higher in GDM patients compared to those without GDM. Poor glycemic control during pregnancy and higher pre-pregnancy BMI are significant factors that contribute to negative outcomes for both GDM patients and their newborns.
-
Case Reports
A Rare Complication of Atraumatic Splenic Rupture in Infectious Mononucleosis: A Case Report.
Aims/Background Atraumatic splenic rupture is a very rare and potentially life-threatening event usually associated with underlying pathological conditions. Splenic rupture in infectious mononucleosis occurs only in 0.1%-0.5% of patients. The aim of the present study was to publish a case report of the atraumatic splenic rupture and to present a mini-review of the international literature. ⋯ Results The patient underwent expeditious total splenectomy, postoperative period was uneventful and he was discharged on the sixth postoperative day. He was scheduled to undergo the post-splenectomy vaccinations and regular follow-ups with his general practitioner abroad. Conclusion In patients without a history of trauma, spontaneous splenic rupture should be considered in the differential diagnosis if patients have complaints of abdominal and left shoulder tip pain, and laboratory results indicate low haemoglobin and haematocrit levels.
-
Aims/Background The drug treatment of recurrent respiratory tract infection caused by mycoplasma pneumonia (MP) has a complex background, involving the characteristics of pathogens, drug resistance, and multiple treatment methods. This study aimed to analyze the therapeutic effect of pulmicort respules and azithromycin on children with recurrent respiratory tract infection caused by MP. Methods The clinical data of 106 children with recurrent respiratory tract infection caused by MP diagnosed in Huoqiu First People's Hospital from July 2021 to July 2023 were retrospectively analyzed. ⋯ After 1 week of treatment, the observation group had significantly lower levels of IgG, IgA, and IgM than the reference group (p < 0.01). This study revealed that the incidence of complications in the observation group was 16.00%, which was significantly lower than the 37.50% in the reference group (p < 0.05). Conclusion In the short-term clinical treatment, the combination application of pulmicort respules and azithromycin can effectively improve the immune function of children with recurrent respiratory tract infection caused by MP and relieve their clinical symptoms.