Brit J Hosp Med
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Aims/Background Gastric cancer is a common and life-threatening cancer, which predisposes patients to certain psychological problems. Implementation of both personalized nutrition and acceptance and commitment therapy (ACT) have shown unique advantages in the treatment of cancer patients. This study aims to evaluate the effects of this comprehensive therapy on psychological resilience, quality of life and side effects of chemotherapy in patients with advanced gastric cancer (AGC), yielding findings that can inform the development of holistic and effective treatment methods. ⋯ After chemotherapy, compared with the group C, the CD-RISC scores of group A and group B were significantly lower (p < 0.001), and the scores of physical function, cancer-related symptoms and overall health in group A and group B were significantly lower (p < 0.001). The incidence of side effects of chemotherapy in group C was 25.68%, which was significantly lower than that in group A and group B (p < 0.05); there was no statistical difference in this regard between group A and group B (p > 0.05), and the same parameter was significantly different between group A and group C (p < 0.05). Conclusion Personalized nutrition management plus ACT has a significant favorable effect on improving psychological resilience, alleviating the side effects of chemotherapy, and enhancing the quality of life in patients with AGC undergoing chemotherapy.
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Aims/Background We aimed to investigate the impact of postoperative chemotherapy (POCT) on survival in patients with primary central nervous system lymphoma (PCNSL) using data from the Surveillance, Epidemiology, and End Results (SEER) database. Methods This study included 786 PCNSL patients, of which 605 received chemotherapy after surgery, and 181 did not. Data from the SEER registry database (2007-2020) were used to analyze PCNSL. ⋯ For patients with PCNSL, those with tumours located in the infratentorial region (HR = 0.231; 95% CI: 0.078-0.682; p = 0.046), supratentorial region (HR = 0.250; 95% CI: 0.163-0.383; p < 0.0001), overlapping brain regions (HR = 0.201; 95% CI: 0.056-0.727; p = 0.0058), and those who underwent biopsy (HR = 0.740; 95% CI: 0.463-1.182; p = 0.003), subtotal resection (STR) (HR = 0.490; 95% CI: 0.265-0.906; p = 0.0064), or gross total resection (GTR) (HR = 0.613; 95% CI: 0.292-1.287; p = 0.0003) had better prognoses in the postoperative chemotherapy group compared to the non-chemotherapy group. Conclusion POCT significantly improves the prognosis of PCNSL patients and identifies the characteristics of the benefiting population. This information aids clinical practitioners in designing personalized treatment plans for individuals and advancing precise treatment.
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Aims/Background The evaluation of health-related quality of life in patients undergoing maintenance haemodialysis has garnered increasing attention. The modified creatinine index, a surrogate marker for muscle mass, has been linked to various clinical outcomes. However, the relationship between modified creatinine index and health-related quality of life in maintenance haemodialysis patients remains unclear. ⋯ Subgroup and interaction analyses indicated that the relationship between modified creatinine index and health-related quality of life was stable and not significantly influenced by age, gender, dialysis vintage, diabetes status, or body mass index (p > 0.05). Conclusion Modified creatinine index is positively correlated with health-related quality of life in maintenance haemodialysis patients, suggesting its potential utility in evaluating patient quality of life. Modified creatinine index could be clinically useful to improve the predictability of health-related quality of life in maintenance haemodialysis patients.
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Aims/Background Liver abscess (LA) is a serious medical condition that predisposes patients to sepsis. However, predicting sepsis in LA patients has rarely been explored. This study employed univariate and multivariate logistic regression analyses to identify independent risk factors for sepsis, which would provide guidance for clinical diagnosis and treatment. ⋯ Multivariate logistic regression analysis revealed that PCT and HbAlc were independent risk predictors of sepsis in LA patients within the derivation cohort (p < 0.05). Conclusion Elevated levels of HbAlc and PCT were independent risk factors for sepsis associated with LA. Patients with LA exhibiting elevated PCT levels demonstrated a 21% increased susceptibility to sepsis, and those with elevated HbAlc levels showed a 38% heightened risk for sepsis.
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Aims/Background Establishing an intraosseous infusion (IO) pathway can rapidly open an urgent route of drug administration for critically ill patients. This study aims to assess different puncture sites on the efficacy of manual intraosseous infusion. Methods Upon applying computed tomography (CT), we compared compact bone thickness and CT values at the same individual's proximal humerus and proximal tibia puncture sites (n = 40). ⋯ Results The compact bone thickness and CT values at the proximal humerus were significantly lower than those at the proximal tibia. The cadaveric experiments further confirmed that the proximal humerus was superior to the proximal tibia as an insertion site, indicating the proximal humerus is a more suitable insertion site for manual bone marrow puncture needles. Conclusion Selection of the puncture site markedly influences the effectiveness of manual intraosseous infusion, with the proximal humerus potentially offering better puncture efficacy than the proximal tibia.