Annals of palliative medicine
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With the introduction of New South Wales Ambulance Authorised Palliative Care Plans within a metropolitan palliative care service, the perspectives of patients, caregivers and clinicians and their understandings of the processes involved in completing the Plans were investigated. ⋯ The Ambulance Palliative Care Plans are a complex intervention that are sometimes misunderstood by patients, particularly those who are very unwell or who have little prognostic awareness. Clinicians perceive the major benefit to be avoidance of admission to the emergency department.
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Meta Analysis
Therapeutic effects of Yiqi Huoxue prescription on diabetic nephropathy: a meta-analysis and systematic review.
Traditional Chinese medicine (TCM) has demonstrated excellent effects in treating diabetic nephropathy, and Yiqi Huoxue prescription has been widely used clinically. In the study, its effects on the kidney function and blood glucose of patients were explored. ⋯ The included literature had low bias risk. Yiqi Huoxue prescription on the basis of conventional Western medicine can significantly improve the renal function and reduce the levels of blood glucose and blood lipids of patients with diabetic nephropathy.
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An increasing number of patients who present to emergency departments are at their end-of-life phase and have significant palliative care needs such as in symptom control for pain and dyspnoea. Evaluating quality of care provided is imperative, yet there is no suitable tool validated in the emergency and Asian settings. We aim to examine the face and construct validity, and reliability of a newly developed questionnaire, Care of the Dying Evaluation - Emergency Medicine, for measuring the quality of end-of-life care in an Asian emergency context. ⋯ The Care of the Dying Evaluation - Emergency Medicine questionnaire may be valid and reliable for use in an Asian emergency setting. Our prospective multicentre study using this evaluation tool may provide more insight on the quality of care rendered to dying patients and identify areas for improvement.
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Research has shown that acute kidney injury (AKI) has a noticeable incidence in critically ill patients with coronavirus disease 2019 (COVID-19). Patients with prior renal insufficiency are particularly susceptible to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), due to their immune dysfunction. However, most patients with COVID-19 do not have a history of kidney dysfunction, and few studies have focused on the incidence of AKI among COVID-19 patients without chronic kidney disease (CKD). In this study, we aimed to investigate the occurrence of AKI in severely and critically ill COVID-19 patients, with a particular focus on those without a CKD history. ⋯ Only 3.3% of severely and critically ill COVID-19 patients without CKD in our research cohort developed AKI. Critically ill patients may be more susceptible to AKI than severely ill patients.
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Randomized Controlled Trial
Comparison of the effect of different volumes ropivacaine on deep serratus anterior plane block in patients undergoing breast surgery: a prospective randomized double-blinded trial.
A larger volume of local anesthetic provides a wider range of blocked sensory but carries a greater risk. The purpose of this trial was to compare the effect of different volumes of ropivacaine injected to deep serratus anterior plane in patients undergoing breast surgery. ⋯ The blocked dermatomes increased with increasing volume when 10, 20 and 30 mL ropivacaine was used for deep serratus anterior plane block. The analgesic effects of 20 and 30 mL were similar to each other and better than 10 mL. Therefore, in breast surgery, volume of 20 mL ropivacaine is considered to be appropriate for deep serratus anterior plane block.