Articles: treatment.
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The purpose of this study was to evaluate the clinical efficacy of internal fixation with locking compression plates (LCP) in the treatment of patients with extremity fractures and the effect on the recovery of limb function. A total of 488 patients with extremity fractures admitted to our hospital from June 2019 to December 2022 were retrospectively analyzed and divided into open reduction and internal fixation (ORIF) group (n = 236) and internal fixation with LCP group (n = 252) according to the surgical procedure. Outcome indicators included intraoperative bleeding, operative time, length of hospital stay, pain duration, quality of life, healing time of the fracture, postoperative complications, and restoration of limb function as per the X-ray examination results and Johner-Wruhs criteria. ⋯ The recovery of limb function was significantly better in the LCP group than in the ORIF group (97.22% vs 85.17%, P < .001). The overall satisfaction rate of treatment in the LCP group was higher than that in the ORIF group (92.06% vs 81.90%, P < .001). Internal fixation with LCP in patients with extremity fractures can effectively promote the recovery of limb function, reduce the incidence of complications and improve the quality of life of patients.
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Semin Respir Crit Care Med · Dec 2023
ReviewEnd-of-Life and Palliative Care Issues for Patients Living with Pulmonary Arterial Hypertension: Barriers and Opportunities.
Pulmonary arterial hypertension (PAH) is a progressive, incurable disease that results in significant symptom burden, health care utilization, and eventually premature death. Despite the advancements made in treatment and management strategies, survival has remained poor. End-of-life care is a challenging issue in management of PAH, especially when patients are in younger age group. ⋯ Despite of the benefits of an early intervention, palliative care remains underutilized in patients with PAH, and this significantly raises issues around end-of-life care in PAH. In this review, we will discuss the opportunities offered and the existing barriers in addressing high symptom burden and end-of-life care issues. We will focus on the current evidence, identify areas for future research, and provide a call-to-action for better guidance to PAH specialists in making timely, appropriate interventions that can help mitigate end-of-life care issues.
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The global pandemic of COVID-19, caused by the novel coronavirus SARS-CoV-2, has resulted in widespread alterations to public health measures worldwide. This observational study aimed to assess the clinical features and results of respiratory failure in patients with severe COVID-19. A single-center observational study was performed at a Chinese hospital between November 1, 2022, and February 31, 2023. ⋯ Respiratory failure combined with COVID-19 infection may lead to higher 30-day mortality (16.36% vs 7.14%, P = .005), longer hospital stays (22.5 ± 5.9 vs 12.8 ± 4.2, P < .001), larger hospitalization costs (P < .001), and increased hospitalization complications, such as pulmonary embolism (10.30% vs 4.76%, P = .039), deep vein thrombosis (33.33% vs 18.57%, P = .001), incidence of 7-day delirium (69.70% vs 46.19%, P < .001), and respiratory failure (38.18% vs 24.77%, P = .005). If respiratory failure occurs while the patient is infected with COVID-19, treatment and prognosis worsen. Our understanding of COVID-19 and the care we provide to patients with respiratory failure is crucial to better prepare for a potential pandemic.
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Randomized Controlled Trial
Safety and Efficacy of Oral Nalbuphine on Postoperative Pain in Hemorrhoidectomy Patients: A Randomized, Double-blind, Placebo-controlled, Pivotal Trial.
Severe postoperative pain requiring opioid treatment has been reported in 20% to 40% of hemorrhoidectomy patients. Compared with morphine, nalbuphine offers better hemodynamic stability, a lower risk of respiratory depression, and a lower potential for addiction. Nalbuphine was developed from the intravenous form into an oral form (PHN131) to alleviate moderate-to-severe pain. ⋯ Our findings demonstrate that PHN131 is effective and well-tolerated in the treatment of moderate-to-severe post hemorrhoidectomy pain and may provide another option for patients to control their pain.
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Numerous randomized controlled trials have evaluated the outcomes of internet-delivered psychological pain management programs (PMPs) as a way of increasing access to care for people with chronic pain. However, there are few reports of the effectiveness of these PMPs when provided as part of routine care. ⋯ These findings highlight the effectiveness and acceptability of internet-delivered psychological PMPs in routine care and point to the need to consider how best to integrate these interventions into the pathways of care for people with chronic pain.