Conectar
Animal bites, primarily from dogs and cats, pose a significant threat, especially to children. Wound infections are common complications caused by bacterial flora in the animal's mouth, making surgical debridement and delayed primary closure the standard treatment. However, recent studies reported no increased infection rates with primary closure compared to delayed closure after adequate debridement, particularly for facial wounds. Primary closure offers better cosmetic and functional outcomes. This study presents a case series to guide decision-making on primary suturing versus leaving wounds exposed. Thirty patients with animal bites underwent surgery, including 23 dog bites and seven cat bites. Eight patients with deep facial lacerations from dog bites received immediate debridement and primary closure with epidermal and subcutaneous sutures. None developed infections, and the cosmetic results were excellent. In contrast, all seven cat bite wounds and nine infected dog bite wounds involved high-risk factors, such as puncture wounds, hand injuries or diabetes. For high-risk wounds, early debridement and leaving the wound open after initial treatment proved effective. Primary repair of facial dog bite injuries, even complex ones, is safe and yields good aesthetic outcomes. For high-risk wounds, leaving them open after debridement is recommended to minimise infection risks.
Preventing skin tears (STs) in older adults is an urgent public health concern, especially in long-term care (LTC) facilities. However, limited research on ST prevention among care workers exists due to a lack of suitable assessment tools. This study aims to develop and psychometrically evaluate the Knowledge, Attitude and Practice instrument for care workers in preventing Skin Tears (KAP-ST) in older adults.
The KAP-ST was developed and validated in four phases during May–October 2024. First, an item pool was generated through a comprehensive literature review. Second, a preliminary instrument was developed through a Delphi expert consultation and pilot testing. Third, the items and the final instrument were optimised through a cross-sectional survey involving 317 care workers from 29 LTC facilities in China. Finally, a psychometric evaluation was conducted in another cross-sectional survey involving 373 care workers from 18 LTC facilities.
The final KAP-ST contains 35 items across knowledge, attitude and practice dimensions. Exploratory factor analysis (EFA) revealed a nine-factor structure (factor loadings ranging from 0.451 to 0.799, accounting for 61.35% of total variance). The Item-Level Content Validity Index (I-CVI) values ranged from 0.926 to 1.000, and the Scale-Level Content Validity Index (S-CVI/Ave) was 0.991. The instrument's Cronbach's α, split-half, and test–retest reliability coefficients were 0.887, 0.744, and 0.934, respectively. The CFA analysis revealed an ideal absolute fit validity (RMSEA = 0.068; RMR = 0.029) and parsimony fit validity (PGFI = 0.684).
The KAP-ST demonstrates strong reliability, structural validity and content validity. It is well-suited for assessing care workers' knowledge, attitudes and practices in preventing STs among older adults. Further research is required to enhance and confirm its validity.
STs in the spotlight recently necessitate the use of appropriate investigative tools to facilitate in-depth research, especially for care workers, who should prioritise access to specialised knowledge. Introducing professional guidance in LTC facilities is recommended to enhance the knowledge, attitude and practice of care workers.
Standardised Guidelines for Scale Construction and COSMIN checklist.
No patient or public contributions.
Faecal contamination of sacral pressure ulcers occurs frequently, so, theoretically, faecal diversion using colostomies is a useful procedure. We retrospectively analysed the data of adult patients for whom colostomies were created to enhance wound healing and compared patients with sacral pressure ulcers who received colostomies and those who did not during the same period. Patients' characteristics analysed included age, gender, comorbidities, WBC count, serum CRP level and microbial profile (before creating colostomy). Additionally, we examined whether the wound was closed, the recurrence rate after wound closure, and mortality outcomes. Regression analysis indicated that colostomy creation was associated with fewer species of gut microbiota cultured and lower rates of wound dehiscence after closure; no association was found between colostomy and mortality. Colostomies help promote wound healing of sacral pressure ulcers after closure by eradicating wound infection, and do not increase patients' mortality rates.
To explore the network characteristics of symptom clusters in people with type 2 diabetes mellitus through network analysis, identify the core and bridging symptoms within the symptom network, and provide a foundation for targeted interventions and symptom management in people with T2DM.
A cross-sectional survey.
A total of 360 people with T2DM who were hospitalised in the endocrinology departments of two hospitals with Grade A in Daqing City between August 2024 and February 2025 were selected using a convenience sampling method. The symptoms of people with T2DM were measured using the Chinese version of the Diabetes Symptom Checklist-Revised (DSC-R). Symptom clusters were identified through factor analysis, and network analysis was used to identify core and bridging symptoms. This research adhered to the STROBE guidelines.
Six symptom clusters were obtained from factor analysis, which were psychological-behavioural symptom cluster, ophthalmological-neuropathy symptom cluster, cardiovascular symptom cluster, metabolic symptom cluster, body symptom cluster and nephrotic symptom cluster. Symptom network analysis revealed that ‘Deteriorating vision’ exhibited the highest strength centrality and expected influence. The top three symptoms with the highest bridge strength and bridge expected influence were ‘Aching calves when walking’, ‘Queer feeling in the legs or feet’ and ‘Sleepiness or drowsiness’.
People with T2DM commonly exhibit a range of symptoms. ‘Deteriorating vision’ is the most core symptom in people with T2DM. ‘Aching calves when walking’, ‘Queer feeling in the legs or feet’ and ‘Sleepiness or drowsiness’ are identified as the bridging symptoms in the network analysis. Healthcare professionals can design targeted interventions based on symptom clusters, core symptoms and bridging symptoms, thereby improving the efficiency of symptom management and optimising outcomes for people with T2DM.
No patient or public contribution.
by Yaowen Hu, Faliang Gao, Yuan Yang, Wei Yang, Huibo He, Jie Zhou, Yujie Zhao, Xi Chen, Wenyan Zhao, Xiaopeng He
ObjectiveTo investigate the prevalence of vitamin D deficiency and its relationship with all-cause and cause-specific mortality among middle-aged and elderly populations in the U.S.
MethodsData were sourced from the National Health and Nutrition Examination Survey (NHANES) 2001–2018. A total of 22,130 participants aged 40–70 years were included. Serum 25-hydroxy vitamin D [25(OH)D] concentrations were measured and categorized. The primary outcome was all-cause mortality, and secondary outcomes were cardiovascular disease (CVD) and cancer mortality. Multivariable-adjusted models and various statistical analyses were employed.
ResultsThe prevalence of vitamin D deficiency (≤50.00 nmol/L) was 33.59%, and insufficiency (≤75.00 nmol/L) was 71.74%. For all-cause mortality, the multivariate adjusted hazard ratios (HRs) across different 25(OH)D levels (p = 0.0069, 0.59 (0.49,0.72) p p Conclusion
This study found that higher serum 25-hydroxyvitamin D concentrations are linked to lower all-cause, cardiovascular, and cancer mortality. The relationship is nonlinear: increases in concentration reduce death risk below a certain threshold, but above it, the association weakens. Further research is needed to understand causal mechanisms.
FreshRSS 