Conectar
by Lei Wang, Chang Han Ma, Si Yuan Yang, Zheng Gang Zhang
BackgroundHigh-dose intravenous iron supplementation offers substantial hematologic protective benefits in clinical practice; however, its efficacy in enhancing blood protection during cardiac surgery remains uncertain. The present study aimed to investigate the effects and safety of high-dose intravenous iron as an optimal blood management strategy for patients undergoing cardiac procedures.
MethodsMajor databases, including PubMed, Embase, and Cochrane, were searched on June 20, 2025, for randomized controlled trials (RCTs) comparing red blood cell transfusion rates in adult patients undergoing high-dose intravenous iron supplementation versus those receiving control therapy (placebo) following cardiac surgery. The secondary outcome measures included postoperative hemoglobin levels, length of hospital stay, and incidence of adverse events.
ResultsSeven RCTs involving 975 subjects were identified in the database search. Compared with the control group (placebo), high-dose intravenous iron significantly decreased the rate of postoperative red blood cell transfusion among patients undergoing cardiac surgery (risk ratio 0.69, 95% confidence interval [CI] 0.52–0.91, P = 0.009, I2 = 61%, n = 975, certainty of evidence: moderate). Furthermore, one week or more following surgery, administration of high-dose intravenous iron resulted in a significant increase in postoperative hemoglobin levels (mean difference 0.71, 95% CI 0.41 to 1.01, P 2 = 63%, certainty of evidence: moderate). Significant differences between the groups were not observed for the other outcome measures, including mortality, infection rates, and cardiovascular events.
ConclusionsHigh-dose intravenous iron supplementation during the perioperative period of cardiac surgery significantly reduces the risk of red blood cell transfusion and enhances postoperative hemoglobin levels. Although the present study demonstrated a favorable safety profile for intravenous iron administration, the limitations of the present meta-analysis necessitate continued vigilance regarding potential drug-related risks associated with intravenous iron therapy. Systematic review protocol: CRD420251069827 (PROSPERO).
Nurse-led telephone-based follow-up interventions play a role in patient follow-up, but at present, no meta-analysis has been found to assess the effectiveness of nurse-led, telephone follow-up interventions for patients with acute coronary syndrome.
This systematic review and meta-analysis aimed to evaluate the effectiveness of nurse-led telephone-based follow-up interventions on health outcomes in people with acute coronary syndromes.
Systematic review and meta-analysis of randomized controlled trials.
A comprehensive search of six databases: PubMed, Web of Science, Embase, Cochrane Library, CINAHL and Scopus was conducted from the inception of the databases to 30 September 2023. The Cochrane Risk of Bias Tool was used to assess the methodological quality of the included randomized controlled studies. Review Manager 5.4 and Stata 16.0 were used to conduct statistical analysis.
A total of 12 studies were included. Nurse-led telephone-based follow-up interventions may reduce systolic and diastolic blood pressure (MD = −2.55, 95% CI [−4.16, −0.94]) (MD = −2.15, 95% CI [−3.18, −1.12]) and low-density lipoprotein (MD = −9.06, 95% CI [−14.33, −3.79]) in patients with acute coronary syndrome. However, its effectiveness in controlling high-density lipoprotein (MD = 1.65, 95% CI [−4.30, 7.61]) and reducing total cholesterol (MD = −2.72, 95% CI [−7.57, 2.13]) was uncertain. In addition, the results showed that the nurse-led follow-up intervention did not play a role in improving anxiety (SMD = −0.20, 95% CI [−0.44, 0.04]) and depression (SMD = −0.07, 95% CI [−0.21, 0.06]) in patients with acute coronary syndrome, but it probably improved drug adherence (RR = 1.30, 95% CI [1.05, 1.60]) and smoking cessation (RR = 1.31, 95% CI [1.08, 1.60]).
The findings of this review suggest that nurse-led telephone-based follow-up interventions had a potentially positive effect on controlling blood pressure and low-density lipoprotein levels, as well as improving medication adherence and smoking cessation among patients with acute coronary syndrome, compared to usual care. However, the intervention did not appear to significantly impact high-density lipoprotein, total cholesterol, anxiety, and depression, indicating that further research in these areas will be necessary in the future.
PROSPERO (International Prospective Register of Systematic Reviews): CRD42023465894
by Jiaxu Chen, Lin Zhao, Jinghui Liu, Gaolei Wang, Zhan Guo
To quantitatively analyze the coupling relationships between railway safety risk factors, identify key factors contributing to railway accidents, and develop scientific strategies for accident prevention, this study introduces a complex network-based N-K model to investigate the coupling relationships of railway safety risk factors. First, we identified 18 railway safety risk factors by analyzing case data from railway accidents. The occurrence probabilities and coupling values of these risk factors were then calculated using the N-K model. Subsequently, based on the constructed railway safety risk complex network, reachability and centrality analyses were performed to determine the key factors of railway safety risk. Results indicate that the occurrence of railway accidents is directly proportional to the risk coupling value; the greater the number of coupling factors, the higher the risk value. The coupling of personnel factors and equipment factors is particularly prone to leading to railway accidents. Conversely, effective management of the coupling between personnel and equipment factors can significantly reduce the likelihood of accidents. Inadequate maintenance and unsafe human behavior were identified as critical factors contributing to railway accidents and should be prioritized in prevention efforts.To investigate the incidence of fear of cancer recurrence in patients with digestive tract cancers analyse its influencing factors, and further establish a visual risk prediction model.
A cross-sectional study.
A cross-sectional survey was conducted among 570 patients with digestive tract tumours admitted to a local hospital, from May 2023 to December 2023 by convenient sampling method. Univariate analysis and logistic analysis were performed on the influencing factors, and the risk prediction nomogram model of fear of cancer recurrence in patients with digestive tract cancer was constructed by using R 4.1.3 software. ROC curve was used to evaluate the differentiation of the nomogram model. The calibration curve and Hosmer-Lemeshow goodness of fit test were used to evaluate the consistency of the model. This study was reported using the TRIPOD checklist.
In this study, 272 (47.7%) patients developed fear of recurrence. The risk prediction model of recurrence fear column chart for digestive tract cancer patients incorporated six variables of gender, therapy, alimentary tract haemorrhage, pain, depression and social support. The C-statistic was (.976), and the calibration curve showed that the predicted probability was more in line with the actual probability of occurrence, and the decision curve showed that the predictive model had better practicality.
The column-line diagram prediction model constructed in this study is effective and facilitates timely intervention and management by healthcare professionals based on their risk factors.
Nomogram is helpful to calculate the risk probability of FCR in patients with digestive tract cancer, identify FCR patients in time, and formulate comprehensive and personalized countermeasures, to provide a good quality of life and prolong the survival cycle of patients with digestive tract cancer.
Participants were hospitalized patients or patients with digestive tract cancer undergoing follow-up. First of all, before the investigation and research, a team is formed to discuss the concept, research purpose, method, significance, etc., and determine the research tools. Second, by reasonably explaining the study to patients to seek informed consent from the patient and sign it, patients filled in the questionnaire independently. For patients with low education levels who could not fill in the questionnaire, the team members made objective explanations to help them choose reasonable options.
FreshRSS 