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To rigorously examine the association between catheterisation duration and urinary tract infections among geriatric patients with hip fractures.
Retrospective cohort study.
We analysed data from 872 patients aged 60 years and older, treated at a tertiary care hospital between January 2022 and May 2023. To address missing data, we employed multiple imputations using chained equations (50 iterations). A comprehensive set of statistical methods, including multivariate logistic regression, generalised additive models, and smooth curve fitting techniques, was applied to investigate variable relationships. Additionally, we used a two-piecewise binary logistic regression model to further elucidate nonlinear associations.
The cohort included 296 males and 576 females, with an overall urinary tract infection prevalence of 25.3%. Multivariate smooth spline analysis revealed a nonlinear relationship between catheterisation duration and urinary tract infection. This finding suggested that the risk of urinary tract infection increased by 2.8% for every 10-h increase with an indwelling duration < 106 h. However, the risk no longer significantly increased with an indwelling duration of ≥ 106 h. Sensitivity and interaction analyses confirmed the robustness of these results.
This study identified an inverse L-shaped relationship between catheterisation duration and urinary tract infection. Given the potential for confounding, further investigations are necessary to validate these findings and explore their implications for clinical practice.
Nurses should prioritise early catheter removal protocols to mitigate infection risk, coupled with enhanced surveillance within the first 106 h after insertion.
Adhered to STROBE guidelines for observational studies.
No public Contribution. Patients contributed through data collected from the Hospital Information System, which was used for analysis.
Many studies have identified the negative psychological impact of in vitro fertilisation and embryo transfer (IVF-ET) on couples with infertility, but there remains a paucity of research clarifying both positive and negative effects within the context of Chinese culture.
To explore the dynamic psychosocial experiences and underlying mechanisms of couples in the whole process of IVF-ET, and to construct a theoretical framework that elucidates this phenomenon within the context of Chinese social-culture.
A grounded theory study.
Guided by constructivist grounded theory methodology, semi-structured face-to-face interviews were conducted in the reproductive medicine outpatient department of a tertiary-level hospital located in northwest China between January and October 2023. Purposive and theoretical sampling methods were used to recruit couples undergoing IVF-ET. Data were analysed through three iterative steps: initial coding, focused coding, and theoretical coding, utilising constant comparative methods and reflective memo-writing. The study is reported using the COREQ checklist.
Theoretical saturation was achieved after interviewing 22 couples. The substantive theory was synthesised into one core category: ‘forward or backward’, which captured the ambivalent psychosocial experiences of couples undergoing IVF-ET within the context of Chinese culture. This theory described three overarching stages: making the decision, undergoing the treatment, and facing the result, with each stage linked to specific promoting and hindering factors.
This study establishes a theoretical foundation for further implementation of comprehensive reproductive health management within the Chinese sociocultural context. It is crucial for healthcare providers and policymakers to focus on the dyad of couples undergoing IVF-ET, pay attention to both negatively and positively psychosocial fluctuations, and enhance both medical care and sociocultural support systems accordingly.
No patient or public contribution.
by Bo Mi Gil, Sun Im, Yu Jin Hong, Hye Seon Kang
PurposeWe investigated whether thoracic skeletal muscle mass index at the diagnosis of aspiration pneumonia (AP) is a predictor for AP recurrence and explored predicting factors for AP recurrence in patients with stroke.
Patients and methodsThis study retrospectively reviewed data of patients with AP who were diagnosed with stroke and who had full medical follow-up data from January 2014 to July 2020 in the Catholic University of Korea Bucheon St. Mary’s Hospital. AP was defined based on clinical signs and/or symptoms suggestive of pneumonia and radiologic findings of pneumonic infiltrations in the dependent portions of the lung. We measured thoracic muscle volume using the cross-sectional area (CSA) of the erector spinae muscle (ESMCSA, cm2) at the 12th vertebral region. Computed tomography scans at the time of AP diagnosis during the acute stroke period were used for analysis and respective CSAs were divided by height squared (m2) to yield the muscle index at T12 (T12MI, cm2/m2) to normalize for stature. Multivariate logistic regression models were used to investigate relationships between clinical parameters and AP recurrence.
ResultsDuring the study period, a total of 268 stroke patients with dysphagia who developed AP were analyzed. The mean T12MI of patients with and without recurrence of AP was 622.3±184.1 cm2/m2 and 708.1±229.9 cm2/m2, respectively (P = 0.001). Multivariate logistic regression revealed that lower T12MI (P = 0.038) and older age (P = 0.007) were independent predictors of AP recurrence in patients with stroke and dysphagia.
ConclusionLow thoracic muscle index at the diagnosis of initial AP after stroke can predict subsequence AP recurrence.
Diabetic cutaneous ulcers often pose considerable challenges in the healing process. These challenges stem from factors including inadequate perfusion of the ulcer's surrounding environment, persistent inflammation, tissue damage and microbial proliferation. The existing standard treatment modalities prove insufficient in fully addressing the complex pathogenesis of these ulcers. As a novel approach, researchers are exploring cellular therapies employing mesenchymal stem cells (MSCs) for the treatment of diabetic skin ulcers. MSCs are readily found in various tissues, including bone marrow, adipose tissue, placenta, amniotic membrane, amniotic fluid and umbilical cord. However, the optimal source of MSCs for effectively treating diabetic skin ulcers remains a topic of ongoing discussion.
We conducted a comprehensive search of Embase, PubMed and Web of Science databases, spanning from their inception to November 2022. Subsequently, we rigorously screened the literature following predetermined inclusion and exclusion criteria and evaluated the quality of the selected studies using the SYRCLE scale. Finally, the included literature underwent analysis, employing the Bayesian school of thought-based R language. To ensure transparency and accountability, we registered this study with PROSPERO's International Systematic Review Prospective Registry, with the Registration ID: CRD42023387421.
We included a total of 11 articles in our analysis, all of which were randomized controlled studies involving 218 animal models. Among these studies, two utilized adipose-derived MSCs, six employed bone marrow-derived MSCs, one utilized amniotic membrane-derived MSCs and three utilized umbilical cord-derived MSCs. Our network meta-analysis results revealed that there were no statistically significant differences in the healing rates of diabetic skin ulcers among MSCs derived from amniotic membrane, adipose tissue, umbilical cord and bone marrow on days 7–8, 10–12 and 12–14. Notably, according to the probability ranking table, the most effective treatment for diabetic wounds was found to be amniotic membrane-derived MSCs.
There was no statistically significant difference in the efficacy of MSCs derived from amniotic membrane, adipose, umbilical cord and bone marrow in the treatment of diabetic skin ulcers during the short-term observation period, and the probability ranking graphs indicate that amniotic membrane-derived MSCs may be the best choice for the treatment of diabetic skin ulcers.
Aimed to clarify the effect of quercetin and its derivatives on wound healing in animal experiments. PubMed, Embase, Science Direct, Web of Science, SinoMed, Vip Journal Integration Platform, China National Knowledge Infrastructure and WanFang databases were searched for animal experiments investigating the effect of quercetin and its derivatives on wound healing to April 2023. The Review Manager 5.4 software was used to conduct meta-analysis. Eighteen studies were enrolled in this article. According to the SYRCLE's RoB tool assessment, these studies exposed relatively low methodological quality. It was shown that animals with cutaneous wound receiving quercetin had faster wound healing in wound closure (%) than the control group. Moreover, the difference in efficacy gradually emerged after third day (WMD = 7.13 [5.52, 8.74]), with a peak reached on the tenth day after wounding (WMD = 19.78 [17.82, 21.74]). Subgroup analysis revealed that quercetin for wound closure (%) was independent of the types of rats and mice, wound area and with or without diabetes. Clear conclusion was also shown regarding the external application of quercetin for wound healing (WMD = 17.77 [11.11, 24.43]). A significant reduction in the distribution of inflammatory cells occurred in the quercetin group. Quercetin could increase blood vessel density (WMD = 1.85 [0.68, −3.02]), fibroblast distribution and collagen fraction. Biochemical indicators, including IL-1β, IL-10, TNF-α, TGF-β, vascular endothelial growth factor (VEGF), hydroxyproline and alpha-smooth muscle actin (α-SMA), had the consistent results. Quercetin and its derivatives could promote the recovery of cutaneous wound in animals, through inhibiting inflammatory response and accelerating angiogenesis, proliferation of fibroblast and collagen deposition.
FreshRSS 