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Conclusion In cirrhotic patients, the severe complications after SAE are not uncommon after the procedure. It causes more suffering, prolonged hospital stay and more medical cost in these patients. It was debatable whether this technique was an appropriate technique for portal hypertension due to liver cirrhosis, patients contraindicated for the treatment should be carefully identified to avoid the complications. © 2020 Zhang et al.Introduction The provision of care according to the code of ethics is of the highest priority in operating rooms (OR). However, the exposure of the surgical team to a high level of stress may result in unethical behavior and undermine their pursuit of excellence. Since the concept of excellence is complex and there are limited published studies in the nursing literature, there was a need for in-depth research. Objective The present study aimed at evaluating the perspective and experience of OR nurses with the concept of excellence. Study Design The conventional qualitative content analysis method was employed to explore the concept of excellence among OR nurses. Participants and Research Environment The current study was conducted on 20 OR nurses in the elective and emergency operating rooms of hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. The data were collected through in-depth semi-structured face-to-face interviews and field notes from April 2017 to June 2018. Findings Thed family caregivers, and promote the pursuit of personal, professional, organizational, and social excellence. selleck chemical © 2020 Bakhtiari et al.Background Moral distress is the cognitive-emotional dissonance that arises when one feels compelled to act against one's moral requirements. The study aimed to assess the proportion of moral distress and associated factors among nurses working in Northwest Amhara Regional State referral hospitals in 2018. Methods A cross-sectional study was conducted among nurses working at Northwest Amhara regional state referral hospitals from April 1-30/2018. A total of 423 study participants were enrolled in the study. A systematic random sampling technique was used to select the study participants. A pretested self-administered structured questionnaire was used to collect data. Moral Distress Scale-Revised (MDS-R) was used to assess the proportion of moral distress. Epi info version 7 for data entry and SPSS version 22 for data analysis were used. A binary logistic model was computed. Variables having p-value less then 0.5 with 95% CI were used to declare the presence of significant associations. Results A total of 423 study participants were enrolled in the study with a response rate of 97.4%. The mean (SD) age of the respondents was 30.62 ± 5.7 years. The majority of nurses 350 (85%) were degree and above holders in nursing. The proportion of moral distress among nurses was found to be 83.7%. Work experience 11-20 years [adjusted odds ratio (AOR)=2, 95% CI 1.01, 3.34], perceived poor team communication [AOR=4.5, 95% CI 1.78, 11.62], perceived powerlessness in decision making [AOR=3.3, 95% CI 1.38, 7.87], inadequate staffing [AOR=2.96, 95% CI 1.26, 6.97], and inappropriate provision of care [AOR=4.12, 95% CI 1.55, 10.9] were significantly associated with moral distress. Conclusion Nurses frequently experienced moral distress in clinical settings. Perceived poor communication, perceived powerlessness in decision making, inadequate staffing, and inappropriate provision care were the factors associated with moral distress. © 2020 Berhie et al.Background Survival rates among breast cancer patients and the number of patients living with treatment side effects have improved, leading to increased focus on quality of life (QOL). The objective of this study was to determine the efficacy of CoQ10 on QOL scores among breast cancer patients in Iranian undergoing tamoxifen therapy. Methods Thirty breast cancer patients were randomized into two groups. The first group received 100 mg CoQ10, and the second group took fplacebo once a day for 8 weeks. QOL was evaluated by a standard QOL questionnaire and a specific questionnaire on QOL of breast cancer patients at baseline and the end of the study. Also, physical activity of patients was assessed with the IPAQ questionnaire and dietary intake determined by a 3-day dietary record. Results The data of 30 subjects were analyzed. According to QOL C30 data, CoQ10 led to a significant increase in physical functioning (P=0.029), emotional functioning (P=0.031), and cognitive functioning (P=0.023) compared to placebo. Symptom scales revealed a notable reduction in appetite loss in the first group (P=0.01). Global health status showed no significant changes in either study arm. On the QOL BR23, progress in functions and decline in symptoms were not statistically significant. Arm symptoms showed significant reduction (P=0.022) in patients that received placebo. Conclusion This trial indicates that CoQ10 supplementation has effects in ameliorating some dimensions of QOL in breast cancer patients. To generalize the results, larger and longer intervention studies are needed. Clinical Trial Registration IRCT2015042021874N1. © 2020 Hosseini et al.Purpose Repository corticotropin injection (RCI) is indicated for a number of autoimmune-mediated diseases including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and dermatomyositis (DM)/polymyositis (PM). To better understand the practice patterns and outcomes of RCI in patients with RA, SLE, or DM/PM, we conducted a retrospective medical record analysis. Patients and Methods Participating providers selected deidentified medical records of patients meeting the inclusion criteria (age ≥18 years; physician-reported diagnosis of RA, SLE, or DM/PM; initiation of treatment with RCI between 1/1/2011 and 2/15/2016; ≥3 in-office visits with same site/provider). Collected data spanned 12 months before and after the first prescription date for RCI. Analyses included patient demographics and clinical history, RCI treatment patterns, and physician's impression of change. Results Data from 54 patients with RA, 30 patients with SLE, and 8 patients with DM/PM were analyzed. The most frequently reported reasons for initiating RCI were lack of efficacy with prior treatment, acute exacerbation of disease, and use as add-on to ongoing therapy.
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