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5%), "evidence is conclusive" (N=35; 6.4%), and "intervention no longer in general use" (N = 34; 6.2%). For the 269 (49%) Cochrane reviews, we considered that the justification for stabilization was not clearly described, that is, sufficiently informative.
Cochrane reviews would benefit from more transparency and consistency in publicly available justifications for stabilizing reviews. Further work in this field will help make decisions about the futility of further research and deciding on enough evidence in the field of research synthesis.
Cochrane reviews would benefit from more transparency and consistency in publicly available justifications for stabilizing reviews. Further work in this field will help make decisions about the futility of further research and deciding on enough evidence in the field of research synthesis.Fibrinogen replacement therapy is a treatment mainstay for patients with afibrinogenemia and significant bleeding. A male infant with congenital afibrinogenemia and several spontaneous hemarthroses commenced cryoprecipitate prophylaxis but developed severe urticarial reactions. He transitioned to a human fibrinogen concentrate (HFC) (RiaSTAP® , CSL Behring; 70 mg/kg biweekly) but continued experiencing hemarthroses (estimated annualized bleeding rate [ABR] 5-6) and severe anaphylactic reactions, despite pre- and postinfusion medications. Following switching to a new HFC (Fibryga® , Octapharma; 50 mg/kg biweekly), ABR was 0-1 with no further infusion reactions. Aged 9 years, because of limited quality of life, development of obesity and fatty liver disease, he underwent orthotopic liver transplant (OLT) under HFC coverage. Pharmacokinetic analysis guided presurgical fibrinogen levels > 150 mg/dL. Selleck LY2228820 No intraoperative HFC infusions were required. Coagulation profile and fibrinogen levels remained within normal limits during and posttransplant. To our knowledge, this is the first pediatric report of afibrinogenemia successfully treated with OLT.
To evaluate psychological well-being and factors associated with post-traumatic stress disorder (PTSD) among front-line nurses during the coronavirus disease-2019 (COVID-19) pandemic.
Coronavirus disease-2019 is a pandemic that has posed a public health emergency of international concern. Psychological well-being of front-line nurses is a big concern during the COVID-19 pandemic.
With a predictive study design, a same survey was sent separately at two time points (i.e. before and after nurses worked at COVID-19 units) between January and March 2020 among 356 front-line nurses in First Affiliated Hospital of Bengbu Medical College, Anhui, China.
Of a total 356 front-line nurses, stress level and the prevalence of PTSD were significantly increased after they worked at COVID-19 units. Nurses who had work experience less than 2years were significantly associated with a high risk of developing PTSD. Nurses who worked in COVID-19 inpatients wards had significantly higher odds of being PTSD (odds ratio [OR]=21.9, 95% confidence interval [CI] 5.08; 94.5) than those who worked in other COVID-19-related units. Resilience was negatively associated with PTSD (OR=0.96, 95% CI 0.93; 0.99).
Nurses had significantly increased risk to develop PTSD during COVID-19 pandemic.
Clinical and policy strategies to support front-line nurses' psychological well-being, particularly young nurses, in response to COVID-19 crisis are urgently needed.
Clinical and policy strategies to support front-line nurses' psychological well-being, particularly young nurses, in response to COVID-19 crisis are urgently needed.
To examine rates and predictors repeat revascularization strategies (percutaneous coronary intervention [PCI] and coronary artery bypass grafting [CABG]) in patients with prior CABG.
Using the National Inpatient Sample, patients with a history of CABG hospitalized for revascularization by PCI or CABG from January 2004 to September 2015 were included. Regression analyses were performed to examine predictors of receipt of either revascularization strategy as well as in-hospital outcomes.
The rate of redo CABG doubled between 2004 (5.3%) and 2015 (10.3%). Patients who underwent redo CABG were more comorbid and experienced significantly worse major adverse cardiovascular and cerebrovascular events (odds ratio [OR] 5.36 95% CI 5.11-5.61), mortality (OR 2.84 95% CI 2.60,-3.11), bleeding (OR 5.97 95% CI 5.44-6.55) and stroke (OR 2.15 95% CI 1.92-2.41), but there was no difference in cardiac complications between groups. Thoracic complications were high in patients undergoing redo CABG (8%), especially in females. Factors favoring receipt of redo CABG compared to PCI included male sex, age < 80 years, and absence of diabetes and renal failure.
Reoperation in patients with prior CABG has doubled in the United States over a 12-year period. Patients undergoing redo CABG are more complex and associated with worse clinical outcomes than those receiving PCI.
Reoperation in patients with prior CABG has doubled in the United States over a 12-year period. Patients undergoing redo CABG are more complex and associated with worse clinical outcomes than those receiving PCI.
To explore the thoughts and experiences of aged care nurses following participation in an ageing-suit simulation intervention.
Globally, people are living longer, and for nurses, there are increasing challenges to meet the needs of the higher numbers of older people in hospital. Educating nurses to understand the ageing process and the experiences of older people in hospital is crucial to addressing these challenges. Ageing-suits were identified as a possible approach to assist with these educational needs.
This study adopted a qualitative descriptive design.
A convenience sample of nurses (n=15) were selected from a single aged care ward. Volunteered nurses participated in a four-hour ageing-suit simulation session. Their immediate thoughts and experiences were explored via postsimulation debriefs, and three 30-to 50-min follow-up focus groups were conducted at 3months to explore perceptions on the impact of their experience on clinical practices. The data were analysed with the Braun and Clarke's six-step thematic analysis method.
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