Clinical Medicine Research

ISSN Online: 2326-9057 ISSN Print: 2326-9049

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Volume 9, Issue 6, November 2020

  • Authors: Mandeep Singh, Khaled Mohamed Nada, Mirza Baig, Salik Malik, En-Shuo Hsu, Justin Seashore, Shawn Pua Nishi

    Abstract: Introduction: Healthcare personnel (HCP) are at risk of psychological and emotional distress during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to assess the prevalence and explore the factors associated with depression and anxiety among HCP taking care of patients with COVID-19 in the United States (US). Methods: The study is cross-sectional, anonymous, web-based survey of HCP distributed in the US via email and social media between April 14, 2020 and May 5, 2020. Participants were stratified based on their occupation (i.e., registered nurses, other first responders, physicians, respiratory therapists, and nurse practitioners or physician assistants) and specialty. Practice settings were stratified based on hospital type (academic or community-based) and location. Study outcomes were prevalence and factors associated with depression and anxiety using the 9-item Patient Health Questionnaire (PHQ-9; range: 0-27) and the 7-item Generalized Anxiety Disorder (GAD 7; range 0-21) questionnaires, respectively. Results: In all, 1426 HCP submitted surveys, predominantly females (81%), aged 31-40 years, and non-Hispanic white (78%). Overall, the prevalence of depression and anxiety was 57.4% and 56.7%, respectively. Factors associated with depression were HCP with COVID-19 risk factors (odds ratio [OR] = 1.46; 95% confidence interval [CI] = 1.1–1.94; P = .009), exposure (OR = 1.87; 95% CI = 1.44–2.44; P = <.001), and being uncomfortable with hospital infection control policies (OR = 1.87; 95% CI = 1.28–2.71; P = .001). Similarly, factors associated with anxiety included HCP with COVID-19 risk factors (OR = 1.36; CI = 1.03–1.81; P = .03), COVID-19 exposure (OR = 1.43; 95% CI = 1.09–1.86; P = .01), and not being comfortable with the healthcare facility infection control policies (OR = 1.66; 95% CI = 1.14–2.41; P = .008). Conclusion and Relevance: The majority of HCP surveyed had a high burden of depression and anxiety early in the COVID-19 pandemic in the US. Organizations and institutions will need to develop preventive and management strategies to optimize and sustain the mental health of HCP, particularly under pandemic conditions.

    Received: Oct. 9, 2020 Accepted: Oct. 24, 2020 Published: Nov. 4, 2020

    DOI: 10.11648/j.cmr.20200906.11 View: Downloads:

  • Authors: Li Chunlan, Luo Guanchu, Tan Linwang, Zhou Jiao

    Abstract: Objective: This study was aimed to evaluate the effect of adipose stem cell gel (SVF-gel) in facial and breast plastic surgery. Methods: A retrospective study of 60 young patients who underwent facial and breast fat transplantation from January 2017 to May 2019 in the Plastic Surgery Department of Yuebei People’s Hospital (SVF-gel transplantation group 30 cases, traditional Coleman fat transplantation group 30 cases), and analyze the patient's curative effect. Results: 60 patients were about 35 years old (34.66±8.76 years old in the SVF-gel group, 35.25±9.01 in the traditional Coleman fat transplantation group). The BMI of the SVF-gel group was 24.36±4.02, while that of the traditional Coleman fat transplantation group was 25.01±4.05. The follow-up time of 60 patients was about 8 months. The results showed that the fullness and contour of the face and breast of all patients were improved to varying degrees compared with preoperatively. The satisfaction degree of SVF-gel transplantation group was higher than that of traditional Coleman fat transplantation group. Conclusion: SVF-gel has obvious advantages over traditional fat transplantation in volume filling and rejuvenation of the face and breasts.

    Received: Nov. 23, 2020 Accepted: Dec. 3, 2020 Published: Dec. 11, 2020

    DOI: 10.11648/j.cmr.20200906.12 View: Downloads:

  • Authors: Feng Hao, Chen Huanshi, Bai Ruifei, Li Wei

    Abstract: Objective: Perioperative bleeding volume of posterior spinal surgery is relatively large. This study was aimed to evaluate the hemostatic effect of Hemocoagulase agkistrodon for injection on open lumbar spine surgery. Methods: In this study, a prospective, blinded, randomized, and controlled clinical trial was used to observe the hemostatic effect of 2U intravenous injection of Hemocoagulase agkistrodon 15 minutes before surgery on the posterior lumbar open surgery. A total of 60 cases were included in this experimental study, 30 cases in the study group (2U agkistrodon hemagglutinin for intravenous injection 15 minutes before surgery) and 30 cases in the control group (Inject normal saline 15 minutes before surgery). We use SAS software to simulate and generate random codes. The third-party blinding method is adopted, that is, a specialized nurse is assigned to allocate study drugs in the order of random codes and intravenously according to the plan. We statistically analyzed the bleeding volume and postoperative drainage volume of posterior lumbar spine surgery, and the changes of coagulation indexes in the two groups. Results: All the selected patients successfully completed the operation, their wounds healed and were discharged from the hospital, and no complications such as infection and thrombosis occurred during the hospitalization. The two groups of patients’ coagulation function indicators include prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), fibrinogen quantification (FIB), and D2 polymer. The difference was not statistically significant. However, comparing the intraoperative blood loss, 24h postoperative drainage, and postoperative total drainage between the two groups, the experimental group was better than the control group. Conclusion: Intravenous injection of Agkistrodon hemagglutinin 2U 15 minutes before surgery can have a satisfactory hemostatic effect on the posterior lumbar spine surgical incision. It can not only significantly reduce the amount of bleeding from surgical incisions, but also has no significant effect on the body's coagulation function. It is a safe and effective hemostatic drug.

    Received: Dec. 16, 2020 Accepted: Dec. 22, 2020 Published: Dec. 28, 2020

    DOI: 10.11648/j.cmr.20200906.13 View: Downloads:

  • Authors: Mei Feng, Ni Zhang, Miaohang Shan, Yanbin Pan, Wanxian Lu, Qingran Lin

    Abstract: Background: Catheter failure means that the arterial catheter loses its original real-time and accurate function of monitoring the blood pressure due to various causes, such as blockage, buckling, displacement of the catheter, edema, bleeding, and oozing of the punctured limb requiring catheter removal. However, there have been few studies about the catheter failure and its related influencing factors. The present study aims to explore the status and influencing factors of failed ultrasound-guided invasive arterial catheterization in ICU patients. Methods: 264 patients who underwent ultrasound-guided invasive arterial catheterization from January 2019 to December 2019 were analyzed retrospectively to observe the status and failure of the arterial catheterization. Statistical analysis was performed using SPSS22.0 software. Results: Among the 264 cases with invasive arterial catheterization, 59 cases had catheter failure, the incidence was 22.34%. Single factor analysis showed that the use of analgesics, the protective catheter sleeve, and the affected limb restraints could prevent catheter failure significantly (P<0.05). The result of multivariate logistic regression analysis showed that the affected limb restraints, and the use of analgesics were protective factors against the failure of invasive arterial catheterization (P<0.05), with OR values of 0.454 and 0.450, respectively. Conclusion: Under ultrasound guidance, the incidence of catheter failure after invasive arterial catheterization is low. For the ICU patients undergoing invasive arterial catheterization, analgesics should be used, affected limbs should be constrained, and health education, and communication should be conducted to further reduce the incidence of catheter failure.

    Received: Dec. 14, 2020 Accepted: Dec. 22, 2020 Published: Dec. 31, 2020

    DOI: 10.11648/j.cmr.20200906.14 View: Downloads:

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