Hospitalizaciones evitables por problemas de salud sensibles a cuidados ambulatorios: construcción y validación de la lista Uruguaya de patologías

Introducción: Las hospitalizaciones por Ambulatory Care Sensitive Conditions es un indicador que mide la utilización de los servicios hospitalarios por problemas de salud que podrían haber sido prevenidos en el primer nivel de atención. El concepto se refiere a los procesos en que la atención ambulatoria efectiva puede ayudar a disminuir los riesgos de hospitalización, en un segundo nivel de atención. El objetivo del estudio fue construir y validar una lista uruguaya de problemas de salud sensibles a cuidados ambulatorios (PSSCA) según CIE-10. Metodología: Para la construcción de la lista inicial de códigos de PSSCA se realizó una revisión de los listados existentes y se propuso un listado inicial que fue validado a través del Método Delphi. Se propone un listado de 99 códigos diagnósticos de PSSCA adaptado a nuestro entono sanitario. Los mismos permiten identificar y cuantificar problemas de salud que pueden producir hospitalizaciones potenciamente evitables mediante cuidados ambulatorios accesibes y oportunos en el primer nivel de atención. Resultados: Se conformó un panel de 12 expertos. A partir de los datos obtenidos, considerando los 99 diagnósticos clasificados por CIE-10, éstos se pueden subclasificar en función de si la patología es infecciosa o no, obteniendo un resultado general de 62 patologías en un total de 99 que pueden ser clasificadas como infecciosas, lo que se corresponde a un 62 %. Discusión: De la comparación de la lista uruguaya de PSSCA a la que hemos arribado y las listas validadas utilizadas para la construcción inicial del listado de patologías propuesto, podemos decir que la primera presenta un mayor porcentaje de coincidencia con la lista de patologías de Bello Horizonte. Podemos mencionar que la mayoría de los problemas de salud identificados con base en el listado de PSSCA, son sensibles de ser resueltos con la atención primaria oportuna y de calidad que podría evitar o disminuir de una manera significativa su hospitalización. Conclusiones: Este trabajo describe el proceso de construcción y validación de una lista de códigos de PSSCA adaptados al contexto uruguayo a través del método Delphi. Hemos arribado a un listado que comprende un total de 99 diagnósticos, agrupadas en un total de diecinueve categorías que considera la especificidad del contexto uruguayo del indicador.

Introduction: Hospitalizations for Ambulatory Care Sensitive Conditions is an indicator that measures the use of hospital services for health problems that could have been prevented at the first level of care. The concept refers to the processes in which effective outpatient care can help reduce the risks of hospitalization, at a second level of care. The objective of the study was to build and validate a Uruguayan list of health problems sensitive to outpatient care (PSS-CA) according to ICD-10. Methodology: To construct the initial list of PSSCA codes, a review of the existing lists was carried out and an initial list was proposed that was validated through the Delphi Method. A list of 99 PSSCA diagnostic codes adapted to our healthcare environment is proposed. They make it possible to identify and quantify health problems that can lead to potentially avoidable hospitalizations through accessible and timely outpatient care at the first level of care. Results: A panel of 12 experts was formed. From the data obtained, considering the 99 diagnoses classified by ICD-10, these can be subclassified depending on whether the pathology is infectious or not, obtaining a general result of 62 pathologies in a total of 99 that can be classified as infectious, which corresponds to 62%. Discussion: From the comparison of the Uruguayan list of PSSCA that we have arrived at and the validated lists used for the initial construction of the proposed list of pathologies, we can say that the first presents a higher percentage of coincidence with the list of pathologies of Bello Horizonte . We can mention that most of the health problems identified based on the PSSCA list are sensitive to being resolved with timely and quality primary care that could prevent or significantly reduce hospitalization. Conclusions: This work describes the process of construction and validation of a list of PSSCA codes adapted to the Uruguayan context through the Delphi method. We have arrived at a list that includes a total of 99 diagnoses, grouped into a total of nineteen categories that consider the specificity of the Uruguayan context of the indicator.

Introdução: As Internações por Condições Sensíveis à Atenção Ambulatorial são um indicador que mede a utilização de serviços hospitalares para problemas de saúde que poderiam ter sido evitados no primeiro nível de atenção. O conceito refere-se aos processos em que um atendimento ambulatorial eficaz pode auxiliar na redução dos riscos de internação, em um segundo nível de atenção. O objetivo do estudo foi construir e validar uma lista uruguaia de problemas de saúde sensíveis à atenção ambulatorial (PSS-CA) segundo a CID-10. Metodologia: Para construir a lista inicial de códigos PSSCA foi realizada uma revisão das listas existentes e foi proposta uma lista inicial que foi validada através do Método Delphi. É proposta uma lista de 99 códigos de diagnóstico PSSCA adaptados ao nosso ambiente de saúde. Permitem identificar e quantificar problemas de saúde que podem levar a hospitalizações potencialmente evitáveis ​​através de cuidados ambulatórios acessíveis e oportunos no primeiro nível de cuidados. Resultados: Foi formado um painel de 12 especialistas. A partir dos dados obtidos, considerando os 99 diagnósticos classificados pela CID-10, estes podem ser subclassificados consoante a patologia seja infecciosa ou não, obtendo-se um resultado geral de 62 patologias num total de 99 que podem ser classificadas como infecciosas, o que corresponde para 62%. Discussão: A partir da comparação da lista uruguaia de PSSCA a que chegamos e das listas validadas utilizadas para a construção inicial da lista de patologias proposta, podemos dizer que a primeira apresenta um maior percentual de coincidência com a lista de patologias de Belo Horizonte. Podemos mencionar que a maioria dos problemas de saúde identificados com base na lista PSSCA são sensíveis para serem resolvidos com cuidados primários oportunos e de qualidade que possam prevenir ou reduzir significativamente a hospitalização. Conclusões: Este trabalho descreve o processo de construção e validação de uma lista de códigos PSSCA adaptados ao contexto uruguaio através do método Delphi. Chegamos a uma lista que inclui um total de 99 diagnósticos, agrupados em um total de dezenove categorias que consideram a especificidade do contexto uruguaio do indicador.

Perception of first-order grating acuity and second-order spatial contrast sensitivity in anisometropia amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To study the perception of first-order grating acuity and second-order spatial contrast sensitivity in patients with monocular anisometropia amblyopia.METHODS:A total of 715 children(715 eyes)diagnosed as monocular anisometropia amblyopia in our hospital from January 2018 to December 2022 were collected as amblyopia group, and 745 children(745 eyes)with normal corrected visual acuity were collected. The best corrected visual acuity(BCVA), first-order grating acuity and/or second-order spatial contrast sensitivity were measured, repectively. The perception ability of amblyopia patients to first-order grating acuity and second-order spatial contrast sensitivity were analyzed.RESULTS:There were significant differences between amblyopia group and normal control group in the perception of first-order grating acuity(11.58±6.10 vs. 20.27±3.47, P<0.001)and second-order spatial contrast sensitivity(0.33±0.16 vs 0.12±0.04, P<0.001). And there were significant differences between mild-to-moderate amblyopia and severe amblyopia patients in first-order grating acuity(12.10±6.23 vs. 8.13±3.70, P<0.001)and second-order spatial contrast sensitivity(0.32±0.16 vs. 0.37±0.17, P<0.05).CONCLUSION: The first-order and second-order visual pathway of the cerebral cortex in children with monocular anisometropia amblyopia have different degrees of damage. The injury of severe amblyopia is more serious than that of mild-to-moderate amblyopia.

Pharmacotherapy plan for metastatic hormone-sensitive prostate cancer：a network meta-analysis / 中国药房

OBJECTIVE To determine the optimal therapeutic plan for metastatic hormone-sensitive prostate cancer （mHSPC）， and to provide reference for clinical decision-making. METHODS Retrieved from Medline， Embase， BIOSIS preview， the Cochrane Library and ClinicalTrials. gov systematically， randomized controlled trials about mHSPC therapy， with overall survival （OS） and radiographic progression-free survival （rPFS） as efficacy outcomes and the incidence of serious adverse events （SAEs） as safety outcome， were collected during the inception-Mar. 2022. Two researchers independently screened the literature， extracted data， and evaluated the risk of bias for the included study before conducting a Bayesian network meta-analysis. RESULTS Eight studies with 9 437 patients were finally included. The effectiveness and safety of 7 therapy plans were compared [abiraterone acetate， apalutamide， darolutamide+docetaxel， docetaxel， enzalutamide， standard non-steroidal antiandrogen （SNA） in addition to ADT， and ADT alone]. In terms of efficacy index， the most beneficial regimen （except for ADT+SNA） for OS was ADT+darolutamide+docetaxel （HR＝0.54， 95%CI of 0.44-0.66）， followed by ADT+abiraterone acetate （HR＝0.64，95%CI of 0.57- 0.71）， apalutamide （HR＝0.65， 95%CI of 0.53-0.79）， enzalutamide （HR＝0.66， 95%CI of 0.53-0.82）； the least beneficial regimen for OS was ADT+docetaxel （HR＝0.79， 95%CI of 0.71-0.88）. The most beneficial regimen （except for ADT+SNA） for rPFS was ADT+enzalutamide （HR＝0.39， 95%CI of 0.30-0.50）， followed by ADT+apalutamide （HR＝0.48， 95%CI of 0.39- 0.60）， abiraterone acetate （HR＝0.57， 95%CI of 0.51-0.64）， docetaxel （HR＝0.62， 95%CI of 0.56-0.69）. The results of the tumor- loading subgroup analysis were the same. In terms of safety， ADT+darolutamide+docetaxel （OR＝25.86， 95%CI of 14.08-51.33）， and ADT+docetaxel （OR＝23.35， 95%CI of 13.26-44.81） were associated with markedly increased SAEs； the incidence of SAEs caused by ADT+abiraterone acetate （OR＝1.42，95%CI of 1.10-1.82） was slightly increased， and those of other therapy plans had no significant difference. CONCLUSIONS Compared with ADT alone， ADT+ darolutamide+docetaxel may provide the most significant OS benefit， but the incidence of SAEs is increased greatly； compared with ADT+docetaxel， ADT+abiraterone acetate， apalutamide or enzalutamide provide more OS benefits. ADT+enzalutamide provide optimal rPFS benefits with no increased SAEs.

TMZ@ZIF-8 nanoparticles：preparation，characterization，and in vivo and in vitro anti-tumor studies / 中国药房

OBJECTIVE To prepare zeolite imidazole framework （ZIF）-8 nanoparticles （NPs） loaded with temozolomide （TMZ） （abbreviated as TMZ@ZIF-8 NPs） drug delivery system， thus increasing drug enrichment and anti-glioma effects in lesions. METHODS After preparing ZIF-8 NPs using the room temperature solution reaction method， the impregnation method was used to prepare TMZ@ZIF-8 NPs drug delivery system. Characterization was carried out using transmission electron microscopy， laser particle size， and Fourier transform infrared spectroscopy， and dissolution and anti-tumor activity experiments in vitro and in vivo were conducted. RESULTS TMZ@ZIF-8 NPs were successfully prepared with the particle size of （126.23±7.92） nm， drug loading amount of （28.79±1.26）%， and 72 h cumulative dissolution rate of （72.36±3.62）%. The results of in vitro anti-tumor activity experiments showed that the relative cell survival rate of ZIF-8 NPs remained above 90%； the prepared TMZ@ZIF-8 NPs delivery system exhibited superior inhibition， higher uptake capacity， and better promoting apoptosis effects on the growth and proliferation of C6 cells as compared with the free TMZ. The results of in vivo anti-tumor activity experiments showed that ZIF-8 NPs were not enriched in the brain of rats， and the enrichment effect of TMZ in the brain was not significant， while TMZ@ZIF-8 NPs had a significant enrichment effect in the brain. CONCLUSIONS ZIF-8 NPs can effectively load TMZ， and successfully prepared TMZ@ZIF-8 NPs can improve TMZ uptake ability and anti-glioma effect.

Research progress on indicators for early diagnosis of diabetic kidney disease / 沈阳医学院学报

Diabetic kidney disease(DKD)is one of the most serious microvascular complications of diabetes and a common cause of end-stage renal disease.Early kidney injury lacks typical clinical symptoms and its onset is insidiously.The common clinical indicators of kidney injury are urine microalbumin,glomerular filtration rate,etc.Due to their lack of sensitivity and specificity,it is easy to cause missed diagnosis,misdiagnosis,and delay the disease.Therefore,it is of great significance to find more convenient,stable,and less invasive detection indicators for the early diagnosis of DKD.This paper reviews the research progress of biological indicators related to glomerular and tubular injury,oxidative stress,inflammatory response,microRNA and proteomics,which provides a certain reference value for the early diagnosis of clinical DKD.

Human beta-defensin 3 hydrogel for treatment of periodontitis in rats / 中国组织工程研究

BACKGROUND:Previous studies have shown that human beta-defensin 3 has significant antifungal,antibacterial,and antiviral activities and plays an important bridging role in linking innate and acquired immune responses. OBJECTIVE:To observe the effect of human beta-defensin 3 hydrogel on treatment of periodontitis in rats. METHODS:Using Poloxamer 188 and 407 as the matrix,a blank hydrogel was constructed by cold solution.Human beta-defensin 3 hydrogel was prepared by mixing human beta-defensin 3 with the hydrogel.Twenty-five SD rats were randomly divided into five groups with five rats in each group:No treatment was given in the healthy group.The periodontitis model was constructed by the orthodontic ligature wire method in the periodontitis group,blank hydrogel group,minocycline hydrochloride group,and human beta-defensin 3 hydrogel group.8 weeks after modeling,blank hydrogel,minocycline hydrochloride,and human β-defensin 3 hydrogel were injected into the buccal and palatal periodontal bags,once a week,and relevant tests were carried out after continuous administration for 4 weeks. RESULTS AND CONCLUSION:(1)Compared with the healthy group,periodontal plaque index,gingival bleeding index,and periodontal probing depth were increased in the periodontitis group(P<0.01).Compared with the periodontitis group,the periodontal plaque index,gingival bleeding index,and periodontal probing depth of rats were decreased in the minocycline hydrochloride group and the human beta-defensin 3 hydrogel group(P<0.05).(2)Hematoxylin-eosin staining proved that the hydrogel was not toxic to the rat organism.(3)Stereomicroscopy and Micro CT showed that compared with the healthy group,the root exposure and the distance between enamel cementum boundary and alveolar crest of the periodontitis group were increased(P<0.05).Compared with the periodontitis group,the root exposure and the distance between enamel cementum boundary and alveolar crest of rats were reduced in the minocycline hydrochloride group and human beta-defensin 3 hydrogel group(P<0.05).(4)Hematoxylin-eosin,Masson,and tartrate-resistant acid phosphatase staining showed that periodontal inflammation was obvious,fiber structure was disordered and osteoclasts were active in the periodontitis group and blank hydrogel group,while periodontal inflammation was decreased,fiber arrangement was more regular,and osteoclasts were reduced in the minocycline hydrochloride group and human beta-defensin 3 hydrogel group.(5)qRT-PCR showed that compared with the healthy group,the mRNA expressions of interleukin 1β,tumor necrosis factor α,interleukin 6,and inducible nitric oxide synthase were increased in the periodontitis group(P<0.05).Compared with the periodontitis group,the mRNA expressions of interleukin 1β,tumor necrosis factor α,interleukin 6,and inducible nitric oxide synthase in gingival tissue of rats were decreased in the minocycline hydrochloride group and human beta-defensin 3 hydrogel group(P<0.05).(6)The results showed that human beta-defensin 3 hydrogel was able to attenuate inflammation in rat periodontal tissues by decreasing the relative expression of inflammatory factors and inhibiting osteoblasts.

Mechanism of local time-sensitive stimulation effect of catgut and polyglycolide-co-lactide thread embedding at"Zusanli"acupoint area of rats / 中国组织工程研究

BACKGROUND:The researchers noted that upon embedding clinical-grade catgut and polyglycolide-co-lactide threads in the normal human"Zusanli"(ST 36)acupoint,the local area displayed temporal and inflammatory stimulatory effects,resulting in thread differentiation.However,the underlying mechanism behind thread involvement remains to be studied. OBJECTIVE:To investigate the expression levels of calcitonin gene-related peptide,5-hydroxytryptamine,leukotriene B4,and bradykinin at point"Zusanli"(ST 36)in rats after embedding catgut and polyglycolide-co-lactide respectively at different time points. METHODS:110 male SD rats were divided into a blank group(10 rats),a catgut embedding group(50 rats),and a polyglycolide-co-lactide embedding group(50 rats)according to the random number table method.In the blank group,no thread was embedded.In catgut embedding group and the polyglycolide-co-lactide embedding group,the thread was embedded in the left side of the ST36 acupoint once.Tissue was collected from the left side of the ST36 acupoint area 8 hours,3,7,14,and 21 days after embedding.The expression levels of calcitonin gene-related peptide and 5-hydroxytryptamine were detected by immunohistochemistry,and the contents of leukotriene B4 and bradykinin were detected by ELISA. RESULTS AND CONCLUSION:(1)Compared with the blank group,the expression of calcitonin gene-related peptide,5-hydroxytryptamine,bradykinin,and leukotriene B4 was significantly increased in the 8 hours,3,7,14,and 21 days of the catgut embedding group(P<0.05);calcitonin gene-related peptide expression was significantly increased in 8 hours,3,7,and 14 days in the polyglycolide-co-lactide embedding group(P<0.05);the expression of bradykinin was significantly increased in 8 hours,3,and 7 days(P<0.05);the expression of leukotriene B4 was significantly increased at 8 hours,3,7,14,and 21 days(P<0.05).(2)Compared with the polyglycolide-co-lactide embedding group,the expression of calcitonin gene-related peptide was increased at 7,14,21 days after thread embedding(P<0.05),and the expression of 5-hydroxytryptamine was increased at 8 hours,3,7,14 and 21 days after thread embedding(P<0.05);contents of leukotriene B4 and bradykinin in tissues were increased at 8 hours,3,14 and 21 days after embedding(P<0.05)in the catgut embedding group.(3)The results show that calcitonin gene-related peptide,5-hydroxytryptamine,leukotriene B4,and bradykinin in the acupoint region alter after catgut embedding in the ST36 of rats,as well as the alteration of calcitonin gene-related peptide,leukotriene B4,and bradykinin is found in the acupoint region after polyglycolide-co-lactide embedding in rats,which may be one of the mechanisms involved in the local time sensitive stimulus effects caused by embedding threads at acupoints.Moreover,there is a discernible difference between the two thread types.

The relationship between HRD score based on GSS algorithm and clinicopathological characteristics, genomic mutations and prognosis in patients with high-risk and metastatic hormone-sensitive prostate cancer / 现代泌尿外科杂志

【Objective】 To statistically analyze the relationship between homologous recombination repair deficiency (HRD) score and clinicopathological characteristics, genomic mutations in patients with high-risk and metastatic hormone-sensitive prostate cancer (mHSPC) and the prognostic predictive value in mHSPC. 【Methods】 A total of 127 patients diagnosed with high-risk prostate cancer and mHSPC, treated at the Department of Urology of Chinese PLA General Hospital during Dec.2021 and Nov.2023 were enrolled.Homologous recombination repair (HRR) gene sequencing was performed, and the genomic scar score (GSS) algorithm were conducted to calculate the HRD score.The relationship between HRD scores and clinicopathological features, genomic alterations, and prognosis were analyzed. 【Results】 The median HRD score was 1.6(0.8, 5.2), 30(23.6%) patients’ HRD scores ≥10, and 11(8.7%) patients’ HRD scores ≥20.Clinicopathological features, including ISUP classification ≥4 (P=0.044) and metastatic status (P=0.008) were associated with high HRD score.Patients with mutations in the BRCA, TP53 and MYC systems had significantly higher HRD score than those with wild-type genes (P<0.05).In mHSPC, the risk of biochemical recurrence was 12.836 times higher in patients with HRD score ≥20 than in those with <20 [OR:12.836 (1.332-124.623), P=0.028]. 【Conclusion】 Baseline HRD score was lower in patients with high-risk prostate cancer and mHSPC.Patients with high HRD score may have higher histological grading (ISUP≥4) and later clinical stage.Further investigation is needed to determine the threshold of HRD scores as biochemical markers suggestive of a poor prognosis.

Clinical characteristics and outcomes of elective gynecologic cases using modified Medically Necessary, Time Sensitive (MeNTS) scoring system in the prioritization of surgery at the Philippine General Hospital during the COVID-19 pandemic

Objectives@#The use of a scoring system that integrates various factors helps in decision-making and triage for Medically Necessary, Time Sensitive (MeNTS) surgical procedures during the COVID-19 pandemic. This study aimed to determine the clinical characteristics and outcomes of cases who were screened and underwent elective gynecologic surgery at a tertiary hospital using the MeNTS tool for prioritization.@*Methods@#A cross sectional study was carried out using data collected through medical chart review of all gynecologic cases screened in a 6-month period, from June 18, 2020 to December 18, 2020.@*Results@#A total of 155 gynecologic cases were screened, with 134 (86.4%) MeNTS cases and 21 (13.5%) non-MeNTS cases. The median length of stay (5 days), the median operating room time (3 hours and 30 minutes), and median estimated blood loss (400ml) were within the acceptable expected outcome as with the scoring system, albeit with some cases (53%) requiring blood transfusion attributed to low baseline hemoglobin levels. There were no cases with post-operative COVID-19 transmission, needing ICU care and intubation, nor mortalities reported.@*Conclusions@#The MeNTS scoring system allowed efficient handling of the backlog of elective gynecologic cases with minimal morbidity and absence of mortality. The study supports the utility of this scoring system in addressing the need of the healthcare system not just to optimally utilize and fairly allocate hospital resources but also to ensure the safety of the patient with the best health service delivery during the pandemic.

Culture of rabbit corneal stromal cells on thermo-sensitive materials by the radiation polymerization / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the synthesis of thermo-sensitive poly N-isopropylacry-lamide(PNIPAAm)and the petri dish grafted with PNIPAAm hydrogels by the electron accelerator, as well as the growth conditions and the biological characteristics of rabbit corneal stromal cells on thermo-sensitive PNIPAAm hydrogels, and the cell sheets obtained from the PNIPAAm hydrogels.METHODS: NIPAAm monomer was dissolved in 2-propanol at concentrations of 55% with 0.5% N,N'-Methylenebisacry-lamide(MBA). Solution(70 μL)was added and spread uniformly over 35 mm petri dish. These dishes were immediately subjected to irradiation. After follow-up treatment, rabbit corneal stromal cells were cultured on thermo-sensitive petri dish in vitro.RESULTS: According to the monomer formula and radiation synthesis scheme in this experiment, PNIPAAm can be synthesized on the surface of the petri dish. Rabbit corneal stromal cells grew well in the thermo- sensitive surface and can be separated into sheets.CONCLUSION: The single and multilayer carrier-free cell sheets can be obtained from the use of thermo-sensitive petri dish.

The regulatory role of the RUS family in plant growth and development / 生物工程学报

The chloroplast genome encodes many key proteins involved in photosynthesis and other metabolic processes, and metabolites synthesized in chloroplasts are essential for normal plant growth and development. Root-UVB (ultraviolet radiation B)-sensitive (RUS) family proteins composed of highly conserved DUF647 domain belong to chloroplast proteins. They play an important role in the regulation of various life activities such as plant morphogenesis, material transport and energy metabolism. This article summarizes the recent advances of the RUS family proteins in the growth and development of plants such as embryonic development, photomorphological construction, VB6 homeostasis, auxin transport and anther development, with the aim to facilitate further study of its molecular regulation mechanism in plant growth and development.

Study on the Safe Use of Sensitive Personal Information of Patients in Medical and Health Institutions / 医学信息学杂志

Purpose/Significance Based on the typical use scenario of sensitive personal information in medical and health institu-tions,the implementation of the secure use of sensitive personal information is explored.Method/Process For user registration,internal utilization and interaction,medical device/wearable device collection and information disclosure and other scenarios,the paper analyzes the risk of sensitive personal information leakage,explores the application scenarios,advantages and disadvantages of various technical means such as identity authentication,access control,data encryption,data desensitization and detection audit.Result/Conclusion The application of technical means can assist medical and health institutions to further protect the security of patients'personal information.

Construction and Application of the Nursing Quality Control Platform Based on Informatization in Tertiary Hospitals of Qing-hai Province / 医学信息学杂志

Purpose/Significance To establish an informatization platform for nursing quality control in tertiary hospitals of Qinghai province,and to analyze its influence on nursing quality.Method/Process According to the needs of nursing quality management in Qing-hai province,based on the nursing quality data platform,a nursing quality index monitoring module is established.A tertiary hospital is selected as a pilot hospital,and the nursing quality data of this hospital from January to June 2021 is selected as the control group by u-sing the historical comparative study method,and the nursing quality data collected by the informatization platform from January to June 2022 is selected as the observation group.The changes of nursing quality before and after the application of informatization platform are compared.Result/Conclusion After the application of the informatization platform for nursing quality control,the rate of physical restraint and unplanned extubation of endotracheal intubation of hospitalized patients decreases significantly,and the score of patients'satisfaction with nursing work increases significantly.The informatization platform has strong operability and clinical application value.

Anti-tumor Mechanism and Clinical Application of Pseudomonas Aeruginosa-Mannose-Sensitive Hemagglutinin / 医药导报

The application of Pseudomonas aeruginosa-mannose-sensitive hemagglutinin(PA-MSHA)in the field of an-titumors has been increasing.PA-MSHA has been found to promote tumor cell apoptosis,inhibit tumor cell invasion and migration,differentiation,and change drug resistance and epithelial-mesenchymal transformation(EMT)by inhibiting the EGFR pathway.Meanwhile,PA-MSHA also enhances the immune killing and inhibition of macrophages and T cells to tumor cells through toll-like receptors(TLRs).In this paper,we reviewed the reported anti-tumor mechanism and clinical application of PA-MSHA,suggesting that PA-MSHA may alter the glycosylation of EGFR and TLR proteins by acting on the regulatory process of the cellular mannosy-lation process.PA-MSHA can act on cell membrane proteins,including more receptors with high-mannosylation of signaling path-ways.Elucidating the deep relationship between PA-MSHA and mannosylation is of great significance for the mechanism research and clinical application of PA-MSHA.

Treatment patterns in hormone-sensitive metastatic prostate cancer: data from a referral hospital in Bogota, real-world evidence study / Patrones de tratamiento en cáncer de próstata metastásico hormonosensible: datos de un hospital de referencia de Bogotá, estudio de evidencia del mundo real

Objective: The objective of the study is to determine through a historical cohort, the characteristics, treatment patterns, and outcomes of a population with hormone-sensitive metastatic cancer at a referral center in Bogota. Method: This was a historical cohort observational study. All patients with metastatic hormone-sensitive prostate cancer from 2018 to May 2022 who received androgen deprivation therapy with or without treatment intensification were included through convenience sampling. The distribution of the epidemiological variables of interest, treatment of choice, and survival analysis was performed, as well as the distribution by years of the therapies of choice. Statistical significance was set at p < 0.05. Results: We included 125 hormone-sensitive metastatic prostate cancer (mHSPC) patients with a median age of 73.5 years (confidence interval: 71.48-75.31), a median PSA of 209 ng/mL, and 90% of patients with synchronous mHSPC. The distribution of high-volume mHSPC was 92% and M1b was 91%. The distribution of castration methods over time revealed that 21% of the patients underwent surgical castration and 79% received pharmacological castration. Since 2018, 40% of patients received androgen deprivation therapies (ADT) exclusively, 30% received treatment with taxanes, and 30% received androgen receptor axis-directed therapies. Trends in treatment distribution from 2018 to 2022 indicated a decline in exclusive ADT use from 41% in 2019 to 16% in 2022. 9% of the patients abandoned treatment. Conclusion: A description of the population of a national reference center for the treatment of hormone-sensitive prostate cancer with demographic characteristics according to global trends was provided

Objetivo: Caracterizar a la población y el tratamiento recibido de pacientes con cáncer metastásico hormonosensible (mHSPC) en un centro de referencia en Bogotá. Método: Cohorte histórica, observacional. Se incluyeron todos los pacientes con mHSPC que recibieron terapia de supresión androgénica, con o sin intensificación, desde el 2018 hasta mayo del 2022. Muestreo por conveniencia. Se describe la distribución de las variables epidemiológicas de interés, el tratamiento de elección, se realiza un análisis de supervivencia, así como de distribución por años de las terapias de elección. Se consideró significación estadística con un grado de significación (p) < 0,05. Resultados: Se incluyeron 125 pacientes con mHSPC, con una mediana de edad de 73,5 años (IC: 71,48-75,31), con una mediana de antigeno porstático específico (PSA) de 209 ng/mL, el 90% de los pacientes con mHSPC sincrónicos. La distribución de mHSPC de alto volumen fue del 92%, M1b 91%. La distribución global en el tiempo de castración quirúrgica fue del 21% y farmacológica del 79%. El 40% de los pacientes recibieron desde el 2018 terapia de deprivación de andrógenos (ADT) exclusiva, tratamiento con taxanos el 30% y terapias dirigidas al eje del receptor de andrógenos el 30% de los pacientes. Se describen las tendencias de distribución por años desde 2018 hasta 2022, pasando de ADT exclusiva en un 41% para el 2019 a un 16% para el 2022. El 9% de los pacientes abandonaron el tratamiento. Conclusión: Se realiza una descripción de la población de un centro de referencia nacional en el tratamiento de cáncer de próstata hormonosensible con características demográficas acorde a las tendencias globales

Internações por condições sensíveis à atenção primária à saúde: associação com a cobertura da atenção primária, 2015 ­ 2021 / Hospitalization for sensitive conditions in primary care: association with primary health care support, 2015-2021 / Hospitalizaciones por afecciones sensibles a la atención primaria: asociación con la cobertura de atención primaria, 2015 ­ 2021

Objetivo: Avaliar as tendências e associações relacionadas as coberturas e internações por condições sensíveis à atenção primária à saúde no município de Fortaleza/Ceará/Brasil, no período de 2015 a 2021. Métodos: Estudo transversal com dados secundários (Sistema de Informações Hospitalares do Sistema Único de Saúde, E- gestor atenção básica e o Instituto Brasileiro de Geografia e Estatística). Utilizou-se o coeficiente de correlação de Pearson para as associações. Resultados: Foram registrados 176.330 internações por condições sensíveis, totalizando 8 principais, correspondendo a 78.5% do total. Obteve-se correlação inversa significativa entre a cobertura de atenção primária e internações por condições sensíveis: r=-0.86, (IC95%: -0.91/-0.61); p<0.001, bem como uma correlação moderada com cobertura de agente comunitário e internações (r=-0.59 (IC95%: -0.68/-0.54); p<0.001) Conclusão: O aumento das internações por condições sensíveis está diretamente relacionado com a cobertura da atenção primária. Além disso, enfrenta-se uma dupla carga de doenças, coexistindo as doenças infecciosas/parasitárias em concomitância com as crônicas.

Objective: To assess trends and associations related to coverage and hospitalizations for conditions sensitive to primary health care in the city of Fortaleza/Ceará/Brazil, from 2015 to 2021. Methods: Cross-sectional study with secondary data (Hospital Information System of the National Unified Health System, E- manager for primary care and the Brazilian Institute of Geography and Statistics). Pearson's correlation coefficient was used to measure associations. Results: 176,330 hospitalizations for sensitive conditions were recorded, totaling 8 main ones, corresponding to 78.5% of the total. A significant inverse correlation was obtained between primary care coverage and hospitalizations for sensitive conditions: r=-0.86, (95%CI: -0.91/-0.61); p<0.001, as well as a moderate correlation with community agent coverage and hospitalizations (r=-0.59 (95%CI: -0.68/-0.54); p<0.001) Conclusion: The increase in hospitalizations for sensitive conditions is directly associated to the primary care coverage. In addition, there is a double burden of disease, with infectious/parasitic diseases coexisting with chronic ones.

Evaluar las tendencias y asociaciones relacionadas con la cobertura y hospitalizaciones por condiciones sensibles a la atención primaria de salud en la ciudad de Fortaleza/Ceará/Brasil de 2015 a 2021. Métodos: Estudio transversal con datos secundarios (Sistema de Informações Hospitalares do Sistema Único de Saúde, E-gestor atenção básica e Instituto Brasileiro de Geografia e Estatística). Se utilizó el coeficiente de correlación de Pearson para las asociaciones. Resultados: Hubo 176.330 hospitalizaciones por condiciones sensibles, totalizando 8 condiciones principales, correspondiendo a 78,5% del total. Se obtuvo una correlación inversa significativa entre la cobertura de atención primaria y las hospitalizaciones por afecciones sensibles: r=- 0,86, (IC 95%: -0,91/-0,61); p<0,001, así como una correlación moderada con la cobertura de agentes comunitarios y las hospitalizaciones (r=-0,59 (IC 95%: -0,68/-0,54); p<0,001) Conclusión: El aumento de las hospitalizaciones por afecciones sensibles está directamente relacionado con la cobertura de atención primaria. Además, se enfrenta a una doble carga de enfermedad, coexistiendo enfermedades infecciosas/parasitarias en concomitancia con enfermedades crónicas.

A prospective study on antibiotic resistance pattern in patients with urinary tract infection

Background: Antibiotics are a blessing to the mankind in the realm of medical treatment. Quite contrary to that fact, they may cause risks in medical treatments of patients if these antibiotics are not taken under medical guidelines. In the current scenario it is a huge challenge for selecting appropriate antibacterial agents for the treatment of UTI. This study aims to evaluate the prescription & resistance pattern of antibiotics in patients with urinary tract infection. Methods: A prospective observational study was carried out for a period of 1 year. Data on 100 research participants' reports and the results of their tests for antibiotic resistance were taken from the microbiology department's records, evaluated, and represented as percentages. Observations were made and meticulously recorded. Results: Out of 100 study participants, Escherichia coli was the most common pathogen with a total of (35%) followed by Klebsiella (17%), Enterococcus with (16%). E. coli were highly resistant to Ampicillin (88.6%) and Cefazolin (88.6%), Ceftraixone (85.3%). Klebsiella were highly resistant to Ampicillin (100%) Cefazolin (93.3%), Cefuroxime (85.7%). Enterococcus were highly resistant to Tetracycline (92.9%) Ciprofloxacin (85.7%), Levofloxacin (81.8%). Where, E. coli were highly sensitive to Amikacin, Imipenem, Ertapenam. Klebsiella were highly sensitive to Meropenem, Cefoperazone/Sulbactam, Amikacin. Enterococcus was highly sensitive to Linezolid, Teicoplanin, Vancomycin. Conclusions: Most of the identified bacteria were resistant to several of the popular antibiotics used in clinical settings. Consequently, it is vital to prescribe antibiotics rationally both before and after culture reports.

Nutrition Sensitive Agriculture Practices in Rural Communities of Nalgonda District, India

Nutrition-Sensitive Agriculture (NSA) is important for rural communities as it promotes the production of diverse, nutrient-rich crops and helps to improve food security, reduce malnutrition, and promote better health outcomes. It also helps to increase the incomes of smallholder farmers and enhance their resilience to climate change and other external shocks.The study indicated that the majority of respondents are between the ages of 20 to 40 (59.50%), have a low level of education (51.70% are illiterate), come from joint families (56.10%), and have an annual income between Rs.50,000-1,50,000 (72.78%).The study provides information on the nutrition and agricultural practices of the respondents. It shows that a high proportion of respondents practice kitchen/nutrition gardening (85.56%) and grow vegetables in their garden (85.56%). Leafy vegetables (51.67%) and fruits (57.22%) are the most commonly grown crops. However, practices such as integrated farming systems (4.44%), the Nutri thali concept (0.00%), and organic farming (7.22%) are not widely adopted.The aim of the study was to know the nutrition sensitive agriculture practices followed by small and marginal women in Nalgonda district of Telangana state. In this study a total number of 180 respondents were selected for the study.This study was an attempt to as there is a need to put attention on the educational aspects by stimulating the small and marginal women farmers and the families of rural communities by adopting farming practices that promote the production and consumption of diverse and nutrient-rich crops, rural farmers can also improve their own nutrition as well as that of their communities.

Protección de datos de salud: el reto de la armonización legislativa en América Latina / Health data protection: the challenge of legislative harmonization in Latin America

RESUMEN La protección de datos personales en los sistemas de salud requiere de medidas y procedimientos especiales para asegurar que la privacidad de la información no sea vulnerada. Los avances en la tecnología digital y el acceso a la transmisión en tiempo real de datos personales, familiares, clínicos y de laboratorio de los pacientes y/o sujetos de estudio, puede comprometer la protección de esta información. La privacidad de los datos personales en salud en tiempos de pandemia ha significado un reto mayor, es por ello que se presenta esta contribución especial que tiene por objetivo, identificar los resguardos éticos y normativos en materia de protección de datos, para garantizar el pleno respeto de los derechos de privacidad de las personas y la confidencialidad de sus datos, bajo el contexto de la atención en salud, sobre todo en condiciones de crisis sanitaria; como la vivida durante la pandemia de SARS-CoV-2. Se propone además una armonización legislativa en América Latina, sobre la privacidad y la protección de datos personales.

ABSTRACT The protection of personal data in health systems requires special measures and procedures to ensure that the privacy of the information is not violated. Advances in digital technology and access to real-time transmission of personal, family, clinical, and laboratory data of patients and/or study subjects may compromise the protection of this information. The privacy of personal data in health in times of pandemic has meant a greater challenge, that is why this unique contribution is presented, whose objective is to identify the ethical and regulatory safeguards in terms of data protection to guarantee full respect for the privacy rights of people and the confidentiality of their data, under the context of health care, especially in conditions of health crisis, such as the one experienced during the SARS-CoV-2 pandemic. It also proposes a legislative harmonization in Latin America, on privacy and protection of personal data.

Lemierre's syndrome: an evolving disease

Lemierre’s syndrome is characterized by thrombophlebitis of the internal jugular vein with resulting systemic septic emboli. Most cases occur following an oropharyngeal infection and have been historically caused by the bacterial pathogen Fusobacterium necrophorum. However, infection from other pathogens is becoming more common in recent years. Our case is special in the sense that Lemierre’s syndrome was caused by staphylococcus aureus after influenza infection. A 23-month-old male presented with complaints of left neck swelling and recurrent fever for one week, following influenza A infection. The child was ill-appearing with fever, tachycardia, tachypnea, and erythematous swelling on the left cheek. Laboratory results revealed elevated inflammatory markers. Computed tomography (CT) scan of the neck showed loculated fluid collection suggesting an intra parotid abscess with poor visualization of the internal jugular vein (IJV). Blood cultures were positive for methicillin-sensitive Staphylococcus aureus. Due to high clinical suspicion of Lemierre’s syndrome, a doppler ultrasound was obtained which showed a left IJV thrombus. CT scan of the chest after the clinical suspicion showed multiple bilateral pulmonary nodules suggesting septic emboli. He was treated with antibiotics and a six-week course of the anticoagulant with a resolution of his thrombus. Though historically, Lemierre’s disease is caused by Fusobacterium necrophorum, other causative organisms such as methicillin-sensitive Staphylococcus aureus are increasingly being recognized. Lemierre’s disease can present as a complication of influenza. A high index of clinical suspicion based on the location of the abscess helped us delineate diagnostic tests and treatment.