Risk Factors Analysis and Pathogen Distribution of Urinary Tract Infection in Patients Undergoing Cutaneous Ureterostomy After Radical Cystectomy for Bladder Cancer.

BACKGROUND: Postoperative urinary tract infection is a common complication that not only significantly prolongs the hospital stay and amplifies the economic burden on patients, but also affects their quality of life and prognosis. This study aimed to investigate risk factors and distribution of pathogenic bacteria in urinary tract infections among bladder cancer patients who underwent cutaneous ureterostomy following radical cystectomy. METHODS: A total of 137 bladder cancer patients, who underwent cutaneous ureterostomy after radical cystectomy at our hospital from November 2018 to October 2022, were enrolled in this retrospective study. Univariate and multivariate logistic regression analyses were employed to investigate the risk factors associated with postoperative urinary tract infection and the distribution of pathogenic bacteria among the infected patients. RESULTS: The results of both univariate and multivariate analyses confirmed that age, proficiency in ostomy knowledge, frequency of ureteral stent tube replacement, ureteral stent tube dislodgement, urine immersion at the outer end of the ureteral stent tube, and the interval of ostomy bag replacement were independent risk factors for urinary tract infection after radical cystectomy and cutaneous ureterostomy in bladder cancer patients. A total of 55 pathogenic bacteria were isolated from 52 patients with infections. Predominantly, these were gram-negative bacteria (34 strains, 61.8%), with Proteus mirabilis having the highest proportion. CONCLUSION: Urinary tract infections after radical cystectomy and cutaneous ureterostomy predominantly involve gram-negative bacteria. This is correlated with factors such as the age of bladder cancer patients, the level of nursing education, the duration of ureteral stent tubes and ostomy bag usage, as well as issues related to impaired urine drainage.

Music-based interventions for pain relief in patients undergoing hemodialysis: A PRISMA-compliant systematic review and meta-analysis.

BACKGROUND: Music therapy and music-based interventions have been used widely in numerous medical procedures to reduce the physical and psychological disorders. However, the effect of music therapy on pain relief in hemodialysis patients still remains unclear. METHODS: Electronic databases were comprehensively searched through MEDLINE, Web of Science, EMBASE, Cochrane, and WANFANG. All studies met inclusion criteria were eligible for systematic review and meta-analysis. Clinical variables were extracted and pooled results were obtained using STATA software. RESULTS: A total of 10 studies with 722 participants were included for systematic review. Overall, music therapy showed a significantly favorable effect on reducing pain for patients undergoing hemodialysis (SMD: -0.90, 95%CIs: -1.25 to -0.55, P < .001). No publication bias was observed. CONCLUSIONS: Music-based interventions could significantly relieve pain for patients undergoing hemodialysis, which should be promoted as an effective and safe complementary method.

Clinical efficacy of enhanced recovery after surgery (ERAS) program in patients undergoing radical prostatectomy: a systematic review and meta-analysis.

BACKGROUND: Enhanced recovery after surgery (ERAS) protocol has been identified to be beneficial in the amount of operations such as gastrointestinal surgery. However, the efficacy and safety in robot-assisted laparoscopic prostatectomy/laparoscopic radical prostatectomy (RALP/LRP) still remain controversial. METHOD: We searched randomized controlled trials and retrospective cohort studies comparing ERAS versus conventional care for prostate cancer patients who have undergone RALP/LRP. ERAS-related data were extracted, and quality of included studies was assessed using the Newcastle-Ottawa quality assessment scale and the Jadad scale. RESULT: As a result, seven trials containing 784 prostate cancer patients were included. ERAS was observed to be significantly associated with shorter length of hospital stay (SMD - 2.55, 95%CI - 3.32 to - 1.78, P < 0.05), shorter time to flatus (SMD - 1.55, 95%CI - 2.26 to - 0.84, P < 0.05), shorter time to ambulate (SMD - 6.50, 95%CI - 10.91 to - 2.09, P < 0.05), shorter time to defecate (SMD - 2.80, 95%CI - 4.56 to - 1.04, P < 0.05), and shorter time to remove drainage tube (SMD - 2.72, 95%CI - 5.31 to - 0.12, P < 0.05). Otherwise, no significant difference was reported in other measurements. CONCLUSIONS: In conclusion, ERAS can reduce length of hospital stay, time to flatus, time to defecate, time to ambulate, and time to remove drainage tube in prostate cancer patients who have undergone RALP/LRP compared with conventional care.

Clinical evidence for acupressure with the improvement of sleep disorders in hemodialysis patients: A systematic review and meta-analysis.

OBJECTIVE: To explore the efficacy of acupressure on the improvement of sleep disorders in patients undergoing hemodialysis. METHODS: A systematic review and meta-analysis was performed. Pubmed, Embase, the Cochrane database, and Chinese database were searched and sleep quality variables were extracted from eligible articles. The quality of original articles was assessed by the Modified Jadad Scale. Standard mean difference (SMD) and 95% confidential interval (CI) were pooled. RESULTS: Nine studies were included in the systematic review, and seven randomized controlled trials (RCTs) were eligible for meta-analysis. The pooled results showed significant improvement of quality of sleep using the acupressure massage (SMD = -0.81, 95%CI: -1.26, -0.36, P < 0.0001, I2 = 78.6%). No severe adverse event was reported during the acupressure intervention. CONCLUSIONS: The results provide further evidence favoring the efficacy and safety of acupressure on the improvement of quality of sleep in hemodialysis patients.