ABSTRACT
Leptospirosis is a zoonosis that is related to potential respiratory, renal, neurological, and cardiovascular failure. At present, antibiotics are the recommended treatment, but due to the underlying cause of the disease, they may induce the Jarisch-Herxheimer reaction (JHR) within 24 hours. At the same time, we speculate that JHR may aggravate the natural course of leptospirosis. Considering that there are few available reports on this event, we will share a case of pulmonary hemorrhagic leptospirosis, where antibiotic treatment is suspected to have triggered the JHR. This report is expected to improve clinical attention to the relationship between leptospirosis and JHR.
ABSTRACT
Objective: The purpose of this study was to clarify the concept of transitional care in patients with heart failure. Background: Transitional care is increasingly being applied in patients with heart failure, but the concept of transitional care in heart failure patients is not uniform and confused with other definitions, which limits further research and practice on transitional care for these patients. Design: Rodgers' evolutionary concept analysis. Methods: A comprehensive literature search was conducted using the PUBMED, EMBASE, EBSCO, Chinese Biological Medicine (CBM), CNKI, and WANFANG databases (up to January 26, 2023). We used Rodgers' evolutionary concept analysis method to identify related concepts, attributes, antecedents, and consequences of transitional care in patients with heart failure. Results: A total of 33 articles were included. The following attributes belonging to transitional care in patients with heart failure were extracted from the literature: self-care, multidisciplinary collaboration, and information transmission. The antecedents were patients' health status, the health literacy of patients and caregivers, the role functions of the main implementer and social and medical resources. Consequences were separated into two categories: patient-centered health outcomes (all-cause mortality, health-related quality of life, discharge preparedness, self-care behaviors, satisfaction of patients) and healthcare utilization outcomes (hospital readmission, length of hospital stay, emergency department visits). Conclusion: This study found that transitional care in heart failure patients is a systemic care process during a vulnerable period that improves patient self-management and coordination between hospital resources and social support systems for continuous management to promote smooth patient transitions between different locations. This concept analysis will inform healthcare providers in designing evidence-based interventions and quality improvement strategies to ensure that transition processes lead to desired outcomes. In addition, this study will also be helpful for developing specific assessment tools to identify patients with HF who need transitional care.
ABSTRACT
Objective: To develop an effective treatment strategy to simultaneously avoid fatal adverse effects in the treatment of oral cancer, combination therapy has been explored because of its multiple functions. This work aims to develop a novel type of gold-nanorod-based nanomaterials decorated with tetrahedral DNA nanostructures (TDN) carrying antitumor drugs, namely, GNR@TDN-DOX nanocomposites. Methods: In the designed structure, TDN, with a three-dimensional geometry composed of DNA strands, can provide GC base pairs for binding with the anticancer drug doxorubicin (DOX). The photothermal heating properties, biocompatibility properties, and antitumor performance of obtained GNR@TDN-DOX nanocomposites were investigated to assess their application potential in tumor treatment. Results: Systematic studies have shown that the obtained GNR@TDN-DOX nanocomposites have high photothermal conversion under the illumination of an 808-nm infrared laser, leading to effective antitumor applications. In addition, the cell viability study shows that GNR@TDN-DOX nanocomposites have good biocompatibility. In vitro studies based on A375 cells show that the GNR@TDN-DOX nanocomposites can effectively eliminate cancer cells because of the combination of photothermal therapy induced by GNRS and chemotherapy induced by TDN-carrying DOX. The result shows that the obtained GNR@TDN-DOX nanocomposites have efficient cellular uptake and lysosome escape ability, together with their nuclear uptake behavior, which results in a significant antitumor effect. Conclusion: This work has demonstrated a potential nanoplatform for anticancer applications.
