Development and validation of the scale for symptom clusters in patients with myasthenia gravis.

BACKGROUND: Patients with myasthenia gravis(MG)often experience multiple symptoms concurrently, which can have an adverse effect on their quality of life(QOL). However, a specific, systemic and reliable scale for symptom clusters in MG is lacking. AIMS: To develop reliable assessment scale for symptom clusters in patients with MG. DESIGN: A cross-sectional descriptive study. METHODS: Based on the unpleasant symptom theory(TOUS), the first draft of the scale was developed through review literature, qualitative interview, and Delphi expert correspondence, the items of the scale were presented and adjusted through cognitive interviews with 12 patients. To conveniently assess the validity and reliability of the scale, a cross-sectional survey was conducted in 283 patients with MG who were recruited from Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, from June to September 2021. RESULTS: The final symptom cluster scale for patients with MG consisted of 19 items(MGSC-19), with a content validity index ranging from 0.828 to 1.000 for each item and the content validity index was 0.980. Four common variables (ocular muscle weakness, general muscular weakness, treatment-related side effects, and psychiatric problems) were identified by exploratory factor analysis, which explained 70.187% of the total variance. The correlation coefficients between the scale dimension and the overall score ranged from 0.395 to 0.769 (all P < 0.01), while the correlation coefficients between dimensions varied from 0.324 to 0.510 (all P < 0.01). The Cronbach's alpha, retest reliability, and half reliability were 0.932, 0.845, and 0.837, respectively. CONCLUSION: The validity and reliability of MGSC-19 were generally good. This scale can be employed to identify the symptom clusters to help healthcare givers develop individualized symptom management measures for patients with MG.

How to rapidly convert general wards to ICUs during the COVID-19 epidemic: Experience from Wuhan, China.

BACKGROUND: Critically ill patients with coronavirus disease 2019 (COVID-19) were surging and far outnumbered existing beds. AIMS: To describe how to rapidly convert general wards to intensive care units for critically ill patients with COVID-19. MATERIALS AND METHODS: Comprehensive assessment and analysis of available resources and standard requirements. RESULTS: The ICUs were successfully assembled in 4 days. The conversion included environment reconstruction, configuration and management of equipment, information system construction and human resource allocation. A total of 172 critically ill patients had been admitted to the contemporary ICUs and none medical staff was infected. DISCUSSION: The epidemic situation of COVID-19 poses a great challenge to various management departments of the hospital, especially for critically ill patients with a high mortality rate. To save more critically ill patients, the conversion of a general ward to a quarantine ICU ward must be completed in a short time, and the optimal allocation of resources must be appropriate to ensure that the medical team works effectively and is of high quality. In face of the overloaded medical system, the ideal non-negative pressure ward is hard to achieve. However, we have demonstrated with evidence that our conversions are effective in both providing care to critical patients and protecting the safety of our staff. CONCLUSION: The conversion is successful and the running experience would be a reference for hospitals in other areas nationally or globally.

Analysis of the prophylactic effect of thymosin drugs on COVID-19 for 435 medical staff: A hospital-based retrospective study.

To explore the role of thymosin drugs in the prevention of novel coronavirus disease (COVID-19), we analyzed the preventive effects of different medication timings on health medical staff, and then provided recommendations for pharmaceutical monitoring of thymus drugs. The hospital-based retrospective study analyzed 435 medical staffers, treated with or without thymosin drugs as preventive medicines in our hospital of Wuhan City, from January 25 to March 25, 2020. For the prophylactics, the medical staff was prevented from pre-exposure prophylaxis (risk prevention of exposure to COVID-19 patients before using thymosin drugs) and postexposure prophylaxis (risk prevention of exposure to COVID-19 patients after using thymosin drugs). The effectiveness and safety of thymosin drugs were studied in the prevention and control of COVID-19 application, in real-world data research for the application of the drug for COVID- 19. In a similar exposure environment, compared to medical staffers who did not take preventive medicine, the use of thymosin drugs, before exposure and after exposure had an insignificant effect, and the adverse drug reaction (ADR) was increased, especially when thymosin drugs were used together with α-interferon.

Application of Improved LANDMARC Indoor Positioning Algorithm in Neurology Medical Care Monitoring and Positioning System.

The paper proposes an improved LANDMARC positioning algorithm to improve the location accuracy of environmental obstacles for medicine care monitoring in neurology. The paper proposes a log path loss correction model and uses the model to compensate the positioning signal to improve the positioning accuracy of the algorithm caused by the attenuation of the indoor positioning signal by the wall. The experimental results show that the LANDMARC positioning algorithm based on the log path loss correction model can improve the positioning accuracy of medical monitoring in neurology.

Nursing Intervention for Outpatient Rehabilitation in Pediatric Patients with Hirschsprung Disease after Colectomy.

OBJECTIVE: The present study was designed to evaluate the effectiveness of a nursing intervention program for outpatient rehabilitation of children with Hirschsprung-associated enterocolitis (HAEC) after radical colectomy for Hirschsprung disease (HD). BACKGROUND: Postoperative outcomes severely affect the quality of life in pediatric HD patients after operation. The improvement in defecation function is regarded as one of the most useful parameters to evaluate the quality of life in HD patients after radical intestinal resection. A close attention should also be paid to the patients' ability of social adaptation. METHODS: This prospective, randomized control trial enrolled 85 pediatric patients with HAEC after colectomy. They were randomly divided into the control and intervention groups. All the patients were followed up for 6 to 12 months after initial HAEC treatment. RESULTS: The intervention group had a lower enterocolitis recurrence rate than the control group, with a better ability to control defecation and their parents had better rehabilitation nursing knowledge (p < 0.05). The degree of parents' satisfaction regarding the outcome was significantly better in the intervention group than that in the control group (p < 0.05). CONCLUSION: A systemic rehabilitation nursing program could decrease enterocolitis recurrence, improve the recovery of anorectal functions, and enhance the quality of life in the pediatric patients after radical colectomy.

Quality of life evaluation in juveniles with disorders of sexual development.

PURPOSE: To evaluate the quality of life of 6-11-year-old children and 12-17-year-old adolescents with disorders of sexual development (DSDs) following reparative surgery. METHODS: Fifty pediatric patients with DSDs, including 32 cases of congenital adrenal hyperplasia, 2 cases of complete androgen insensitivity syndrome, 1 case of partial androgen insensitivity syndrome, 6 cases of complete testicular dysgenesis, 7 cases of partial testicular dysgenesis, and 2 cases of ovotesticular DSD, with complete follow-up data, were recruited. Healthy control subjects (matched for age, gender, and living environment) served as controls. Physical, socio-emotional, and psychological evaluations were performed. RESULT: Among 50 patients, eight boys and two girls (designated by social gender) were unsatisfied with the morphology of their external genitalia. Social limitations were observed in 4/8 (50 %) of the boys and in 12/42 (28.6 %) of the girls. Psychological problems were significantly more prevalent in the DSD group than in the control group (p < 0.05). CONCLUSIONS: The quality of life of pediatric patients with DSDs was impaired to varying degrees following reparative surgery.