Application of fecal collection device in Intensive Care Unit Patients with fecal incontinence Receiving Extracorporeal Membrane Oxygenation: A Comparison Cohort Study.

Objective: The objective of this study was to assess the effectiveness of fecal collection devices in preventing incontinence-associated dermatitis (IAD) and reducing skin care time in ICU patients with fecal incontinence undergoing Extracorporeal Membrane Oxygenation (ECMO). Methods: A nonrandomized comparison cohort (quasi-experimental) study with pre-post comparison was carried out in a general intensive care unit. 85 bedridden patients receiving ECMO with fecal incontinence (FI) in a general intensive care unit between June 2017 and May 2022 participated in the study and separated into two groups according to the fecal collection device they received. 40 were assigned to the Control group (structured IAD preventive care protocol alone) and 45 to the Intervention group (structured IAD preventive care protocol plus application of fecal collection device). The status of IAD was assessed using the Incontinence Associated Dermatitis Intervention Tool (IAD-IT). Fecal consistency was evaluated via the Bristol Stool Scale. Outcome measures included the nursing time for skin care and the incidence of IAD, and bleeding complications between the two groups during the period. Results: Participants in the Intervention group had fewer IAD occurrences than participants in the Control group (13.33% vs. 52.50%, P < .05). The patients in the Intervention group significantly reduced skincare time (63.30±14.09 min in the Control group versus 28.44±2.04 min in the Intervention group, P < .01). There was 3 turning complications for bleeding in the Intervention group and 11 in the Control group and had a significant reduction in urning complications(3 vs.11, P = .022). Conclusions: Applying a fecal collection device may reduce skincare time and reduce occurrences of IAD and bleeding related to turning position for skin care in ICU patients with FI associated with diarrhea receiving ECMO Support.This study offers a more efficient way to use the fecal collection device in ECMO patients.Future research needs to focus on the perianal skin in ECMO patients regarding fecal collection devices connected to continuous low-negative-pressure suction devices.

Quality indicators of colonoscopy care: a qualitative study from the perspectives of colonoscopy participants and nurses.

BACKGROUND: Quality of care in colonoscopy is closely related to colonoscopy participants and the nursing workforce in endoscopy-related settings. However, limited data are available on the evaluations and recommendations regarding quality indicators for nursing care by these two groups. Therefore, the aim of this study was to explore the standards and requirements of quality of care in colonoscopy from the perspectives of patients and nurses. METHOD: With a descriptive qualitative study, semi-structured interviews were conducted between November 2021 and January 2022 with colonoscopy participants (P = 11) and nursing workforce (N = 7) in the endoscopy unit in a tertiary hospital. The interviews were analyzed using a thematic analysis. RESULTS: Nine major themes emerged according to the structure, process, and outcome care quality model: workforce structure, quality requirements, unit facilities, nursing tools, nursing quality control systems, dynamic assessment and intervention, pre-examination care, strengthening education, and colonoscopy outcomes. CONCLUSION: The indicator of quality of colonoscopy care should be used to assess and improve current practices to ensure a more direct and sustained impact of colonoscopy care. This study highlights the importance of nurse managers valuing the opinions and reflections of people involved in colonoscopy to improve the quality of colonoscopy care.

Trends Analysis of Non-Hodgkin Lymphoma at the National, Regional, and Global Level, 1990-2019: Results From the Global Burden of Disease Study 2019.

Background: Non-Hodgkin lymphoma is a common hematologic malignancy. This article aimed to estimate the trends of non-Hodgkin lymphoma (NHL) globally from 1990 to 2019. Methods: Data on the NHL burden were explored from the Global Burden of Disease study 2019. The trends of NHL burden were estimated using age-standardized rate (ASR) and estimated annual percentage change (EAPC). Results: The ASR of NHL incidence showed an increasing trend worldwide from 1990 to 2019, with an EAPC of.56 [95% CI: 0.45-0.66]. Meanwhile, increasing trends were observed in both sexes and in most geographic regions, particularly East Asia (EAPC = 3.57, 95% CI: 3.29-3.86). The most pronounced increasing trends were seen in Georgia (EAPC = 4.7, 95% CI: 4.20-5.21), followed by Belarus and Uzbekistan. However, death and disability-adjusted life years (DALYs) caused by NHL showed decreasing trends globally, in which the respective EAPCs were -0.09 (95% CI: -0.17 to -0.02) and -0.28 (95% CI: -0.35 to -0.22). Decreasing trends were mainly seen in high and high-middle sociodemographic index (SDI) areas. At the national level, the largest increasing trends of death and DALYs were observed in Georgia, in which the respective EAPCs were 4.54 (95% CI: 4.01-5.07) and 4.97 (95% CI: 4.42-5.52). Conclusions: Decreasing trends of death and DALYs caused by NHL were observed worldwide from 1990 to 2019, but NHL remains a substantial challenge globally. The findings would inform the strategies for reducing the burden of NHL.

Trends of cervical cancer at global, regional, and national level: data from the Global Burden of Disease study 2019.

BACKGROUND: Cervical cancer is an important global health problem. In this study we aimed to analyze trends in cervical cancer at the global, regional, and national levels from 1990 to 2019, to inform health service decision-making. METHODS: Data on cervical cancer was extracted from the Global Burden of Disease study, 2019. Trends in cervical cancer burden were assessed based on estimated annual percentage change (EAPC) and age-standardized rate (ASR). RESULTS: Globally, decreasing trends were observed in incidence, death, and disability adjusted life years (DALYs) of cervical cancer from 1990 to 2019, with respective EAPCs of - 0.38 (95% confidence interval [CI]: - 0.41 to - 0.34), - 0.93 (95%CI: - 0.98 to - 0.88), and - 0.95 (95 CI%: - 1.00 to - 0.90). Meanwhile, decreasing trends were detected in most sociodemographic index (SDI) areas and geographic regions, particularly death and DALYs in Central Latin America, with respective EAPCs of - 2.61 (95% CI: - 2.76 to - 2.46) and - 2.48 (95% CI: - 2.63 to - 2.32); hhowever, a pronounced increasing trend in incidence occurred in East Asia (EAPC = 1.33; 95% CI: 1.12 to 1.55). At the national level, decreasing trends in cervical cancer were observed in most countries/territories, particularly DALYs in the Maldives (EAPC = - 5.06; 95% CI: - 5.40 to - 4.72), Whereas increasing trends were detected in Lesotho, Zimbabwe, and Bulgaria. CONCLUSIONS: Slowly decreasing trends in cervical cancer were detected worldwide from 1990 to 2019. Cervical cancer remains a substantial health problem for women globally, requiring more effective prevention and control strategies.

Impact of some social and clinical factors on the development of postpartum depression in Chinese women.

BACKGROUND: Postpartum depression (PPD) is prevalent and may present major adverse impacts on mother and child health. According to previous studies, mostly from the western society, PPD may have complicated etiologies, such as genetic, social and psychological factors. The aim of this study was to explore the associations of some social and clinical factors, particularly those unique in Chinese, with significant PPD symptoms. METHODS: A sample of 556 pregnant women in their 36th to 40th gestational week were randomly recruited in a cross-sectional study using a self-reported questionnaire, which collected maternal sociodemographic and clinical information. During their 2nd to 4th postpartum months, 522 participants responded to our screening of significant PPD symptoms, based on a score of Edinburgh Postnatal Depression Scale ≥9. RESULTS: A total of 90 (17.3%) participants were identified with significant PPD symptoms, and the following factors were observed more frequently in women with significant PPD symptoms (PPD+) than with fewer symptoms (PPD-): intensive involvement of parents-in-law in a participant's life (living together with her, taking care of her, or discriminating against a female baby), lack of support from husband, cesarean delivery, and breast milk insufficiency (supplemented with formula). After multiple logistic regression analysis, parents-in-law's preference to baby boy while devaluing baby girl, dissatisfaction with husband's support, cesarean delivery, and mixed feeding were strongly associated with significant PPD symptoms. CONCLUSION: The potential risk factors for significant PPD symptoms, i.e., "son preference" custom, cesarean delivery and mixed feeding, deserve confirmation in continued, especially clinical diagnosis-based longitudinal studies.

Clinical study of the use of gastroscopy as oral choledochoscopy.

Clinical value and safety of the use of gastroscopy as oral choledochoscopy in the treatment of biliary diseases was explored. Clinical data of 55 patients with biliary diseases who underwent gastroscopy were retrospectively analyzed. The types of gastroscopy, size of duodenal papilla incision, balloon dilatation, the success rate of gastroscopy entry, depth of gastroscopy entering into bile duct, endoscopic diagnosis and postoperative complications were recorded. Simple insertion-by-hand was performed, and insertion into common bile duct was successfully achieved in 53 cases, and the overall technical success rate was 96.4%. Residual bile duct stones in 25 patients (45.5%) after endoscopic retrograde cholangio-pancreatography (ERCP) were removed through endoscopy. Nine cases of benign stenosis and 2 cases of malignant stenosis were confirmed as 'cholangiocarcinoma' or 'duodenal papilla well-differentiated adenocarcinoma' by biopsy. Balloon oppression under intraoperative endoscopy was performed for 2 cases (3.6%) with biliary hemorrhage, and argon ion coagulation was successfully performed. No obvious abnormalities were found in 13 cases (23.6%) through gastroscopic biliary exploration. Complications occurred in 15 patients with a complication rate of 27.3%, including 2 cases of cholecystitis (3.6%), 8 cases of amyloidosis (14.6%) and 4 cases of acute pancreatitis (7.3%), and all those complications were cured. One case (1.8%) had perforation of biliary tract and was discharged after conservative treatment. The use of gastroscopy as oral choledochoscopy is safe as effective. However, this technique causes some rare and serious complications. Therefore, further studies are needed to improve this technique.