BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehe...BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehensively assess the efficacy of indomethacin therapy in reducing PEP risk.METHODS We searched PubMed,EMBASE,Scopus,and Cochrane Library databases to identify randomized controlled trials(RCTs)that compared rectal indomethacin with a control group to prevent PEP.Duplicates were removed,and studies were included based on the established inclusion criteria.We used the Cochrane Collaboration’s tool to assess the risk of bias in the RCTs.A random-effects model was applied to produce pooled risk ratios(RRs)with 95%confidence intervals(CIs).RESULTS We included a total of 30 RCTs involving 16977 patients.Compared to the control group,rectal indomethacin showed comparable rates of overall PEP(PEP;RR=0.85,95%CI:0.69-1.04,I2=79%)with no statistically significant difference of RR in mild(RR=0.92,95%CI:0.74-1.14),moderate(RR=0.78,95%CI:0.59-1.02),or severe PEP(RR=1.12,95%CI:0.75-1.67).There was also no difference in cases of adverse events(RR=0.97,95%CI:0.69-1.35),abdominal pain(RR=1.14,95%CI:0.80-1.62),bleeding(RR=1.07,95%CI:0.70-1.63),or mortality(RR=0.86,95%CI:0.56-1.33)between the two groups.Subgroup analyses were also performed.CONCLUSION Rectal indomethacin appears to be safe and may offer benefit in selected high-risk patients,though findings should be interpreted with caution due to high heterogeneity.展开更多
AIM:To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers.It also investigates the effects of supple...AIM:To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers.It also investigates the effects of supplements dosage,intervention duration,and geographical variation on intervention results.METHODS:A systematic search and screening of randomized controlled trials(RCTs)completed between 2014 and 2023 was undertaken using the PubMed,EMBASE,Cochrane Library,and Web of Science databases,in accordance with the PRISMA recommendations.The Cochrane risk of bias method was used to assess the quality of the studies.A Meta-analysis was performed using Stata 17.0 to calculate standardized mean differences(SMDs)and 95%confidence intervals(CIs).Subgroup analyses were performed to look at the effects of different doses,intervention periods,and geographic areas.Additionally,publication bias was assessed using Egger’s test.RESULTS:Ten studies including 1035 participants with myopia were analyzed.Supplementation with lutein and zeaxanthin resulted in a significant reduction in axial length elongation among adolescents in the intervention group(SMD=-0.40,P=0.001),an increase in macular pigment optical density(SMD=0.50,P=0.010),and an enhancement in visual sensitivity(SMD=0.53,P=0.008).Subgroup analyses revealed that participants receiving high doses and those undergoing intervention for more than 12mo exhibited significantly improved outcomes compared to those in the low-dose and short-term groups(high-dose vs low-dose:SMD=-0.41 vs-0.22,P=0.003;>12mo vs 6-12mo:SMD=-0.43 vs-0.23,P=0.004,respectively).Furthermore,Egger’s test indicated no significant publication bias(P=0.094).CONCLUSION:Combined lutein and zeaxanthin supplementation has a significant effect on myopia prevention in adolescents,with more pronounced benefits observed in high-dose and long-term interventions.The findings provide scientific evidence for its use as an adjunctive approach in myopia control.展开更多
The problem of gastric cancer(GC)prevention remains relevant for a long time.Various methods of population serological screening of atrophic gastritis and precancerous changes in the gastric mucosa have been created a...The problem of gastric cancer(GC)prevention remains relevant for a long time.Various methods of population serological screening of atrophic gastritis and precancerous changes in the gastric mucosa have been created at present.Modern endoscopic and morphological methods of verification of the diagnosis of precancerous diseases and changes in the gastric mucosa have been introduced into the practice of gastroenterologists and oncologists.GC risk stratification systems allow the formation of risk groups that require population screening.Practical hints for population serological screening of atrophic gastritis,endoscopic and morphological verification of precancerous changes and diseases of the stomach recommend using it:When developing state programs for the prevention of stomach cancer;when implementing preventive measures for stomach cancer by doctors of all specialties;the authors also offer the possibility of use by anyone over the age of 40,provided that they seek methodological help from their doctor;in the work of health schools in any medical and preventive institutions.The use of an assessment system of certain risk factor signatures with prognostic value would add significant assistance to preventive measures against GC.展开更多
Objective Alzheimer’s disease(AD)presents a significant global health challenge with a steadily increasing prevalence and impact.This comprehensive review aimed to delve into the epidemiology,pathophysiology,pharmaco...Objective Alzheimer’s disease(AD)presents a significant global health challenge with a steadily increasing prevalence and impact.This comprehensive review aimed to delve into the epidemiology,pathophysiology,pharmacological therapies,emerging research,challenges,and future directions of AD.Major findings from recent studies were synthesised,encompassing insights into the global prevalence,molecular pathology,high-risk factors,and therapeutic interventions,including cholinesterase inhibitors,glutamate receptor antagonists,and antibodies against Aβand tau proteins.Additionally,emerging research areas such as gene therapy and lipid nanoparticles were highlighted.This review emphasised the urgent need for ongoing research on novel therapeutic avenues and addressing the challenges in AD diagnosis,treatment,and care.Future perspectives underscore the potential of disease-modifying treatments,personalised medical approaches,and holistic interventions to alleviate the growing burden of AD on individuals,families,and healthcare systems worldwide.By fostering collaboration and innovation,we can strive towards a future where effective prevention,early detection,and personalised treatments enhance the lives of millions affected by AD globally.展开更多
Enamel demineralization,the formation of white spot lesions,is a common issue in clinical orthodontic treatment.The appearance of white spot lesions not only affects the texture and health of dental hard tissues but a...Enamel demineralization,the formation of white spot lesions,is a common issue in clinical orthodontic treatment.The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment.The prevention,diagnosis,and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties.This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment,advocating for proactive prevention,early detection,timely treatment,scientific follow-up,and multidisciplinary management of white spot lesions throughout the orthodontic process,thereby maintaining the dental health of patients during orthodontic treatment.展开更多
Colorectal cancer(CRC)is the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide.The leading risk factors for CRC include male gender,age over 50,family history,obesity,tobacco ...Colorectal cancer(CRC)is the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide.The leading risk factors for CRC include male gender,age over 50,family history,obesity,tobacco smoking,alco-hol consumption,and unhealthy diet.CRC screening methods vary considerably between countries and depend on incidence,economic resources and healthcare structure.Important aspects of screening include adherence,which can vary signi-ficantly across ethnic and socioeconomic groups.Basic concepts of CRC screening include pre-stratification of patients by identifying risk factors and then using fecal immunochemical test or guaiac-based fecal occult blood test and/or colono-scopy or radiologic imaging techniques.Technological capabilities for CRC scree-ning are rapidly evolving and include stool DNA test,liquid biopsy,virtual colo-nography,and the use of artificial intelligence.A CRC prevention strategy should be comprehensive and include active patient education along with targeted imple-mentation of screening.展开更多
Aiming at reducing the dust pollution during the tunneling process and improving the application efficiency of air curtain dust prevention technology,according to the changes of radial jet velocity(v_(r)),axial extrac...Aiming at reducing the dust pollution during the tunneling process and improving the application efficiency of air curtain dust prevention technology,according to the changes of radial jet velocity(v_(r)),axial extraction velocity(v_(e))and extraction distance(L)in the formation process of air curtain,the numerical simulation method was used to analyze the rules of airflow structure evolution and the diffusion characteristics of dust particles in fully mechanized excavation tunnel.The results indicate that as v_(r) and v_(e) increase,the migration path of the wall jet of the air curtain changes into an axial direction;as L decreases,the migration distance increases accordingly.These phenomena make the airflow distribution in the working face tends to be uniform.The dust diffusion distance reduces as well,wherein,the range of the discrete area of dust particles decreases sharply,until all dust particles are concentrated in the accumulation area.On this basis,the v_(r),v_(e) and L were optimized and applied in the 63_(up) 08 fully mechanized working face.By the application of the optimal parameters,the average dust removal efficiency at the driver’s position increased by 71%.The dust concentration was reduced and the working environment had been improved effectively.展开更多
In 1999,China released its first edition of the“Guidelines for the Prevention and Treatment of Hypertension”,which was subsequently updated in 2005,2010,and 2018,establishing a diagnostic,assessment,grading,stratifi...In 1999,China released its first edition of the“Guidelines for the Prevention and Treatment of Hypertension”,which was subsequently updated in 2005,2010,and 2018,establishing a diagnostic,assessment,grading,stratification,prevention,intervention,and management framework for hypertension tailored to the unique characteristics of the Chinese population.Over the past two decades,these guidelines have been widely implemented in clinical practice across China and have played a significant role in the management of hypertension and chronic diseases,the development of grassroots guidelines,the formulation of clinical pathways,and the implementation of health insurance policies.展开更多
The management of gastrointestinal(GI)bleeding patients during endoscopy remains a challenge.Hemorrhage is still one of the significant causes of morbidity and even death.Several therapeutic options have been used ove...The management of gastrointestinal(GI)bleeding patients during endoscopy remains a challenge.Hemorrhage is still one of the significant causes of morbidity and even death.Several therapeutic options have been used over the years depending on the extent,site and cause of bleeding.These include thermal therapy,injection therapy,and mechanical methods of hemostasis(e.g.,endoscopic clips and ligation bands).Patients with refractory bleeding,high-risk ulcer lesions,malignant disease,antiplatelet medications,and chronic kidney disease are at increased risk of upper and lower GI bleeding(LGIB).In this editorial,I commented on the paper by Ballester et al.Their work aimed at evaluating PuraStat^(■)(TDM-621),a novel hemostatic agent,particularly its efficacy,applications,feasibility,and safety in treating GI bleeding lesions.The authors concluded that PuraStat^(■)is an effective therapy for GI bleeding and is usually easy to use.Although the authors recommended its consideration as a frontline therapy in the future,they did not explore the clinical and GI uses of PuraStat®.This editorial focuses on the pharmacology of PuraStat®and how it differs from Hemospray®(TC-325)(hemostatic powder).It also explores the current experience of using PuraStat^(■)in upper and LGIB,its uses and safety,and the need for further research to fully understand its potential.展开更多
Objective: Stroke is perceived as a serious illness although it is preventable, and lifestyle alterations can be made to reduce its risk. Improvement of stroke care should be achieved through awareness of public, espe...Objective: Stroke is perceived as a serious illness although it is preventable, and lifestyle alterations can be made to reduce its risk. Improvement of stroke care should be achieved through awareness of public, especially through high-risk group. Henceforth, the aim of this study was to evaluate the effect of nursing intervention on improving awareness of high-risk people about stroke prevention. Methods: A quasi-experimental design was used to carry out this study, where a purposive sample of 80 adult patients at high risk for stroke were enrolled while they were attending the out-patient clinics of Zagazig University Hospitals for follow-up treatment;they were divided into two groups: case (40 patients) and control (40 patients). An interview questionnaire was used to assess patients’ knowledge regarding warning signs, risk factors, and immediate treatment;attitude;and their practice for prevention for stroke at pretest and posttest. Results: The study revealed the poor level of knowledge, bad level of preventive behavior, and negative attitude regarding stroke prevention at pre-intervention. However, after intervention, the high-risk people had fair level of knowledge with moderate practice for stroke prevention and positive attitude, with statistically significant difference between pre-post intervention and between the case and control groups. Conclusions: The study revealed that the nursing intervention seemed to change the knowledge, practice, and attitude of subjects regarding stroke prevention. This, in turn, implies that awareness of prevention of stroke and high-risk factor control could be important to reduce the burden of stroke in Egypt. Thus, further research on a larger scale is required to improve population knowledge and behavior for stroke prevention and control.展开更多
Mycotoxins,toxic secondary metabolites produced by fungus including Aspergillus,Penicillium,and Fusarium,pose considerable threats to food safety and human health worldwide.This review analyzes the main categories of ...Mycotoxins,toxic secondary metabolites produced by fungus including Aspergillus,Penicillium,and Fusarium,pose considerable threats to food safety and human health worldwide.This review analyzes the main categories of mycotoxins—namely aflatoxins,ochratoxins,and fusarium toxins(zearalenone and fumonisins)—along with their health implications,sources of contamination,and environmental circumstances conducive to their production.The document highlights the pressing necessity for efficient management techniques and investigates the use of food polymer-based nanotechnology as an innovative solution.Biopolymeric nanoparticles produced from natural food materials exhibit notable antibacterial characteristics,biodegradability,and the ability to enhance mycotoxin detection and management.This review emphasizes the transformative capacity of nanotechnology based innovative strategies in improving mycotoxin control,providing insights into emerging research avenues and practical applications to bolster food safety systems and keyword co-occurrence analysis,limitations and future perspectives.展开更多
Objective:Several therapeutic modalities for the prevention of calcium oxalate(CaOx)stones have been studied,but only a select few of these modalities have been incorporated into the American Urological Association gu...Objective:Several therapeutic modalities for the prevention of calcium oxalate(CaOx)stones have been studied,but only a select few of these modalities have been incorporated into the American Urological Association guidelines.Our study aimed to organize and interrogate existing research that may be promising for CaOx prevention.Methods:A literature search was conducted using MEDLINE and Embase from inception to November 16,2022.Our study population included adults with or without a history of CaOx kidney stones.Studies in which patients were treated with pharmacotherapies,herbal supplements,or uncategorized research chemicals that are not included in the current American Urological Association guidelines for preventing CaOx stones were included.Nonoriginal research was excluded.Results:Out of the 6155 identified articles,38 were included in the final analysis.The five distinct categories of interventions for stone prevention were“medications”,“herbal supplements”,“food and macronutrients”,“micronutrients”,and“enzymes and probiotics”.Modalities that were found to reduce known urinary risk factors were tolvaptan,cranberry juice,magnesium citrate,oxalate-degrading enzyme ALLN-177,and malic acid.Prophylaxis that reduced stone formation were sodium-glucose cotransporter-2 inhibitors,eicosapentaenoic acid,ethane-1-hydroxy-1,1-disphosphonate.Therapies that reduced urinary risk factors and stone formation were Phyllanthus niruri,rice bran,and magnesium hydroxide.Conclusion:Several of the identified therapies may provide prophylactic benefits for CaOx stone formation and may be useful for inclusion in guidelines for kidney stone prevention.展开更多
Ulcerative colitis(UC)is associated with an increased risk of developing colitisassociated colorectal cancer(caCRC),a major complication of long-standing disease.In this review,we examined the pathogenic association b...Ulcerative colitis(UC)is associated with an increased risk of developing colitisassociated colorectal cancer(caCRC),a major complication of long-standing disease.In this review,we examined the pathogenic association between UC and caCRC,highlighting the risk factors,molecular mechanisms,and current strategies for prevention and management.Compared to sporadic colorectal cancer,caCRC tends to occur at a younger age and is more frequently characterized by mucinous or signet-ring cell histology,proximal colonic involvement,and a higher incidence of synchronous lesions.The risk of caCRC increases 8-10 years after UC diagnosis and is influenced by disease duration,extent of colonic involvement,inflammatory burden,family history of colorectal cancer,and coexisting primary sclerosing cholangitis.The inflammation-to-cancer progression follows a multistep pathway of genetic alterations,advancing from low-grade to high-grade dysplasia,and ultimately to carcinoma.While chemopreventive agents such as 5-aminosalicylates may offer some benefit,surveillance colonoscopy remains the primary strategy for risk reduction.Early detection and individualized prevention strategies are critical for improving long-term outcomes in patients with UC.展开更多
Objective:Patient falls in the healthcare settings are unwanted events that can have severe consequences for both inpatients and outpatients;however,falls are preventable and nurses play an important role in this prev...Objective:Patient falls in the healthcare settings are unwanted events that can have severe consequences for both inpatients and outpatients;however,falls are preventable and nurses play an important role in this prevention.The purpose of this study was to investigate nurse activities in fall prevention and its relevant factors.Methods:This descriptive cross-sectional study was conducted at Can Tho Central General Hospital,with the participation of 90 nurses.Data were collected using a structured questionnaire consisting of five parts,including personal characteristics,knowledge about fall prevention,self-efficacy in fall prevention,nursing practice environment,and fall prevention activities.The data were entered and analyzed using SPSS 18.0 software with descriptive statistics,independent t-test,one-way ANOVA,and Pearson’s correlation coefficients.Results:The mean score of participants’knowledge in fall prevention was 4.67(SD=2.50)out of 11 scores;the self-efficacy score was 49.43(SD=8.55)out of 66 scores;nursing practice environment score was 29.69(SD=4.00)out of 40 scores;and the fall prevention activity scores were 75.58(SD=9.96)out of 100 scores.Factors related to fall prevention activities included gender(p=0.03),place of work(p=0.02),number of fall prevention training sessions(p=0.03),self-efficacy in fall prevention(r=0.61,p<0.001),and the nursing practice environment(r=0.25,p<0.05).Conclusions:An intervention program for fall prevention can be implemented to enhance the knowledge about fall prevention among nurses and improve the nursing practice environment to enhance patient safety.展开更多
To the editor:Schizophrenia is a chronic and severe mental disorder characterised by profound disruptions in thinking,affecting language,perception and the sense of self. These disruptions can significantly impair an ...To the editor:Schizophrenia is a chronic and severe mental disorder characterised by profound disruptions in thinking,affecting language,perception and the sense of self. These disruptions can significantly impair an individual’s ability to function socially and occupationally, leading to a high burden on both the individuals affected and society as a whole.展开更多
Probiotics show anti-influenza activity,offering a potential variant-resistant alternative for infection prevention and control.In this study,we evaluated whether a specially formulated yogurt enriched with synbiotics...Probiotics show anti-influenza activity,offering a potential variant-resistant alternative for infection prevention and control.In this study,we evaluated whether a specially formulated yogurt enriched with synbiotics(named yogurt 1)with 7 probiotics and 6 prebiotics,has anti-influenza effects and its underlying mechanisms using a mouse model challenged with influenza virus H1N1 PR8 strain.The mice were treated with phosphate-buffered saline(negative control),yogurt matrix,yogurt 1,and oseltamivir(positive control),respectively.Yogurt 1 treatment improved the survival of infected mice(from 0%to 30%),alleviated pathological injuries in the lungs and colon,and reduced the viral load of influenza virus on day 3 and day 7 post-infection.Yogurt 1 also downregulated some inflammation-related signaling pathways and reduced the levels of proinflammatory cytokines or chemokines in the lungs or serum,including interleukin(IL)-1β,IL-6,tumor necrosis factor-α(TNF-α)and keratinocyte chemoattractant(KC).The levels of short-chain fatty acids in the cecal content were increased,the diversity of the intestinal flora was partially restored,and influenza-specific Ig G and interferon-secreting lymphocytes were enhanced following yogurt 1 administration.Thus,yogurt 1,as a commercial and easily accessible dairy product,demonstrated a notable anti-influenza effect in mice by inhibiting viral proliferation,suppressing excessive inflammatory responses,and promoting influenza virus-specific adaptive humoral and cellular immune responses,demonstrating its potential for influenza epidemic prevention and control.展开更多
Open fractures are common and severe injuries in orthopedic clinical practice.Their high risk of infection significantly affects patient prognosis and may even lead to serious consequences such as functional impairmen...Open fractures are common and severe injuries in orthopedic clinical practice.Their high risk of infection significantly affects patient prognosis and may even lead to serious consequences such as functional impairment or amputation.In recent years,with advancements in trauma care techniques and optimization of antimicrobial strategies,progress has been made in the prevention of infections associated with open fractures.However,numerous challenges remain.This article provides a systematic review of the latest research advances in this field,focusing on the refinement of infection risk assessment systems,innovations in debridement techniques(such as pulsed lavage and negative pressure wound therapy),optimization of antibiotic application strategies(including timing,duration,and combination therapy),the use of local antimicrobial technologies(e.g.,antibiotic-loaded bone cement and silver dressings),and the application of biomaterials(such as antimicrobial-coated implants).By integrating findings from clinical studies and evidence-based medicine,this paper proposes a multimodal comprehensive prevention strategy that emphasizes the synergistic effects of early intervention,precise debridement,rational drug use,and advanced technologies to minimize infection risks and improve patients’functional recovery.Additionally,the article discusses future research directions,including the development of personalized prevention protocols and novel antimicrobial materials,aiming to provide theoretical and technical support for clinical practice.展开更多
Objectives:Decades of clinical and fundamental research advancements in oncology have led to significant breakthroughs such as early screening,targeted therapies,and immunotherapy,contributing to reduced mortality rat...Objectives:Decades of clinical and fundamental research advancements in oncology have led to significant breakthroughs such as early screening,targeted therapies,and immunotherapy,contributing to reduced mortality rates in cancer patients.Despite these achievements,cancer continues to be a major public health challenge.This study employs bibliometric techniques to visually analyze the English literature on cancer prevention,screening,diagnosis,treatment,and rehabilitation.Methods:We systematically reviewed publications from 01 March 2014,to 01 March 2024,indexed in the Web of Science core collection.Tools such as VOSviewer Version 1.6.20 is characterized by its core idea of co-occurrence clustering.CiteSpace 6.3.R3 is distinguished by its powerful capabilities in bibliometric analysis,including co-citation analysis,co-occurrence analysis of keywords,author collaboration network analysis,and journal co-citation analysis,providing effective insights into research hotspots and detecting emerging trends.Bibliometrix version 3.0.3 offers rich visualization features,including collaboration network diagrams,citation distribution graphs,and keyword clouds.facilitated the analysis of the literature,helping to map out the current research landscape,identify pressing issues,and discern emerging trends,thus offering insights for future research directions.Results:The analysis revealed that major research hotspots include lung and breast cancer.Attention is predominantly concentrated on cancer treatment,subdivided into targeted therapy,immunotherapy,traditional Chinese medicine,and the development of new anticancer drugs.Significant terms identified in the study include immune checkpoint inhibitors,tumor microenvironment,and cancer stem cells.Conclusion:This bibliometric analysis highlights the evolving directions in oncology research,pinpointing nanotherapy,resistance to targeted therapies,and the integration of artificial intelligence as pivotal future research avenues in the prevention,screening,diagnosis,treatment,and rehabilitation of cancer.展开更多
Background: Erythrodermic psoriasis (EP) is a rare, severe variant of psoriasis characterized by widespread erythema, scaling, and systemic complications. Despite advances in systemic treatments, the management of EP ...Background: Erythrodermic psoriasis (EP) is a rare, severe variant of psoriasis characterized by widespread erythema, scaling, and systemic complications. Despite advances in systemic treatments, the management of EP remains challenging, particularly in patients with comorbidities or contraindications to standard therapies. Objectives: To evaluate the effectiveness of ozonated water as an adjunctive treatment for EP, delivered using a patented robotic therapy system designed for hygiene and infection prevention in non-self-sufficient patients. Methods: We report the case of a 90-year-old male patient with acute EP who received daily skin treatments with ozonated water in conjunction with supportive care, including rehydration and antibiotics. The intervention was facilitated by the robotic system “COPERNICO Surveillance & Prevention,” which ensured standardized hygiene practices and clinical documentation. Results: Within one week of treatment, the patient showed complete desquamation of necrotic skin, resolution of erythema, and significant metabolic recovery. Fever subsided, renal function improved, and the patient was discharged in stable condition. Follow-up confirmed sustained clinical improvement, and no adverse events were reported. Conclusions: Ozonated water demonstrated efficacy in alleviating the dermatological and systemic manifestations of EP in a high-risk elderly patient. This case highlights the potential of ozone therapy as a safe, cost-effective adjunctive treatment for EP and underscores the utility of robotic systems in managing complex dermatological conditions. Further research is warranted to validate these findings in larger cohorts.展开更多
In recent years,nosocomial infections caused by Clostridium difficile(C.difficile)have risen,becoming a leading cause of hospital-acquired diarrhea.The global prevalence of C.difficile infection(CDI)varies across regi...In recent years,nosocomial infections caused by Clostridium difficile(C.difficile)have risen,becoming a leading cause of hospital-acquired diarrhea.The global prevalence of C.difficile infection(CDI)varies across regions and populations.The diagnosis relies primarily on laboratory testing,including toxin,glutamate dehy-drogenase,and nucleic acid amplification tests.Treatment strategies for CDI in-clude antimicrobial therapy(e.g.,metronidazole,vancomycin,and fidamycin),fecal transplantation,and immunotherapy(e.g.,belotozumab),depending on the patient’s specificity and severity.This paper reviews recent research on CDI’s epidemiological characteristics,risk factors,diagnosis,treatment,and prevention,aiming to support hospitals and public health initiatives in implementing effective detection,prevention,and treatment strategies.展开更多
文摘BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehensively assess the efficacy of indomethacin therapy in reducing PEP risk.METHODS We searched PubMed,EMBASE,Scopus,and Cochrane Library databases to identify randomized controlled trials(RCTs)that compared rectal indomethacin with a control group to prevent PEP.Duplicates were removed,and studies were included based on the established inclusion criteria.We used the Cochrane Collaboration’s tool to assess the risk of bias in the RCTs.A random-effects model was applied to produce pooled risk ratios(RRs)with 95%confidence intervals(CIs).RESULTS We included a total of 30 RCTs involving 16977 patients.Compared to the control group,rectal indomethacin showed comparable rates of overall PEP(PEP;RR=0.85,95%CI:0.69-1.04,I2=79%)with no statistically significant difference of RR in mild(RR=0.92,95%CI:0.74-1.14),moderate(RR=0.78,95%CI:0.59-1.02),or severe PEP(RR=1.12,95%CI:0.75-1.67).There was also no difference in cases of adverse events(RR=0.97,95%CI:0.69-1.35),abdominal pain(RR=1.14,95%CI:0.80-1.62),bleeding(RR=1.07,95%CI:0.70-1.63),or mortality(RR=0.86,95%CI:0.56-1.33)between the two groups.Subgroup analyses were also performed.CONCLUSION Rectal indomethacin appears to be safe and may offer benefit in selected high-risk patients,though findings should be interpreted with caution due to high heterogeneity.
文摘AIM:To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers.It also investigates the effects of supplements dosage,intervention duration,and geographical variation on intervention results.METHODS:A systematic search and screening of randomized controlled trials(RCTs)completed between 2014 and 2023 was undertaken using the PubMed,EMBASE,Cochrane Library,and Web of Science databases,in accordance with the PRISMA recommendations.The Cochrane risk of bias method was used to assess the quality of the studies.A Meta-analysis was performed using Stata 17.0 to calculate standardized mean differences(SMDs)and 95%confidence intervals(CIs).Subgroup analyses were performed to look at the effects of different doses,intervention periods,and geographic areas.Additionally,publication bias was assessed using Egger’s test.RESULTS:Ten studies including 1035 participants with myopia were analyzed.Supplementation with lutein and zeaxanthin resulted in a significant reduction in axial length elongation among adolescents in the intervention group(SMD=-0.40,P=0.001),an increase in macular pigment optical density(SMD=0.50,P=0.010),and an enhancement in visual sensitivity(SMD=0.53,P=0.008).Subgroup analyses revealed that participants receiving high doses and those undergoing intervention for more than 12mo exhibited significantly improved outcomes compared to those in the low-dose and short-term groups(high-dose vs low-dose:SMD=-0.41 vs-0.22,P=0.003;>12mo vs 6-12mo:SMD=-0.43 vs-0.23,P=0.004,respectively).Furthermore,Egger’s test indicated no significant publication bias(P=0.094).CONCLUSION:Combined lutein and zeaxanthin supplementation has a significant effect on myopia prevention in adolescents,with more pronounced benefits observed in high-dose and long-term interventions.The findings provide scientific evidence for its use as an adjunctive approach in myopia control.
文摘The problem of gastric cancer(GC)prevention remains relevant for a long time.Various methods of population serological screening of atrophic gastritis and precancerous changes in the gastric mucosa have been created at present.Modern endoscopic and morphological methods of verification of the diagnosis of precancerous diseases and changes in the gastric mucosa have been introduced into the practice of gastroenterologists and oncologists.GC risk stratification systems allow the formation of risk groups that require population screening.Practical hints for population serological screening of atrophic gastritis,endoscopic and morphological verification of precancerous changes and diseases of the stomach recommend using it:When developing state programs for the prevention of stomach cancer;when implementing preventive measures for stomach cancer by doctors of all specialties;the authors also offer the possibility of use by anyone over the age of 40,provided that they seek methodological help from their doctor;in the work of health schools in any medical and preventive institutions.The use of an assessment system of certain risk factor signatures with prognostic value would add significant assistance to preventive measures against GC.
文摘Objective Alzheimer’s disease(AD)presents a significant global health challenge with a steadily increasing prevalence and impact.This comprehensive review aimed to delve into the epidemiology,pathophysiology,pharmacological therapies,emerging research,challenges,and future directions of AD.Major findings from recent studies were synthesised,encompassing insights into the global prevalence,molecular pathology,high-risk factors,and therapeutic interventions,including cholinesterase inhibitors,glutamate receptor antagonists,and antibodies against Aβand tau proteins.Additionally,emerging research areas such as gene therapy and lipid nanoparticles were highlighted.This review emphasised the urgent need for ongoing research on novel therapeutic avenues and addressing the challenges in AD diagnosis,treatment,and care.Future perspectives underscore the potential of disease-modifying treatments,personalised medical approaches,and holistic interventions to alleviate the growing burden of AD on individuals,families,and healthcare systems worldwide.By fostering collaboration and innovation,we can strive towards a future where effective prevention,early detection,and personalised treatments enhance the lives of millions affected by AD globally.
基金funded with National Key R&D Program of China(2022YFC2405904)National Natural Science Foundation of China(11932012,and 32171348).
文摘Enamel demineralization,the formation of white spot lesions,is a common issue in clinical orthodontic treatment.The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment.The prevention,diagnosis,and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties.This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment,advocating for proactive prevention,early detection,timely treatment,scientific follow-up,and multidisciplinary management of white spot lesions throughout the orthodontic process,thereby maintaining the dental health of patients during orthodontic treatment.
文摘Colorectal cancer(CRC)is the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide.The leading risk factors for CRC include male gender,age over 50,family history,obesity,tobacco smoking,alco-hol consumption,and unhealthy diet.CRC screening methods vary considerably between countries and depend on incidence,economic resources and healthcare structure.Important aspects of screening include adherence,which can vary signi-ficantly across ethnic and socioeconomic groups.Basic concepts of CRC screening include pre-stratification of patients by identifying risk factors and then using fecal immunochemical test or guaiac-based fecal occult blood test and/or colono-scopy or radiologic imaging techniques.Technological capabilities for CRC scree-ning are rapidly evolving and include stool DNA test,liquid biopsy,virtual colo-nography,and the use of artificial intelligence.A CRC prevention strategy should be comprehensive and include active patient education along with targeted imple-mentation of screening.
基金financially supported by the Natural Science Foundation of Shandong Province(ZR2020QE124,ZR2023ME031 and ZR2023ME012)Innovation Achievement Cultivation Project of Qingdao University of Technology(CLZ2022-002)National Natural Science Foundation of China(52404222 and 52374209).
文摘Aiming at reducing the dust pollution during the tunneling process and improving the application efficiency of air curtain dust prevention technology,according to the changes of radial jet velocity(v_(r)),axial extraction velocity(v_(e))and extraction distance(L)in the formation process of air curtain,the numerical simulation method was used to analyze the rules of airflow structure evolution and the diffusion characteristics of dust particles in fully mechanized excavation tunnel.The results indicate that as v_(r) and v_(e) increase,the migration path of the wall jet of the air curtain changes into an axial direction;as L decreases,the migration distance increases accordingly.These phenomena make the airflow distribution in the working face tends to be uniform.The dust diffusion distance reduces as well,wherein,the range of the discrete area of dust particles decreases sharply,until all dust particles are concentrated in the accumulation area.On this basis,the v_(r),v_(e) and L were optimized and applied in the 63_(up) 08 fully mechanized working face.By the application of the optimal parameters,the average dust removal efficiency at the driver’s position increased by 71%.The dust concentration was reduced and the working environment had been improved effectively.
文摘In 1999,China released its first edition of the“Guidelines for the Prevention and Treatment of Hypertension”,which was subsequently updated in 2005,2010,and 2018,establishing a diagnostic,assessment,grading,stratification,prevention,intervention,and management framework for hypertension tailored to the unique characteristics of the Chinese population.Over the past two decades,these guidelines have been widely implemented in clinical practice across China and have played a significant role in the management of hypertension and chronic diseases,the development of grassroots guidelines,the formulation of clinical pathways,and the implementation of health insurance policies.
文摘The management of gastrointestinal(GI)bleeding patients during endoscopy remains a challenge.Hemorrhage is still one of the significant causes of morbidity and even death.Several therapeutic options have been used over the years depending on the extent,site and cause of bleeding.These include thermal therapy,injection therapy,and mechanical methods of hemostasis(e.g.,endoscopic clips and ligation bands).Patients with refractory bleeding,high-risk ulcer lesions,malignant disease,antiplatelet medications,and chronic kidney disease are at increased risk of upper and lower GI bleeding(LGIB).In this editorial,I commented on the paper by Ballester et al.Their work aimed at evaluating PuraStat^(■)(TDM-621),a novel hemostatic agent,particularly its efficacy,applications,feasibility,and safety in treating GI bleeding lesions.The authors concluded that PuraStat^(■)is an effective therapy for GI bleeding and is usually easy to use.Although the authors recommended its consideration as a frontline therapy in the future,they did not explore the clinical and GI uses of PuraStat®.This editorial focuses on the pharmacology of PuraStat®and how it differs from Hemospray®(TC-325)(hemostatic powder).It also explores the current experience of using PuraStat^(■)in upper and LGIB,its uses and safety,and the need for further research to fully understand its potential.
文摘Objective: Stroke is perceived as a serious illness although it is preventable, and lifestyle alterations can be made to reduce its risk. Improvement of stroke care should be achieved through awareness of public, especially through high-risk group. Henceforth, the aim of this study was to evaluate the effect of nursing intervention on improving awareness of high-risk people about stroke prevention. Methods: A quasi-experimental design was used to carry out this study, where a purposive sample of 80 adult patients at high risk for stroke were enrolled while they were attending the out-patient clinics of Zagazig University Hospitals for follow-up treatment;they were divided into two groups: case (40 patients) and control (40 patients). An interview questionnaire was used to assess patients’ knowledge regarding warning signs, risk factors, and immediate treatment;attitude;and their practice for prevention for stroke at pretest and posttest. Results: The study revealed the poor level of knowledge, bad level of preventive behavior, and negative attitude regarding stroke prevention at pre-intervention. However, after intervention, the high-risk people had fair level of knowledge with moderate practice for stroke prevention and positive attitude, with statistically significant difference between pre-post intervention and between the case and control groups. Conclusions: The study revealed that the nursing intervention seemed to change the knowledge, practice, and attitude of subjects regarding stroke prevention. This, in turn, implies that awareness of prevention of stroke and high-risk factor control could be important to reduce the burden of stroke in Egypt. Thus, further research on a larger scale is required to improve population knowledge and behavior for stroke prevention and control.
基金Financial support for this study is acknowledged by the University of Sri Jayewardenepura,Sri Lanka under the research grant number RC/URG/SCI/2024/12。
文摘Mycotoxins,toxic secondary metabolites produced by fungus including Aspergillus,Penicillium,and Fusarium,pose considerable threats to food safety and human health worldwide.This review analyzes the main categories of mycotoxins—namely aflatoxins,ochratoxins,and fusarium toxins(zearalenone and fumonisins)—along with their health implications,sources of contamination,and environmental circumstances conducive to their production.The document highlights the pressing necessity for efficient management techniques and investigates the use of food polymer-based nanotechnology as an innovative solution.Biopolymeric nanoparticles produced from natural food materials exhibit notable antibacterial characteristics,biodegradability,and the ability to enhance mycotoxin detection and management.This review emphasizes the transformative capacity of nanotechnology based innovative strategies in improving mycotoxin control,providing insights into emerging research avenues and practical applications to bolster food safety systems and keyword co-occurrence analysis,limitations and future perspectives.
文摘Objective:Several therapeutic modalities for the prevention of calcium oxalate(CaOx)stones have been studied,but only a select few of these modalities have been incorporated into the American Urological Association guidelines.Our study aimed to organize and interrogate existing research that may be promising for CaOx prevention.Methods:A literature search was conducted using MEDLINE and Embase from inception to November 16,2022.Our study population included adults with or without a history of CaOx kidney stones.Studies in which patients were treated with pharmacotherapies,herbal supplements,or uncategorized research chemicals that are not included in the current American Urological Association guidelines for preventing CaOx stones were included.Nonoriginal research was excluded.Results:Out of the 6155 identified articles,38 were included in the final analysis.The five distinct categories of interventions for stone prevention were“medications”,“herbal supplements”,“food and macronutrients”,“micronutrients”,and“enzymes and probiotics”.Modalities that were found to reduce known urinary risk factors were tolvaptan,cranberry juice,magnesium citrate,oxalate-degrading enzyme ALLN-177,and malic acid.Prophylaxis that reduced stone formation were sodium-glucose cotransporter-2 inhibitors,eicosapentaenoic acid,ethane-1-hydroxy-1,1-disphosphonate.Therapies that reduced urinary risk factors and stone formation were Phyllanthus niruri,rice bran,and magnesium hydroxide.Conclusion:Several of the identified therapies may provide prophylactic benefits for CaOx stone formation and may be useful for inclusion in guidelines for kidney stone prevention.
文摘Ulcerative colitis(UC)is associated with an increased risk of developing colitisassociated colorectal cancer(caCRC),a major complication of long-standing disease.In this review,we examined the pathogenic association between UC and caCRC,highlighting the risk factors,molecular mechanisms,and current strategies for prevention and management.Compared to sporadic colorectal cancer,caCRC tends to occur at a younger age and is more frequently characterized by mucinous or signet-ring cell histology,proximal colonic involvement,and a higher incidence of synchronous lesions.The risk of caCRC increases 8-10 years after UC diagnosis and is influenced by disease duration,extent of colonic involvement,inflammatory burden,family history of colorectal cancer,and coexisting primary sclerosing cholangitis.The inflammation-to-cancer progression follows a multistep pathway of genetic alterations,advancing from low-grade to high-grade dysplasia,and ultimately to carcinoma.While chemopreventive agents such as 5-aminosalicylates may offer some benefit,surveillance colonoscopy remains the primary strategy for risk reduction.Early detection and individualized prevention strategies are critical for improving long-term outcomes in patients with UC.
文摘Objective:Patient falls in the healthcare settings are unwanted events that can have severe consequences for both inpatients and outpatients;however,falls are preventable and nurses play an important role in this prevention.The purpose of this study was to investigate nurse activities in fall prevention and its relevant factors.Methods:This descriptive cross-sectional study was conducted at Can Tho Central General Hospital,with the participation of 90 nurses.Data were collected using a structured questionnaire consisting of five parts,including personal characteristics,knowledge about fall prevention,self-efficacy in fall prevention,nursing practice environment,and fall prevention activities.The data were entered and analyzed using SPSS 18.0 software with descriptive statistics,independent t-test,one-way ANOVA,and Pearson’s correlation coefficients.Results:The mean score of participants’knowledge in fall prevention was 4.67(SD=2.50)out of 11 scores;the self-efficacy score was 49.43(SD=8.55)out of 66 scores;nursing practice environment score was 29.69(SD=4.00)out of 40 scores;and the fall prevention activity scores were 75.58(SD=9.96)out of 100 scores.Factors related to fall prevention activities included gender(p=0.03),place of work(p=0.02),number of fall prevention training sessions(p=0.03),self-efficacy in fall prevention(r=0.61,p<0.001),and the nursing practice environment(r=0.25,p<0.05).Conclusions:An intervention program for fall prevention can be implemented to enhance the knowledge about fall prevention among nurses and improve the nursing practice environment to enhance patient safety.
基金funded by Peking University Sixth Hospital(BDLYYLZL2024-01)the Capital Health Development Research Project Program of China(2014-4-4112).
文摘To the editor:Schizophrenia is a chronic and severe mental disorder characterised by profound disruptions in thinking,affecting language,perception and the sense of self. These disruptions can significantly impair an individual’s ability to function socially and occupationally, leading to a high burden on both the individuals affected and society as a whole.
基金supported by funding from the National Natural Science Foundation of China(32072191)Special Funds for Guiding Local Scientific and Technological Development by the Central Government(Guike ZY22096025)。
文摘Probiotics show anti-influenza activity,offering a potential variant-resistant alternative for infection prevention and control.In this study,we evaluated whether a specially formulated yogurt enriched with synbiotics(named yogurt 1)with 7 probiotics and 6 prebiotics,has anti-influenza effects and its underlying mechanisms using a mouse model challenged with influenza virus H1N1 PR8 strain.The mice were treated with phosphate-buffered saline(negative control),yogurt matrix,yogurt 1,and oseltamivir(positive control),respectively.Yogurt 1 treatment improved the survival of infected mice(from 0%to 30%),alleviated pathological injuries in the lungs and colon,and reduced the viral load of influenza virus on day 3 and day 7 post-infection.Yogurt 1 also downregulated some inflammation-related signaling pathways and reduced the levels of proinflammatory cytokines or chemokines in the lungs or serum,including interleukin(IL)-1β,IL-6,tumor necrosis factor-α(TNF-α)and keratinocyte chemoattractant(KC).The levels of short-chain fatty acids in the cecal content were increased,the diversity of the intestinal flora was partially restored,and influenza-specific Ig G and interferon-secreting lymphocytes were enhanced following yogurt 1 administration.Thus,yogurt 1,as a commercial and easily accessible dairy product,demonstrated a notable anti-influenza effect in mice by inhibiting viral proliferation,suppressing excessive inflammatory responses,and promoting influenza virus-specific adaptive humoral and cellular immune responses,demonstrating its potential for influenza epidemic prevention and control.
文摘Open fractures are common and severe injuries in orthopedic clinical practice.Their high risk of infection significantly affects patient prognosis and may even lead to serious consequences such as functional impairment or amputation.In recent years,with advancements in trauma care techniques and optimization of antimicrobial strategies,progress has been made in the prevention of infections associated with open fractures.However,numerous challenges remain.This article provides a systematic review of the latest research advances in this field,focusing on the refinement of infection risk assessment systems,innovations in debridement techniques(such as pulsed lavage and negative pressure wound therapy),optimization of antibiotic application strategies(including timing,duration,and combination therapy),the use of local antimicrobial technologies(e.g.,antibiotic-loaded bone cement and silver dressings),and the application of biomaterials(such as antimicrobial-coated implants).By integrating findings from clinical studies and evidence-based medicine,this paper proposes a multimodal comprehensive prevention strategy that emphasizes the synergistic effects of early intervention,precise debridement,rational drug use,and advanced technologies to minimize infection risks and improve patients’functional recovery.Additionally,the article discusses future research directions,including the development of personalized prevention protocols and novel antimicrobial materials,aiming to provide theoretical and technical support for clinical practice.
基金supported by the grants from the Scientific and Technological Innovation Project of Information Traditional Chinese Medicine,China Academy of Chinese Medical Sciences(No.CI2021 B002).
文摘Objectives:Decades of clinical and fundamental research advancements in oncology have led to significant breakthroughs such as early screening,targeted therapies,and immunotherapy,contributing to reduced mortality rates in cancer patients.Despite these achievements,cancer continues to be a major public health challenge.This study employs bibliometric techniques to visually analyze the English literature on cancer prevention,screening,diagnosis,treatment,and rehabilitation.Methods:We systematically reviewed publications from 01 March 2014,to 01 March 2024,indexed in the Web of Science core collection.Tools such as VOSviewer Version 1.6.20 is characterized by its core idea of co-occurrence clustering.CiteSpace 6.3.R3 is distinguished by its powerful capabilities in bibliometric analysis,including co-citation analysis,co-occurrence analysis of keywords,author collaboration network analysis,and journal co-citation analysis,providing effective insights into research hotspots and detecting emerging trends.Bibliometrix version 3.0.3 offers rich visualization features,including collaboration network diagrams,citation distribution graphs,and keyword clouds.facilitated the analysis of the literature,helping to map out the current research landscape,identify pressing issues,and discern emerging trends,thus offering insights for future research directions.Results:The analysis revealed that major research hotspots include lung and breast cancer.Attention is predominantly concentrated on cancer treatment,subdivided into targeted therapy,immunotherapy,traditional Chinese medicine,and the development of new anticancer drugs.Significant terms identified in the study include immune checkpoint inhibitors,tumor microenvironment,and cancer stem cells.Conclusion:This bibliometric analysis highlights the evolving directions in oncology research,pinpointing nanotherapy,resistance to targeted therapies,and the integration of artificial intelligence as pivotal future research avenues in the prevention,screening,diagnosis,treatment,and rehabilitation of cancer.
文摘Background: Erythrodermic psoriasis (EP) is a rare, severe variant of psoriasis characterized by widespread erythema, scaling, and systemic complications. Despite advances in systemic treatments, the management of EP remains challenging, particularly in patients with comorbidities or contraindications to standard therapies. Objectives: To evaluate the effectiveness of ozonated water as an adjunctive treatment for EP, delivered using a patented robotic therapy system designed for hygiene and infection prevention in non-self-sufficient patients. Methods: We report the case of a 90-year-old male patient with acute EP who received daily skin treatments with ozonated water in conjunction with supportive care, including rehydration and antibiotics. The intervention was facilitated by the robotic system “COPERNICO Surveillance & Prevention,” which ensured standardized hygiene practices and clinical documentation. Results: Within one week of treatment, the patient showed complete desquamation of necrotic skin, resolution of erythema, and significant metabolic recovery. Fever subsided, renal function improved, and the patient was discharged in stable condition. Follow-up confirmed sustained clinical improvement, and no adverse events were reported. Conclusions: Ozonated water demonstrated efficacy in alleviating the dermatological and systemic manifestations of EP in a high-risk elderly patient. This case highlights the potential of ozone therapy as a safe, cost-effective adjunctive treatment for EP and underscores the utility of robotic systems in managing complex dermatological conditions. Further research is warranted to validate these findings in larger cohorts.
文摘In recent years,nosocomial infections caused by Clostridium difficile(C.difficile)have risen,becoming a leading cause of hospital-acquired diarrhea.The global prevalence of C.difficile infection(CDI)varies across regions and populations.The diagnosis relies primarily on laboratory testing,including toxin,glutamate dehy-drogenase,and nucleic acid amplification tests.Treatment strategies for CDI in-clude antimicrobial therapy(e.g.,metronidazole,vancomycin,and fidamycin),fecal transplantation,and immunotherapy(e.g.,belotozumab),depending on the patient’s specificity and severity.This paper reviews recent research on CDI’s epidemiological characteristics,risk factors,diagnosis,treatment,and prevention,aiming to support hospitals and public health initiatives in implementing effective detection,prevention,and treatment strategies.
