Student period belongs to people easily affected and more sensitive period, so the possibility of psychological problems in the student group, especially the change of relocation of poverty alleviation students, becau...Student period belongs to people easily affected and more sensitive period, so the possibility of psychological problems in the student group, especially the change of relocation of poverty alleviation students, because its living environment and experience is relatively special and need to face life, study, family and other pressure, so the possibility of psychological problems is relatively greater. In order to ensure the mental health of students relocated from inhospitable areas, this paper mainly explores the effective mental health education mode of students relocated from inhospitable areas for reference.展开更多
BACKGROUND Non-ST-elevation myocardial infarction(NSTEMI)is a prevalent acute coronary syndrome among the elderly,a population often underrepresented in clinical trials.Frailty,a marker of physiologic vulnerability,ma...BACKGROUND Non-ST-elevation myocardial infarction(NSTEMI)is a prevalent acute coronary syndrome among the elderly,a population often underrepresented in clinical trials.Frailty,a marker of physiologic vulnerability,may influence the risks and benefits of percutaneous coronary intervention(PCI)in these patients.AIM To evaluate the impact of frailty status on in-hospital outcomes among patients aged≥75 years with NSTEMI undergoing PCI.METHODS We conducted a retrospective cohort study using the 2021-2022 National Inpatient Sample to evaluate the impact of frailty on in-hospital outcomes among NSTEMI patients aged≥75 years undergoing PCI.Patients were stratified into three frailty categories using the Hospital Frailty Risk Score.Multivariable logistic and generalized linear models with interaction terms assessed the association between frailty and clinical outcomes.RESULTS Among 456690 NSTEMI admissions,37.95%,50.71%,and 11.34%were categorized as low,intermediate,and high frailty,respectively.PCI use declined with increasing frailty(35.0%in low vs 7.5%in high;P<0.001).Adjusted mortality was lower with PCI across all frailty levels[odds ratios(OR):0.27(low),0.37(intermediate),0.43(high);all P<0.001].However,the mortality benefit was attenuated with increasing frailty(interaction OR:1.56 and 1.83 for intermediate and high vs low frailty;P<0.001).Frailty was independently associated with higher odds of complications,including acute kidney injury,respiratory failure,delirium,and bleeding.PCI was associated with shorter hospital stays in low(-0.90 days)but longer in the high-frail category(+2.47 days;P<0.001),and increasing frailty correlated with significantly higher hospital charges.CONCLUSION In elderly NSTEMI patients,PCI conferred a survival benefit across all frailty strata,although with a diminishing magnitude as frailty increased.Frailty correlated with increased complications and healthcare resource utilization.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)has a spectrum of clinical syndromes with serious involvement of the lung and frequent effection of the liver and hemostatic system.Blood biomarkers are affordable,rapid,ob...BACKGROUND Coronavirus disease 2019(COVID-19)has a spectrum of clinical syndromes with serious involvement of the lung and frequent effection of the liver and hemostatic system.Blood biomarkers are affordable,rapid,objective,and useful in the evaluation and prognostication of COVID-19 patients.AIM To investigate the association between aspartate transferase-to-platelet ratio index(APRI)and in-hospital mortality to develop a COVID-19 mortality prediction model.METHODS A multicenter cohort study with a retrospective design was conducted.Medical records of all consecutive adult patients admitted to Al-Azhar University Hospital(Assiut,Egypt)and Chest Hospital(Assiut,Egypt)with confirmed COVID-19 from July 1,2020 to October 1,2020,were retrieved and analyzed.The patient cohort was classified into the following two categories based on the APRI:(1)COVID-19 presenting with APRI≤0.5;and(2)COVID-19 presenting with APRI(>0.5 and≤1.5).The association between APRI and all-cause in-hospital mortality was analyzed,and the new model was developed through logistic regression analyses.RESULTS Of the 353 patients who satisfied the inclusion criteria,10%were admitted to the intensive care unit(n=36)and 7%died during the hospital stay(n=25).The median age was 40 years and 50.7%were male.On admission,49%had aspartate transferase-dominant liver injury.On admission,APRI(>0.5 and≤1.5)was independently associated with all-cause in-hospital mortality in unadjusted regression analysis and after adjustment for age and sex;after stepwise adjustment for several clinically relevant confounders,APRI was still significantly associated with all-cause inhospital mortality.On admission,APRI(>0.5 and≤1.5)increased the odds of mortality by fivetimes(P<0.006).From these results,we developed a new predictive model,the APRI-plus,which includes the four predictors of age,aspartate transferase,platelets,and serum ferritin.Performance for mortality was very good,with an area under the receiver operating curve of 0.90.CONCLUSION APRI-plus is an accurate and simplified prediction model for mortality among patients with COVID-19 and is associated with in-hospital mortality,independent of other relevant predictors.展开更多
Dear editor, Out-of-hospital cardiac arrest survival rates vary between 7% and 46% and are lower than those for inhospital cardiac arrests (IHCA).[1,2] Therefore, efforts are being made to increase survival rates for ...Dear editor, Out-of-hospital cardiac arrest survival rates vary between 7% and 46% and are lower than those for inhospital cardiac arrests (IHCA).[1,2] Therefore, efforts are being made to increase survival rates for out-ofhospital cardiac arrests (OHCA). According to advanced cardiac life support (ACLS) guidelines, out-of-hospital cardiac arrest survival rates may be increased by performing cardiopulmonary resuscitation (CPR) with minimal interruptions.[3] According to the latest ACLS, does the patient need an advanced airway.展开更多
文摘Student period belongs to people easily affected and more sensitive period, so the possibility of psychological problems in the student group, especially the change of relocation of poverty alleviation students, because its living environment and experience is relatively special and need to face life, study, family and other pressure, so the possibility of psychological problems is relatively greater. In order to ensure the mental health of students relocated from inhospitable areas, this paper mainly explores the effective mental health education mode of students relocated from inhospitable areas for reference.
文摘BACKGROUND Non-ST-elevation myocardial infarction(NSTEMI)is a prevalent acute coronary syndrome among the elderly,a population often underrepresented in clinical trials.Frailty,a marker of physiologic vulnerability,may influence the risks and benefits of percutaneous coronary intervention(PCI)in these patients.AIM To evaluate the impact of frailty status on in-hospital outcomes among patients aged≥75 years with NSTEMI undergoing PCI.METHODS We conducted a retrospective cohort study using the 2021-2022 National Inpatient Sample to evaluate the impact of frailty on in-hospital outcomes among NSTEMI patients aged≥75 years undergoing PCI.Patients were stratified into three frailty categories using the Hospital Frailty Risk Score.Multivariable logistic and generalized linear models with interaction terms assessed the association between frailty and clinical outcomes.RESULTS Among 456690 NSTEMI admissions,37.95%,50.71%,and 11.34%were categorized as low,intermediate,and high frailty,respectively.PCI use declined with increasing frailty(35.0%in low vs 7.5%in high;P<0.001).Adjusted mortality was lower with PCI across all frailty levels[odds ratios(OR):0.27(low),0.37(intermediate),0.43(high);all P<0.001].However,the mortality benefit was attenuated with increasing frailty(interaction OR:1.56 and 1.83 for intermediate and high vs low frailty;P<0.001).Frailty was independently associated with higher odds of complications,including acute kidney injury,respiratory failure,delirium,and bleeding.PCI was associated with shorter hospital stays in low(-0.90 days)but longer in the high-frail category(+2.47 days;P<0.001),and increasing frailty correlated with significantly higher hospital charges.CONCLUSION In elderly NSTEMI patients,PCI conferred a survival benefit across all frailty strata,although with a diminishing magnitude as frailty increased.Frailty correlated with increased complications and healthcare resource utilization.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)has a spectrum of clinical syndromes with serious involvement of the lung and frequent effection of the liver and hemostatic system.Blood biomarkers are affordable,rapid,objective,and useful in the evaluation and prognostication of COVID-19 patients.AIM To investigate the association between aspartate transferase-to-platelet ratio index(APRI)and in-hospital mortality to develop a COVID-19 mortality prediction model.METHODS A multicenter cohort study with a retrospective design was conducted.Medical records of all consecutive adult patients admitted to Al-Azhar University Hospital(Assiut,Egypt)and Chest Hospital(Assiut,Egypt)with confirmed COVID-19 from July 1,2020 to October 1,2020,were retrieved and analyzed.The patient cohort was classified into the following two categories based on the APRI:(1)COVID-19 presenting with APRI≤0.5;and(2)COVID-19 presenting with APRI(>0.5 and≤1.5).The association between APRI and all-cause in-hospital mortality was analyzed,and the new model was developed through logistic regression analyses.RESULTS Of the 353 patients who satisfied the inclusion criteria,10%were admitted to the intensive care unit(n=36)and 7%died during the hospital stay(n=25).The median age was 40 years and 50.7%were male.On admission,49%had aspartate transferase-dominant liver injury.On admission,APRI(>0.5 and≤1.5)was independently associated with all-cause in-hospital mortality in unadjusted regression analysis and after adjustment for age and sex;after stepwise adjustment for several clinically relevant confounders,APRI was still significantly associated with all-cause inhospital mortality.On admission,APRI(>0.5 and≤1.5)increased the odds of mortality by fivetimes(P<0.006).From these results,we developed a new predictive model,the APRI-plus,which includes the four predictors of age,aspartate transferase,platelets,and serum ferritin.Performance for mortality was very good,with an area under the receiver operating curve of 0.90.CONCLUSION APRI-plus is an accurate and simplified prediction model for mortality among patients with COVID-19 and is associated with in-hospital mortality,independent of other relevant predictors.
文摘Dear editor, Out-of-hospital cardiac arrest survival rates vary between 7% and 46% and are lower than those for inhospital cardiac arrests (IHCA).[1,2] Therefore, efforts are being made to increase survival rates for out-ofhospital cardiac arrests (OHCA). According to advanced cardiac life support (ACLS) guidelines, out-of-hospital cardiac arrest survival rates may be increased by performing cardiopulmonary resuscitation (CPR) with minimal interruptions.[3] According to the latest ACLS, does the patient need an advanced airway.
