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Pressure ulcers are a common problem among individuals who, for medical reasons, must spend most of their day in bed. Manually turning a person's body is labor intensive and can easily cause occupational injuries. To compare the effectiveness of a new assisted turning mattress in pressure management with that of a conventional air mattress. This is a single-session crossover trial study. Twenty-four participants confined to bed were transferred onto the selected mattress (assisted turning or conventional air mattresses) in the selected position. Average interface pressures of bony prominences were measured after the participants laid on the mattress in different positions. After the data collection, they were transferred to the second mattress, and the process was repeated. Subjective feedback from participants and caregivers was also acquired immediately following a one-week trial period of assisted turning mattresses. The mean interface pressures were comparable for most body parts between two mattresses. Subjective feedback showed that assisted turning mattresses could relieve caregivers' workload but at the cost of patients' decreased feelings of safety. Assisted turning mattresses are equal to conventional air mattresses in pressure distribution. Proper pressure management through scheduled positional changes is required in assisted turning mattresses.
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OBJECTIVE: This study aimed to investigate the correlation between self-care knowledge, psychological well-being, and disease self-management in patients with hypertensive nephropathy, and to assess the effect of psychological well-being as a mediator of self-care knowledge and disease self-management. METHODS: This is a cross-sectional study. The 220 patients with hypertensive nephropathy were recruited from a teaching hospital in Taiwan using purposive sampling. The average age was 70.14 (SD = 11.96) years old. Among them, 128 (58.2%) were male and 92 (41.8%) were female. Instruments included a hypertensive nephropathy self-care knowledge scale, the World Health Organization-5 Well-Being Index, and the chronic kidney disease self-management instrument. The mediating effect was determined with linear regression models and the Sobel test. RESULTS: The total explanatory variation of age, systolic blood pressure, psychological well-being, and self-care knowledge on the disease self-management was 27.7%. Psychological well-being was the most important explanatory factor and alone explains 16%. Psychological well-being was a partial mediator of self-care knowledge and quality of life in patients with hypertensive nephropathy, with a total effect of 23.2%. CONCLUSIONS: This study showed that older patients with hypertensive nephropathy and those with a higher systolic blood pressure had lower levels of disease self-management. The higher the patients' self-care knowledge and psychological well-being, the better their disease self-management.
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Automanejo , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Hipertensión Renal , Masculino , Persona de Mediana Edad , Nefritis , Calidad de Vida , Autocuidado/psicologíaRESUMEN
BACKGROUND: The stromal vascular fraction (SVF) derived from adipose tissue contains heterogeneous cell populations and has enormous potential for clinical therapy. There are two main methods for SVF isolation: enzymatic isolation and mechanical isolation, both of which have shortcomings. In this study, optimized conditions for the isolation of high-quality SVF were established, and applications in fat grafting were evaluated. METHODS: Adipose tissue was chopped into small pieces and then ground into an erosive shape using a syringe. The pieces were digested with 0.15% type II collagenase for 35 min at 37 °C. After centrifugation, the pellets were resuspended in DMEM and passed through a 100-µm strainer. The filtered cells were analyzed by flow cytometry. The fat graft was enriched with isolated SVF and subcutaneously transplanted into nude mice. Three weeks after transplantation, grafts were isolated, and H&E staining, immunocytochemistry, and western blotting were conducted. RESULTS: The harvested SVF cells reached > 2 × 106/ml of adipose tissue within 90 min of operation. The number of CD34+ ADSCs in our SVF pellets was > 6 × 105/ml of adipose tissue, which has the potential for differentiating into osteoblasts, adipocytes, and chondrocytes. Freshly collected adipose tissue is better for SVF isolation, and isolated SVF should also be kept at 4 °C and used as soon as possible. SVF may promote revascularization after fat grafting. The adipose tissue of an SVF co-transplanted group had an integral structure, clear capillaries, and higher VEGF expression. SVF co-transplantation inhibited adipose cell apoptosis. CONCLUSION: Our study provides an efficient procedure for SVF isolation, its application in fat grafting, and possible underlying mechanisms. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Fracción Vascular Estromal , Factor A de Crecimiento Endotelial Vascular , Ratones , Animales , Ratones Desnudos , Tejido Adiposo/trasplante , ColagenasasRESUMEN
The influence of surgery and anesthesia on immune function during the perioperative period should not be neglected. In this study, we evaluated the effects of oxycodone combined with flurbiprofen axetil on postoperative analgesia and immune function in patients undergoing radical resection of colorectal cancer (CRC). One hundred and thirty-three were randomized into the oxycodone combined with flurbiprofen axetil (OF) group or the sufentanil combined with flurbiprofen axetil (SF) group. Patients in the OF group were prescribed oxycodone hydrochloride 0.1 mg/kg combined with flurbiprofen axetil 3 mg/kg for postoperative analgesia, whereas the SF group received sufentanil 0.1 µg/kg combined with flurbiprofen axetil 3 mg/kg. The primary outcome was visual analog scale (VAS) score. Secondary outcomes included the quantities of CD4+ , CD8+ , and natural killer (NK) T cells, tumor necrosis factor (TNF)-α level, and interleukin (IL)-6 in peripheral blood, the consumption of analgesics, and the incidence of adverse reactions, and so forth. The VAS scores at rest were similar in both group. However, the VAS scores at cough in the OF group at 8, 12, and 24 hours postsurgery were lower than those in the SF group. Compared with the SF group, the count of CD4+ T cells and ratio of CD4+ /CD8+ were higher in the OF group at 12, 24, 48, and 72 hours postsurgery, although the count of CD8+ and NK T cells was higher than that in the SF group at 48 and 72 hours postsurgery. In addition, the serum level of TNF-α and IL-6 at 12, 24, 48, and 72 hours postsurgery in the OF group was lower than that in the SF group. In addition, the incidence of postoperative nausea, postoperative vomiting, and pruritus was lower, the time to first flatus and bowel movement was earlier in the OF group. Oxycodone combined with flurbiprofen axetil applied for patient-controlled intravenous analgesia could effectively reduce pain intensity, particularly for visceral pain, and help to reverse the status of immunosuppression during radical resection of CRC.