Introduction: The primary issue following lumbar discectomy for disc herniation is the risk of reherniation in the post-operative period. Many surgical techniques have been proposed to treat disc reherniation, however, the optimal one remains variable. This meta-analysis aimed to investigate the prevalence of symptomatic reherniation after using a Bone-anchored annular closure device following lumbar discectomy and the contributing factors. Materials and methods: Identification of published literature was performed on PubMed, Google Scholar, Scopus, and Web of Science databases. Studies published until 14 February 2024 reported the prevalence of symptomatic reherniation after using a Bone-anchored annular closure device following lumbar discectomy and the associated contributing factors. A random effects model was used to conduct Bayesian frequentist network meta-analysis and pair-wise meta-analysis, with the assessment based on standardised mean difference (SMD) and 95% confidence interval (CI). Results: Eleven studies published in 2012 − 2022 recruiting a total of 5195 patients were included in the meta-analysis. The prevalence of reherniation in ACD and control groups was 23.2% (95% CI: 18.2% − 28.1%) and 36.4% (95% CI: 28.2% − 44.5%), respectively. The moderator effect of sample size is significant for pooled data of the ACD group (p-mod=0.002), but not for the control group (pmod=0.278). After the adjustment with sample size, the prevalence rates were 13.6% (95% CI: 6.2% − 21.1%) and 29.6% (95% CI: 14.9% − 33.2%) for ACD and control groups, respectively. Conclusion: Comparatively to lumbar discectomy alone, using a Bone-anchored annular closure device following lumbar discectomy decreased the symptomatic reherniation rate and post-operative complications, as well as the necessity for subsequent surgeries.

Arsenic trioxide (ATO) serves as a component of traditional Chinese medicine and a modern anticancer agent, demonstrating remarkable efficacy in the long-term treatment of acute promyelocytic leukemia. With increasing research into its application in solid tumors, ATO's diverse mechanisms of action and potential clinical value have attracted widespread attention. ATO can inhibit tumor cell proliferation by inducing various forms of cell death, such as apoptosis, autophagy, pyroptosis, necroptosis, and ferroptosis, as well as by regulating cell differentiation. Moreover, its modulatory effects on the tumor immune microenvironment provide a new aspectto its antitumor activity. Nevertheless, the clinical application of ATO in solid tumors faces challenges such as low bioavailability, inadequate targeting, and adverse effects. The development of nanocarriers and targeted delivery systems has emerged asa key strategy for enhancing the therapeutic efficacy of ATO. This review systematically summarizes the multiple mechanisms of action of ATO in solid tumors and recent advances in nanodelivery technologies, explores the potential of ATO-based combination therapies, and discusses future directions, aiming to provide a theoretical foundation and practical guidance for the clinical application of ATO in solid tumors.

Human ; Observation ; Widowhood

Objective To clarify the current development status and research hotspots in the field of experimental drug management in China through data mining by bibliometric. Methods Key words such as “experiment”, “drug”, and “management” were used to search the Chinese literature in China National Knowledge Infrastructure （CNKI）. The title, author name, author affiliation, Chinese abstract, Chinese keywords, publication period, journal name, and other content of the literature were extracted from the literature. Cluster analysis was performed by CNKI literature visualization analysis system, CiteSpace and other software, and a network knowledge map was drawn. Results The literature in the field of experimental drug management in China was first published in 1994, and a total of 140 articles were published until 2022. Among them, 20 articles were supported by relevant funds, and the keyword co-occurrence frequency was highest among “subjects”. The most frequently published medium was the Chinese Pharmacological Yearbook. Conclusion At present, the quantity and quality of literature in the field of experimental drug management in China were relatively small, and the cooperation and communication among authors were not close. The funding from various fund projects in this field was also lacking. These factors led to a lower overall development level and slower development speed in this field.

BACKGROUND

The crop of novice nurses who are currently employed is a product of flexible learning who had limited contact hours with actual patients, which is contrary to those who graduated from traditional learning modalities. Hence, it is essential to evaluate how the impact of flexible learning modality has affected the practice preparedness levels of novice nurses in the hospital setting.

This study aimed to determine the level of practice preparedness and its associated factors among novice nurses who work in private hospitals.

The study utilized a cross-sectional survey design. Data was gathered from a total enumeration of ninety-four novice staff nurses who graduated from the flexible learning curriculum and are currently employed in private hospitals in Baguio City and La Trinidad. The tool used was a questionnaire in two parts. Part 1 consisted of questions related to demographic information and factors related to practice preparedness, and part 2 included the Nursing Practice Readiness Scale, with validity and reliability scores of >0.924 and 0.90, respectively. The data was analyzed using the SPSS V27 trial version. The protocol was approved by the Saint Louis University Research Ethics Committee.

Findings reveal that more novice nurses in private hospitals perceived themselves as well-prepared across all domains of practice preparedness: “Collaborative Interpersonal Relationship” (n=94, 100%); “Patient Centeredness” (n=92, 97.90%); “Self-regulation” (n=90, 95.70%); “Clinical Judgment and Nursing Performance” (n=78, 83.00%); and “Professional Attitudes” (n=76, 80.90%). There is a significant association between practice preparedness and the following factors: “Attended more than one Training/Seminars per year” (p=0.02), “Graduated from Private Schools” (p=0.03), and “Assigned in Regular Wards” (p=0.05). On the other hand, no significant association was found between practice preparedness and the following factors: “Sex” (p=0.61) and “Membership in Professional Organizations” (p=0.73).

In agreement with existing studies, practice preparedness is multifactorial. However, what this study contributes are new factors that are favorable in making novice nurses more confident in performing their roles and responsibilities. These include being a graduate of private schools, being assigned to regular wards, and attending professional training/seminars more than once annually. Advantageously, these factors that promote practice preparedness are modifiable.

Paradoxical response to anti-tuberculosis treatment, defined as clinical or radiologic worsening of pre-existing lesions or the development of new lesions while ongoing treatment, poses diagnostic dilemma. Intestinal perforation as a paradoxical response is rare. We report a 10-year-old female who presented with recurrent abdominal pain, anorexia, and bloody diarrhea, and was diagnosed with disseminated tuberculosis. She had marked improvement after one month of anti-tuberculosis treatment but developed a recurrence of initial symptoms on the third month of therapy and was treated for cecal perforation. Histopathology of cecum revealed chronic granulomatous inflammation. The patient improved after the surgery and the resumption of anti-tuberculosis medications. Recognition of paradoxical reactions and differentiating it from drug resistance of other pathology is important as these necessitates different management strategies.

BACKGROUND

Patients with diabetes mellitus are more vulnerable to COVID-19 infection and exhibit more severe manifestations and worse clinical outcomes. Since the start of the COVID-19 pandemic, there has been a noted increase in the incidence of hyperglycemic crises in hospitals, and this involves both patients with COVID-19 infection and patients without COVID-19 infection. Aside from COVID-19 infection, the factors that are responsible for this increase in incidence of hyperglycemic crises may include reduced medical services, fear of seeking health care, and psychosocial factors. In the Philippines, there is a lack of data comparing these two subsets of patients. This study aims to give a comparison of the clinical outcomes of COVID-19 positive and COVID-19 negative patients who presented with hyperglycemic crises during the COVID-19 pandemic.

This is a retrospective cohort study of adult patients with hyperglycemic crisis on admission from March 1, 2020 to February 28, 2022 at the St. Luke’s Medical Center Global City. Their medical records were reviewed to determine their clinical background, presenting clinical manifestations, non-COVID-19 acute conditions, biochemical and clinical parameters, treatment regimen, and clinical outcomes.

We analyzed 15 COVID-19 positive patients and 38 COVID-19 negative patients who had a hyperglycemic crisis on admission. Patients who were COVID-19 positive were found to be significantly older (mean age of 59 years) than COVID-19 negative patients (mean age of 46 years) (p = 0.0197). The COVID-19 positive group also had a significantly higher proportion of patients with malignancy (p = 0.031), urinary tract infection on admission (p = 0.039), and more frequently received steroids concurrent with treatment for hyperglycemic crisis (p = 0.002). The COVID-19 positive group had a significantly higher proportion of in-hospital mortality before resolution of hyperglycemic crisis (p = 0.008), as well as development of acute respiratory failure (p = 0.000). On the other hand, the COVID-19 negative group had a significantly higher proportion of patients who developed acute kidney injury during hospitalization (p = 0.026). There were no statistically significant differences in terms of time to resolution of DKA, development of hypoglycemia or hypokalemia, length of ICU and hospital stay, or development of cardiac decompensation and acute liver injury.

Patients hospitalized with hyperglycemic crisis who also had a COVID-19 infection had a higher in-hospital mortality rate than patients who were COVID-19 negative. Contributing factors may include older age and concurrent steroid treatment, which were more frequent among patients with COVID-19 infection. Aggressive treatment of hyperglycemic crisis in COVID-19 patients is warranted. Efforts to prevent hyperglycemic crises should be improved.

Purpose: Fractures of the posterior column and posterior wall acetabulum are the most common pelvic fractures. In this study, we aimed to test the design of a new acetabular plate that combines the spring plate’s function and the plate’s reconstruction. This design should ease fixation and reduce surgery time, but is biomechanically untested. We analyzed this plate using finite element analysis (FEA). Materials and Methods: This observational study compares seven pelvic models: normal pelvis, posterior wall acetabular fracture, posterior column fracture, these two fractures combined, and the three fracture models fixed with the new acetabular plate. The evaluation was based on the analysis of deformation and stress distribution in each pelvic model under a force of 1,000 N directed at 45° from the sagittal and coronal planes. Results: In the normal pelvis, the greatest deformity was found on the ischial tuberosity (up to 3.91 mm and stress distribution tend to be homogenous. The new acetabular plate normalized the deformity and stress distribution to resemble the normal pelvis with highest stress on the ischial tuberosity and inferior side of the acetabulum. The largest deformation was in the middle of the plate and in the screw. Conclusion The novel plate can normalize stress and deformity in a fractured pelvis and may provide a solution for combining the posterior column and posterior wall of the acetabulum.

Background: The global resurgence of mpox, formerly monkeypox, poses an emerging threat to pregnant women due to immunological changes and potential vertical transmission, yet its impact on pregnancy remains underexplored. This study aims to pioneer a comprehensive assessment of pregnancy outcomes and the risks of vertical transmission associated with mpox infection during pregnancy. Materials and Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched three databases up to September 2024 for studies on pregnant women with mpox confirmed by quantitative polymerase chain reaction. Primary outcomes were composite adverse pregnancy outcomes:miscarriage or fetal death, congenital anomalies, and chorioamnionitis; the secondary outcome was vertical transmission. Study quality was assessed using Joanna Briggs Institute tools. Statistical analysis employed R software using a one-proportion model with Freeman-Tukey transformation and random-effects meta-analysis (restricted maximum-likelihood estimator, Knapp-Hartung adjustment), presenting estimated proportions with 95% confidence intervals (CIs). Results: Six studies (three case series, three case reports) comprising 11 singleton pregnancies were included.Diagnoses occurred in the first (27.3%), second (45.4%), and third trimesters (27.3%). Among the five genotypically identified Mpox cases, 20.0% were classified Clade I and 80.0% as Clade II. Meta-analysis indicated that an estimated 63% (95% CI, 43–83%) of pregnancies experienced composite adverse pregnancy outcomes. Specifically, miscarriage or fetal death occurred in 62% (95% CI, 21–102%), congenital anomalies in 50% (95% CI, 21–80%), and chorioamnionitis in 78% (95% CI, 44–96%). Vertical transmission was observed in 79% (95% CI, 6–151%). Despite small sample sizes leading to wide confidence intervals, high estimated proportions suggest that mpox severely impacts pregnancy outcomes, likely linked to maternal inflammation, placental invasion, and significant fetal risks from vertical transmission. Conclusion Mpox infection during pregnancy appears to be associated with high rates of adverse pregnancy outcomes and vertical transmission. Further large-scale studies are warranted to confirm these findings and develop preventive and management strategies mitigating this emerging threat.