BACKGROUND Breast cancer(BC)is a common cancer among females in Africa.Being infected with BC in Africa seems like a life sentence and brings devastating experiences to patients and households.As a result,BC is comorb...BACKGROUND Breast cancer(BC)is a common cancer among females in Africa.Being infected with BC in Africa seems like a life sentence and brings devastating experiences to patients and households.As a result,BC is comorbid with trauma,post-traumatic stress disorder(PTSD),and post-traumatic growth(PTG).AIM To identify empirical evidence from peer-reviewed articles on the comorbidity trajectories between BC and trauma,BC and PTSD,and BC and PTG.METHODS This review adhered to the PRISMA guidelines of conducting a systematic review.Literature searches of the National Library of Medicine,Scopus,PubMed,Google Scholar,and Scopus databases were conducted using search terms developed for the study.The search hint yielded 769 results,which were screened based on inclusion and exclusion criteria.At the end of the screening,24 articles were included in the systematic review.RESULTS BC patients suffered trauma and PTSD during the diagnosis and treatment stages.These traumatic events include painful experiences during and after diagnosis,psychological distress,depression,and cultural stigma against BC patients.PTSD occurrence among BC patients varies across African countries,as this review disclosed:90%was reported in Kenya,80%was reported in Zimbabwe,and 46%was reported in Nigeria.The severity of PTSD among BC patients in Africa was based on the test results communicated to the patients.Furthermore,this review revealed that BC patients experience PTG,which involves losing,regaining,and surrendering final control over the body,rebuilding a personified identity,and newfound appreciation for the body.CONCLUSION Patients with BC undergo numerous traumatic experiences during their diagnosis and treatment.Psychological interventions are needed in SSA to mitigate trauma and PTSD,as well as promote PTG.展开更多
目的:系统评价早期活动对重症监护室(ICU)创伤病人ICU住院时间、医院住院时间、机械通气时间、深静脉血栓发生率、病死率的影响。方法:计算机检索中国期刊全文数据库(CNKI)、万方数据库、PubMed、the Cochrane Library、EMbase、Web of ...目的:系统评价早期活动对重症监护室(ICU)创伤病人ICU住院时间、医院住院时间、机械通气时间、深静脉血栓发生率、病死率的影响。方法:计算机检索中国期刊全文数据库(CNKI)、万方数据库、PubMed、the Cochrane Library、EMbase、Web of Science中有关早期活动对ICU创伤病人影响的干预性研究。2名研究者独立对纳入文献进行质量评价和资料提取。采用RevMan 5.4软件进行Meta分析。结果:共纳入文献9篇。Meta分析结果显示,两组机械通气时间[MD=-1.22,95%CI(-2.11,-0.32),P=0.008]、病死率[OR=0.80,95%CI(0.65,0.98),P=0.03],合并效应均有统计学意义;ICU住院时间[MD=-0.63,95%CI(-1.40,-0.14),P=0.11]、医院住院时间[MD=-3.55,95%CI(-7.67,0.57),P=0.09]差异无统计学意义。结论:现在证据表明,ICU创伤病人进行早期活动安全有效,早期活动能够缩短ICU创伤病人的机械通气时间,降低其病死率。展开更多
Objective To evaluate the usefulness of quantitative electroencephalogram （QEEG）, flash visual evoked potential （F-VEP） and auditory brainstem responses （ABR） as indicators of general neurological status. Method...Objective To evaluate the usefulness of quantitative electroencephalogram （QEEG）, flash visual evoked potential （F-VEP） and auditory brainstem responses （ABR） as indicators of general neurological status. Methods Comparison was conducted on healthy controls （N=30） and patients with brain concussion （N=60） within 24 h after traumatic brain injury. Follow-up study of patient group was completed with the same standard paradigm 3 months later. All participants were recorded in multi-modality related potential testing in both early and late concussion at the same clinical setting. Glasgow coma scale, CT scanning, and physical examinations of neuro-psychological function, optic and auditory nervous system were performed before electroencephalogram （EEG） and evoked potential （EEG-EP） testing. Any participants showed abnormal changes of clinical examinations were excluded from the study. Average power of frequency spectrum and power ratios were selected for QEEG testing, and latency and amplitude of F-VEP and ABR were recorded. Results Between patients and normal controls, the results indicated： （1） Highly significance （P 〈 0.01） in average power of α1 and power ratios of θ/α1, 0/α2, α1/α2 of EEG recording; （2） N70-P 100 amplitude of F-VEP in significant difference at early brain concussion; and （3） apparent prolongation of Ⅰ～Ⅲ inter-peak latency of ABR appeared in some individuals at early stage after concussion. The follow-up study showed that some patients with concussion were also afflicted with characteristic changes of EEG components for both increments of α1 average power and θ/α2 power ratio after 3 months recording. Conclusion EEG testing has been shown to be more effective and sensitive than evoked potential tests alone on detecting functional state of patients with mild traumatic brain injury （MTBI）. Increments of α1 average power and θ/α2 power ratio are the sensitive EEG parameters to determining early concussion and evaluating outcome of 展开更多
Study objective: Aero medical crews offer an advanced level of practice and rapid transport to definitive care;however, their efficacy remains unproven. Previous studies have used relatively small sample sizes or have...Study objective: Aero medical crews offer an advanced level of practice and rapid transport to definitive care;however, their efficacy remains unproven. Previous studies have used relatively small sample sizes or have been unable to adequately control the effect of other potentially influential variables. Here we explore the impact of aeromedical response in patients with moderate to severe traumatic brain injury. Methods: This was a cross-sectional study using our county trauma registry. All patients with trauma injury, who referred to our emergency department by helicopter or car, were included. The impact of aeromedical response was determined using logistic regression, adjusting for age, sex, mechanism, preadmissionGlasgowComa Scale score and?Injury Severity Score. Finally, the aeromedical patients undergoing field intubation were compared with ground patients undergoing emergency department (ED) intubation. Results: A total of 243 patients meeting all inclusion and exclusion criteria and with complete data sets were identified. Overall mortality was 25% in the air- and ground-transported cohorts, but outcomes were not significantly better for the aeromedical patients when adjusted for age, sex, mechanism of injury, hypotension, Glasgow Coma Scale score, head Abbreviated Injury Score, and Injury Severity Score (adjusted odds ratio [OR] 1.90;95% confidence interval [CI] 1.60 to 2.25;P: 0001). Good outcomes (discharge to home, jail, psychiatric facility, rehabilitation, or leaving against medical advice) were also higher in aeromedical patients (adjusted OR 1.36;95% CI 1.18 to 1.58;P: 0001). Conclusion: Here we analyze a large database of patients with moderate to severe traumatic brain injury. Aeromedical response appears to yield no significantly improved outcomes after adjustment for multiple influential factors in patients with moderate to severe traumatic brain injury.展开更多
文摘BACKGROUND Breast cancer(BC)is a common cancer among females in Africa.Being infected with BC in Africa seems like a life sentence and brings devastating experiences to patients and households.As a result,BC is comorbid with trauma,post-traumatic stress disorder(PTSD),and post-traumatic growth(PTG).AIM To identify empirical evidence from peer-reviewed articles on the comorbidity trajectories between BC and trauma,BC and PTSD,and BC and PTG.METHODS This review adhered to the PRISMA guidelines of conducting a systematic review.Literature searches of the National Library of Medicine,Scopus,PubMed,Google Scholar,and Scopus databases were conducted using search terms developed for the study.The search hint yielded 769 results,which were screened based on inclusion and exclusion criteria.At the end of the screening,24 articles were included in the systematic review.RESULTS BC patients suffered trauma and PTSD during the diagnosis and treatment stages.These traumatic events include painful experiences during and after diagnosis,psychological distress,depression,and cultural stigma against BC patients.PTSD occurrence among BC patients varies across African countries,as this review disclosed:90%was reported in Kenya,80%was reported in Zimbabwe,and 46%was reported in Nigeria.The severity of PTSD among BC patients in Africa was based on the test results communicated to the patients.Furthermore,this review revealed that BC patients experience PTG,which involves losing,regaining,and surrendering final control over the body,rebuilding a personified identity,and newfound appreciation for the body.CONCLUSION Patients with BC undergo numerous traumatic experiences during their diagnosis and treatment.Psychological interventions are needed in SSA to mitigate trauma and PTSD,as well as promote PTG.
基金This work was supported in part by grants from National Natural Science Foundation of China （No. 30571909） China Postdoctoral Science Foundation （No. 32134006） Foundation of Soozhow University （No. Q4134405）.
文摘Objective To evaluate the usefulness of quantitative electroencephalogram （QEEG）, flash visual evoked potential （F-VEP） and auditory brainstem responses （ABR） as indicators of general neurological status. Methods Comparison was conducted on healthy controls （N=30） and patients with brain concussion （N=60） within 24 h after traumatic brain injury. Follow-up study of patient group was completed with the same standard paradigm 3 months later. All participants were recorded in multi-modality related potential testing in both early and late concussion at the same clinical setting. Glasgow coma scale, CT scanning, and physical examinations of neuro-psychological function, optic and auditory nervous system were performed before electroencephalogram （EEG） and evoked potential （EEG-EP） testing. Any participants showed abnormal changes of clinical examinations were excluded from the study. Average power of frequency spectrum and power ratios were selected for QEEG testing, and latency and amplitude of F-VEP and ABR were recorded. Results Between patients and normal controls, the results indicated： （1） Highly significance （P 〈 0.01） in average power of α1 and power ratios of θ/α1, 0/α2, α1/α2 of EEG recording; （2） N70-P 100 amplitude of F-VEP in significant difference at early brain concussion; and （3） apparent prolongation of Ⅰ～Ⅲ inter-peak latency of ABR appeared in some individuals at early stage after concussion. The follow-up study showed that some patients with concussion were also afflicted with characteristic changes of EEG components for both increments of α1 average power and θ/α2 power ratio after 3 months recording. Conclusion EEG testing has been shown to be more effective and sensitive than evoked potential tests alone on detecting functional state of patients with mild traumatic brain injury （MTBI）. Increments of α1 average power and θ/α2 power ratio are the sensitive EEG parameters to determining early concussion and evaluating outcome of
文摘Study objective: Aero medical crews offer an advanced level of practice and rapid transport to definitive care;however, their efficacy remains unproven. Previous studies have used relatively small sample sizes or have been unable to adequately control the effect of other potentially influential variables. Here we explore the impact of aeromedical response in patients with moderate to severe traumatic brain injury. Methods: This was a cross-sectional study using our county trauma registry. All patients with trauma injury, who referred to our emergency department by helicopter or car, were included. The impact of aeromedical response was determined using logistic regression, adjusting for age, sex, mechanism, preadmissionGlasgowComa Scale score and?Injury Severity Score. Finally, the aeromedical patients undergoing field intubation were compared with ground patients undergoing emergency department (ED) intubation. Results: A total of 243 patients meeting all inclusion and exclusion criteria and with complete data sets were identified. Overall mortality was 25% in the air- and ground-transported cohorts, but outcomes were not significantly better for the aeromedical patients when adjusted for age, sex, mechanism of injury, hypotension, Glasgow Coma Scale score, head Abbreviated Injury Score, and Injury Severity Score (adjusted odds ratio [OR] 1.90;95% confidence interval [CI] 1.60 to 2.25;P: 0001). Good outcomes (discharge to home, jail, psychiatric facility, rehabilitation, or leaving against medical advice) were also higher in aeromedical patients (adjusted OR 1.36;95% CI 1.18 to 1.58;P: 0001). Conclusion: Here we analyze a large database of patients with moderate to severe traumatic brain injury. Aeromedical response appears to yield no significantly improved outcomes after adjustment for multiple influential factors in patients with moderate to severe traumatic brain injury.
