Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divid...Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.展开更多
Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in ...Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in which an automated blood pressure cuff of the Spacelabs Ultraview Clinical Workstation monitor (model No. 90385) applied pressure for about five hours resulting in limb thrombosis. In order to analyze this catastrophe, simulation scenarios were tested to elucidate the possible errors and malfunctions that may have led to this injury. We present the analysis of the advantages and validity of the hearsay case report. We also include our proposed criteria that should be required when a hearsay case is considered for publication.展开更多
Background: First responders (firefighters, paramedics, and police) working in an urban setting can be exposed to a high-stress environment caused by strenuous physical exertion, potentially dangerous work conditions,...Background: First responders (firefighters, paramedics, and police) working in an urban setting can be exposed to a high-stress environment caused by strenuous physical exertion, potentially dangerous work conditions, sleep deprivation due to shift work, poor dietary habits, psychological stress and noise levels that are excessive. This may induce chronic increases in blood pressure. The purpose of this study was to determine the presence of hypertension in people working in occupations generally accepted as high stress in comparison to those working in an environment where less of these obvious high stressors were present. Methods: Resting blood pressure was measured by TrUBP in 1067 on-duty first responders (fire, paramedic, and police), and in participants generally associated with a lower-stress work environment (transit workers, city and bank employees, factory workers and legislature employees). Results: The average age, systolic and diastolic blood pressures were significantly lower in those employees working in a high-stress environment than those in a low-stress job. This difference was observed in both male and female sexes. Conclusions: Our data do not support an association of high resting blood pressure values in those employed in activities typically associated with a high-stress urban working environment.展开更多
Background: Tooth loss results in impaired mastication, which in turn, makes it difficult to chew hard food, consequently leading to deteriorate dietary habits and to develop hypertension. The purpose of this study wa...Background: Tooth loss results in impaired mastication, which in turn, makes it difficult to chew hard food, consequently leading to deteriorate dietary habits and to develop hypertension. The purpose of this study was to examine the effect of tooth loss on blood pressure among Congolese population. Methods: A cross-sectional study was conducted from October 2019 until December 2023 among Congolese population aged at least 30 years reporting to the living in DR Congo. All participants were enrolled from Dental Clinic located in the DR Congo. To be eligible to participate in the study, were the willing to participate and having signed informed consent;had a missing tooth;had carried out blood pressure measurement (hypertension/normotensive). The exclusion criteria were determined: being less than 30 years old, being pregnant for women considering the risk of existing gestational hypertension, obesity, excessive alcohol consumption, smoking, and diabetes. Hypertension was defined as the mean of three measurements of systolic blood pressure (SBP) (140 mmHg or higher), diastolic blood pressure (DBP) (90 mm or higher) or physician diagnosed hypertension confirmed from medical records. We determined the number of tooth loss from oral examination. A multivariable logistic regression model was used to investigate the effect of tooth loss on blood pressure. Results: In all, 25,396 participants were enrolled among Congolese population for this study. After oral examination, 13,421 were excluded for no tooth loss and 11,975 participants were selected. The average number of tooth loss among study population was 11.06. Among the participants with hypertension had lost an average of 11 teeth, significantly higher than those without hypertension (6.09) (p = 0.001). After adjusting for covariates (socio-demographic characteristics), tooth loss (>10) was significantly associated with hypertension, with OR = 1.32 (95% CI 1.073 - 2.38). Conclusion: Tooth loss maybe associated with severe hypertension among Congolese population adults. Prevention of tooth loss is very important to the overall health of this population.展开更多
Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patie...Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patients'blood pressure,they were divided into Group A,Group B and Group C,and all the data of hypertension patients in this study were collected,including age,gender,BMI,smoking,drinking,basic diseases(diabetes,cerebrovascular disease,hyperlipidemia,etc.),fasting blood glucose,ambulatory blood pressure(24-hour mean systolic pressure,24-hour mean diastolic pressure,daytime mean systolic pressure and daytime mean diastolic pressure).Results:There were significant differences in mean systolic blood pressure and mean diastolic blood pressure at night among Group A,Group B and Group C(P<0.05).Age,hyperlipidemia and fasting blood glucose were risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium was a protective factor for circadian rhythm abnormality(P<0.05).Conclusion:Age,hyperlipidemia and fasting blood glucose are risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium is a protective factor for circadian rhythm abnormality(P<0.05).展开更多
Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with sever...Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with severe bronchial asthma combined with respiratory failure between September 2022 and December 2023 were selected for the study and randomly divided into the experimental group(NIPPV-assisted treatment)and the control group.The differences between the two groups were compared in terms of total effective rate of treatment,days of clinical symptom disappearance,days of hospitalization,lung function indexes,incidence of adverse reactions,and quality of life.Results:Patients in the experimental group had a significantly higher total effective rate of treatment(97.78%)than the control group(75.56%).In terms of pulmonary function indexes,patients in the experimental group showed significant improvement after treatment,especially the increase in forced expiratory volume and forced vital capacity,while these improvements were not as obvious in the control group.In addition,the incidence of adverse reactions was significantly lower in the experimental group than in the control group,suggesting that the application of NIPPV is relatively safe.Quality of life assessment also showed that patients in the experimental group had significantly better quality of life than the control group after treatment.Conclusion:This study demonstrated the effectiveness of NIPPV as an adjunctive treatment for severe bronchial asthma combined with respiratory failure.NIPPV can improve lung function,reduce the incidence of adverse effects,increase the overall effectiveness of the treatment,and contribute to the improvement of patients'quality of life.Therefore,NIPPV should be regarded as an effective and safe treatment in clinical management,especially in patients with severe bronchial asthma combined with respiratory failure,where its application has potential clinical significance.展开更多
Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe p...Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.展开更多
Background:High blood pressure(BP)is a major contributor to mortality and cardiovascular diseases.Despite the known benefits of exercise for reducing BP,it is crucial to identify the most effective physical activity(P...Background:High blood pressure(BP)is a major contributor to mortality and cardiovascular diseases.Despite the known benefits of exercise for reducing BP,it is crucial to identify the most effective physical activity(PA)intervention.This systematic review and network meta-analysis(NMA)aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on BP.Methods:A search of PubMed,SPORTDiscus,PsycINFO,Web of Science,CINAHL,Cochrane,and Eric databases was conducted up to December 2022 for this systematic review and NMA.Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6-12 years old were included in this study.Only studies that compared controlled and intervention groups using PA or exercise as the major influence were included.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.Three independent investigators performed the literature screening,data extraction,and risk of bias assessment.We used Bayesian arm-based NMA to synthesize the data.The primary outcomes were systolic BP and diastolic BP.We calculated the mean differences(MDs)in systolic BP and diastolic BP before and after treatment.Mean treatment differences were estimated using NMA and random-effect models.Results:We synthesized 27 studies involving 15,220 children and adolescents.PA combined with nutrition and behavior change was the most effective intervention for reducing both systolic BP and diastolic BP(MD=-8.64,95%credible interval(95%CI):-11.44 to-5.84;MD=-6.75,95%CI:-10.44 to-3.11),followed by interventions with multiple components(MD=-1.39,95%CI:-1.94 to-0.84;MD=-2.54,95%CI:-4.89 to-0.29).Conclusion:Our findings suggest that PA interventions incorporating nutrition and behavior change,followed by interventions with multiple components,are most effective for reducing both systolic BP and diastolic BP in children and adolescents.展开更多
Monitoring blood pressure is a critical aspect of safeguarding an individual’s health,as early detection of abnormal blood pressure levels facilitates timely medical intervention,ultimately leading to a reduction in ...Monitoring blood pressure is a critical aspect of safeguarding an individual’s health,as early detection of abnormal blood pressure levels facilitates timely medical intervention,ultimately leading to a reduction in mortality rates associated with cardiovascular diseases.Consequently,the development of a robust and continuous blood pressure monitoring system holds paramount significance.In the context of this research paper,we introduce an innovative deep learning regression model that harnesses phonocardiogram(PCG)data to achieve precise blood pressure estimation.Our novel approach incorporates a convolutional neural network(CNN)-based regression model,which not only enhances its adaptability to spatial variations but also empowers it to capture intricate patterns within the PCG signals.These advancements contribute significantly to the overall accuracy of blood pressure estimation.To substantiate the effectiveness of our proposed method,we meticulously gathered PCG signal data from 78 volunteers,adhering to the ethical guidelines of Suranaree University of Technology(Human Research Ethics number EC-65-78).Subsequently,we rigorously preprocessed the dataset to ensure its integrity.We further employed a K-fold cross-validation procedure for data division and alignment,combining the resulting datasets with a CNNfor blood pressure estimation.The experimental results are highly promising,yielding aMeanAbsolute Error(MAE)and standard deviation(STD)of approximately 10.69±7.23 mmHg for systolic pressure and 6.89±5.22 mmHg for diastolic pressure.Our study underscores the potential for precise blood pressure estimation,particularly using PCG signals,paving the way for a practical,non-invasive method with broad applicability in the healthcare domain.Early detection of abnormal blood pressure levels can facilitate timely medical interventions,ultimately reducing cardiovascular disease-related mortality rates.展开更多
Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease i...Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease in the world. The objective was to determine the prevalence, treatment rate and control of hypertension. Methods: This was a cross-sectional and descriptive study which took place over a period of 6 months in a hospital environment and in the general population. Results: Of the 1000 participants, 637 had hypertension, giving a prevalence of 63.70% with a female predominance. Thirty-three percent (33%) were unaware of their high blood pressure. The age group 60 and more was the most represented (44%). A proportion of 33 and 23.20 were overweight and obese participants, respectively. Male subjects were more overweight than female, unlike obesity which was more common among female subjects. Sixty-two percent (62%) of hypertensives were treated, of whom 44% were non-compliant. The excessively high cost and consumption of medications as needed were the main factors in therapeutic non-compliance. Twenty-two percent (22%) of all hypertensive patients and 35% of treated hypertensive patients were controlled. Women were more treated but less observant and less controlled than men. Therapeutic coverage and combination therapy rates were lower in rural areas. Hypertensives who had a high level of education were better treated and controlled than those who had no level. Conclusion: High blood pressure remains a real public health problem in Mali. It is more common in people aged 60 and over and in females. One in three hypertensives were unaware of their hypertension. The majority received antihypertensive treatments, but only a minority of them had their hypertension controlled.展开更多
Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors inclu...Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliability tests of the collected data were carried out. For this, the Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value. Descriptive analysis was possible using R software version 3.2, SPSS version 25.0, XLSTAT 2016, PAST and EXCEL programs from Microsoft Office 2013. Results: The main results highlight economic stress, with 45.60% of households surveyed earning less than US$154 per month;55% of household heads were women in single-parent families;14% of household heads were unemployed, 22% worked in the private sector and 19% were self-employed. This general economic situation leads to precarious living conditions, thereby increasing the risk of high blood pressure among the Cameroonian population.展开更多
Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of sk...Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.展开更多
Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determin...Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.展开更多
BACKGROUND Pre-eclampsia has long been proven to be an independent risk factor for postpartum depression(PPD).Excessive increase in body mass index(BMI)during pregnancy is an important factor inducing pre-eclampsia.In...BACKGROUND Pre-eclampsia has long been proven to be an independent risk factor for postpartum depression(PPD).Excessive increase in body mass index(BMI)during pregnancy is an important factor inducing pre-eclampsia.Increased blood pressure is the main symptom of patients with pre-eclampsia.However,whether there is a correlation between BMI and blood pressure variability during pregnancy and PPD occurrence in pregnant women with pre-eclampsia remains unclear.AIM To investigate the relationship between BMI,blood pressure variability,and PPD in pregnant women with pre-eclampsia.METHODS Using a cross-sectional survey research,201 pregnant women with pre-eclampsia who were treated and delivered in Suzhou Ninth People’s Hospital from May 2016 to June 2024 were selected as this study’s subjects.At 42 days after delivery,the subjects were re-examined in the hospital’s outpatient department.The Edinburgh Postnatal Depression Scale(EPDS)was used to evaluate whether PPD symptoms,divided the subjects into two groups:The PPD and non-PPD groups.We analyzed clinical data,changes in BMI during pregnancy,and blood pressure variability in the two groups.The Pearson method was used to test the correlation between BMI increase,blood pressure variability during pregnancy,and EPDS score in patients with pre-eclampsia.Logistic regression analysis was performed to explore whether increased BMI and blood pressure variability during pregnancy are influencing factors for PPD occurrence in patients with pre-eclampsia.RESULTS Of the 201 pre-eclamptic women who underwent an outpatient review 42 days after delivery,37 had PPD symptoms based on the EPDS scale evaluation,resulting in an incidence rate of 18.41%(37/201).The differences between the PPD and non-PPD groups in terms of age,educational level,place of residence,reproductive history,gestational age,mode of delivery,newborn gender,and newborn birth weight were not statistically significant(P>0.05).The gestational BMI increase,24-hour systolic blood pressure(SBP)variability,and 24-hour diastolic blood pressure(DBP)variability in the PPD group were significantly higher than those in the non-PPD group;the differences were statistically significant(P<0.001).Pearson correlation analysis showed that BMI increase,SBP variability,and DBP variability during pregnancy correlated positively with the EPDS score of pregnant women with pre-eclampsia(r=0.349,0.336,and 0.241;P<0.001).Logistic regression analysis showed that a high increase in BMI during pregnancy[odds ratio(OR)=4.614,95%confidence interval(CI):1.749-12.170,P=0.002],large variability in 24-hour SBP(OR=2.910,95%CI:1.322-6.404,P=0.008),and large variability in 24-hour DBP(OR=2.347,95%CI:1.138-4.831,P=0.021)were factors affecting PPD occurrence in patients with pre-eclampsia.CONCLUSION Increased BMI and blood pressure variability during pregnancy can increase the risk of PPD in patients with preeclampsia.Strengthening pregnancy guidance and controlling fluctuations in BMI and blood pressure variability during pregnancy within a reasonable range can help reduce the risk of PPD in patients with pre-eclampsia.展开更多
To improve the accuracy of predicting non-invasive blood glucose concentration in the near-infrared spectrum, we utilized the Particle Swarm Optimization (PSO) algorithm to optimize hyperparameters for the Multi-Kerne...To improve the accuracy of predicting non-invasive blood glucose concentration in the near-infrared spectrum, we utilized the Particle Swarm Optimization (PSO) algorithm to optimize hyperparameters for the Multi-Kernel Learning Support Vector Machine (MKL-SVR). With these optimized hyperparameters, we established a non-invasive blood glucose regression model, referred to as the PSO-MKL-SVR model. Subsequently, we conducted a comparative analysis between the PSO-MKL-SVR model and the PSO-SVR model. In a dataset comprising ten volunteers, the PSO-MKL-SVR model exhibited significant precision improvements, including a 16.03% reduction in Mean Square Error and a 0.29% increase in the Squared Correlation Coefficient. Moreover, there was a 0.14% higher probability of the Clark’s Error Grid Analysis falling within Zone A. Additionally, the PSO-MKL-SVR model demonstrated a faster operational speed compared to the PSO-SVR model.展开更多
Objective:The aim of the study was to evaluate the quality of sleep in nurses performing shift work in therapeutic and surgical depar tments and to establish possible relationships between level of blood pressure(BP)a...Objective:The aim of the study was to evaluate the quality of sleep in nurses performing shift work in therapeutic and surgical depar tments and to establish possible relationships between level of blood pressure(BP)and quality of sleep.Methods:A total of 20 nurses of the therapeutic depar tments and 20 nurses of the surgical depar tments were enrolled in the study.Sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI).BP was measured according to the standard protocol using the Korotkoff method;a sphygmomanometer was used for this twice with an interval of 2 min between 10:00 a.m.and 10:30 a.m.The average value for the 2 indicators was calculated.The diagnosis of essential ar terial hyper tension(AH)was established according to the recommendations of the European Association of Cardiology and the European Association of Hypertension(2018).Results:The overall assessment of the sleep quality of the nurses involved in shift work indicates poor sleep quality;this was true in respondents of both the surgical and therapeutic profiles.However,it was observed that the quality of sleep was significantly lower in nurses of the therapeutic departments.Moreover,poor sleep quality was associated with AH,which was diagnosed in 65%of the nurses of the therapeutic departments and 45%of the nurses of the surgical departments,that is,in almost all of the subjects.Herewith,in the nurses of the therapeutic departments,the level of systolic BP exceeded that of the nurses of the surgical departments.Conclusions:Poor sleep quality is a significant risk factor for AH development and is relevant to nurses performing shift work.Additional clinical studies should be conducted to better understand the mechanisms underlying such adverse cardiometabolic outcomes associated with sleep disorders in the health-sector shift workers.展开更多
Objective:To study the causality relationship between diastolic blood pressure(DBP)and hypertensive renal disease with renal failure(HRDRF)and the mediating role of hear t failure(HF)in the causality relationship by n...Objective:To study the causality relationship between diastolic blood pressure(DBP)and hypertensive renal disease with renal failure(HRDRF)and the mediating role of hear t failure(HF)in the causality relationship by network Mendelian randomization(MR).Methods:Genome-wide analysis of DBP,HRDRF,and HF was downloaded from the public database(Genome-Wide Analysis Study[GWAS])and was used to analyze the results and to conduct mediated MR analysis.Results:Analysis showed that DBP was positively correlated with HRDRF(OR=1.0002,95%CI:1.0001–1.0003,P=1.8076e-05)and DBP was positively correlated with HF(OR=1.0295,95%CI:1.0221–1.0370,P=2.5292e-15).HF and HRDRF had a positive causal effect(OR=1.0001,95%CI:1.0000–1.0001,P=0.0152).Mediation analysis showed that the contribution ratio of HF to the combined effect of DBP and HRDRF was 24.69%.Conclusions:DBP can increase the risk of renal disease with renal failure,and HF may play an impor tant role in mediating this causal relationship.展开更多
<strong>Rationale: </strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Acute respiratory failur...<strong>Rationale: </strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Acute respiratory failure is an uncommon complication of pregnancy. However, it is the most frequent organ dysfunction associated with obstetric admissions to an intensive care unit. The obstetric population is a different group due to its physiology and the presence of the fetus that lacks evidence in the literature within the subject of ventilatory support. Noninvasive positive pressure ventilation (NIPPV) is often avoided due to the lack of knowledge on the safety and efficacy of this modality. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Currently,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> there are no guidelines for the management of respiratory failure in pregnancy. </span><b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:Verdana;">To provide evidence in support of the use of NIPPV as a safe and reasonable modality for pregnant patients with respiratory failure. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">We retrospectively reviewed medical records of 29 pregnant patients of the Obstetric Critical Care Unit of a tertiary hospital in Panamá City who received NIPPV from 2013 to 2015. Failure to response was defined as the lack of increase in the </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio or clinical deterioration 6 hours after initiating NIPPV. Demographics, indication for NIPPV, duration of treatment, as well as maternal and fetal outcomes were collected. </span><b><span style="font-family:Verdana;">Measurements</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Main</span></b> <b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Mean age was 28.4 ± 6 years, mean body mass index 27.4 ± 3.3, and mean gestational age at admission was 30</span><sup><span style="font-family:Verdana;">5/7</span></sup><span style="font-family:Verdana;"> ± 5 weeks. Twenty-four patients (82.8%) met the criteria for acute lung injury (ALI) and an additional two (6.9%) for acute respiratory distress syndrome (ARDS). The mean duration of ventilation was 50.6 ± 17.27 hours. Statistically significant differences were noted between the </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratios in failure and successful patients within 2 hours of NIPPV therapy (P = 0.007) and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio within 6 hours of NIPPV therapy (P = 0.03). Success was defined when the patient was administered NIPPV, resulting in an improvement (increase in </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">p</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">a/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio) of her ventilatory parameters. Three patients (10.3%) failed to respond to NIPPV and needed to be converted to invasive mechanical ventilation. Patients who required intubation had a longer duration of ICU stay (P = 0.006) and overall hospital stay (P = 0.03). None of patients presented aspiration during NIPPV therapy. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The current series is the largest report of pregnant patients requiring ventilatory support who received NIPPV as first line of therapy. This report shows the usefulness of this ventilation modality, avoiding intubation with its risks, of a significant number of patients, especially ventilator-associated pneumonia.</span></span></span></span>展开更多
Objective: To evaluate the efficiency of an implanted chip system on blood pressure regulation. Methods: The mean arterial pressure (MAP) and heart rate (HR) were recorded in anesthetized rabbits. Based on the set poi...Objective: To evaluate the efficiency of an implanted chip system on blood pressure regulation. Methods: The mean arterial pressure (MAP) and heart rate (HR) were recorded in anesthetized rabbits. Based on the set point theory, an implanted chip system was designed to regulate the blood pressure by stimulating the aortic depressor nerve (ADN) according to the feedback of blood pressure. The blood pressure regulation induced by the implanted chip system was carried out twice (lasted for 15 min and 60 min respectively) and the change of MAP and HR during the regulation was compared with the control. Results: There was a significant decrease of MAP during the first regulation ([-32.0 ± 6.6] mmHg) and second regulation ([-27.4 ± 6.2] mmHg) compared with the control (P<0.01). The HR was also significantly decreased during regulation compared with the control. Both MAP and HR returned to the baseline immediately without rebound after the regulation ceased. Conclusion: The implanted chip system can regulate the blood pressure successfully and keep the blood pressure in a lower constant level without adaptation.展开更多
文摘Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.
文摘Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in which an automated blood pressure cuff of the Spacelabs Ultraview Clinical Workstation monitor (model No. 90385) applied pressure for about five hours resulting in limb thrombosis. In order to analyze this catastrophe, simulation scenarios were tested to elucidate the possible errors and malfunctions that may have led to this injury. We present the analysis of the advantages and validity of the hearsay case report. We also include our proposed criteria that should be required when a hearsay case is considered for publication.
文摘Background: First responders (firefighters, paramedics, and police) working in an urban setting can be exposed to a high-stress environment caused by strenuous physical exertion, potentially dangerous work conditions, sleep deprivation due to shift work, poor dietary habits, psychological stress and noise levels that are excessive. This may induce chronic increases in blood pressure. The purpose of this study was to determine the presence of hypertension in people working in occupations generally accepted as high stress in comparison to those working in an environment where less of these obvious high stressors were present. Methods: Resting blood pressure was measured by TrUBP in 1067 on-duty first responders (fire, paramedic, and police), and in participants generally associated with a lower-stress work environment (transit workers, city and bank employees, factory workers and legislature employees). Results: The average age, systolic and diastolic blood pressures were significantly lower in those employees working in a high-stress environment than those in a low-stress job. This difference was observed in both male and female sexes. Conclusions: Our data do not support an association of high resting blood pressure values in those employed in activities typically associated with a high-stress urban working environment.
文摘Background: Tooth loss results in impaired mastication, which in turn, makes it difficult to chew hard food, consequently leading to deteriorate dietary habits and to develop hypertension. The purpose of this study was to examine the effect of tooth loss on blood pressure among Congolese population. Methods: A cross-sectional study was conducted from October 2019 until December 2023 among Congolese population aged at least 30 years reporting to the living in DR Congo. All participants were enrolled from Dental Clinic located in the DR Congo. To be eligible to participate in the study, were the willing to participate and having signed informed consent;had a missing tooth;had carried out blood pressure measurement (hypertension/normotensive). The exclusion criteria were determined: being less than 30 years old, being pregnant for women considering the risk of existing gestational hypertension, obesity, excessive alcohol consumption, smoking, and diabetes. Hypertension was defined as the mean of three measurements of systolic blood pressure (SBP) (140 mmHg or higher), diastolic blood pressure (DBP) (90 mm or higher) or physician diagnosed hypertension confirmed from medical records. We determined the number of tooth loss from oral examination. A multivariable logistic regression model was used to investigate the effect of tooth loss on blood pressure. Results: In all, 25,396 participants were enrolled among Congolese population for this study. After oral examination, 13,421 were excluded for no tooth loss and 11,975 participants were selected. The average number of tooth loss among study population was 11.06. Among the participants with hypertension had lost an average of 11 teeth, significantly higher than those without hypertension (6.09) (p = 0.001). After adjusting for covariates (socio-demographic characteristics), tooth loss (>10) was significantly associated with hypertension, with OR = 1.32 (95% CI 1.073 - 2.38). Conclusion: Tooth loss maybe associated with severe hypertension among Congolese population adults. Prevention of tooth loss is very important to the overall health of this population.
文摘Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patients'blood pressure,they were divided into Group A,Group B and Group C,and all the data of hypertension patients in this study were collected,including age,gender,BMI,smoking,drinking,basic diseases(diabetes,cerebrovascular disease,hyperlipidemia,etc.),fasting blood glucose,ambulatory blood pressure(24-hour mean systolic pressure,24-hour mean diastolic pressure,daytime mean systolic pressure and daytime mean diastolic pressure).Results:There were significant differences in mean systolic blood pressure and mean diastolic blood pressure at night among Group A,Group B and Group C(P<0.05).Age,hyperlipidemia and fasting blood glucose were risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium was a protective factor for circadian rhythm abnormality(P<0.05).Conclusion:Age,hyperlipidemia and fasting blood glucose are risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium is a protective factor for circadian rhythm abnormality(P<0.05).
文摘Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with severe bronchial asthma combined with respiratory failure between September 2022 and December 2023 were selected for the study and randomly divided into the experimental group(NIPPV-assisted treatment)and the control group.The differences between the two groups were compared in terms of total effective rate of treatment,days of clinical symptom disappearance,days of hospitalization,lung function indexes,incidence of adverse reactions,and quality of life.Results:Patients in the experimental group had a significantly higher total effective rate of treatment(97.78%)than the control group(75.56%).In terms of pulmonary function indexes,patients in the experimental group showed significant improvement after treatment,especially the increase in forced expiratory volume and forced vital capacity,while these improvements were not as obvious in the control group.In addition,the incidence of adverse reactions was significantly lower in the experimental group than in the control group,suggesting that the application of NIPPV is relatively safe.Quality of life assessment also showed that patients in the experimental group had significantly better quality of life than the control group after treatment.Conclusion:This study demonstrated the effectiveness of NIPPV as an adjunctive treatment for severe bronchial asthma combined with respiratory failure.NIPPV can improve lung function,reduce the incidence of adverse effects,increase the overall effectiveness of the treatment,and contribute to the improvement of patients'quality of life.Therefore,NIPPV should be regarded as an effective and safe treatment in clinical management,especially in patients with severe bronchial asthma combined with respiratory failure,where its application has potential clinical significance.
文摘Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.
文摘Background:High blood pressure(BP)is a major contributor to mortality and cardiovascular diseases.Despite the known benefits of exercise for reducing BP,it is crucial to identify the most effective physical activity(PA)intervention.This systematic review and network meta-analysis(NMA)aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on BP.Methods:A search of PubMed,SPORTDiscus,PsycINFO,Web of Science,CINAHL,Cochrane,and Eric databases was conducted up to December 2022 for this systematic review and NMA.Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6-12 years old were included in this study.Only studies that compared controlled and intervention groups using PA or exercise as the major influence were included.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.Three independent investigators performed the literature screening,data extraction,and risk of bias assessment.We used Bayesian arm-based NMA to synthesize the data.The primary outcomes were systolic BP and diastolic BP.We calculated the mean differences(MDs)in systolic BP and diastolic BP before and after treatment.Mean treatment differences were estimated using NMA and random-effect models.Results:We synthesized 27 studies involving 15,220 children and adolescents.PA combined with nutrition and behavior change was the most effective intervention for reducing both systolic BP and diastolic BP(MD=-8.64,95%credible interval(95%CI):-11.44 to-5.84;MD=-6.75,95%CI:-10.44 to-3.11),followed by interventions with multiple components(MD=-1.39,95%CI:-1.94 to-0.84;MD=-2.54,95%CI:-4.89 to-0.29).Conclusion:Our findings suggest that PA interventions incorporating nutrition and behavior change,followed by interventions with multiple components,are most effective for reducing both systolic BP and diastolic BP in children and adolescents.
基金Suranaree University of Technology,Thailand Science Research and Innovation(TSRI)National Science,Research,and Innovation Fund(NSRF)(NRIIS Number 179292).
文摘Monitoring blood pressure is a critical aspect of safeguarding an individual’s health,as early detection of abnormal blood pressure levels facilitates timely medical intervention,ultimately leading to a reduction in mortality rates associated with cardiovascular diseases.Consequently,the development of a robust and continuous blood pressure monitoring system holds paramount significance.In the context of this research paper,we introduce an innovative deep learning regression model that harnesses phonocardiogram(PCG)data to achieve precise blood pressure estimation.Our novel approach incorporates a convolutional neural network(CNN)-based regression model,which not only enhances its adaptability to spatial variations but also empowers it to capture intricate patterns within the PCG signals.These advancements contribute significantly to the overall accuracy of blood pressure estimation.To substantiate the effectiveness of our proposed method,we meticulously gathered PCG signal data from 78 volunteers,adhering to the ethical guidelines of Suranaree University of Technology(Human Research Ethics number EC-65-78).Subsequently,we rigorously preprocessed the dataset to ensure its integrity.We further employed a K-fold cross-validation procedure for data division and alignment,combining the resulting datasets with a CNNfor blood pressure estimation.The experimental results are highly promising,yielding aMeanAbsolute Error(MAE)and standard deviation(STD)of approximately 10.69±7.23 mmHg for systolic pressure and 6.89±5.22 mmHg for diastolic pressure.Our study underscores the potential for precise blood pressure estimation,particularly using PCG signals,paving the way for a practical,non-invasive method with broad applicability in the healthcare domain.Early detection of abnormal blood pressure levels can facilitate timely medical interventions,ultimately reducing cardiovascular disease-related mortality rates.
文摘Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease in the world. The objective was to determine the prevalence, treatment rate and control of hypertension. Methods: This was a cross-sectional and descriptive study which took place over a period of 6 months in a hospital environment and in the general population. Results: Of the 1000 participants, 637 had hypertension, giving a prevalence of 63.70% with a female predominance. Thirty-three percent (33%) were unaware of their high blood pressure. The age group 60 and more was the most represented (44%). A proportion of 33 and 23.20 were overweight and obese participants, respectively. Male subjects were more overweight than female, unlike obesity which was more common among female subjects. Sixty-two percent (62%) of hypertensives were treated, of whom 44% were non-compliant. The excessively high cost and consumption of medications as needed were the main factors in therapeutic non-compliance. Twenty-two percent (22%) of all hypertensive patients and 35% of treated hypertensive patients were controlled. Women were more treated but less observant and less controlled than men. Therapeutic coverage and combination therapy rates were lower in rural areas. Hypertensives who had a high level of education were better treated and controlled than those who had no level. Conclusion: High blood pressure remains a real public health problem in Mali. It is more common in people aged 60 and over and in females. One in three hypertensives were unaware of their hypertension. The majority received antihypertensive treatments, but only a minority of them had their hypertension controlled.
文摘Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliability tests of the collected data were carried out. For this, the Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value. Descriptive analysis was possible using R software version 3.2, SPSS version 25.0, XLSTAT 2016, PAST and EXCEL programs from Microsoft Office 2013. Results: The main results highlight economic stress, with 45.60% of households surveyed earning less than US$154 per month;55% of household heads were women in single-parent families;14% of household heads were unemployed, 22% worked in the private sector and 19% were self-employed. This general economic situation leads to precarious living conditions, thereby increasing the risk of high blood pressure among the Cameroonian population.
文摘Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.
文摘Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.
文摘BACKGROUND Pre-eclampsia has long been proven to be an independent risk factor for postpartum depression(PPD).Excessive increase in body mass index(BMI)during pregnancy is an important factor inducing pre-eclampsia.Increased blood pressure is the main symptom of patients with pre-eclampsia.However,whether there is a correlation between BMI and blood pressure variability during pregnancy and PPD occurrence in pregnant women with pre-eclampsia remains unclear.AIM To investigate the relationship between BMI,blood pressure variability,and PPD in pregnant women with pre-eclampsia.METHODS Using a cross-sectional survey research,201 pregnant women with pre-eclampsia who were treated and delivered in Suzhou Ninth People’s Hospital from May 2016 to June 2024 were selected as this study’s subjects.At 42 days after delivery,the subjects were re-examined in the hospital’s outpatient department.The Edinburgh Postnatal Depression Scale(EPDS)was used to evaluate whether PPD symptoms,divided the subjects into two groups:The PPD and non-PPD groups.We analyzed clinical data,changes in BMI during pregnancy,and blood pressure variability in the two groups.The Pearson method was used to test the correlation between BMI increase,blood pressure variability during pregnancy,and EPDS score in patients with pre-eclampsia.Logistic regression analysis was performed to explore whether increased BMI and blood pressure variability during pregnancy are influencing factors for PPD occurrence in patients with pre-eclampsia.RESULTS Of the 201 pre-eclamptic women who underwent an outpatient review 42 days after delivery,37 had PPD symptoms based on the EPDS scale evaluation,resulting in an incidence rate of 18.41%(37/201).The differences between the PPD and non-PPD groups in terms of age,educational level,place of residence,reproductive history,gestational age,mode of delivery,newborn gender,and newborn birth weight were not statistically significant(P>0.05).The gestational BMI increase,24-hour systolic blood pressure(SBP)variability,and 24-hour diastolic blood pressure(DBP)variability in the PPD group were significantly higher than those in the non-PPD group;the differences were statistically significant(P<0.001).Pearson correlation analysis showed that BMI increase,SBP variability,and DBP variability during pregnancy correlated positively with the EPDS score of pregnant women with pre-eclampsia(r=0.349,0.336,and 0.241;P<0.001).Logistic regression analysis showed that a high increase in BMI during pregnancy[odds ratio(OR)=4.614,95%confidence interval(CI):1.749-12.170,P=0.002],large variability in 24-hour SBP(OR=2.910,95%CI:1.322-6.404,P=0.008),and large variability in 24-hour DBP(OR=2.347,95%CI:1.138-4.831,P=0.021)were factors affecting PPD occurrence in patients with pre-eclampsia.CONCLUSION Increased BMI and blood pressure variability during pregnancy can increase the risk of PPD in patients with preeclampsia.Strengthening pregnancy guidance and controlling fluctuations in BMI and blood pressure variability during pregnancy within a reasonable range can help reduce the risk of PPD in patients with pre-eclampsia.
文摘To improve the accuracy of predicting non-invasive blood glucose concentration in the near-infrared spectrum, we utilized the Particle Swarm Optimization (PSO) algorithm to optimize hyperparameters for the Multi-Kernel Learning Support Vector Machine (MKL-SVR). With these optimized hyperparameters, we established a non-invasive blood glucose regression model, referred to as the PSO-MKL-SVR model. Subsequently, we conducted a comparative analysis between the PSO-MKL-SVR model and the PSO-SVR model. In a dataset comprising ten volunteers, the PSO-MKL-SVR model exhibited significant precision improvements, including a 16.03% reduction in Mean Square Error and a 0.29% increase in the Squared Correlation Coefficient. Moreover, there was a 0.14% higher probability of the Clark’s Error Grid Analysis falling within Zone A. Additionally, the PSO-MKL-SVR model demonstrated a faster operational speed compared to the PSO-SVR model.
文摘Objective:The aim of the study was to evaluate the quality of sleep in nurses performing shift work in therapeutic and surgical depar tments and to establish possible relationships between level of blood pressure(BP)and quality of sleep.Methods:A total of 20 nurses of the therapeutic depar tments and 20 nurses of the surgical depar tments were enrolled in the study.Sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI).BP was measured according to the standard protocol using the Korotkoff method;a sphygmomanometer was used for this twice with an interval of 2 min between 10:00 a.m.and 10:30 a.m.The average value for the 2 indicators was calculated.The diagnosis of essential ar terial hyper tension(AH)was established according to the recommendations of the European Association of Cardiology and the European Association of Hypertension(2018).Results:The overall assessment of the sleep quality of the nurses involved in shift work indicates poor sleep quality;this was true in respondents of both the surgical and therapeutic profiles.However,it was observed that the quality of sleep was significantly lower in nurses of the therapeutic departments.Moreover,poor sleep quality was associated with AH,which was diagnosed in 65%of the nurses of the therapeutic departments and 45%of the nurses of the surgical departments,that is,in almost all of the subjects.Herewith,in the nurses of the therapeutic departments,the level of systolic BP exceeded that of the nurses of the surgical departments.Conclusions:Poor sleep quality is a significant risk factor for AH development and is relevant to nurses performing shift work.Additional clinical studies should be conducted to better understand the mechanisms underlying such adverse cardiometabolic outcomes associated with sleep disorders in the health-sector shift workers.
基金supported by the scientific research project of Shanxi Provincial Health Commission(No.2022073)。
文摘Objective:To study the causality relationship between diastolic blood pressure(DBP)and hypertensive renal disease with renal failure(HRDRF)and the mediating role of hear t failure(HF)in the causality relationship by network Mendelian randomization(MR).Methods:Genome-wide analysis of DBP,HRDRF,and HF was downloaded from the public database(Genome-Wide Analysis Study[GWAS])and was used to analyze the results and to conduct mediated MR analysis.Results:Analysis showed that DBP was positively correlated with HRDRF(OR=1.0002,95%CI:1.0001–1.0003,P=1.8076e-05)and DBP was positively correlated with HF(OR=1.0295,95%CI:1.0221–1.0370,P=2.5292e-15).HF and HRDRF had a positive causal effect(OR=1.0001,95%CI:1.0000–1.0001,P=0.0152).Mediation analysis showed that the contribution ratio of HF to the combined effect of DBP and HRDRF was 24.69%.Conclusions:DBP can increase the risk of renal disease with renal failure,and HF may play an impor tant role in mediating this causal relationship.
文摘<strong>Rationale: </strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Acute respiratory failure is an uncommon complication of pregnancy. However, it is the most frequent organ dysfunction associated with obstetric admissions to an intensive care unit. The obstetric population is a different group due to its physiology and the presence of the fetus that lacks evidence in the literature within the subject of ventilatory support. Noninvasive positive pressure ventilation (NIPPV) is often avoided due to the lack of knowledge on the safety and efficacy of this modality. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Currently,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> there are no guidelines for the management of respiratory failure in pregnancy. </span><b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:Verdana;">To provide evidence in support of the use of NIPPV as a safe and reasonable modality for pregnant patients with respiratory failure. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">We retrospectively reviewed medical records of 29 pregnant patients of the Obstetric Critical Care Unit of a tertiary hospital in Panamá City who received NIPPV from 2013 to 2015. Failure to response was defined as the lack of increase in the </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio or clinical deterioration 6 hours after initiating NIPPV. Demographics, indication for NIPPV, duration of treatment, as well as maternal and fetal outcomes were collected. </span><b><span style="font-family:Verdana;">Measurements</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Main</span></b> <b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Mean age was 28.4 ± 6 years, mean body mass index 27.4 ± 3.3, and mean gestational age at admission was 30</span><sup><span style="font-family:Verdana;">5/7</span></sup><span style="font-family:Verdana;"> ± 5 weeks. Twenty-four patients (82.8%) met the criteria for acute lung injury (ALI) and an additional two (6.9%) for acute respiratory distress syndrome (ARDS). The mean duration of ventilation was 50.6 ± 17.27 hours. Statistically significant differences were noted between the </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratios in failure and successful patients within 2 hours of NIPPV therapy (P = 0.007) and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio within 6 hours of NIPPV therapy (P = 0.03). Success was defined when the patient was administered NIPPV, resulting in an improvement (increase in </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">p</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">a/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio) of her ventilatory parameters. Three patients (10.3%) failed to respond to NIPPV and needed to be converted to invasive mechanical ventilation. Patients who required intubation had a longer duration of ICU stay (P = 0.006) and overall hospital stay (P = 0.03). None of patients presented aspiration during NIPPV therapy. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The current series is the largest report of pregnant patients requiring ventilatory support who received NIPPV as first line of therapy. This report shows the usefulness of this ventilation modality, avoiding intubation with its risks, of a significant number of patients, especially ventilator-associated pneumonia.</span></span></span></span>
文摘Objective: To evaluate the efficiency of an implanted chip system on blood pressure regulation. Methods: The mean arterial pressure (MAP) and heart rate (HR) were recorded in anesthetized rabbits. Based on the set point theory, an implanted chip system was designed to regulate the blood pressure by stimulating the aortic depressor nerve (ADN) according to the feedback of blood pressure. The blood pressure regulation induced by the implanted chip system was carried out twice (lasted for 15 min and 60 min respectively) and the change of MAP and HR during the regulation was compared with the control. Results: There was a significant decrease of MAP during the first regulation ([-32.0 ± 6.6] mmHg) and second regulation ([-27.4 ± 6.2] mmHg) compared with the control (P<0.01). The HR was also significantly decreased during regulation compared with the control. Both MAP and HR returned to the baseline immediately without rebound after the regulation ceased. Conclusion: The implanted chip system can regulate the blood pressure successfully and keep the blood pressure in a lower constant level without adaptation.
