Impella (Abiomed, Danvers, MA) devices nowadays have been linked to cardiogenic shock (CS) due to the importance of their use as therapeutic instruments. This study aims to review pathophysiologic mechanisms of cardiogenic shock and the implementation of Impella to overcome this condition. To investigate several different types of studies and analyze the use of Impella device in cardiogenic shock and the outcomes of heart malfunctioning and determine its positive and negative impacts as a therapeutic tool in cardiac ischemia and use as a resource in critical patients, we conducted a systematic review through different databases (PubMed, ScienceDirect, and Google Scholar) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and used the Medical Subjects Heading (MeSH) search strategy to obtain significant articles. We found 883 papers in total, and after removing duplicates, applying inclusion/exclusion criteria, and finding the most significant information, we ended up with 30 articles that were reviewed containing information about the impact of Impella device in cardiogenic shock in different locations. The study strongly concludes that Impella device in the setting of cardiogenic shock has more advantages than disadvantages in terms of outcomes and complications as a non-pharmacologic tool. Improvements in left ventricular ejection fraction and signs and symptoms of cardiogenic shock criteria were determinants. Nevertheless, complications during the implementation and use of the device were established; in this manner, the evaluation and treatment of each patient separately are imperative. Consequently, more studies on this relevant topic are needed.
BackgroundDistal radius fractures account for almost one-sixth of all fractures in a casualty setting. The usual aim of distal radius fracture treatment is to restore the function of the wrist joint, of which the distal radius is an important part. There seems to be no consensus regarding which mode of treatment is optimal for managing distal radius fracture, particularly when it is associated with distal radioulnar joint instability. ObjectiveTo describe the functional outcome in patients presenting with displaced distal radius fractures who undergo Joshi's external stabilization system (JESS) fixation. MethodsAn observational study was done among 32 working-age (18 to 55 years) patients presenting with unilateral displaced distal radius fractures (excluding volar displaced) and subsequently treated with JESS fixation. The outcomes of the patients were assessed using the Green and O'Brien Scoring System modified by Cooney et al. at six months and one year following the surgery. Radiographs were also taken postoperatively and during follow-up. The data were analyzed (using IBM SPSS software version 22 and Microsoft Excel) in terms of the proportion of patients with acceptable clinical and radiological outcomes. ResultsAcceptable functional outcomes (good and excellent scores in the Green and O'Brien Scoring System) were observed in 78.1% of the study population. Though the functional outcome scores were higher among the younger age group, a statistically significant difference was not obtained. 96.9% of the patients had acceptable radiological reductions, and infection of the pin tracts complicated 9.4% of the cases. A significant improvement in outcome scores (p-value 0.0001) was observed between the outcome scores at six months and one year after surgery. ConclusionsJESS fixation is an easy and effective method for treating displaced distal radius fractures to achieve good to excellent clinical outcomes. The functional outcome scores were better in the younger age group and male patients, but no statistically significant difference was observed.
Clostridioides difficile (C. difficile) is a gram-positive, anaerobic, spore-forming bacterium that produces toxins A and B, disrupting the intestinal brush border and resulting in severe diarrhea. The most common causes of infection include prolonged antibiotic use, proton pump inhibitors (PPIs), and long-term hospitalization resulting in complications such as pseudomembranous colitis and toxic megacolon. This systematic review aims to consider fecal microbiota transplantation (FMT) as an early treatment modality in C. difficile infection to prevent complications and reduce related morbidity and mortality. We systematically screened three databases using regular keywords such as “fecal microbiota transplantation,” “ C. difficile ,” “pseudomembranous colitis,” and “toxic megacolon” and Medical Subject Headings (MeSH) terms. We applied the inclusion and exclusion criteria and performed a thorough quality appraisal using standardized checklists. We were finally left with 10 articles, including seven case reports, one case series, and two observational studies. Questions remain as to the route of administration of FMT, timing, safety, availability, and the number of sittings required. More randomized controlled trials are needed to address all these questions and to assess the safety of FMT. We believe the role of FMT is very important as it can prevent C. difficile related complications and would be an ideal treatment option in a population group that is often unfit for surgical management.
Prematurity refers to the birth of a baby before 37 completed weeks of pregnancy. This can be related to considerable parental anxiety and mental status changes. Anxiety can manifest as worrying thoughts, feelings of tension, and altered vital signs. This review aims to analyze the relationship between premature birth and parental anxiety, focusing on the emotional status of both mothers and fathers. The review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines. A search was undertaken in PubMed, PubMed Central, MEDLINE, and ScienceDirect. Screening of articles was carried out to find relevant and appropriate articles. Articles were then quality-checked before inclusion. Our analysis showed that mothers of preterm infants had greater symptoms of anxiety, and comorbid anxiety and depression, than mothers of term infants. Mothers of preterm infants 5 years after discharge showed long-term consequences of stress and anxiety, including inappropriate responses and reduced praise for their children. Mothers of preterm multiples were more likely to experience stress and anxiety than mothers of preterm singletons. Fathers of preterm infants experienced higher levels of stress than fathers of term infants, but fathers of preterm infants experienced less stress than mothers of preterm infants. These findings suggest that routine mental health screening and intervention should be undertaken for both mothers and fathers of preterm infants.
Borderline Personality Disorder (BPD) is an extraordinarily complex and least-understood mental disorder. It is currently known that BPD is related to aggression and anger. However, fewer studies focused on the prevalence of BPD symptoms among criminal offenders and their association with crime. This systematic review act per Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines. We searched PubMed, PubMed Central (PMC), Medical Literature Analysis and Retrieval System Online (MEDLINE), and Science Direct for appropriate studies and research. Screening of articles was performed based on relevance and inclusion and exclusion criteria. To check for bias, we used relevant quality appraisal tools. Initially, we found 10026 articles. After removing duplicates and irrelevant papers, we finalized 18 studies based on titles, abstracts, and reading entire articles. We excluded eight studies because of poor quality, and the remaining ten papers were included in this review. BPD was related to criminal activities and suicidal and non-suicidal acts. Adverse childhood experiences positively predicted self-injurious behavior. There is a positive linkage between BPD symptoms and general offense, Inter-Partner Violence (IPV), and Child Abuse Potential (CPA).
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