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- Hansson, Anna, et al.
(författare)
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Characteristics, complications, and a comparison between early and late tracheostomy: A retrospective observational study on tracheostomy in patients with COVID‐19‐related acute respiratory distress syndrome
- 2022
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Ingår i: Health Science Reports. - Hoboken, NJ, United States : John Wiley & Sons. - 2398-8835. ; 5:3
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Tidskriftsartikel (refereegranskat)abstract
- Background and AimsAs the coronavirus disease 2019 (COVID-19) pandemic spread worldwide in 2020, the number of patients requiring intensive care and invasive mechanical ventilation (IMV) has increased rapidly. During the pandemic, early recommendations suggested that tracheostomy should be postponed, as the potential benefits were not certain to exceed the risk of viral transmission to healthcare workers. The aim of this study was to assess the utility of tracheostomy in patients with COVID-19-related acute respiratory distress syndrome, in terms of patient and clinical characteristics, outcomes, and complications, by comparing between early and late tracheostomy.MethodsA multicenter, retrospective observational study was conducted in Jönköping County, Sweden. Between 14 March 2020 and 13 March 2021, 117 patients were included. All patients ≥18 years of age with confirmed COVID-19, who underwent tracheostomy were divided into two groups based on the timing of the procedure (≤/>7 days). Outcomes including the time on IMV, intensive care unit (ICU) length of stay, and mortality 30 days after ICU admission, as well as complications due to tracheostomy were compared between the groups.ResultsEarly tracheostomy (<7 days, n = 56) was associated with a shorter median duration of mechanical ventilation (7 [12], p = 0.001) as well as a shorter median ICU stay (8 [14], p = 0.001). The most frequent complication of tracheostomy was minor bleeding. With the exception of a higher rate of obesity in the group receiving late tracheostomy, the patient characteristics were similar between the groups.ConclusionThis study showed that early tracheostomy was safe and associated with a shorter time on IMV as well as a shorter ICU length of stay, implicating possible clinical benefits in critically ill COVID-19 patients. However, it is necessary to verify these findings in a randomized controlled trial.
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- Iwarsson, Susanne, et al.
(författare)
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People with Parkinson's disease and housing issues : A scoping review
- 2022
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Ingår i: Health Science Reports. - : Wiley. - 2398-8835. ; 5:2
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Forskningsöversikt (refereegranskat)abstract
- Background and Aims: There is evidence that housing issues are associated with health outcomes as people age, but little is known in this respect regarding the specific population of people with Parkinson's disease (PD). The objective of this literature review was to identify and analyze the knowledge gap concerning people with PD and housing issues. Methods: Applying established guidelines for scoping reviews, a systematic literature search was done in relevant databases applying the following inclusion criteria: empirical studies including human participants with PD, addressing housing in the objective, hypothesis or research questions, and published in English in peer-reviewed journals. Data were analyzed using a framework of domains, factors, and variables influencing housing decisions among older people. Results: Twelve publications were identified, originating from a few researchers and with very different scopes. While the social dimension was scarcely attended to, the publications addressed all six domains of the analytical framework and 30% of the variables specified therein, but many were only used for descriptive purposes. Conclusion: This scoping review reveals that there is a substantial knowledge gap regarding people with PD and housing issues. The knowledge gap is most evident in the social dimension, while the studies identified provide more information relating to the health dimension than what is the case in research on housing targeting the general aging population. Because society urgently needs evidence to support the development of housing policies and provide suitable housing for this vulnerable population, more research targeting people with PD and housing issues is warranted.
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- Löjdahl, Erika, et al.
(författare)
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App-based pelvic floor muscle training in pregnant and postnatal women : a prospective cohort study exploring factors associated with prevention and improvement of urinary incontinence
- 2022
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Ingår i: Health Science Reports. - : John Wiley & Sons. - 2398-8835. ; 5:5
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: Pelvic floor muscle training (PFMT) is recommended for continent pregnant women and postnatal women experiencing urinary incontinence (UI). The app Tät® has been developed for the treatment of stress UI with a focus on PFMT. The aim of this study was to investigate factors associated with the improvement of incontinence symptoms and retained continence in pregnant and postnatal women who used the app.Methods: A prospective cohort study was carried out based on user questionnaires from the app Tät®. We included pregnant and postnatal women who answered the inclusion questionnaire between June 19, 2019 and September 19, 2020. The questionnaire included questions about the frequency and amount of leakage, the impact that UI has on everyday life, and experienced improvements at follow-up. We analyzed factors associated with improvement and retained continence using logistic regression.Results: We included 10,307 pregnant and 13,670 postnatal women, and 44% of the pregnant women and 52% of the postnatal women were incontinent. A total of 3680 women were included in the follow-up analysis, and 52% of the pregnant incontinent women and 73% of the postnatal incontinent women experienced improvement. Pregnant women who performed PFMT and used the app at least once per week had increased odds of improvement (odds ratio [OR]: 1.83, 95% confidence interval [CI]: 1.01–3.29 and OR: 3.38, 95% CI: 1.94–5.90, respectively) compared to those who performed no training and had no app usage. Postnatal women who used the app at least once per week and had more severe incontinence had increased odds of improvement (OR: 4.26, 95% CI: 2.37–7.64 and OR: 1.11, 95% CI: 1.05–1.16, respectively).Conclusions: The app Tät® is widely used by pregnant and postnatal women in Sweden for the prevention and treatment of UI. Majority of the women with incontinence experienced improvement after using the app. Regular PFMT and app use seemed to be important factors for experiencing improvement.
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- Redebrandt, Henrietta N., et al.
(författare)
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Clinical evaluation versus magnetic resonance imaging findings in patients with radicular arm pain—A pragmatic study
- 2022
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Ingår i: Health Science Reports. - : Wiley. - 2398-8835. ; 5:3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Cervical nerve root compression can lead to radiculopathy in the arm. Some studies have reported low accuracy in determining the responsible nerve root in both cervical and lumbar regions. This prospective, observational, pragmatic study aimed to determine the accuracy of the clinical evaluation relative to magnetic resonance imaging (MRI) findings in patients with arm radiculopathy. Methods: Patients with neck pain and neck-related arm pain referred to a spine unit underwent a standard clinical neurological examination and cervical spine MRI. The clinical examination required a judgment of the most likely cervical root involved, including the side. The Interobserver reproducibility was tested. Using MRI, the most likely nerve root involved according to radiology was assessed. Results: Eighty-three patients met the inclusion criteria. The Interobserver reproducibility between clinical evaluators was 58%, with a modest κ coefficient (0.33, 95% confidence interval [CI]: 0.18–0.47) classified only as "fair agreement.” Only 31% (95% CI: 22–42) of the 83 patients exhibited full agreement regarding the suspected cervical root as assessed via the clinical evaluation and MRI. In another 28% (95% CI: 18–39), the clinical evaluation identified an adjacent level to that identified on MRI. Conclusions: In cervical radiculopathy, the clinical-neurological examination diagnosed the same in 31% or an adjacent cervical root in 28% of the patients in relation to the most affected cervical root on MRI.
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- Rosén, Jacob, et al.
(författare)
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Effect of high-flow nasal oxygen on postoperative oxygenation in obese patients : A randomized controlled trial
- 2022
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Ingår i: Health Science Reports. - : John Wiley & Sons. - 2398-8835. ; 5:3
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aim Postoperative hypoxemia is common after general anesthesia in obese patients. We investigated if early application of high-flow nasal oxygen (HFNO) improved postoperative oxygenation in obese patients compared with standard oxygen therapy following general anesthesia for laparoscopic bariatric surgery. Methods This was an open labeled randomized controlled trial conducted at a university hospital in Sweden between October 23, 2018 and February 11, 2020. The study was performed as a substudy within a previously published trial. After ethics committee approval and written informed consent, 40 obese patients (body mass index [BMI] >= 35 kg m(-2)) scheduled for laparoscopic bariatric surgery were randomized to receive oxygen using a standard low-flow nasal cannula (NC group) or HFNO at 40 L min(-1) (HF group) immediately upon arrival to the post-anesthesia care unit. Flow rate (NC group) or FiO(2) (HF group) was titrated to reach an initial SpO(2) of 95%-98% after which settings were left unchanged. The primary outcome was PaO2 at 60 min following postoperative baseline values. Secondary outcomes included PaCO2, SpO(2), hemodynamic variables, and patient self-assessed discomfort. Results Thirty-four patients were available for analysis. PaO2 was similar between groups at postoperative baseline. After 60 min, PaO2 had increased to 12.6 +/- 2.8 kPa in the NC group (n = 15) and 14.0 +/- 2.7 kPa in the HF group (n = 19); (mean difference 1.4 kPa, 95% confidence interval -0.6 to 3.3; p = 0.16). There were no differences in PaCO2, hemodynamic variables, or self-assessed discomfort between groups after 60 min. Conclusion In obese patients, HFNO did not improve postoperative short-term oxygenation compared with standard low-flow oxygen following general anesthesia for laparoscopic bariatric surgery.
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