The Association between Preoperative Blood Pressure Elevations and Postoperative Adverse Outcomes after Non-cardiac Surgery: A Single-center Retrospective Observational Study

Blood pressure (BP) often rises before surgery. This study investigated whether BP elevation immediately before surgery was associated with adverse outcomes. Medical records of 11,732 patients (average age: 61 years; male: 47.4%) who underwent non-cardiac elective inpatient surgery under general anesthesia at Kagawa University Hospital between January 2011 and June 2019 were reviewed. Differences between the first BP values measured on the day before surgery and the first BP values in the operating room were defined as Δ systolic BP (ΔSBP) and Δ diastolic BP (ΔDBP). The relationships between ΔSBP/ΔDBP and 30-day mortality, 30-day readmission, and over-the-standard length of hospital stay (OSLOS) were assessed. OSLOS was defined as a hospital stay longer than mean+2 standard deviations and was calculated using the Japanese Diagnosis Procedure Combination data. In univariate analysis, the differences in ΔSBP and ΔDBP between the OSLOS and standard LOS groups were both 2 mmHg. In multivariate logistic regression analysis, only ΔDBP was associated with OSLOS. The adjusted odds ratio (95% confidence interval) for the largest quartile was 1.31 (1.02-1.69) (p<0.05). ΔDBP was associated with OSLOS; however, there may be little need to worry about large ΔSBPs and ΔDBPs in clinical practice

Goishi tea consumption inhibits airway hyperresponsiveness in BALB/c mice

<p>Abstract</p> <p>Background</p> <p>Airway hyperresponsiveness (AHR) is one of the important traits that characterize bronchial asthma. Goishi tea is a post-heating fermented tea that has been reported to have higher free radical scavenging activity. In this study, we evaluated the prophylactic effects of Goishi tea on AHR in BALB/c mice.</p> <p>Results</p> <p>The number of inflammatory cells in BAL fluid was considerably reduced in Goishi tea/<it>Der f </it>and Gallic acid/<it>Der f </it>groups as compared with Tap water/<it>Der f </it>group. Regarding inflammatory cells in BAL, a significant reduction of eosinophils and neutrophils was observed in Goishi tea-treated mice (p < 0.01), as well as in the Gallic acid/<it>Der f </it>group (p < 0.05), as compared with Tap water/<it>Der f </it>group. In asthmatic mice (Tap water/<it>Der f </it>group), the intensity of airway resistance increased simultaneously with the increase in acetylcholine concentration in a dose-dependant way. AHR was significantly inhibited in Goishi tea/<it>Der f </it>and Gallic acid/<it>Der f </it>(p < 0.01) groups as compared with the Tap water/<it>Der f </it>group. Regarding serum specific-IgG₁, significantly lower levels of this antibody were observed in Goishi tea/<it>Der f </it>and Gallic acid/<it>Der f </it>groups as compared with the Tap water/<it>Der f </it>group (p < 0.05). In addition, adiponectin level was significantly higher in the Goishi tea group as compared with the Tap water treated mice (p < 0.01).</p> <p>Conclusions</p> <p>The results suggest that Goishi tea consumption exerted an inhibitory effect on eosinophilic and neutrophilic infiltration in the lung, attenuated the increase in airway resistance and increased the production of adiponectin; thus reducing Der f induced allergic inflammatory process in mice.</p

Health and Family Support Issues of Women Refugees and Related Nursing Interventions: Literature Review

Aim:&nbsp;Migration has become one of global human security issues of the 21st century. Women refugees face a unique set of problems and their health is often compromised. The aim of this study was to describe health and family support issues encountered by women refugees in refugee setting and related nursing interventions. Methods:&nbsp;A literature review was performed using Academic Search Premier, CINAHL and Medline databases, and the following keywords were used separately and in combination to retrieve related abstracts and articles: `women refugees`, `health`, `nursing`. Only original articles from qualitative studies published in English and focusing on women\u27s health and family support in the refugee setting were selected for the review. Results:&nbsp;Three major themes related to women refugees\u27 health issues were identified: `Culture sensitivity`, `Seeking life balance` and `Gender-based violence`. In addition, nine major themes related to family support were found: `Family reunion (difficulty to emigrate)`, `Changes in family\u27s connections and roles`, `Unsatisfactory family life`, `Discrimination and contempt by community`, `Health problems in children`, `Mental health problems in family member`, `Adjustment and adaptation of life pattern in a new country`, `Family time and togetherness` and `Concern about forgetting one\u27s homeland`. On the other hand, we identified 11 major themes related to nursing interventions implemented for women refugees. Conclusion:&nbsp;Disaster nurses have important role to protect and promote human security among women refugees. Future studies should determine how disaster nurses can efficiently promote human security for women in refugee setting