3 g/dL 4 weeks after clozapine discontinuation, and the patient was discharged with olanzapine 5 mg/d. Clozapine has been reported to cause hematological abnormalities. In our patient, the diagnosis of pure red cell aplasia was made on the basis of severe and selective anemia, reticulocytopenia, and erythroid aplasia. The pathogenesis of hematologic abnormalities due to clozapine treatment is not known. Suggested mechanisms include a direct toxic effect of clozapine, or its metabolite, on the erythroid precursor cells, or formation of a drug-antibody complex. These aspects call for further and deeper research and reports of clinical observations.
.OBJECTIVES In order to continuously promote the rational clinical application of antibacterial drugs and provide data support for hospital scientific management decision-making, we evaluated the use rate of antibiotics in outpatients in 2010 - 2018. MATERIALS AND METHODS A retrospective analysis of the use rate of antibiotics in outpatients from January 2010 to October 2018 was performed in our hospital. We analyzed the antibacterial use rate in each month in outpatients and evaluated the changes in the antibacterial use rate in outpatients over the past 9 years. Autoregressive integrated moving average (ARIMA) model was established and verified, and we predicted the trends of antibacterial use rate in outpatients from November 2018 to March 2019. RESULTS The level of clinical rational drug use management in our hospital is continually improving. The average monthly use rate of antibiotic drugs in outpatients in 2010 - 2013 decreased from 13.04 to 12.28% in 2014 - 2018 (p = 0.002). The goodness-of-fit of the ARIMA model is high. The verification results show that the model can accurately predict the changing trend. The average absolute error of the actual value and the fitted value of the antibiotic drug use rate was 0.76% from January to October 2018. The established ARIMA model can better simulate the trend of antibacterial use rate in outpatients. CONCLUSION The model can be applied to the short-term prediction and dynamic analysis of antibacterial use rate in outpatients, helping hospitals to reasonably evaluate and monitor the use of clinical antibiotics and provide decision-making services for hospital management.
.Endometriosis is a chronic inflammatory disease. Pain is the most common symptom in endometriosis. Endometriosis-associated pain is caused by inflammation, and is related to aberrant innervation. Although the specific mechanism between endometriosis-associated pain and the interaction of aberrant innervation and inflammation remains unclear, many studies have confirmed certain correlations between them. In addition, we found that some chronic inflammatory autoimmune diseases (AIDs) such as inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) share similar characteristics the changes in dysregulation of inflammatory factors as well as the function and innervation of the autonomic nervous system (ANS). The mechanisms underlying the interaction between the ANS and inflammation have provided new advances among these disorders. Therefore, the purpose of this review is to compare the changes in inflammation and ANS in endometriosis, IBD, and RA; and to explore the role and possible mechanism of sympathetic and parasympathetic nerves in endometriosis-associated inflammation by referring to IBD and RA studies to provide some reference for further endometriosis research and treatment.BACKGROUND Children and adolescents form a distinct patient group, whose experiences are relatively under-represented in research. Surveys have shown that healthcare professionals (HCPs) do not always communicate with them well, leaving children and adolescents under-involved and unsure who to ask when concerned. Recent qualitative studies have recognised that HCPs have a major influence on children's and adolescents' experiences, where poorer interactions can lead to fear, missed appointments and potentially a worse clinical outcome. Little is known about how children and adolescents experience the HCPs who play such an integral role in their healthcare. This review aims to explore children's and adolescents' lived experience of HCPs, so that a deeper understanding of the interactions between them can equip HCPs to provide care that better aligns with patients' needs. METHOD This study will use scoping review methodology to map the existing published literature comprehensively and systematically, following a six-step framework. It will extract children's and adolescents' experiences, in the form of direct quotations, and thematically analyse them. The consultation exercise with children and adolescents will gather additional insights. Findings will consist of descriptions of each theme along with exemplar quotations and consultation comments. DISCUSSION This scoping review is unique, as it will present children's and adolescents' lived experiences of HCPs, from synthesis of their direct quotations. Findings will assist HCPs to tailor their interpersonal skills to meet patients' needs so that better healthcare can be provided. This study will have implications for clinical educators, policy makers and guideline developers and provide suggestions for further research. SYSTEMATIC REVIEW REGISTRATION Not registered.BACKGROUND Ovarian cancer (OC) is usually detected in late clinical stages, and imaging at diagnosis is crucial. Peritoneal carcinomatosis (PC) and cardio phrenic lymph nodes (CPLN) are pathological findings of computed tomography (CT) and are relevant for surgical planning. Furthermore, mammographic breast density (BD) has shown an association with OC risk and might be prognostically relevant. However, it is not known if PC, CPLN, and BD are associated with aggressive OC subtypes and impaired OC survival.  https://www.selleckchem.com/products/cb-839.html  Herein, we investigated associations between three comprehensive image parameters and OC subtypes and survival. METHODS The Malmö Diet and Cancer Study is a prospective study that included 17,035 women (1991-1996). Tumor information on 159 OC and information on OC specific survival (last follow-up, 2017-12-31) was registered. The CT and mammography closest to diagnosis were evaluated (Peritoneal Carcinomatosis Index PCI, CPLN, and BD). Associations between CT-PCI, CPLN, and BD vs. clinical stage [stage I vs.