PURPOSE: The study was conducted to evaluate the effects of swaddle bathing in preventing temperature loss among preterm infants.
METHOD: Comprehensive search was conducted on PubMed, Cochrane Library, EMBASE, CINAHL, and Airiti Library databases. Methodological quality was assessed using RoB 2 for randomized controlled trials, randomized crossover trials, and ROBINSI for nonrandomized controlled trials. In addition, Comprehensive Meta-Analysis version 2.0 was used to conduct the meta-analysis.
RESULTS: Total of 4 randomized controlled trials, 2 randomized crossover trials, and 2 nonrandomized controlled trials, involving 424 preterm infants, were included. Overall effect size of the body temperature in the swaddle bathing (SMD = 1.17, 95% CI [0.61, 1.73], P < .001). Subgroup analysis was performed based on the body temperature measurement intervals and bathing duration; these findings indicate that swaddle bathing is effective in preventing body temperature loss among preterm infants.
LINKING EVIDENCE TO ACTION: Swaddle bathing is a recommended intervention to prevent body temperature loss in preterm infants. Neonatal nurses are encouraged to integrate this technique as a standard practice in neonatal intensive care units and special care nurseries. Clinical implementation should ensure a bathing duration of 4-11 minutes, room temperature 24°C-28°C, relative humidity 50%-60%, and bathwater temperature 37°C-39°C to optimize thermoregulation. These findings highlight the importance of individualized care planning, incorporation of swaddle bathing into nursing protocols, and ongoing staff education to ensure consistency.
MATERIALS AND METHODS: Two hundred fifty-eight patients with primary liver tumors who underwent FDG-PET before LDLT were enrolled in this retrospective study. Unfavorable tumor histology was defined as primary liver tumor other than a well- or moderately differentiated HCC. Thirteen patients had unfavorable tumor histology, including 2 poorly differentiated HCC, 2 sarcomatoid HCC, 5 combined hepatocellular cholangiocarcinoma, 3 intrahepatic cholangiocarcinoma, and 1 hilar cholangiocarcinoma.
RESULTS: FDG-PET positivity was significantly associated with unfavorable tumor histology (P < 0.001). Both FDG-PET positivity and unfavorable tumor histology were significant independent predictors of tumor recurrence and overall survival. In a subgroup analysis of patients with FDG-PET-positive tumors, unfavorable tumor histology was a significant independent predictor of tumor recurrence and overall survival. High FDG uptake (tumor to non-tumor uptake ratio ≥ 2) was a significant predictor of unfavorable tumor histology. Patients with high FDG uptake and/or unfavorable tumors had significantly higher 3-year cumulative recurrence rate (70.8% versus 26.2%, P = 0.004) and worse 3-year overall survival (34.1% versus 70.8%, P = 0.012) compared to those with low FDG uptake favorable tumors.
CONCLUSIONS: The expression of FDG-PET is highly associated with histology of explanted HCC and predicts the recurrence. FDG-PET-positive tumors with high FDG uptake may be considered contraindication for LDLT due to high recurrence rate except when pathology proves favorable histology.