264,481 results match your criteria clinical setting

Gram-negative bacteria as a cause of mediastinitis after cardiac surgery.

Curr Opin Infect Dis 2021 Oct 13. Epub 2021 Oct 13.

Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale (ASUFC) Division of Cardiac Surgery, Cardiothoracic Department, University Hospital of Udine, Udine, Italy.

Purpose Of Review: Poststernotomy mediastinitis (PSM) remains a serious infection and is significantly associated with high morbidity, short-term and long-term mortality. Gram-negative bacteria (GNB) are an underestimated cause of PSM, and there is little information on the risk factors, prevention, diagnosis and management of GNB PSM.

Recent Findings: The pathogenesis of PSM is the result of a complex and multifactorial interplay between intraoperative wound contamination, host-related and surgical host factors but GNB are probably mostly translocated from other host site infections. Read More

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October 2021

Predictors of thermal increase in magnetic resonance-guided focused ultrasound treatment for essential tremor: histogram analysis of skull density ratio values for 1024 elements.

J Neurosurg 2021 Oct 15:1-6. Epub 2021 Oct 15.

2Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba.

Objective: Sufficient thermal increase capable of generating thermocoagulation is indispensable for an effective clinical outcome in patients undergoing magnetic resonance-guided focused ultrasound (MRgFUS). The skull density ratio (SDR) is one of the most dominant predictors of thermal increase prior to treatment. However, users currently rely only on the average SDR value (SDRmean) as a screening criterion, although some patients with low SDRmean values can achieve sufficient thermal increase. Read More

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October 2021

Biomarkers During Recovery From AKI and Prediction of Long-term Reductions in Estimated GFR.

Am J Kidney Dis 2021 Oct 1. Epub 2021 Oct 1.

Department of Renal Medicine, Royal Derby Hospital, Derby, UK; Centre for Kidney Research and Innovation, University of Nottingham, UK. Electronic address:

Rationale & Objective: The effects of acute kidney injury (AKI) on long-term kidney function, cardiovascular disease, and mortality are well documented. We aimed to identify biomarkers for estimating the risk of new or worsening chronic kidney disease (CKD) following AKI.

Study Design: Prospective cohort study. Read More

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October 2021

Lack of Association Between Perioperative Medication and Postoperative Delirium in Hip Fracture Patients in an Orthogeriatric Care Pathway.

J Am Med Dir Assoc 2021 Oct 12. Epub 2021 Oct 12.

Department of Geriatric Medicine, Unit of Peri-Operative Geriatric Care, Assistance Publique Hôpitaux de Paris (APHP), Hôpital la Pitié-Salpêtrière, Paris, France; Sorbonne Université, UMRS INSERM 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France.

Objectives: Units for perioperative geriatric care are playing a growing role in the care of older patients after hip fracture surgery. Postoperative delirium is one of the most common complications after hip fracture, but no study has assessed the impact of therapeutics received during a dedicated orthogeriatric care pathway on its incidence. Our main objective was to assess the association between drugs used in emergency, operating, and recovery departments and postoperative delirium during the acute stay. Read More

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October 2021

Comparison of educational environments in different sized rural hospitals during a longitudinal integrated clerkship in Thailand.

Rural Remote Health 2021 Oct 15;21(4):6883. Epub 2021 Oct 15.

Hatyai Medical Education Center, Hatyai Hospital, 182 Rattakarn Road, Songkhla 90110, Thailand

Introduction: The longitudinal integrated clerkship (LIC) curriculum model focuses on patient-centered care and continuity of clinical and cultural learning between medical students, patients, clinicians, and a system of care. In rural settings, participating medical students are expected to have an interest in rural medicine and an involvement in the community. Many schools in the USA, Canada, and Australia have implemented LICs in undergraduate programs in different ways. Read More

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October 2021

Clinical profile, etiology, and diagnostic challenges of primary adrenal insufficiency in Sudanese children: 14-years' experience from a resource limited setting.

J Pediatr Endocrinol Metab 2021 Oct 15. Epub 2021 Oct 15.

Pediatric Endocrinology Unit, Gaafar Ibn Auf Children Hospital (GIA), Khartoum, Sudan.

Objectives: Primary adrenal insufficiency (PAI) in children is an uncommon condition. Congenital adrenal hyperplasia (CAH) is the commonest cause followed by autoimmune disorders. Diagnosis and management are challenging especially in resource-limited settings. Read More

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October 2021

Crinecerfont Lowers Elevated Hormone Markers in Adults with 21-Hydroxylase Deficiency Congenital Adrenal Hyperplasia.

J Clin Endocrinol Metab 2021 Oct 15. Epub 2021 Oct 15.

Neurocrine Biosciences, Inc.; El Camino Real, San Diego, CA.

Context: Classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21OHD) is characterized by impaired cortisol synthesis and excess androgen production. Corticotropin-releasing factor type 1 receptor (CRF1R) antagonism may decrease adrenal androgen production.

Objective: To evaluate the safety, tolerability, and efficacy of crinecerfont (NBI-74788), a selective CRF1R antagonist, in 21OHD. Read More

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October 2021

United States Military Implantable Collamer Lens Surgical Outcomes: An 11 Year Retrospective Review.

J Cataract Refract Surg 2021 Sep 20. Epub 2021 Sep 20.

Department of Ophthalmology, Womack Army Medical Center, Fort Bragg, NC, USA Department of Clinical Investigation, Womack Army Medical Center, Fort Bragg, NC, USA.

Purpose: To examine the long-term efficacy and safety of myopic implantable collamer lens (ICL) implantation in active duty US military personnel.

Setting: Hospital practice.

Design: Retrospective longitudinal observational study. Read More

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September 2021

Intraoperative Complications and Visual Outcomes of Cataract Surgery in Patients with Retinal Vein Occlusion: A Multicenter Database Study.

J Cataract Refract Surg 2021 Sep 27. Epub 2021 Sep 27.

Jones Eye Institute, University of Arkansas for Medical Sciences, Arkansas, USA Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt. Wolverhampton Eye Infirmary, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, United Kingdom Department of Ophthalmology, Gloucestershire Hospitals NHS Trust, Cheltenham, United Kingdom.

Purpose: To compare the visual outcome and the rate of intraoperative complications in eyes with and without retinal vein occlusion (RVO) underwenting phacoemulsification over a period of 15 years in a real-world clinical setting.

Setting: Eight independent United Kingdom National Health Service ophthalmology departments.

Design: Retrospective, multicenter cohort study. Read More

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September 2021

Smartphone-Connected Hearing Aids Enable and Empower Self-Management of Hearing Loss: A Qualitative Interview Study Underpinned by the Behavior Change Wheel.

Ear Hear 2021 Oct 13. Epub 2021 Oct 13.

National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom Nottingham Audiology Services, Nottingham University Hospitals National Health Service Trust, Queens Medical Centre, Nottingham, United Kingdom Faculty of Life and Health Sciences, De Montfort University, Leicester, United Kingdom Hearing Sciences Section, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom Audiology Department, Royal Berkshire National Health Service Foundation Trust, Reading, United Kingdom School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom Ear Science Institute Australia, Perth, Australia Faculty of Health Sciences, Curtin University, Perth, Australia.

Objectives: To identify patient-reported barriers and facilitators to using smartphone-connected hearing aids, using the Behavior Change Wheel (BCW) to understand experiences and how these can be addressed.

Design: A single-center, prospective, observational study. Eight hearing aid users (new = 1, existing = 7; mean age = 71. Read More

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October 2021

Prognosis of Advanced Cholangiocarcinoma in the Palliative Care Setting: A Series of 201 Cases.

Altern Ther Health Med 2021 Oct 15. Epub 2021 Oct 15.

Objective: Prognosis of cholangiocarcinoma is poor, and palliative treatment options are limited in China. This study aimed to analyze prognostic factors affecting survival in patients with advanced cholangiocarcinoma.

Methods: Clinical data on 201 consecutive patients with cholangiocarcinoma who received treatment at a single center from May 2014 to December 2018 were analyzed retrospectively. Read More

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October 2021

Impact of Cell-Seeding Density and Cell Confluence on Human Tissue Engineered Skeletal Muscle.

Tissue Eng Part A 2021 Oct 15. Epub 2021 Oct 15.

University of Michigan Department of Molecular and Integrative Physiology, 200746, Ann Arbor, Michigan, United States;

Tissue engineering methodologies have the potential to treat volumetric muscle loss (VML) via the growth of exogenous skeletal muscle grafts from small autogenous muscle biopsies. A significant obstacle preventing the widespread use of engineered skeletal muscle grafts in a clinical setting is the high number of skeletal muscle stem cells, known as satellite cells, required for fabrication of human-sized skeletal muscle tissue. Additionally, there is a lack of work adapting engineered constructs created for animal models into skeletal muscle engineered from a primary human skeletal muscle cell source. Read More

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October 2021

Does comprehensive geriatric assessment (CGA) in an outpatient care setting affect the causes of death and the quality of palliative care? A subanalysis of the age-FIT study.

Eur Geriatr Med 2019 Jun 8;10(3):455-462. Epub 2019 May 8.

Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.

Purpose: The purposes of this study were to retrospectively study whether comprehensive geriatric assessment (CGA) given to community-dwelling old patients with high health care usage has effects regarding: (1) the cause of death and (2) the quality of the provided palliative care when compared to patients without CGA-based care.

Method: This study includes secondary data from a randomised controlled trial (RCT) with 382 participants that took place in the periods 2011-2013. The present study examines all electronical medical records (EMR) from the deceased patients in the original study regarding cause of death [intervention group (IG) N = 51/control group (CG) N = 66] and quality of palliative care (IG N = 33/CG N = 41). Read More

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European cohorts of older HIV adults: POPPY, AGEIV, GEPPO, COBRA and FUNCFRAIL.

Eur Geriatr Med 2019 Apr 13;10(2):247-257. Epub 2019 Feb 13.

Modena HIV Metabolic Clinic, Infectious Diseases Unit, School of Medicine, University of Modena and Reggio Emilia, Via del Pozzo 71, 41100, Modena, Italy.

Aim: The recent and rapid demographic changes affecting people living with HIV (PLWH) produced a subset of older adults demanding a prompt response both in clinical practice and research setting. The scientific community had to properly design studies that include older adults living with HIV (OALWH), aged > 50 years, or geriatric PLWH, aged > 65 years to explore the interaction between aging and HIV itself, antiretroviral therapy (ART) and non-infectious co-morbidities (NICM). Choosing between these two types of cohorts may represent a trap, but also a possibility to measure different outcomes and obtain different evidence. Read More

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Developing a Frailty Index from routinely collected data in the Emergency Department among of hospitalized patients.

Eur Geriatr Med 2019 Oct 19;10(5):727-732. Epub 2019 Aug 19.

Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.

Purpose: The number of frail patients admitted to Emergency Departments is increasing. The so-called Frailty Index based on the age-related accumulation of deficits models is often perceived as excessively burdening or not feasible in busy clinical settings due to its quantitative nature. We wanted to prove the possibility of generating a Frailty Index in the Emergency Department from data that are routinely collected during the standard clinical practice in this setting and to test its predictive capacity for adverse events. Read More

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October 2019

Attitudes towards use of proton pump inhibitors among geriatricians in Italy.

Eur Geriatr Med 2019 Oct 17;10(5):827-831. Epub 2019 Jul 17.

Cattedra di Medicina Interna e Geriatria, Università Campus Bio Medico, Rome, Italy.

Background/objectives: Proton pump inhibitors (PPIs) are among the most commonly used drugs in the Italian older population. The study aimed to identify prescribing behaviours related to PPIs in Italian geriatricians, and assess their knowledge of prescription appropriateness, potential drug interactions and contraindications.

Design And Setting: Survey conducted among geriatricians in Italy. Read More

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October 2019

["iFightDepression" in inpatient treatment : Evaluation of a web-based, therapist-guided self-management program on a specialized ward for affective disorders].

Nervenarzt 2021 Oct 15. Epub 2021 Oct 15.

Department für Psychische Gesundheit, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, AöR, Semmelweisstr. 10, 04103, Leipzig, Deutschland.

Background: E‑mental health mainly plays a role in the outpatient treatment of patients with depressive disorders. The goal of this study was to implement and evaluate the web-based, therapist-guided self-management tool "iFightDepression" (iFD) to clarify if there is a benefit for inpatient use.

Material And Methods: In this study 78 inpatients with affective disorders (ICD-10 F32. Read More

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October 2021

Palliative care interventions in intensive care unit patients.

Intensive Care Med 2021 Oct 15. Epub 2021 Oct 15.

Division of Pulmonary, Critical Care and Sleep Medicine, Cambia Palliative Care Center of Excellence at UW Medicine, University of Washington, 325 Ninth Avenue, Box 359762, Seattle, WA, 98104, USA.

Purpose: The integration of palliative care into intensive care units (ICUs) is advocated to mitigate physical and psychological burdens for patients and their families, and to improve end-of-life care. The most efficacious palliative care interventions, the optimal model of their delivery and the most appropriate outcome measures in ICU are not clear.

Methods: We conducted a systematic review of randomised clinical trials and observational studies to evaluate the number and types of palliative care interventions implemented within the ICU setting, to assess their impact on ICU practice and to evaluate differences in palliative care approaches across different countries. Read More

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October 2021

Factors Associated With Treatment Failure in Moderately Severe Community-Acquired Pneumonia: A Secondary Analysis of a Randomized Clinical Trial.

JAMA Netw Open 2021 Oct 1;4(10):e2129566. Epub 2021 Oct 1.

UMRS 1168 VIMA, INSERM, Versailles Saint-Quentin University, Versailles, France.

Importance: Failure of treatment is the most serious complication in community-acquired pneumonia (CAP).

Objective: To assess the potential risk factors for treatment failure in clinically stable patients with CAP.

Design, Setting, And Participants: This secondary analysis assesses data from a randomized clinical trial on CAP (Pneumonia Short Treatment [PTC] trial) conducted from December 19, 2013, to February 1, 2018. Read More

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October 2021

A ladder that matters: Conceptual development of a clinical ladder program for nurse practitioners and physician assistants.

J Am Assoc Nurse Pract 2021 Oct 13. Epub 2021 Oct 13.

Department of Surgery and the Department of Clinical Education, Johns Hopkins All Children's Hospital, St. Petersburg, Florida College of Nursing, University of Florida, Gainesville, Florida.

Abstract: Clinical ladders are professional enhancement models that encourage and reward participants for continued professional engagement and leadership development. They have the potential to affect patient care through improved provider retention, advanced and refined clinical skills, and increased engagement. Recent literature has demonstrated development and implementation of clinical ladder models for nurse practitioners (NPs) in the acute care setting. Read More

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October 2021

Recurrent lupus enteritis in a child-chase the calm before the storm.

Lupus 2021 Oct 15:9612033211045923. Epub 2021 Oct 15.

Department of Radiodiagnosis, 29751Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Systemic lupus erythematosus (SLE) is a complex multisystemic autoimmune disease. Lupus enteritis (LE), one of the less commonly described manifestations of childhood SLE, presents with relatively nonspecific clinical and laboratory features. In addition, recurrent episodes of LE occurring in temporal proximity are rare in children. Read More

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October 2021

Nocturnal bladder emptying and quality of life in patients with spinal cord injury.

Eur J Phys Rehabil Med 2021 Oct 15. Epub 2021 Oct 15.

Department of Urology, Ghent University Hospital, Ghent, Belgium.

Background: Little is known about the relationship between sleep disruption due to nocturnal bladder emptying and quality of life in patients with spinal cord injury AIM: To evaluate the possible influence of number of nocturnal bladder emptyings, bladder emptying method and nocturnal incontinence on the quality of life of patients with spinal cord injury.

Design: Cross-sectional descriptive study.

Setting: In- and outpatient. Read More

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October 2021

Feasibility of a standardized protocol for respiratory training with Intermitted Positive Pressure Breathing ventilator application in dysphonia and dysarthria.

Eur J Phys Rehabil Med 2021 Oct 15. Epub 2021 Oct 15.

School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy.

Background: Brain damage can affect several functions related to speech production leading to dysphonia and dysarthria. Most rehabilitation treatments focus on articulation training rather than on pneumophonic coordination and respiratory muscle strength. Respiratory training using an Intermitted Positive Pressure Breathing (IPPB) ventilator can be used for this last purpose; no agreement on a standard protocol has been reached to date. Read More

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October 2021

Pathological lesions of lambs infected in utero with bovine viral diarrhoea virus type 1c (BVDV-1c).

Vet Rec 2021 Feb 24;188(3):e6. Epub 2021 Jan 24.

School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.

Background: Acute bovine viral diarrhoea virus (BVDV) infections in sheep are largely sub-clinical although infections of pregnant ewes have shown to result in significant fetal losses and persistently infected lambs. However, the extent and severity of abnormalities in lambs infected with BVDV in utero is still largely unknown.

Methods: Twenty-two ewes were experimentally infected with BVDV-1c between 59 and 69 days of gestation. Read More

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February 2021

Brief Report: Impact of the COVID-19 Pandemic on Virological Suppression in People Living With HIV Attending a Large Italian HIV Clinic.

J Acquir Immune Defic Syndr 2021 11;88(3):299-304

III Infectious Diseases Unit, ASST Fatebenefratelli-Sacco, Milan, Italy.

Background: We assessed the impact of the coronavirus disease 2019 (COVID-19) pandemic on HIV suppression rates in people living with HIV (PLWH) attending a large Italian HIV clinic.

Setting: The HIV outpatient clinic of the Infectious Diseases Department of Luigi Sacco Hospital, Milan, Italy, which serves more than 5000 PLWH per year.

Methods: A before and after quasi-experimental study design was used to make a retrospective assessment of the monthly trend of HIV-RNA determinations of ≥50 among the PLWH attending our clinic, with "before" being the period from January 1, 2016 to February 20, 2020, and "after" being the period from February 21, 2020 to December 31, 2020 (the COVID-19 period). Read More

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November 2021

Probing the Relationship Between Declining Renal Glomerular Filtration Over the Life Span and General Biological Aging: Does the Former Provide Means to Estimate the Latter?

J Am Coll Nutr 2021 Oct 15:1-12. Epub 2021 Oct 15.

Emergency Department, Veterans Administration Medical Center, Salem, Virginia, USA.

While a consistent, gradual decline in the renal glomerular filtration rate (GFR) is a characteristic occurrence over the human life span, the exact pathophysiology behind this event remains unresolved. Evidence to date suggests that the endogenous glucose-insulin system could be involved at some level. Diabetic-induced nephropathy, one of the most prevalent chronic renal diseases, is closely linked to a severe form of insulin resistance (IR). Read More

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October 2021

HO-1 Protects Remnant Liver against Dysfunction after Major Hepatectomy in Humans.

J Invest Surg 2021 Oct 15:1-7. Epub 2021 Oct 15.

Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.

Objective: During major resection of liver carcinoma, liver regeneration (LR) is induced by various clinical and biological factors. Heme oxygenase (HO)-1 has been found as a key inducer of LR in preclinical trial. The clinical evidence for the role of HO-1 in liver dysfunction (LD) including LR is still unknown and has been included in this study. Read More

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October 2021

Valgus Control Feedback and Taping Improves the Effects of Plyometric Exercises in Women With Dynamic Knee Valgus.

Sports Health 2021 Oct 15:19417381211049805. Epub 2021 Oct 15.

Graduate Athletic Training Program, Health & Human Performance Department, University of Tennessee Chattanooga, Chattanooga, Tennessee.

Background: Female athletes are more predisposed to anterior cruciate ligament (ACL) injuries in comparison with their male counterparts. Research on ACL injury prevention strategies has demonstrated beneficial effects of plyometric exercises and feedback (FB) during the exercises. FB has resulted in reductions in vertical ground-reaction force and kinematic risk factors associated with ACL injury. Read More

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October 2021

Leaning towards Cytomegalovirus serological screening in pregnancy to prevent congenital infection: a cost-effectiveness perspective.

BJOG 2021 Oct 15. Epub 2021 Oct 15.

EA7328, Imagine Institut, Université de Paris, Paris, France.

Objective: To assess the cost-effectiveness of prenatal detection of congenital cytomegalovirus (cCMV) following maternal primary infection in the first trimester within standard pregnancy follow-up or involving population-based screening (serological testing at 7 and 12 weeks of gestation), with or without secondary prevention (valaciclovir) in maternal CMV primary infection.

Design, Setting, And Population: From the perspective of the French national health insurance system, cost-effectiveness based on previously published probability estimates and associated plausible ranges that were applied to a hypothetical population of 1,000,000 pregnant women.

Methods: Cost-effectiveness of detecting fetal cCMV in terms of the total direct medical costs involved and associated expected outcomes. Read More

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October 2021

COVID-19 and dexamethasone-induced hyperglycaemia: workload implications for diabetes inpatient teams.

Diabet Med 2021 Oct 15:e14716. Epub 2021 Oct 15.

East Surrey Hospital, Surrey & Sussex Healthcare NHS Trust, Canada Avenue, Redhill, Surrey, RH1 5RH, United Kingdom.

The RECOVERY trial showed that mortality in patients requiring supplementary oxygen or ventilation for COVID-19 is reduced by administration of dexamethasone 6 mg daily for up to 10 days [1]. This welcome finding led to an increased frequency of dexamethasone use at our district general hospital. However, high-dose glucocorticoid exposure is a well-recognised cause of hyperglycaemia, particularly in the presence of diabetes [2-7]. Read More

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October 2021