264,769 results match your criteria critical patients


Optimizing Fluid Resuscitation and Preventing Fluid Overload in Patients with Septic Shock.

Semin Respir Crit Care Med 2021 Oct 20;42(5):698-705. Epub 2021 Sep 20.

Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska.

Intravenous fluid administration remains an important component in the care of patients with septic shock. A common error in the treatment of septic shock is the use of excessive fluid in an effort to overcome hypovolemia and vasoplegia. While fluids are necessary to help correct the intravascular depletion, vasopressors should be concomitantly administered to address vasoplegia. Read More

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October 2021

Any Role of High-Dose Vitamin C for Septic Shock in 2021?

Semin Respir Crit Care Med 2021 Oct 20;42(5):672-682. Epub 2021 Sep 20.

Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University, Atlanta, Georgia.

While the use of vitamin C as a therapeutic agent has been investigated since the 1950s, there has been substantial recent interest in the role of vitamin C supplementation in critical illness and particularly, sepsis and septic shock. Humans cannot synthesize vitamin C and rely on exogenous intake to maintain a plasma concentration of approximately 70 to 80 μmol/L. Vitamin C, in healthy humans, is involved with antioxidant function, wound healing, endothelial function, and catecholamine synthesis. Read More

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October 2021

What Is the Utility of Measuring Lactate Levels in Patients with Sepsis and Septic Shock?

Semin Respir Crit Care Med 2021 Oct 20;42(5):650-661. Epub 2021 Sep 20.

Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.

Elevations in blood lactate concentrations have been studied in sepsis and other disease states for decades and are well known to be associated with increased mortality. Many studies have also demonstrated the prognostic accuracy of serial lactate levels, and some have suggested that lactate clearance may be a useful therapeutic target for resuscitation. Lactate measurements have therefore gained an increasingly prominent role in sepsis definitions, screening protocols, management guidelines, and quality measures over the past two decades. Read More

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October 2021

Integrated Multiorgan Bedside Ultrasound for the Diagnosis and Management of Sepsis and Septic Shock.

Semin Respir Crit Care Med 2021 Oct 20;42(5):641-649. Epub 2021 Sep 20.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.

Despite decades of research, the mortality rate of sepsis and septic shock remains unacceptably high. Delays in diagnosis, identification of an infectious source, and the challenge of providing patient-tailored resuscitation measures routinely result in suboptimal patient outcomes. Bedside ultrasound improves a clinician's ability to both diagnose and manage the patient with sepsis. Read More

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October 2021

In-office Endonasal Minor Revision Rhinoplasty.

Facial Plast Surg 2021 Sep 20. Epub 2021 Sep 20.

Section of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.

The revision rhinoplasty presents many unique challenges to the facial plastic surgeon. While many cases will require a full revision in the operating room, there are several isolated deformities which may be repaired in the office via an endonasal approach. This provides many benefits to the patient and surgeon including decreased cost, shorter recovery time, avoidance of general anesthesia, and less discomfort. Read More

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September 2021

Intensive Care Unit prioritization: The impact of ICU bed availability on mortality in critically ill patients who requested ICU admission in court in a Brazilian cohort.

J Crit Care 2021 Sep 17;66:126-131. Epub 2021 Sep 17.

Graduation Program in Health Sciences, University of Brasília (UnB), Brasília, Federal District, Brazil; Graduation Program in Health Sciences, School of Health Sciences (ESCS), Brasília, Federal District, Brazil.

Purpose: To assess hospital mortality in patients who requested ICU admission in court due to the scarcity of ICU beds in the Brazilian public health system and the consequences of these judicial litigations.

Material And Methods: Retrospective cohort study that included adult patients from the public health system of the Federal District, Brazil, who claimed ICU admission in court from January 2017 to December 2019.

Results: Of the 1752 patients, 1031 were admitted to ICU (58. Read More

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September 2021

Risk of seizure clusters and status epilepticus following rapid and ultra-rapid medication discontinuation during intracranial EEG monitoring.

Epilepsy Res 2021 Sep 13;177:106756. Epub 2021 Sep 13.

Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, 68198-8435, USA. Electronic address:

Objective: Anti-seizure medications (ASMs) are discontinued in the course of intracranial EEG (iEEG) monitoring for presurgical evaluation. The ASM withdrawal facilitates an emergence of seizures but may also precipitate seizure clusters (SC) and status epilepticus (SE). The aim of this study was to compare the rates of SC and SE during the ultra-rapid withdrawal (URW) and rapid withdrawal (RW) of ASMs during iEEG. Read More

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September 2021

CSF high-mobility group box 1 is associated with drug-resistance and symptomatic etiology in adult patients with epilepsy.

Epilepsy Res 2021 Sep 15;177:106767. Epub 2021 Sep 15.

Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China. Electronic address:

Purpose: Extracellular high-mobility group box 1 (HMGB1) is considered a proinflammatory mediator and is involved in various neurological disorders. This study aims to determine the expression profiles of HMGB1 in cerebrospinal fluid (CSF) and paired serum, and to explore whether there is a relationship between CSF HMGB1 concentrations with seizure parameters in adult patients with epilepsy.

Methods: CSF and paired serum HMGB1 concentrations were measured in patients with drug-refractory epilepsy (DRE, n = 27), newly diagnosed epilepsy (NDE, n = 56), and other non-inflammatory neurological disorders (ONNDs, n = 22). Read More

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September 2021

Palindromic-assisted self-annealing transcription amplification for reliable genotyping of epidermal growth factor receptor exon mutations.

Biosens Bioelectron 2021 Sep 13;194:113633. Epub 2021 Sep 13.

Center of Smart Laboratory and Molecular Medicine, School of Medicine, Chongqing University, Chongqing, 400044, PR China. Electronic address:

Reliable discrimination of specific epidermal growth factor receptor (EGFR) gene mutations plays a critical role in guiding lung cancer therapeutics. Until now, convenient and accurate recognition of the specific deletion of EGFR exons has remained particularly challenging. Herein, we propose a palindromic-assisted self-annealing transcription amplification (PASTA) strategy for the reliable detection of circulating EGFR exon mutations. Read More

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September 2021

Experiences and needs of patients with rectal cancer confronted with bowel problems after stoma reversal: A systematic review and thematic-synthesis.

Eur J Oncol Nurs 2021 Aug 20;54:102018. Epub 2021 Aug 20.

Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Staff Member Nursing Department, Ghent University Hospital, Ghent, Belgium.

Purpose: After the reversal of the temporary stoma, rectal cancer survivors are often confronted with bowel complaints largely impacting on their quality of life. This systematic review aims to identify and synthesise the experiences and needs of patients with rectal cancer confronted with bowel problems after stoma reversal.

Methods: A systematic search was performed through Pubmed, CINAHL and Web of Science. Read More

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Longitudinal clinico-serological analysis of anti-nucleocapsid and anti-receptor binding domain of spike protein antibodies against SARS-CoV-2.

Int J Infect Dis 2021 Sep 17. Epub 2021 Sep 17.

ICMR-National Institute of Virology, Pune, Maharashtra, Pin 411021, India. Electronic address:

Objectives: Monitoring the antibody responses to SARS-CoV-2 infection and its correlation to clinical spectrum of disease is critical in understanding the disease progression and protection against re-infection. We assessed the nucleocapsid (N) and receptor-binding-domain of spike (SRBD) protein specific IgG and neutralizing antibody (NAb) responses in COVID-19 patients up to 8 months and its correlation with diverse disease spectrum.

Methods: During the first wave of SARS-CoV-2 pandemic, from 284 COVID-19 patients, 608 samples were collected up to 8 months post infection. Read More

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September 2021

ADIPOSE TISSUE DYSFUNCTION AND MAFLD IN OBESITY ON THE SCENE OF COVID-19.

Clin Res Hepatol Gastroenterol 2021 Sep 17:101807. Epub 2021 Sep 17.

Department of Social Applied Nutrition, Micronutrients Research Center (NPqM), Institute of Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.

Obesity is a known risk factor for respiratory infection and many other chronic diseases, including metabolic dysfunction-associated fatty liver disease (MAFLD), previously known as nonalcoholic fatty liver disease (NAFLD). Recently, it has been considered an important and independent predictor for coronavirus disease 2019 (COVID-19) complications in adults, especially cardiopulmonary, presenting in a great number of individuals in critical care. In obesity, adipose tissue (AT) undergoes expansion via several processes: expansion of adipocytes and insufficient vascularization lead to hypoxia; adipocyte apoptosis/necrosis; irregular fatty acid flux; and enhanced secretion of inflammatory adipokines, cytokines, and chemokines. Read More

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September 2021

Medialized versus Lateralized Humeral Implant in Reverse Total Shoulder Arthroplasty: The Comparison of Outcomes in Pseudoparalysis with Massive Rotator Cuff Tear.

J Shoulder Elbow Surg 2021 Sep 17. Epub 2021 Sep 17.

Department of Orthopaedic Surgery, Myongji Hospital, 697-24 Hwajung-dong, Deokyang-gu, Goyang-si, Gyeonggi-do 412-270, Republic of Korea. Electronic address:

Background: With the increasing use of the lateralized humeral implants in reverse total shoulder arthroplasty (RTSA), it is still unclear whether or not this design will be as advantageous as the medialized humeral implants in the setting of pseudoparalysis (PP).

Methods: A total of 51 eligible RTSA cases for PP signs due to massive rotator cuff deficiency were selected for the retrospective review. Twenty-five patients were allocated to Group L in which the isolated humeral side lateralization was performed (neck-shaft angle of 145°), and 26 patients were allocated to Group M (neck-shaft angle of 155°). Read More

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September 2021

Dysregulation of Non-coding RNAs mediates Cisplatin Resistance in Hepatocellular Carcinoma and therapeutic strategies.

Pharmacol Res 2021 Sep 17:105906. Epub 2021 Sep 17.

Department of Pharmacy, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui Provincial Hospital, Hefei, Anhui, 230001, P.R. China. Electronic address:

Hepatocellular carcinoma (HCC) is the fourth major contributor to cancer-related deaths worldwide, and patients mostly have poor prognosis. Although several drugs have been approved for the treatment of HCC, cisplatin (CDDP) is still applied in treatment of HCC as a classical chemotherapeutic drug. Unfortunately, the emergence of CDDP resistance has caused HCC patients to exhibit poor drug response. Read More

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September 2021

Hypoparathyroidism, neutropenia and nephrotic syndrome in a patient with mitochondrial trifunctional protein deficiency: A case report and review of the literature.

Eur J Med Genet 2021 Sep 17:104344. Epub 2021 Sep 17.

Department of Neurology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, 400014, China; Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China. Electronic address:

Introduction: Mitochondrial trifunctional protein (TFP) deficiency is an autosomal recessive disorder that causes a clinical spectrum of diseases ranging from severe infantile cardiomyopathy to mild chronic progressive neuromyopathy, however, parathyroid glands, hematologic system and kidney damage are not the common presentations of this disease.

Methods: We describe the clinical, biochemical and molecular features of the TFP deficiency patient at our institution. We also provide an extensive literature review of previous published cases with emphasis on the clinical/biochemical phenotype-genotype correlation of this disorder. Read More

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September 2021

The Society for Vascular Surgery Objective Performance Goals for Critical Limb Ischemia are attainable in select patients with ischemic wounds managed with wound care alone.

Ann Vasc Surg 2021 Sep 17. Epub 2021 Sep 17.

Division of Vascular Surgery, Department of Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address:

Objectives: To set therapeutic benchmarks, in 2009 the Society for Vascular Surgery defined objective performance goals (OPG) for treatment of patients with chronic limb threatening ischemia (CLTI) with either open surgical bypass or endovascular intervention. The goal of these OPGs are to set standards of care from a revascularization standpoint and to provide performance benchmarks for 1 year patency rates for new endovascular therapies. While OPGs are useful in this regard, a critical decision point in the treatment of patients with CLTI is determining when revascularization is necessary. Read More

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September 2021

Early intravenous nitroglycerin use in prehospital setting and in the emergency department to treat patients with acute heart failure: Insights from the EAHFE Spanish registry.

Int J Cardiol 2021 Sep 17. Epub 2021 Sep 17.

Momentum Research, Inc., Durham, NC, USA; INSERM U-942 (Biotherapy in the critically ill), Paris, France.

Background And Objective: Although recommended for the treatment of acute heart failure (AHF), the use of intravenous (IV) nitroglycerin (NTG) is supported by scarce and contradicting evidence. In the current analysis, we have assessed the impact of IV NTG administration by EMS or in emergency department (ED) on outcomes of AHF patients.

Methods: We analyze AHF patients included by 45 hospitals that were delivered to ED by EMS. Read More

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September 2021

BMI Category and Adverse Events in Hospitalized Children.

Acad Pediatr 2021 Sep 17. Epub 2021 Sep 17.

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD 21205 USA. Electronic address:

Objective: To identify associations between patient body mass index (BMI) category and adverse event (AE) rate, severity, and preventability in a cohort of children discharged from an academic children's hospital.

Methods: We identified patients 2-17 years old consecutively discharged between June and October 2018. Patient age, sex, height, and weight were used to categorize patients as having underweight, normal weight, overweight, or obesity. Read More

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September 2021

Revisiting Mild Asthma: Current Knowledge and Future Needs.

Chest 2021 Sep 17. Epub 2021 Sep 17.

Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, Texas.

Asthma is a common chronic airway disease with significant impact on patients, caregivers, and the healthcare system. While most research and novel interventions have mainly focused on patients with uncontrolled severe asthma, the majority of patients with asthma have mild disease. Epidemiologic studies suggest that many patients with mild asthma report frequent exacerbations of their disease and uncontrolled symptoms. Read More

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September 2021

In vitro and In vivo Optimization of Liposomal Nanoparticles Based Brain Targeted Vgf Gene Therapy.

Int J Pharm 2021 Sep 17:121095. Epub 2021 Sep 17.

Department of Pharmaceutical Sciences, School of Pharmacy, College of Health Professions, North Dakota State University, Fargo 58105, ND, USA. Electronic address:

Vgf (non-acronymic), a neurotrophin stimulated protein which plays a crucial role in learning, synaptic activity, and neurogenesis, is markedly downregulated in the brain of Alzheimer's disease (AD) patients. However, since vgf is a large polar protein, a safe and efficient gene delivery vector is critical for its delivery across the blood brain barrier (BBB). This research work demonstrates brain-targeted liposomal nanoparticles optimized for delivering plasmid encoding vgf across BBB and transfecting brain cells. Read More

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September 2021

Latent Class Analysis Reveals COVID-19-related ARDS Subgroups with Differential Responses to Corticosteroids.

Am J Respir Crit Care Med 2021 Sep 20. Epub 2021 Sep 20.

Columbia University, Medicine/Pulmonary and Critical Care, New York City, New York, United States.

Rationale Two distinct subphenotypes have been identified in acute respiratory distress syndrome (ARDS), but the presence of subgroups in ARDS associated with COVID-19 is unknown. The objective of this study was to identify clinically relevant, novel subgroups in COVID-19-related ARDS, and compare them to previously described ARDS subphenotypes. Methods Eligible participants were adults with COVID-19 and ARDS at Columbia University Irving Medical Center. Read More

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September 2021

Community-based Lung Cancer Screening Results in Relation to Patient and Radiologist Characteristics: the PROSPR Consortium.

Ann Am Thorac Soc 2021 Sep 20. Epub 2021 Sep 20.

Kaiser Permanente Colorado, Institute for Health Research, Denver, United States.

Rationale: Lung-RADS classification was developed to standardize reporting and management of lung cancer screening using low-dose computed tomography (LDCT). While variation in Lung-RADS distribution between healthcare systems has been reported, it is unclear if this is explained by patient characteristics, radiologist experience with lung cancer screening, or other factors.

Objective: Our objective was to determine if patient or radiologist factors are associated with Lung-RADS score. Read More

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September 2021

Association between oral health, pneumonia and mortality in patients of intensive care.

Rev Med Inst Mex Seguro Soc 2020 ;58(4):468-476

Fundación Universitaria Autónoma de las Américas, Facultad de Odontología. Pereira, Risaralda, Colombia.

IntroducciÓn: Los pacientes con ventilación mecánica corren riesgo de adquirir neumonía cuando la higiene bucodental es deficiente, a causa de la colonización bacteriana del tracto respiratorio. Se sugiere verificar esta asociación para implementar acciones de prevención.

Objetivo: Identificar la asociación entre el estado de salud bucal, la neumonía asociada a ventilador y la mortalidad en pacientes con ventilación mecánica en un hospital de tercer nivel de Pereira, Colombia. Read More

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January 2020

Severity of preeclampsia: data from a high specialty hospital in Mexico City.

Rev Med Inst Mex Seguro Soc 2020 ;58(4):444-449

Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Ginecología y Obstetricia No. 3, Unidad de Cuidados Intensivos. Ciudad de México, México.

IntroducciÓn: La severidad de la preeclampsia puede variar según la población en estudio.

Objetivo: Identificar la frecuencia y el tipo de datos de severidad de la preeclampsia en pacientes atendidas en una unidad médica de alta especialidad de la Ciudad de México.

Material Y MÉtodos: Estudio observacional, retrospectivo y transversal de una serie de 100 pacientes embarazadas con preeclampsia grave atendidas en un hospital de tercer nivel de la Ciudad de México, del 1 de agosto al 31 de diciembre de 2018. Read More

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January 2020

The renin-angiotensin-aldosterone system and its inhibitors in the context of the COVID-19 pandemic.

Authors:
Moisés Mercado

Rev Med Inst Mex Seguro Soc 2020 ;58(4):378-380

Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Unidad de Investigación Médica en Enfermedades Endocrinas. Ciudad de México, México.

Una de las confusiones que ha generado la pandemia de COVID-19 es la idea de que los inhibidores de la enzima convertidora de la angiotensina y los antagonistas del receptor de la angiotensina II de tipo 1 pueden agravar el daño pulmonar inducido por el SARS-CoV-2 en pacientes de edad avanzada. En este breve comunicado se analiza, desde una perspectiva crítica, la evidencia científica que secunda esta asociación.

One of the confusions aroused by the outbreak of COVID-19 pandemic is the idea that angiotensin converting enzyme inhibitors and type 1 angiotensin II receptor may aggravate the lung damage induced by SARS CoV-2 virus in older adult patients. Read More

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January 2020

Impact of Concussion History on Heart Rate Variability during Bouts of Acute Stress.

J Athl Train 2021 Sep 20. Epub 2021 Sep 20.

Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

Context: Following a sports-related concussion, many athletes experience persisting neurophysiological alterations. These alterations may be absent at rest but emerge during moments of physiological stress. Unnoticed and untreated neurophysiological dysfunction may negatively impact long-term neurological health in adolescent athletes as they are at a critical point in development. Read More

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September 2021

Combined endo- and epicardial pace-mapping to localize ventricular tachycardia isthmus in ischaemic and non-ischaemic cardiomyopathy.

Europace 2021 Sep 20. Epub 2021 Sep 20.

Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan.

Aims: A high-density pace-mapping can depict an abrupt transition in paced QRS morphology from a poor to excellent match, unmasking the critical component of ventricular tachycardia (VT) isthmus from the entrance to exit. We sought to assess pace-mapping at multiple sites within the endo- and epicardial scars to identify the VT isthmus in patients with ischaemic (ICM) and non-ischaemic cardiomyopathy (NICM).

Methods And Results: Colour-coded maps correlating to the percentage matches between 12-lead electrocardiograms during VT and pace-mapping [referred to as correlation score maps (CSMs)] were analysed. Read More

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September 2021

Androgen receptor transactivates KSHV noncoding RNA PAN to promote lytic replication-mediated oncogenesis: A mechanism of sex disparity in KS.

PLoS Pathog 2021 Sep 20;17(9):e1009947. Epub 2021 Sep 20.

Key Laboratory of Gastrointestinal Cancer (Ministry of Education), School of Basic Medical Sciences, Fujian Medical University, Fuzhou, P.R. China.

Kaposi's sarcoma-associated herpesvirus (KSHV) preferentially infects and causes Kaposi's sarcoma (KS) in male patients. However, the biological mechanisms are largely unknown. This study was novel in confirming the extensive nuclear distribution of the androgen receptor (AR) and its co-localization with viral oncoprotein of latency-associated nuclear antigen in KS lesions, indicating a transcription way of AR in KS pathogenesis. Read More

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September 2021

Prevalence and relevant factors of positive RF in brucellosis patients with arthralgia.

PLoS Negl Trop Dis 2021 Sep 20;15(9):e0009749. Epub 2021 Sep 20.

Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, China.

Background: Brucellosis is a critical zoonotic disease in the world, it is the non-specific arthralgia that make brucellosis patients easily misdiagnosed as rheumatoid arthritis (RA) in endemic regions. Elevated rheumatoid factor (RF) is an essential indicator of RA, and the RF in brucellosis patients is significantly higher than healthy people. Therefore, this study further explored the distribution of RF and the relevant factors of the RF positivity in brucellosis patients with arthralgia, in order to strengthen the recognition of physicians for brucellosis patients with RF positivity, especially in brucellosis-endemic areas, so as to avoid misdiagnosis and untimely treatment that may lead to malignant outcomes. Read More

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September 2021

Urinary Neutrophil Gelatinase-Associated Lipocalin/Hepcidin-25 Ratio for Early Identification of Patients at Risk for Renal Replacement Therapy After Cardiac Surgery: A Substudy of the BICARBONATE Trial.

Anesth Analg 2021 Sep 20. Epub 2021 Sep 20.

Department of Anesthesiology and Intensive Care, Helios Klinikum Leisnig, Leisnig, Germany.

Background: Acute kidney injury requiring renal replacement therapy (AKI-RRT) is strongly associated with mortality after cardiac surgery; however, options for early identification of patients at high risk for AKI-RRT are extremely limited. Early after cardiac surgery, the predictive ability for AKI-RRT even of one of the most extensively evaluated novel urinary biomarkers, neutrophil gelatinase-associated lipocalin (NGAL), appears to be only moderate. We aimed to determine whether the NGAL/hepcidin-25 ratio (urinary concentrations of NGAL divided by that of hepcidin-25) early after surgery may compare favorably to NGAL for identification of high-risk patients after cardiac surgery. Read More

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September 2021