Zobrazení zdroje stránky Jenningsholland3625

Syncope is the motivation for numerous diagnostic tests, among them transthoracic echocardiography (TTE); however, previous evidence suggests there is little utility in this test. Our objective was to assess its diagnostic yield in syncope, analysing the effect of age and sex.<br /><br /> We conducted an observational study that included patients with syncope and who underwent TTE between 1990 and 2015. We defined diagnostic findings related to syncope and performed a descriptive analysis, assessing the diagnostic yield (overall and according to age and sex).<br /><br /> The study included 3302 patients and measured a diagnostic yield of 8.8%; the most common finding was ventricular dysfunction (4.5%). The probability of a diagnostic TTE significantly increased with age (p&lt;.001) but was low for patients younger than 50 years (2.3%). The male sex was significantly related with a diagnostic TTE (p&lt;.001), mostly due to the higher rate of ventricular dysfunction.<br /><br /> The diagnostic yield of TTE in patients with syncope is moderate, low in patients younger than 50 years and lower in women than in men. These factors should be considered when conducting a diagnostic study of patients with syncope.<br /><br />The diagnostic yield of TTE in patients with syncope is moderate, low in patients younger than 50 years and lower in women than in men. These factors should be considered when conducting a diagnostic study of patients with syncope.<br /><br /> To assess the degree of compliance with the recommendations of the 2009 and 2015 versions of the Spanish guidelines for managing asthma (Guía Española para el Manejo del Asma [GEMA]) and the effect of this compliance on controlling the disease.<br /><br /> We conducted an observational ambispective study between September 2015 and April 2016 in which 314 primary care physicians and 2864 patients participated.<br /><br /> Using retrospective data, we found that 81 of the 314 physicians (25.8%; 95% CI 21.3-30.9) stated that they complied with the GEMA2009 recommendations. At the start of the study, 88 of the 314 physicians (28.0%; 95% CI 23.4-33.2) complied with the GEMA2015 recommendations. [https://www.selleckchem.com/products/5-chloro-2-deoxyuridine.html 5-Chlorodeoxyuridine;CldU] Poorly controlled asthma (OR, 0.19; 95% CI 0.13-0.28) and persistent severe asthma at the start of the study (OR, 0.20; 95% CI 0.12-0.34) were negatively associated with having well-controlled asthma by the end of the follow-up. In contrast, compliance with the GEMA2015 recommendations was positively associated with a greater likelihood that the patient would have well-controlled asthma by the end of the follow-up (OR, 1.70; 95% CI 1.40-2.06).<br /><br /> Low compliance with the clinical guidelines for managing asthma is a common problem among primary care physicians. Compliance with these guidelines is associated with a better asthma control. Actions need to be taken to improve primary care physician compliance with the asthma management guidelines.<br /><br />Low compliance with the clinical guidelines for managing asthma is a common problem among primary care physicians. Compliance with these guidelines is associated with a better asthma control. Actions need to be taken to improve primary care physician compliance with the asthma management guidelines.<br /><br /> A physical examination has limited performance in estimating systemic venous congestion and predicting mortality in patients with heart failure. We have evaluated the usefulness of the N-terminal prohormone of brain natriuretic peptide (NT-proBNP), cancer antigen 125 (CA125), lung ultrasound findings, relative plasma volume (rPV) estimation, and the urea/creatinine ratio as surrogate parameters of venous congestion and predictors of mortality.<br /><br /> This work is a retrospective study of 203 patients admitted for acute heart failure in a tertiary hospital's internal medicine department with follow-up in a specialized outpatient clinic between 2013 and 2018. Clinical data were collected from hospital records. Treatment was decided upon according to the clinical judgment of each patient's attending physician. The main outcome measure was all-cause mortality at one year of follow-up.<br /><br /> Patients' mean age was 78.8 years and 47% were male. A total of 130 (65%) patients had chronic heart failure, 51 (26.2%) patients were in New York Heart Association class III-IV, and 116 (60%) patients had preserved left ventricular ejection fraction. During follow-up, 42 (22%) patients died. Values of NT-proBNP≥3804pg/mL (HR 2.78 [1.27-6.08]; p=.010) and rPV≥-4.54% (HR 2.74 [1.18-6.38]; p=.019) were independent predictors of all-cause mortality after one year of follow-up.<br /><br /> NT-proBNP and rPV are independent predictors of one-year mortality among patients hospitalized for decompensated heart failure.<br /><br />NT-proBNP and rPV are independent predictors of one-year mortality among patients hospitalized for decompensated heart failure.<br /><br /> This work aims to analyze the prognosis and mortality of patients hospitalized for acute coronary syndrome before and after the implementation of a coronary care unit, hemodynamics room, and the Código Corazón [Infarction Code] primary angioplasty program.<br /><br /> We conducted an observational, retrospective study that analyzed the epidemiological characteristics, reperfusion strategies, adverse cardiovascular events, and mortality over a follow-up period of five years. The results from the post-code period (March 1 - December 31, 2012; n=471) were compared with those from the pre-code period (March 1 - December 31, 2009; n=432).<br /><br /> There were no differences in the baseline characteristics of the two groups. However, an increase in ST-elevation acute coronary syndrome (STE-ACS) from 17.6% to 34.8% (p&lt;.001) was observed during the postcode phase. The use of percutaneous coronary intervention was made widespread at the hospital and was used in 64.8% of non-ST-elevation acute coronary syndrome (NSTE-ACS) cases and in 95.5% of STE-ACS cases. A reduction was observed in readmissions (from 38.2% to 25.1% for NSTE-ACS (p=.001) and from 23.7% to 11.0% for STE-ACS (p=.018)), the composite prognostic variable of adverse cardiovascular events and 5-year mortality (from 58.7% to 45% (p=.001) for NSTE-ACS and from 40.8% to 23.8% (p=.009) for STE-ACS), and a decrease in 30-day mortality in STE-ACS (from 11.8% to 3.7%; p=.021).<br /><br /> With the structural changes in the hospital, the use of percutaneous coronary intervention was made widespread and improved the prognosis of patients with acute coronary syndrome, decreasing admissions, adverse cardiovascular events, and mortality.<br /><br />With the structural changes in the hospital, the use of percutaneous coronary intervention was made widespread and improved the prognosis of patients with acute coronary syndrome, decreasing admissions, adverse cardiovascular events, and mortality.<br /><br /> On January 7th, 2020, a new coronavirus, SARS-CoV-2, was identified, as responsible for a new human disease COVID-19. Given its recent appearance, our current knowledge about the possible influence that this disease can exert on pregnancy is very limited. One of the unknowns to be solved is whether there is a vertical transmission of the infection during pregnancy.<br /><br /> Using the Real-time Polymerase Chain Reaction techniques for SARS-CoV-2 nucleic acids, the possible presence of this germ in vaginal discharge and amniotic fluid was investigated in four pregnant Caucasian patients affected by mild acute symptoms of COVID-19 during the second trimester of pregnancy.<br /><br /> There is no laboratory evidence to suggest a possible passage of SARS-CoV-2 from the infected mother to the amniotic fluid.<br /><br /> It is necessary to expand the investigation of COVID-19 cases diagnosed during pregnancy to clarify the real influence that SARS-CoV-2 has on pregnant women and their offspring, as well as those factors that modulate the disease.<br /><br />It is necessary to expand the investigation of COVID-19 cases diagnosed during pregnancy to clarify the real influence that SARS-CoV-2 has on pregnant women and their offspring, as well as those factors that modulate the disease.<br /><br /> Fatigue, the second most common symptom after dyspnea in patients with chronic obstructive pulmonary disease, impairs functional capacity and quality of life. This study aims to predict the factors that affect fatigue severity and investigate the effects of fatigue in patients with chronic obstructive pulmonary disease.<br /><br /> Data were collected to assess demographic and clinical characteristics, cigarette consumption, fatigue severity (Fatigue Severity Scale), dyspnea severity (Medical Research Council Dyspnea Scale), level of physical activity (International Physical Activity Questionnaire Short-Form), and health-related quality of life (36-Item Short Form Health Survey).<br /><br /> A total of 64 male COPD patients were evaluated (mean age 61.1 ± 4.7 years, mean FSS score 39.8 ± 14.4). The result of the linear regression model was significant and explained 84% of the variance in fatigue severity (Adjusted R-squared = 0.84, F = 29.48, df = 60, p &lt; .001). It showed that the MRC score (β = .40), cigarette consumption (β = .35), and physical activity level (β = -.37) were significantly correlated with the severity of fatigue (p &lt; .001 for all) and that they independently contributed to the prediction of severity of fatigue.<br /><br /> Dyspnea, cigarette consumption, and physical activity level affect fatigue severity. Additionally, physical activity level, pulmonary function, and HRQOL were also associated with fatigue. These findings support the assertion that it is important to measure fatigue and the factors that affect its severity.<br /><br />Dyspnea, cigarette consumption, and physical activity level affect fatigue severity. Additionally, physical activity level, pulmonary function, and HRQOL were also associated with fatigue. These findings support the assertion that it is important to measure fatigue and the factors that affect its severity.<br /><br /> To identify factors associated with the risk of death in adolescent and adult inpatients with laboratory-positive (reverse-transcription polymerase chain reaction) influenza in Mexico during consecutive influenza seasons (2018-2020).<br /><br /> A retrospective cohort study used national surveillance system data, enrolling 3.422 individuals. The association between various risk factors and 30-day in-hospital lethality were evaluated through risk ratios (RRs) and 95% confidence intervals (CIs).<br /><br /> The lethality rate was 18.1%. Flu vaccination history (RR=0.56, 95% CI 0.42-0.78), early antiviral drug administration (≤2 days from symptom onset [reference ≥5 days], RR=0.68, 95% CI 0.58-0.81), and a history of asthma (RR=0.66, 95% CI 0.47-0.95) showed protective effects against influenza-attributable death. Mechanical ventilator support produced the highest increase in death risk (RR=3.31, 95% CI 2.89-3.79). Male sex, older age, AH1N1 subtype, and other chronic diseases were also associated with fatal in-hospital influenza-related outcomes.<br /><br /> Our findings highlight the major relevance of promoting immunization in high-risk individuals, together with ensuring early and effective antiviral management in suspected influenza cases.<br /><br />Our findings highlight the major relevance of promoting immunization in high-risk individuals, together with ensuring early and effective antiviral management in suspected influenza cases.