Hassinglangballe6078
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Ability of RVEF/E to predict patient outcomes compared with two established parameters of RV function over two-year follow-up period. Primary outcome measure was all-cause mortality.
RVEF/E is equal to TAPSE & RVFAC in predicting outcome (p ≤ 0.01 vs p ≤ 0.01) and provides additional benefit of RV volume estimation based on standard 2D echo measurements.
In this study we have shown that RVEF/E derived from ellipsoid model is not inferior to well established measures of RV function as a prognostic indicator of outcome in the acute HF.
In this study we have shown that RVEF/E derived from ellipsoid model is not inferior to well established measures of RV function as a prognostic indicator of outcome in the acute HF.
Stress from obstructive sleep apnoea (OSA) stimulates catecholamine release and consequently can exacerbate hypertension, even in the absence of a catecholamine-producing tumour (phaeochromocytoma). As such, a positive screening test for suspected phaeochromocytoma may be misleading. ALK inhibitor There exists only a handful case reports, and no controlled trials, how continuous positive airway pressure (CPAP) to treat OSA influences catecholamine levels. We examined changes to levels of urinary catecholamine and blood pressure in response to CPAP treatment.
We conducted a meta-analysis of data aggregated from published case reports of individual patient data up to April 2020. The quality of the reports was evaluated using the risk of bias in non-randomized studies of interventions (ROBINS-I) tool.
A total of 13 cases (seven men and six women) from seven reports met our search criteria. Patients had mean age of 49.1 years (range = 36-62) and body mass index of 37.4 kg/m
(range = 27-56). Most had moderate to severe OSA with CPAP treatment. Nine cases had 24-hour urinary noradrenaline assessment before and after CPAP treatment. CPAP treatment led to a 21% reduction (104 nmol/24-hours, 95% credible interval =59 to 148) in 24-hour urinary noradrenaline to within reference ranges, and 25% reduction (from 131 to 100 mmHg) in mean arterial pressure. The risk of overall bias evaluated by the ROBINS-I tool was found to be low in the majority of reports.
Investigations of patients suspected of phaeochromocytoma, particularly obese individuals, should exclude OSA and treat this condition if present before performing screening tests to assess for catecholamine levels.
Investigations of patients suspected of phaeochromocytoma, particularly obese individuals, should exclude OSA and treat this condition if present before performing screening tests to assess for catecholamine levels.Background In the midst of the coronavirus disease 2019 (COVID-19) pandemic, there are many ways to communicate hygiene measures, such as memes and stickers that are widely used on social networks. We carried out a systematic review in order to determine the impact of stickers and memes as tools to face the COVID-19 pandemic, following the PRISMA guide. Methods The search was carried out in scientific databases (MEDLINE / PubMed, ScientiDirect, Scielo, LILACS, and Latindex), and in public pre-publication servers (bioRxiv, SocArXiv, medRxiv and Preprints). The publications were identified using the terms (((meme) OR (sticker)) AND ((COVID-19) OR (SARS-COV-2)) AND (WhatsApp)) and the corresponding translations for Spanish and Portuguese. Results In the initial search, 8434 studies were obtained, 7749 in Preprints, 446 in SocArXiv, 145 in ScientDirect, 82 in medRxiv, and 12 in PubMed. No studies were found in LILACS, Latindex, Scielo, or bioRxiv. Of the 51 studies included as eligible, all were eliminated for not meeting the study inclusion criteria. The majority (40 studies) were eliminated as studies were publications related to the social aspects related to COVID-19, but did not develop an analysis of stickers or memes. Conclusions No studies were identified that met the inclusion criteria related to the role of stickers and memes as tools to face the COVID-19 pandemic. More studies are needed to estimate its role as a means of communication in health.
Peruwasone of the countries with the highestCOVID-19mortalityworldwide during the first stage of the pandemic. It is then relevantto evaluate the risk factors for mortality in patients hospitalized for COVID-19 in three hospitals in Peru in 2020, from March to May, 2020. MethodsWe carried out aretrospective cohort study. The population consisted of patientsfrom three Peruvian hospitalshospitalized for a diagnosis of COVID-19 during the March-May 2020 period. Independent sociodemographic variables, medical history, symptoms, vital functions, laboratory parameters and medical treatment were evaluated. In-hospital mortality was assessed astheoutcome.We performedCox regressionmodels(crude and adjusted) to evaluate risk factors forin-hospitalmortality. Hazard ratios (HR) with their respective 95% confidence intervals (95% CI) were calculated. ResultsWe analyzed493 hospitalized adults;72.8% (n=359) were male and the mean age was 63.3 ± 14.4 years.COVID-19symptoms appeared on average 7.9 ± 4.0 days before admissiotensive care unit admission, only 3.3% (n=16) were admitted to this unit, and 60.2% (n=297) of the sample died. In the adjusted regression analysis, it was found that being 60 years old or older (HR=1.57; 95% CI 1.14-2.15), having two or more comorbidities (HR=1.53; 95% CI 1.10-2.14), oxygen saturation between 85-80% (HR=2.52; 95% CI 1.58-4.02), less than 80% (HR=4.59; 95% CI 3.01-7.00), and being in the middle (HR=1.65; 95% CI 1.15-2.39) and higher tertile (HR=2.18; 95% CI 1.51-3.15) of the neutrophil-to-lymphocyte ratio, increased the risk of mortality. Conclusions The risk factors found agree with what has been described in the literature and allow the identification of vulnerable groups in whom monitoring and early identification of symptoms should be prioritized in order to reduce mortality.Abnormalities that characterize pulmonary arterial hypertension include impairment in the structure and function of pulmonary vascular endothelial and smooth muscle cells. Aldosterone levels are elevated in human pulmonary arterial hypertension and in experimental pulmonary hypertension, while inhibition of the aldosterone-binding mineralocorticoid receptor attenuates pulmonary hypertension in multiple animal models. We explored the role of mineralocorticoid receptor in endothelial and smooth muscle cells in using cell-specific mineralocorticoid receptor knockout mice exposed to sugen/hypoxia-induced pulmonary hypertension. Treatment with the mineralocorticoid receptor inhibitor spironolactone significantly reduced right ventricular systolic pressure. However, this is not reproduced by selective mineralocorticoid receptor deletion in smooth muscle cells or endothelial cells. Similarly, spironolactone attenuated the increase in right ventricular cardiomyocyte area independent of vascular mineralocorticoid receptor with no effect on right ventricular weight or interstitial fibrosis.
