Monahandean1222
n at a higher stimulation intensity within the safety limit may maximize tDCS effects in modulating aberrant functional connectivity of patients with neurological disorders.
Coronavirus disease-19 (COVID-19) is associated with acute kidney injury (AKI) and acute respiratory distress syndrome (ARDS) with high mortality rates. In African American (AA) populations, COVID-19 presentations and outcomes are more severe. NIH and Interim WHO guidelines had suggested against the use of corticosteroids unless in clinical trials until the recent publication of the RECOVERY trial. Here, we analyzed the treatment effect of methylprednisolone on patients with AKI and ARDS during the initial 2 months of COVID-19 and detail the learning effect within our institution.
Between March 1 and April 30, 2020, 75 AA patients met our inclusion criteria for ARDS and AKI, of which 37 had received corticosteroids. Twenty-eight-day mortality, improvement in PaO
/FiO
ratio, and renal function were analyzed. The impact of methylprednisolone treatment was assessed with multivariable methods.
Survival in the methylprednisolone group reached 51% at 21 days compared to 29% in the non-corticosteroid group (
< .001). Methylprednisolone improved the likelihood of renal function improvement. PaO
/FiO
ratio in the methylprednisolone group improved by 73% compared to 45% in the non-corticosteroid group (
= .01). Age, gender, BMI, preexisting conditions, and other treatment factors did not show any impact on renal or PaO
/FiO
ratio improvement. The use of anticoagulants, the month of treatment, and AKI during hospitalization also influenced outcomes.
In AA COVID-19 positive patients with ARDS and AKI, IV methylprednisolone lowered the incidence of mortality and improved the likelihood of renal and lung function recovery. Further investigation with a randomized control trial of corticosteroids is warranted.
In AA COVID-19 positive patients with ARDS and AKI, IV methylprednisolone lowered the incidence of mortality and improved the likelihood of renal and lung function recovery. Further investigation with a randomized control trial of corticosteroids is warranted.Arrhythmias in patients with coronavirus disease 2019 (COVID-19) are prevalent and deserve special attention because they are associated with an increased risk of fatal outcome. The mechanism of arrhythmia in COVID-19 remains unclear. Here, we report our first case of confirmed COVID-19 with documented Torsade de Pointes (TdP). A 64-year-old woman, previously healthy, presented to our emergency department with progressive shortness of breath, dry cough, and 1 week of fever. She was treated with chloroquine phosphate, meropenem, and ciprofloxacin. After 5 days of admission, her condition deteriorated and she was admitted to the intensive care unit. The patient had two episodes of malignant arrhythmias within 24 hours. The former was TdP, and the latter was a fatal pulseless ventricular tachycardia that occured even after chloroquine was discontinued. There was evidence of cardiac injury shown by increased serum level of troponin I. We propose a synergistic concept of lethal arrhythmia due to direct severe acute respiratory syndrome coronavirus (SARS-CoV)-2-associated cardiac injury, hyperinflammatory response, and drug-induced arrhythmia.
Red blood cell transfusion is a key element of treatment among patients with transfusion-dependent thalassemia (TDT). Volume overload and HCC syndrome (hypertension, convulsion, and intracranial hemorrhage) are fatal complications related to transfusion. Furosemide has been widely used to prevent hypertension secondary to volume overload with unclear supportive evidence. This study aimed to evaluate the efficacy of furosemide to prevent volume overload among children and young adults diagnosed with TDT.
Patients diagnosed with TDT were enrolled and randomized to receive either furosemide pretransfusion or no furosemide pretransfusion. After 3 weeks to 4 months of wash-out periods, those patients underwent the alternate regimens as per crossover design of the study. Clinical and laboratory parameters including blood pressure and NT-proBNP levels were measured before and after each transfusion. The difference of those parameters between two randomized groups and their potential associated factors were analyusion NT-proBNP levels were analyzed, and none of those were affected concerning the difference in the levels.
Furosemide has been included in standard transfusion guidelines in many institutions. Our study provided important evidence of the unnecessary use of the drug in preventing volume overload particularly in pediatric and young adult patients with TDT.
TCTR20180209001. Registered 6 February 2018, https//www.clinicaltrials.in.th/.
TCTR20180209001. Registered 6 February 2018, https//www.clinicaltrials.in.th/.
The primary purpose of this research is to investigate the adoption process of mobile smoking cessation apps for Korean American smokers with the eventual purpose of proposing a new combined model of smartphone smoking cessation adoption.
From September 2018 to March 2019, a total of 227 Korean American smokers responded to surveys regarding the effectiveness of mobile applications for smoking cessation. A path analysis was used to analyze the predictors of adopting and using smoking cessation applications available via smartphones.
Perceived benefits and self-efficacy were important factors for influencing the perceived usefulness of a smoking cessation mobile app. Moreover, the perceived usefulness of a smoking cessation mobile app was also positively related to intention to use a smoking cessation mobile app.
Although mobile smoking cessation apps can help many individuals quit smoking, most Korean American smokers are not current users of smoking cessation mobile apps. Therefore, there is a strong need to use strategic evidence-based communication interventions for promoting the widespread adoption of smoking cessation applications.
Although mobile smoking cessation apps can help many individuals quit smoking, most Korean American smokers are not current users of smoking cessation mobile apps. Cl-amidine in vitro Therefore, there is a strong need to use strategic evidence-based communication interventions for promoting the widespread adoption of smoking cessation applications.