Waltersrytter3085

This study analyzes the usefulness of the CHA2DS2-VASc score for mortality prediction in patients with acute coronary syndromes (ACSs) and evaluates if the addition of renal functional status could improve its predictive accuracy.

CHA2DS2-VASc score was calculated by using both the original scoring system and adding renal functional status using 3 alternative renal dysfunction definitions (CHA2DS2-VASc-R1 eGFR <60 mL/min/1.73 mq = 1 point; CHA2DS2-VASc-R2 eGFR <60 mL/min/1.73 mq = 2 points; and CHA2DS2-VASc-R3 eGFR <60 mL/min/1.73 mq = 1 point, <30 mL/min/1.73 mq = 2 points). Inhospital mortality (IHM) and post-discharge mortality (PDM) were recorded, and discrimination of the various risk models was evaluated. Finally, the net reclassification index (NRI) was calculated to compare the mortality risk classification of the modified risk models with that of the original score.

Nine hundred and eight ACS patients (median age 68 years, 30% female, 51% ST-elevation) composed the study population. risk of death.

Roux-en-Y gastric bypass (RYGB) is the most common surgical procedure for morbid obesity. However, it can present serious late complications, like postprandial hyperinsulinemic hypoglycemia (PHH). Recent data suggested an increase in intestinal SGLT-1 after RYGB. However, there is no data on the inhibition of SGLT-1 to prevent PHH in patients with prior RYBG. On this basis, we aimed to evaluate (a) the effect of canagliflozin 300 mg on the response to 100 g glucose overload (oral glucose tolerance test [OGTT]); (b) the pancreatic response after intra-arterial calcium stimulation in the context of PHH after RYGB.

This is a prospective pilot study including patients (n = 21) with PHH after RYGB, matched by age and gender with healthy controls (n = 5). Basal OGTT and after 2 weeks of daily 300 mg of canagliflozin was performed in all cases. In addition, venous sampling after intra-arterial calcium stimulation of the pancreas was performed in 10 cases.

OGTT after canagliflozin showed a significant reduction of plasma glucose levels (minute 30 161.5 ± 36.22 vs. 215.9 ± 58.11 mg/dL; minute 60 187.46 ± 65.88 vs. 225.9 ± 85.60 mg/dL, p < 0.01) and insulinemia (minute 30 95.6 ± 27.31 vs. 216.35 ± 94.86 mg/dL, p = 0.03; minute 60 120.85 ± 94.86 vs. 342.64 ± 113.32 mIU/L, p < 0.001). At minute 180, a significant reduction (85.7%) of the rate of hypoglycemia was observed after treatment with canagliflozin (p < 0.00001). All cases presented normal pancreatic response after intra-arterial calcium administration.

Canagliflozin (300 mg) significantly decreased glucose absorption and prevented PHH after 100 g OGTT in patients with RYGB. Our results suggest that canagliflozin could be a new therapeutic option for patients that present PHH after RYGB.

Canagliflozin (300 mg) significantly decreased glucose absorption and prevented PHH after 100 g OGTT in patients with RYGB. Our results suggest that canagliflozin could be a new therapeutic option for patients that present PHH after RYGB.Telehealth services for long-term monitoring of chronically ill patients are becoming more and more common, leading to huge amounts of data collected by patients and healthcare professionals each day. While most of these data are structured, some information, especially concerning the communication between the stakeholders, is typically stored as unstructured free-texts. This paper outlines the differences in analyzing free-texts from the heart failure telehealth network HerzMobil as compared to the diabetes telehealth network DiabMemory. A total of 3,739 free-text notes from HerzMobil and 228,109 notes from DiabMemory, both written in German, were analyzed. A pre-existing, regular expression based algorithm developed for heart failure free-texts was adapted to cover also the diabetes scenario. The resulting algorithm was validated with a subset of 200 notes that were annotated by three scientists, achieving an accuracy of 92.62%. When applying the algorithm to heart failure and diabetes texts, we found various similarities but also several differences concerning the content. As a consequence, specific requirements for the algorithm were identified.Clinical decision support systems (CDSS) have been shown in a variety of diseases to lead to improvements in care. The aim of this study is to design a CDSS to assist GPs to assess and manage breathlessness, a highly prevalent symptom in practice. A focus group is conducted to explore the needs of general practitioners (GPs), assess current workflow to identify points for intervention and develop early prototypes for testing. selleck kinase inhibitor Five GPs took part in the focus group elucidating 248 relevant data points which were then qualitatively analyzed using the Technology Acceptance Model as the theoretical framework. In general, there was a positive attitude towards the use of CDSS for breathlessness with various proposed features from the participants. Twelve high level workflow steps were identified with 5 as key points for intervention. Several proposed features such as reporting likelihood of causes of breathlessness in a patient, link with evidence-based recommendations, integration with clinical notes and patient education materials were translated into a prototype. Mixed-method studies are planned to assess its usability to inform subsequent iterations of the CDSS development.

Delirium is a patient safety issue that often occurs within the population of elderly people. As delirium may be characterized by fluctuating progress, the aim of this work is to find methods to visualize the occurrence of delirium over time in different patient stays in gerontopsychatric settings.

We analyzed current data mining visualization techniques for clinical research using a delirium data set collected in a gerontopsychatric setting.

We identified heatmaps and dendrograms resulting from hierarchical clustering as a suitable visualization method.

Heat maps with hierarchical clustering are a suitable data mining tool or visualization technique to study delirium cases in the time course of patient stays.

Heat maps with hierarchical clustering are a suitable data mining tool or visualization technique to study delirium cases in the time course of patient stays.