检索结果-南通市图书馆

Discharging patients home from the intensive care unit:A new trend

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of clinical Cases 2024年第23期12卷 5313-5319页

作者： Esraa M Hassan Abbas B Jama Ahmed Sharaf Asim Shaikh Mohamad El Labban Salim Surani Syed A Khan Department of Critical Care medicine Mayo Clinic Health systemMankatoMN 56001United States Department of internal medicine Baptist Hospital of Southeast TexasBeaumontTX 77701United States Department of medicine Aga Khan UniversityKarachi 74200SindhPakistan Department of internal medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of medicine and Pharmacology Texas A&M UniversityCollege StationTX 77843United States Department of Anaesthesiology Mayo Clinic Health SystemRochesterMN 55905United States

Discharging patients directly to home from the intensive care unit(ICU)is becoming a new *** review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU *** analyzing available evidence and healthcare professionals'experiences,the review explores the potential impacts on patient outcomes and healthcare *** practice of direct discharge from the ICU presents both opportunities and *** it can potentially reduce costs,enhance patient comfort,and mitigate complications linked to extended hospitalization,it necessitates meticulous patient selection and robust post-discharge support *** this strategy successfully mandates the availability of home-based care services and a careful assessment of the patient's readiness for the *** critical evaluation of existing literature,this review underscores the significance of tailored patient selection criteria and comprehensive post-discharge support systems to ensure patient safety and optimal *** insights provided contribute evidence-based recommendations for refining the direct discharge approach,fostering improved patient outcomes,heightened satisfaction,and streamlined healthcare ***,the review seeks to balance patientcentered care and effective resource utilization within ICU discharge strategies.

关键词： Intensive care unit Critical care Early discharge Cost effective critical care Patient comfort Early recovery

Congestive ischemic colitis successfully treated with antiinflammatory therapy: A case report

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of clinical Cases 2024年第1期12卷 142-147页

作者： Geon Woo Lee Su Bum Park Department of internal medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsan 50612South Korea

BACKGROUND Congestive ischemic colitis is a rare subtype of ischemic colitis with an unknown *** conservative management,such as fasting,no established treatment exists;therefore,surgical intervention should be considered in some cases if symptoms *** literature suggests that anti-inflam-matory agents may effectively treat congestive ischemic *** SUMMARY We present the case of a 68-year-old female patient who underwent laparoscopic left hemicolectomy for transverse colon cancer 3 years ***,follow-up included an annual colonoscopy and abdominal computed tomography(CT)at a local ***,progressive erythema and edema of the sigmoid colon were observed 1 year *** admission to our hospital,she complained of abdominal pain and *** CT showed thickening of the sigmoid colon walls,and colonoscopy revealed erythema,edema,and multiple ulcers with exudate in the sigmoid *** angiography showed engorgement of the sigmoid vasa recta without any vascular *** diagnosis was congestive ischemic colitis,and we treated the patient with anti-inflammatory *** 2 mo of glucocorticoid therapy(20 mg once daily)and 7 mo of 5-aminosalicylate therapy(1 g twice daily),the ulcers completely *** has not experienced any recurrence for 2 *** Anti-inflammatory therapy,specifically glucocorticoids and 5-aminosalicylate,has demonstrated promising efficacy and introduces potential novel treatment options for congestive ischemic colitis.

关键词： Ischemic colitis Glucocorticoids 5-aminosalicylate Colon cancer

Constipation and colonoscopy

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Endoscopy 2024年第5期16卷 244-249页

作者： Dusan Dj Popovic Branka Filipovic Faculty of medicine University of BelgradeBelgrade 11000Serbia Department of Gastroenterology and Hepatology Clinic for Internal MedicineUniversity Clinical Hospital Center“Dr.Dragisa Misovic-Dedinje”Belgrade 11000Serbia

Constipation is a significant sociomedical problem,which can be caused by various *** the diagnostic approach to patients with constipation,the following data are usually sufficient:History,complete physical examination(including rectal examination),and additional diagnostic tests.A colonoscopy is not a necessary diagnostic method for all patients with ***,if patients have alarm symptoms/signs,that suggest an organic reason for constipation,a colonoscopy is *** most important alarm symptoms/signs are age>50 years,gastrointestinal bleeding,new-onset constipation,a palpable mass in the abdomen and rectum,weight loss,anemia,inflammatory bowel disease,and family history positive for colorectal *** endoscopists do not like to deal with patients with *** are two reasons for this,namely the difficulty of endoscopy and the adequacy of *** are adversely affected by *** improve the quality of colonoscopy in these patients,good examination techniques and often more extensive preparation are *** colonoscopy technique implies adequate psychological preparation of the patient,careful insertion of the endoscope with minimal insufflation,and early detection and resolution of *** preparation for colonoscopy often requires prolonged preparation and sometimes the addition of other laxatives.

关键词： Constipation Functional constipation Colonoscopy Bowel preparation Polyethylene glycol

Prediabetes: An overlooked risk factor for major adverse cardiac and cerebrovascular events in atrial fibrillation patients

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Diabetes 2024年第1期15卷 24-33页

作者： Rupak Desai Nishanth Katukuri Sumaja Reddy Goguri Azra Kothawala Naga Ruthvika Alle Meena Kumari Bellamkonda Debankur Dey Sharmila Ganesan Minakshi Biswas Kuheli Sarkar Pramoda Prattipati Shaylika Chauhan Independent Researcher Independent ResearcherAtlantaGA 30079United States Department of internal medicine Mayo ClinicRochesterMN 55902United States Department of medicine Chalmeda Anand Rao Institute of Medical SciencesTelangana 505001India Department of medicine Jawaharlal Nehru Medical CollegeBelgaum 590010India Department of medicine Narayana Medical CollegeAndhra PradeshNellore 524003India Department of medicine Dr Pinnamaneni Siddhartha Institute of Medical Sciences and Research FoundationVijaywada 521286India Department of medicine Medical College KolkataKolkata 700073India Department of medicine P.E.S.Institute of Medical Sciences and ResearchAndhra Pradesh 517425India Department of medicine Shaheed Ziaur Rahman Medical CollegeBogra 5800Bangladesh Department of medicine College of Medicine and J.N.M HospitalKalyani 741235India Department of medicine Jawaharlal Nehru Medical College IndiaKarnatakaBelagavi 590010India Department of internal medicine Geisinger Health SystemWikes-BarrePA 18702United States

BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not been extensively ***,this study aimed to establish a link between prediabetes and MACCE in AF *** To investigate a link between prediabetes and MACCE in AF *** We used the National Inpatient Sample(2019)and relevant ICD-10 CM codes to identify hospitalizations with AF and categorized them into groups with and without prediabetes,excluding *** primary outcome was MACCE(all-cause inpatient mortality,cardiac arrest including ventricular fibrillation,and stroke)in AF-related *** Of the 2965875 AF-related hospitalizations for MACCE,47505(1.6%)were among patients with *** prediabetes cohort was relatively younger(median 75 vs 78 years),and often consisted of males(56.3%vs 51.4%),blacks(9.8%vs 7.9%),Hispanics(7.3%vs 4.3%),and Asians(4.7%vs 1.6%)than the non-prediabetic cohort(Pvascular disease,and hyperthyroidism(all P<0.05).The prediabetes cohort was often discharged routinely(51.1%vs 41.1%),but more frequently required home health care(23.6%vs 21.0%)and had higher *** adjusting for baseline characteristics or comorbidities,the prediabetes cohort with AF admissions showed a higher rate and significantly higher odds of MACCE compared to the non-prediabetic cohort[18.6%vs 14.7%,odds ratio(OR)1.34,95%confidence interval 1.26-1.42,P<0.001].On subgroup analyses,males had a stronger association(aOR 1.43)compared to females(aOR 1.22),whereas on the race-wise comparison,Hispanics(aOR 1.43)and Asians(aOR 1.36)had a stronger association with MACCE with prediabetes vs whites(aOR 1.33)and blacks(aOR 1.21).CONCLUSION This population-

关键词： Prediabetes Atrial fibrillation Cardiovascular disease risk Major adverse cardiovascular and cerebrovascular events Stroke Mortality

COVID-19 and the vascular Elderly Subject: Illustration of Therapeutic Management with Corticosteroids in an Elderly Diabetic Patient with COVID-19

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Open Journal of clinical Diagnostics 2024年第1期14卷 1-6页

作者： Ibrahima Amadou Dembele Abrar-Ahmad Zulfiqar Romuald Nounga Nyanke Sékou Landoure Stéphane Loique Djeugoue Adama Sinayoko Nouhoum Kone Paul Antoni Amadou Nouroudine Rosunee Ahsveen Yacouba Koné Aoua Diarra Tania Mekuiko Ngeupi Mamadou Cissoko Mamadou Mallé Keïta Kaly Djibril Sy Djénébou Traoré Didier Mukéba Tshialala Assétou Soukho Kaya Emmanuel Andres internal medicine Department Medical Clinic B University Hospital Center of Strasbourg Strasbourg France internal medicine Department University Hospital Center Point G Bamako Mali Faculty of medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali Faculty of medicine Pharmacy and Public Health University of Mbuji-Mayi Democratic Republic of Congo

Introduction: The severity of Sars-Cov-2 infection is associated with the development of acute respiratory distress syndrome (ARDS). The progression to ARDS appears to be driven by a major inflammatory mechanism potentially sensitive to corticosteroids. Observation: This article describes the case of an elderly patient was admitted to emergency departments for intense asthenia, accompanied by motor diarrhoea, dyspnoea with desaturation in ambient air, in a context of strong suspicion of infection linked to COVID-19. The article also reviews the existing literature on the diagnosis and treatment of this severe form of the disease. Conclusion: Corticosteroids, and in particular dexamethasone, have been shown to be effective in the management of patients with COVID-19, an oxygen-releasing disease.

关键词： COVID-19 Diabetes Mellitus Elderly person Corticosteroids internal medicine

Impact of index admission cholecystectomy vs interval cholecystectomy on readmission rate in acute cholangitis: National Readmission Database survey

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Endoscopy 2024年第6期16卷 350-360页

作者： Abdullah Sohail Ahmed Shehadah Ammad Chaudhary Khadija Naseem Amna Iqbal Ahmad Khan Shailendra Singh Department of internal medicine University of Iowa Roy J and Lucille A Carver College of MedicineIowaIA 52242United States Department of internal medicine Rochester General HospitalRochesterNY 14621United States Department of internal medicine Henry Ford HospitalDetroitMI 48202United States Department of internal medicine Cleveland Clinic FoundationClevelandOH 44195-0001United States Department of internal medicine University of ToledoToledoOH 43606United States Department of Gastroenterology and Hepatology Case Western Reserve University HospitalClevelandOH 44106United States Division of Gastroenterology and Hepatology West Virginia University School of MedicineMorgantownWV 26505United States

BACKGROUND Elective cholecystectomy(CCY)is recommended for patients with gallstone-related acute cholangitis(AC)following endoscopic decompression to prevent recurrent biliary ***,the optimal timing and implications of CCY remain *** To examine the impact of same-admission CCY compared to interval CCY on patients with gallstone-related AC using the National Readmission Database(NRD).METHODS We queried the NRD to identify all gallstone-related AC hospitalizations in adult patients with and without the same admission CCY between 2016 and *** primary outcome was all-cause 30-d readmission rates,and secondary outcomes included in-hospital mortality,length of stay(LOS),and hospitalization *** Among the 124964 gallstone-related AC hospitalizations,only 14.67%underwent the same admission *** all-cause 30-d readmissions in the same admission CCY group were almost half that of the non-CCY group(5.56%vs 11.50%).Patients in the same admission CCY group had a longer mean LOS and higher hospitalization costs attrib-utable to *** the most common reason for readmission was sepsis in both groups,the second most common reason was AC in the interval CCY *** Our study suggests that patients with gallstone-related AC who do not undergo the same admission CCY have twice the risk of readmission compared to those who undergo CCY during the same *** readmis-sions can potentially be prevented by performing same-admission CCY in appropriate patients,which may reduce subsequent hospitalization costs secondary to readmissions.

关键词： Acute cholangitis Gallstone-related complications National Readmission Database 30-d readmission rates Resource utilization In-hospital mortality

Anticoagulant use before COVID-19 diagnosis prevent COVID-19 associated acute venous thromboembolism or not:A systematic review and meta-analysis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Methodology 2024年第3期14卷 141-162页

作者： Kinza Iqbal Akshat Banga Taha Bin Arif Sawai Singh Rathore Abhishek Bhurwal Syeda Kisa Batool Naqvi Muhammad Mehdi Pankaj Kumar Mitali Madhu Salklan Ayman Iqbal Jawad Ahmed Nikhil Sharma Amos Lal Rahul Kashyap Vikas Bansal Juan Pablo Domecq Department of internal medicine Dow Medical CollegeKarachi 74200Pakistan Department of internal medicine Sawai Man Singh Medical CollegeJaipur 302004India Department of internal medicine Dr.Sampurnanand Medical CollegeJodhpur 342003RajasthanIndia Department of Gastroenterology and Hepatology Rutgers Robert Wood Johnson School of MedicineNew BrunswickNJ 08901United States Department of internal medicine Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical SciencesRohtak 124001HaryanaIndia Department of Nephrology and Hypertension Mayo ClinicRochesterMN 55905United States Department of medicine Division of Pulmonary and Critical Care MedicineMayo ClinicRochesterMN 55905United States Department of Research Wellspan HealthYorkPA 17403United States

BACKGROUND Coagulopathy and thromboembolic events are associated with poor outcomes in coronavirus disease 2019(COVID-19)*** is conflicting evidence on the effects of chronic anticoagulation on mortality and severity of COVID-19 *** To summarize the body of evidence on the effects of pre-hospital anticoagulation on outcomes in COVID-19 *** A Literature search was performed on LitCovid PubMed,WHO,and Scopus databases from inception(December 2019)till June 2023 for original studies reporting an association between prior use of anticoagulants and patient outcomes in adults with *** primary outcome was the risk of thromboembolic events in COVID-19 patients taking *** outcomes included COVID-19 disease severity,in terms of intensive care unit admission or invasive mechanical ventilation/intubation requirement in patients hospitalized with COVID-19 infection,and *** random effects models were used to calculate crude and adjusted odds ratios(aORs)with 95%confidence intervals(95%CIs).RESULTS Forty-six observational studies met our inclusion *** unadjusted analysis found no association between prior anticoagulation and thromboembolic event risk[n=43851,9 studies,odds ratio(OR)=0.67(0.22,2.07);P=0.49;I2=95%].The association between prior anticoagulation and disease severity was non-significant[n=186782;22 studies,OR=1.08(0.78,1.49);P=0.64;I2=89%].However,pre-hospital anticoagulation significantly increased all-cause mortality risk[n=207292;35 studies,OR=1.72(1.37,2.17);P<0.00001;I2=93%].Pooling adjusted estimates revealed a statistically non-significant association between pre-hospital anticoagulation and thromboembolic event risk[aOR=0.87(0.42,1.80);P=0.71],mortality[aOR=0.94(0.84,1.05);P=0.31],and disease severity[aOR=0.96(0.72,1.26);P=0.76].CONCLUSION Prehospital anticoagulation was not significantly associated with reduced risk of thromboembolic events,improved survival,and lower disease seve

关键词： Prior anticoagulation COVID-19 Prehospital anticoagulation Chronic anticoagulation Mortality Severity Thromboembolic events

Rhabdomyolysis-related acute kidney injury in patients with COVID- 19

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Virology 2024年第3期13卷 76-81页

作者： Ahmet Murt Mehmet Riza Altiparmak Department of Nephrology clinic Istanbul University-CerrahpasaCerrahpasa Medical FacultyIstanbul 34000Türkiye Department of internal medicine Division of NephrologyIstanbul UniversityIstanbul 34000Türkiye

BACKGROUND Viral and bacterial infections may be complicated by rhabdomyolysis,which has a spectrum of clinical presentations ranging from asymptomatic laboratory abnor-malities to life-threatening conditions such as renal *** viral injury as well as inflammatory responses may cause rhabdomyolysis in the course of coronavirus disease 2019(COVID-19).When presented with acute kidney injury(AKI),rhabdomyolysis may be related to higher morbidity and *** To compare rhabdomyolysis-related AKI with other AKIs during *** A total of 115 patients with COVID-19 who had AKI were evaluated *** patients had a definite diagnosis of rhabdomyolysis(i.e.,creatine kinase levels increased to>5 times the upper normal range with a concomitant increase in transaminases and lactate dehydrogenase).These patients were aged 61.0±19.1 years and their baseline creatinine levels were 0.87±0.13 mg/*** were treated according to national COVID-19 treatment *** were compared with patients with COVID-19 who had AKI due to other *** For patients with rhabdomyolysis,creatinine reached 2.47±1.17 mg/dL during follow-up in *** these patients,13.3%had AKI upon hospital admission,and 86.4%developed AKI during hospital *** peak C-reactive protein reached as high as 253.2±80.6 mg/L and was higher than in patients with AKI due to other reasons(Pclinical course.

关键词： Rhabdomyolysis Acute kidney injury COVID-19 SARS-CoV-2 Creatine kinase

Epidemiology,therapy and outcome of hepatocellular carcinoma between 2010 and 2019 in Piedmont,Italy

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Oncology 2024年第3期16卷 761-772页

作者： Christian Bracco Marta Gallarate Marco Badinella Martini Corrado Magnino Salvatore D'Agnano Roberta Canta Giulia Racca Remo Melchio Cristina Serraino Valentina Polla Mattiot Giovanni Gollè Luigi Fenoglio Department of internal medicine Santa Croce e Carle General HospitalCuneo 12100Italy Department of Medical Sciences "City of Health and Science"University HospitalTorino 10100Italy

BACKGROUND Hepatocellular carcinoma(HCC)is the most common primary liver malignancy and the second leading cause of cancer deaths *** is often diagnosed at an advanced stage and therefore its prognosis remains poor with a low 5-year survival *** patients have increasingly complex and constantly changing characteristics,thus up-to-date and comprehensive data are *** To analyze the epidemiology and main clinical characteristics of HCC patients in a referral center hospital in the northwest of Italy between 2010 and *** In this retrospective study,we analyzed the clinical data of all consecutive patients with a new diagnosis of HCC recorded at"Santa Croce e Carle"Hospital in Cuneo(Italy)between 1 January 2010 and 31 December *** highlight possible changes in HCC patterns over the 10-year period,we split the population into two 5-year groups,according to the diagnosis period(2010-2014 and 2015-2019).RESULTS Of the 328 HCC patients who were included(M/F 255/73;mean age 68.9±11.3 years),154 in the first period,and 174 in the *** C virus infection was the most common HCC risk factor(41%,135 patients).The alcoholic etiology rate was 18%,the hepatitis B virus infection etiology was 5%,and the non-viral/non-alcoholic etiology rate was 22%.The Child-Pugh score distribution of the patients was:class A 75%,class B 21%and class C 4%.The average Mayo end-stage liver disease score was 10.6±3.7.A total of 55 patients(17%)were affected by portal vein thrombosis and 158(48%)by portal *** average nodule size of the HCC was 4.6±3.1 cm.A total of 204 patients(63%)had more than one noduleclinic Liver Cancer(BCLC)staging distribution of all patients was:4%very early,32%early,23%intermediate,34%advanced,and 7%*** survival rate was 1.6±0.3 *** 20%of the patients underwent ***,presence of ascites,BCLC stage and therapy w

关键词： Hepatocellular carcinoma Hepatitis virus Alcoholic hepatitis Non-alcoholic fatty liver disease Diagnosis Etiology Treatment