Medicine
-
Multicenter Study Observational Study
Association between oral loop diuretics duration before discharge and hospital readmission in acute decompensated heart failure: A multicenter retrospective cohort study.
There are uncertainties when to start patients on oral loop diuretics after managing acute decompensated heart failure (ADHF) before discharge. This study aims to investigate the impact of prolonging observation duration on hospital readmissions following the switch to oral loop diuretics before discharge in patients with ADHF. A multicenter retrospective study that included adult patients (>18 years) diagnosed with ADHF and discharged on oral loop diuretics in Saudi Arabia. ⋯ ADHF patients with <24 hours observation durations were significantly associated with higher all-cause 30-day readmissions compared to those with ≥24 hours observations (odds ratio = 1.83, 95% confidence interval = 1.11-3.02, P = .017). Our study showed a significant decrease in all-cause 30-day readmissions for ADHF patients who received oral loop diuretics at discharge with a longer duration of observation. This study emphasizes the significance of standardizing the observational period when initiating oral loop diuretics before discharge following admission to ADHF.
-
Multicenter Study Observational Study
Evaluation of risk factors for postpartum cerebral venous sinus thrombosis, a multicenter retrospective observational study.
The postpartum period is a well-defined risk factor for cerebral venous sinus thrombosis (CVST). However, it is unclear which patients are at risk for CVST in the postpartum period. Thus, determining some CVST risk factors in postpartum patients may be useful for preventing the disorder in this population. ⋯ Women with PE who had recently delivered were found to be at increased risk of developing CVST. The primary limitation of this study is that it was retrospective, and the control group was hospital-based. We recommend that these findings be confirmed by multicenter prospective international studies.
-
Immune checkpoint inhibitors have been used to treat cancer patients. Non-small cell lung cancer (NSCLC) patients with a high expression level of programmed cell death ligand-1 (PD-L1) could benefit from immune checkpoint inhibitor monotherapy. However, treating NSCLC patients with PD-L1 negative is still a clinical challenge. The utilization of new-type tumor markers as predictive indicators of therapeutic efficacy, with the aim of guiding clinical medication strategies, has emerged as a paramount focus of clinical investigation and interest. ⋯ A comprehensive evaluation of multiple tumor biomarkers should be considered in NSCLC patients. Pembrolizumab monotherapy could benefit NSCLC patients with negative driver genes, PD-L1 negative, a high tumor mutational burden, and positive tumor-infiltrating lymphocytes.
-
This study aimed to report and recall a simple method to remove the lens capsule ab externo when performing intrascleral fixation of an intracapsular intraocular lens (IOL) dislocation with reuse of the IOL. ⋯ In cases of 3-piece IOL dislocation, employing the ab externo technique for lens capsule extraction has been proven to be a straightforward and efficient method. This approach facilitates the removal of the lens capsule around the IOL. If subsequent damage to the IOL is identified, it allows for easy conversion to replacement.
-
Observational Study
Lactate, lactate clearance, and lactate-to-albumin ratio in predicting mortality in patients with critical polytrauma: A retrospective observational study.
Lactate is a product of anaerobic metabolism used to determine prognosis in critically ill trauma patients. This study investigates the mortality-predictive performance of lactate, lactate clearance, and lactate-to-albumin ratio (LAR) on admission in patients with polytrauma in a tertiary center's intensive care unit (ICU). Polytrauma patients in the ICU between June 2019 and June 2022 were evaluated. ⋯ In receiver operating characteristics curve analysis, the cutoff value of lactate was ≥5.4, the area under the curve (AUC) was 0.75 (95% confidence interval [CI], 0.66-0.84), the cutoff value of lactate clearance was ≤39.2, AUC was 0.60, (95% CI, 0.51-0.69), and the cutoff value of LAR was value ≥1.50, AUC 0.83 (95% CI, 0.75-0.90). In critically ill polytrauma patients, LAR on ICU admission is an independent predictor of mortality and has acceptable prognostic value. LAR is superior to lactate and 24-hour lactate clearance in predicting mortality.