Irish journal of medical science
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Early cardiac death is more common in patients with Crohn's disease (CD) than in healthy adults, but the exact cause is unknown. ⋯ This study suggests visually undetectable myocardial involvement due to chronic systemic inflammation in patients with Crohn's disease. Cardiac MRI can help assess and monitor cardiac involvement in patients with CD.
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Tokyo guidelines (TG13/18) are used for the severity assessment of acute cholangitis (AC). Lactate is a clinical marker of tissue hypoxia and disease severity, independent from blood pressure. ⋯ The blood lactate level is associated with the severity of AC. In addition to TG13/18 guidelines, blood lactate level can be a useful biomarker in the severity grading of AC.
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Callispheres® microspheres (CSM) are the first drug-eluting bead (DEB) product developed in China; meanwhile, DEB-transarterial chemoembolization (TACE) with CSM is effective and safe in the treatment of hepatocellular carcinoma and intrahepatic cholangiocarcinoma. However, the data regarding the role of irinotecan-eluting beads-TACE (DEBIRI-TACE) using CSM for colorectal cancer liver metastases (CRLM) treatment is limited. Therefore, the present study aimed to investigate the efficacy and safety of DEBIRI-TACE using CSM in the patients with unresectable CRLM. ⋯ DEBIRI-TACE with CSM achieves high treatment response, acceptable survival benefits, and good toleration in unresectable CRLM treatment.
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Patients suspected to have upper gastrointestinal (UGI) cancer can be referred directly for investigation; however, at times this may result to inappropriate referrals. This study explores the model of a "one-stop" clinic as an alternative to the direct referral system. The current study aims to assess the feasibility and outcomes of a one-stop UGI clinic and evaluate sensitivity and specificity of "on-the-day" diagnoses. ⋯ The one-stop clinic was feasible and had good specificity and sensitivity. The finding of 10.7% of cases not being suitable for OGD indicates that a patient/specialist consultation is necessary to prevent misuse of endoscopy appointments. The authors recommend widespread adoption of one-stop clinics in UGI surgery.
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Observational Study
A retrospective cohort study of risk factors and outcomes in older patients admitted to an inner-city geriatric unit in London during first peak of COVID-19 pandemic.
Compared to younger patients, coronavirus disease 2019 (COVID-19) clinical presentation in older people can be more heterogeneous and fatal. We aim to describe a cohort of older adults admitted in an inner-city London hospital during the first peak of the pandemic. ⋯ We have described a cohort of patients with SARS-CoV-2 infection in the first UK peak of the global pandemic. We found that these patients had significant frailty with multiple comorbidities. There was a high mortality and increased dependency and greater social care need in survivors.