The American journal of the medical sciences
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This study evaluates the effect of dapagliflozin, a SGLT2 inhibitor, on fluid or electrolyte balance and its effect on urea transporter-A1 (UT-A1), aquaporin-2 (AQP2) and Na-K-2Cl cotransporter (NKCC2) protein abundance in diabetic rats. ⋯ Dapagliflozin treatment augmented the compensatory changes in medullary transport proteins in DM. These changes would tend to conserve solute and water even with persistent glycosuria. Therefore, diabetic rats treated with dapagliflozin have a mild osmotic diuresis compared to nondiabetic animals, but this does not result in an electrolyte disorder or significant volume depletion.
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Missed appointments are problematic because they occupy an appointment that could have been used by another patient and represent lost resources for the hospital system. The objective of this study was to determine patient-related factors associated with missed appointments. ⋯ Patients with limited health literacy and current smokers had higher rates of missed appointments. In addition, patients who were compliant with screening mammography were also more likely to be compliant with appointments. Appointment reminders should be kept simple to accommodate the rapidly growing population with limited health literacy.
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Editorial Case Reports Historical Article
Booker T. Washington and the Secret of Hypertension in African Americans.
Booker T. Washington rose from slavery to become one of the most admired Americans of his time. ⋯ At that time the medical profession was just beginning to recognize the importance of hypertension as a risk factor for cardiovascular disease. In spite of intensive research fueled by ongoing speculation, why Washington might have been predisposed to the ravages of hypertension, and African Americans continue to be so predisposed, is a secret yet to be told.
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The excessive correction of acute hypernatremia is not known to be harmful. This study aimed to evaluate whether a reduction rate of serum sodium (RRSeNa) > 1mEq/L/hour in acute severe hypernatremia is an independent risk factor for mortality in critically ill patients undergoing continuous venovenous hemofiltration (CVVH) treatment. ⋯ In addition to the Acute Physiology and Chronic Health Evaluation II score and vasopressor dependency, the excessive correction of acute severe hypernatremia was possibly associated with mortality in critically ill patients undergoing CVVH treatment. The optimal reduction rate of acute hypernatremia should be extensively studied in critically ill patients.
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Observational Study
Effect of Bacteremia in Elderly Patients With Urinary Tract Infection.
The clinical effect of bacteremia on outcomes in urinary tract infection (UTI) is still debated. This study aims to examine the clinical effect of bacteremia in elderly patients with UTI requiring hospital admission. ⋯ Our study suggests that the presence or absence of bacteremia in elderly people with UTI requiring hospitalization does not have an influence on outcomes such as in-hospital mortality or length of stay.