Medicina
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Comparative Study
A Comparative Analysis of Toxicology and Non-Toxicology Care in Intoxicated Patients with Acute Kidney Injury.
Background and Objectives: Intoxicated patients with acute kidney injury (AKI) experience high morbidity and mortality. While prior studies suggest that toxicology care settings improve outcomes, the impact of care settings on patients with AKI remains unclear. This study aimed to compare the outcomes of intoxicated patients with AKI managed in toxicology versus non-toxicology care settings. ⋯ Additionally, hospital stays were consistently longer in the AKI group than in the non-AKI group across all age groups. Conclusions: Hospital length of stay and mortality did not differ significantly between toxicology and non-toxicology care settings for intoxicated patients with AKI. However, both hospital length of stay and mortality were notably higher in patients with AKI compared to those without AKI.
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Review
Impact of DPP-4 Inhibitors in Patients with Diabetes Mellitus and Heart Failure: An In-Depth Review.
The increasing prevalence of both type 2 diabetes mellitus and heart failure has underscored the urgent need for optimized therapeutic strategies that address the complex interplay between these conditions. Dipeptidyl peptidase-4 (DPP-4) inhibitors have emerged as a popular class of glucose-lowering agents due to their favorable glycemic effects, safety profile, and potential cardiovascular benefits. However, the impact of DPP-4 inhibitors on heart failure outcomes in patients with diabetes remains contentious, with conflicting evidence from clinical trials and observational studies. ⋯ Comparative insights into alternative glucose-lowering therapies such as SGLT2 inhibitors and GLP-1 receptor agonists are also provided, highlighting potential implications for treatment selection in this high-risk population. In summary, this review synthesizes available evidence on DPP-4 inhibitors' impact in diabetic patients with heart failure, aiming to guide clinicians in making informed therapeutic decisions. While DPP-4 inhibitors remain a viable option in diabetes management, caution is warranted in patients with advanced heart failure, and future research is essential to refine patient-specific guidelines.
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Randomized Controlled Trial
Diagnosis of Pain Deception Using Minnesota Multiphasic Personality Inventory-2 Based on XGBoost Machine Learning Algorithm: A Single-Blinded Randomized Controlled Trial.
Background and Objectives: Assessing pain deception is challenging due to its subjective nature. The main goal of this study was to evaluate the diagnostic value of pain deception using machine learning (ML) analysis with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales, considering accuracy, precision, recall, and f1-score as diagnostic parameters. Materials and Methods: This study was a single-blinded, randomized controlled trial. ⋯ In the logistic regression analysis, pain and MMPI-2 did not show diagnostic value. However, in the ML analysis, values of the selected MMPI-2 (sMMPI-2) scales related to pain deception showed an accuracy of 0.724, a precision of 0.692, a recall of 0.692, and an f1-score of 0.692. Conclusions: Using MMPI-2 test results, ML can diagnose pain deception better than the conventional logistic regression analysis method by considering different scales and patterns together.
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Background/Objectives: Tobacco smoking is the most important cause of chronic diseases and premature death worldwide. Very brief advice (VBA) and brief advice (BA) represent evidence-based interventions designed to increase quit attempts. These are appropriate for all smokers, regardless of their motivation to quit, and involve several steps regarding the assessment, advice, and action. ⋯ Results: We have checked if these interventions can be used as an innovative method to help active smokers make an informed decision regarding their behaviour. Assisted/supported/guided by a general practitioner, current cigarette smokers can decide to quit smoking and identify the best way of cessation. We processed relevant data where brief interventions were used as the main counselling method to aid smoking cessation, regardless of using nicotine replacement therapy (NRT), heated tobacco products (HTPs), or vaping.
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Background and Objectives: Elizabethkingia species have become significant sources of infections acquired in hospital settings and are commonly linked to high mortality rates. Antimicrobial resistance can be influenced by Elizabethkingia species, geographical location, antimicrobial susceptibility testing methods, and the time of bacterial isolation. There are distinct antimicrobial susceptibility patterns among species, and the investigation into potential antibiotic susceptibility variations among species is beneficial. ⋯ The sensitivity levels of Elizabethkingia miricola to piperacillin-tazobactam (41.6-94.0%), ciprofloxacin (14-75%), levofloxacin (77.0-100%), trimethoprim-sulfamethoxazole (18.0-100%), tigecycline (50%), minocycline (100%), and rifampicin (66-85.7%) varied. Conclusions: The majority of the isolates of Elizabethkingia species were susceptible to minocycline and rifampin. This issue requires professional knowledge integration and treatment recommendations.