International journal of clinical practice
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Int. J. Clin. Pract. · Dec 2020
Diagnostic performance of Fibroscan and computed tomography in 322 normal alanine aminotransferase non-obese non-alcoholic fatty liver disease patients diagnosed by ultrasound.
To compare the evaluation of various non-invasive examination include ultrasound, fibroscan and computed tomography (CT) in normal alanine aminotransferase (ALT) non-obese patients, to analyse the consistency and advantages among these non-invasive examination in non-alcoholic fatty liver disease (NAFLD) patients. ⋯ There is a discrepancy in the evaluation NAFLD by fibroscan, CT and ultrasound. LSM may affect the diagnostic coincidence rate of fibroscan, CT and ultrasound. Non-invasive assessment model including multiple clinical data and image results should be investigated in evaluating the degree of NAFLD. Interpretation of the diagnostic results about fibroscan, CT and ultrasound in the evaluation of NAFLD should take into account the specific clinical data of each patient.
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Int. J. Clin. Pract. · Dec 2020
Observational StudyNon-vitamin K antagonist oral anticoagulant (NOAC) use and dosing in Canadian practice: Insights from the optimising pharmacotherapy in the management approach to lowering risk in atrial fibrillation (OPTIMAL AF) Programme.
To estimate the rate of non-vitamin K oral anticoagulant (NOAC) dosing that is lower- and higher-than-recommended and to describe the reasons for NOAC dose discordance with Health Canada prescribing information. ⋯ The vast majority of Canadian patients meeting the Canadian Cardiovascular Society (CCS) guideline recommendations for OAC to decrease AF-related stroke risk were receiving product monograph-concordant NOAC dosing (85%). Nonetheless, this highlights the fact that an important proportion of patients were prescribed doses that are discordant and opportunities remain to improve NOAC dosing to optimise stroke prevention.
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Int. J. Clin. Pract. · Dec 2020
Prognostic machine learning models for COVID-19 to facilitate decision making.
An increasing number of COVID-19 cases worldwide has overwhelmed the healthcare system. Physicians are struggling to allocate resources and to focus their attention on high-risk patients, partly because early identification of high-risk individuals is difficult. ⋯ Implementing such an algorithm to predict high-risk individuals during the early stages of infection would be helpful in decision making for clinicians such that irreversible damage could be prevented. Here, we propose recommendations to develop prognostic machine learning models using electronic health records so that a real-time risk score can be developed for COVID-19.
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Urea is a hygroscopic molecule that, because of its moisturising properties, is topically used for the treatment of skin dryness at concentrations ranging from 2% to 12% in different formulations. Based on existing literature, low-concentration urea-containing products are effective in the treatment and/or prevention of xerosis in some skin disorders such as ichthyosis, atopic dermatitis and psoriasis, or unrelated to specific skin diseases. Generally, urea formulations at low concentration are well-tolerated and suited for the treatment of large skin areas, once or twice daily, even for a long period of time. At low concentrations stinging and burning sensation is rare and transient, whit no reported sensitisation despite its widespread use.
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We aimed to investigate the demographic shifts in emergency service admissions, possible measures and room for improvement in emergency services during the Covid-19 pandemic. ⋯ Measures taken to prevent the spread of Covid-19 infection have caused a significant drop in emergency service admissions. We are of the opinion that this will lead to an increase in deaths occurring at home, and we will soon encounter patients with worse prognosis and overcrowded emergency services. We are in opinion that the public awareness about emergency conditions requiring emergency service admission should be heightened alongside of the "stay home" calls. As: "In order to reduce morbidity and mortality from non-covid-19 conditions, we call for heightened public awareness on other emergency and urgent symptoms, which should prompt urgent attendance to medical services."