International journal of clinical practice
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Int. J. Clin. Pract. · Jan 2023
Emergency Presentations for Dizziness-Radiological Findings, Final Diagnoses, and Mortality.
Dizziness is a frequent presentation in patients presenting to emergency departments (EDs), often triggering extensive work-up, including neuroimaging. Therefore, gathering knowledge on final diagnoses and outcomes is important. We aimed to describe the incidence of dizziness as primary or secondary complaint, to list final diagnoses, and to determine the use and yield of neuroimaging and outcomes in these patients. ⋯ Work-up for dizziness in emergency presentations has to consider a broad differential diagnosis, but due to the low yield, it should include neuroimaging only in few and selected cases, particularly with additional neurological abnormalities. Presentation with primary dizziness carries a generally favorable prognosis lacking short-term mortality. .
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Int. J. Clin. Pract. · Jan 2023
The Effect of Diabetes Management Shared Care Clinic on Glycated Hemoglobin A1c Compliance and Self-Management Abilities in Patients with Type 2 Diabetes Mellitus.
We aim to evaluate the impact of diabetes management shared care clinic (DMSCC) on glycated hemoglobin A1c (HbA1c) compliance and self-management abilities in patients with type 2 diabetes mellitus (T2DM). ⋯ DMSCC can help patients with T2DM reduce HbA1c, increase HbA1c compliance, improve diabetes self-management behaviors, empowerment, and diabetes-related emotional distress and serve as an effective exploration and practice of diabetes self-management education and support.
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Int. J. Clin. Pract. · Jan 2023
Identification of Crotonylation Metabolism Signature Predicting Overall Survival for Clear Cell Renal Cell Carcinoma.
Immunotherapy shows promise in treating cancer by leveraging the immune system to combat cancer cells. However, the influence of crotonylation metabolism on the prognosis and tumor environment in ccRCC patients is not fully understood. ⋯ Our study highlights the critical role of crotonylation metabolism in cancer development and progression, particularly its link to poor prognosis. CRS proves to be an accurate predictor of patient outcomes and immune features in ccRCC. KAT2A shows strong associations with clinical factors and the immunosuppressive environment, suggesting potential for innovative immunotherapies in ccRCC treatment.
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Int. J. Clin. Pract. · Jan 2023
Severe Spontaneous Hematomas in Patients Hospitalized with COVID-19.
To describe the epidemiological, clinical, laboratory, and radiological characteristics, medical treatment, and outcomes of a case series of severe spontaneous hematoma in COVID-19. Material and Methods. This retrospective study included patients hospitalized for COVID-19 who were diagnosed with severe spontaneous bleeding complications by following a standardized treatment protocol that included computed tomography angiography (CTA) from 1 March 2020 to 28 February 2022. The main outcomes were embolization and all-cause mortality. Baseline variables were analyzed for their association with mortality using bivariable logistic regression, and results were expressed as odds ratios (OR) and 95% confidence intervals (CI). ⋯ Although severe bleeding is an uncommon complication of COVID-19, its prevalence is higher than in inpatients without COVID-19, it usually needs embolization, and it is associated with high mortality.
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Int. J. Clin. Pract. · Jan 2023
Influencing Factors of Massive Hemorrhage and High-Grade Renal Vascular Injury after PCNL: A Retrospective Comparative Study.
Severe hemorrhage after percutaneous nephrolithotomy (PCNL) is a rare but alerting event. In this study, we report the factors affecting massive hemorrhage after PCNL, various levels of vascular damage during renal angiography, and the therapeutic effect of superselective renal artery embolization (SRAE). Patients and Methods. A retrospective analysis was performed on the data of 69 patients with postoperative PCNL hemorrhage who underwent SRAE from January 2010 to March 2021. Inclusion criteria for all cases were failure of conservative treatment for severe renal hemorrhage after surgery and then treatment with SRAE. In addition, 98 patients without significant hemorrhage after PCNL were randomly selected as the control group. All clinical data are confirmed by imaging and laboratory examinations. We performed univariate and multivariate analyses to find risk factors of massive hemorrhage and high-grade renal vascular injury after PCNL. ⋯ During the perioperative period of PCNL, patients with a risk of hypertension, urinary tract infection, and no hydronephrosis should be strengthened to monitor their high risk of postoperative hemorrhage. For patients with postoperative hemorrhage, we can use the patient's age and decreased hemoglobin before and after operation for analysis. In this way, individualized assessment can greatly improve the efficiency of SRAE treatment.