Articles: function.
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Critical care medicine · Feb 2024
The Relationship Between Manifestation of Diabetes Insipidus and Estimated Glomerular Filtration Rate in Brain Death.
Systematic reviews have revealed that up to 50% of patients with brain death have residual hypothalamic/pituitary activity based on the absence of central diabetes insipidus (DI). We hypothesized that different degrees of renal dysfunction may impact the presence of DI in patients with brain death. ⋯ Renal dysfunction significantly impacts DI's clinical manifestation in brain death. We report that patients who experience brain death with severe renal dysfunction may not develop clinical signs of DI.
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J Coll Physicians Surg Pak · Feb 2024
Spectrum of Liver Injury in Dengue Fever: Cause or Effect of Severe Dengue?
The study aimed to determine if deranged liver function tests (LFTs) can predict severe dengue or mortality. It included 135 dengue patients, with a mean age of 30.9 ± 12.09 years. Among the patients, 82 (60.7%) were under 30 years of age. ⋯ The study findings suggested that hepatic derangement is a common occurrence in dengue patients, and increased ALP levels could be an indicator of a higher risk of mortality. These findings can help improve patient care by identifying the potential risk factors for mortality. Key Words: Dengue, Liver function tests, Alanine transaminase, Alkaline phosphatase.
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J Coll Physicians Surg Pak · Feb 2024
Evaluation of the Blood Urea Nitrogen-to-Left Ventricular Ejection Fraction Ratio in Predicting Mortality in Patients Presenting to the Emergency Department with Heart Failure Symptoms.
Heart failure is a clinical syndrome. In this study, the significance of the blood urea nitrogen-to-left ventricular ejection fraction (BUNLVEF) ratio in predicting short-term mortality in patients with heart failure symptoms was evaluated. This retrospectively designed study was conducted by evaluating the records of patients with a history of heart failure who presented to the emergency department with heart failure symptoms and signs from 01 January 2018 to 01 January 2020. ⋯ Blood urea nitrogen (BUN) and the BUNLVEF ratio had a significant relationship with mortality (p=0.004 and <0.010, respectively). In patients with a known history of heart failure presenting to the emergency department with heart failure symptoms, it would be more appropriate to evaluate poor outcomes with the BUNLVEF ratio rather than the LVEF or BUN value alone. Key Words: Blood urea nitrogen, Prognosis, Left ventricular dysfunction.
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HFrEF causes significant morbidity and mortality and represents a major public health burden. Recently, there have been significant scientific advances in the treatment of HFrEF, with ARNI, BB, MRA, and SGLT-2i forming the GDMT for HFrEF. ⋯ In addition, new initiation and titration procedures have recently been introduced that may progressively improve the management and prognosis of HFrEF. Further efforts are also needed to improve the use of GDMT, which is currently underutilized.
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Randomized Controlled Trial
Effectiveness of a new "focused pulse" high-frequency chest wall oscillation in patients with moderate to severe COPD.
Chest physiotherapy plays a crucial role in the treatment of COPD, although the optimal techniques for airway clearance have not been definitively established. Among the different techniques, high-frequency chest wall oscillation (HFCWO) has gained attention for its potential to create a widespread lung percussion, facilitating the removal of secretions and potentially clearing the peripheral bronchial tree. This study aims to assess the effectiveness of a novel "focused pulse" HFCWO in patients with moderate to severe COPD. ⋯ The focused pulse HFCWO technique improves daily life activities and lung function in patients with stable COPD. The device demonstrated significantly greater effectiveness in lowering COPD exacerbations as well as visits to ED or practitioner.