Articles: function.
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Critical care medicine · Aug 2023
A Comparison of Long-Term Outcomes in Patients Managed With Venovenous Extracorporeal Membrane Oxygenation in the First and Second Waves of the COVID-19 Pandemic in the United Kingdom.
Early studies of venovenous extracorporeal membrane oxygenation (ECMO) in COVID-19 have revealed similar outcomes to historical cohorts. Changes in the disease and treatments have led to differences in the patients supported on venovenous ECMO in the first and second waves. We aimed to compare these two groups in both the acute and follow-up phase. ⋯ Most patients with COVID-19 supported on ECMO in both waves survived in the short and longer term. At follow-up patients had similar lung function and QOL across the two waves. This suggests that ECMO has an ongoing role in the management of a carefully selected group of patients with COVID-19.
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The parasympathetic system and its main neurotransmitter, acetylcholine, contributes to homeostasis of inflammation. Cholinergic dysregulation is thought to contribute to the pathogenesis of inflammatory rheumatic diseases. Cholinesterase activity in patients with psoriatic arthritis (PsA) has not been investigated. ⋯ We demonstrated similar cholinesterase activity in patients with psoriatic arthritis and controls, highlighting a potential effect of biologic treatment on cholinergic activity in patients with PsA.
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Patients with chronic renal insufficiency often show symptoms that are atypical for cardiovascular problems. The correct interpretation of the symptoms is crucial in order to correctly assess the risk of a heart-related emergency and to take preventive measures and initiate the right therapy. Biomarkers such as NT-proBNP, troponin T or hsCRP (highly sensitive CRP) are independent predictors of mortality, but do not replace instrument-based diagnostics. Patients with renal insufficiency often have stiff vessels which, due to the premature reflection of the pulse wave, can lead to left ventricular dysfunction and ultimately to heart failure.
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Harrington J, Carnicelli AP, Hua K, et al. Direct oral anticoagulants versus warfarin across the spectrum of kidney function: patient-level network meta-analyses from COMBINE AF. Circulation. 2023;147:1748-1757. 37042255.
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Randomized Controlled Trial
Ultrasound-Guided Percutaneous Electrical Nerve Stimulation versus Surgery for Women with Unilateral Carpal Tunnel Syndrome: A Randomized Parallel-group Trial.
The aim of this clinical trial was to compare the outcomes of the application of ultrasound-guided percutaneous nerve stimulation (PENS) targeting the median nerve versus surgery for improving pain and function in women with CTS. ⋯ The application of percutaneous nerve stimulation was more effective at short-term, but similar effective at mid and long-term, than surgery in women with carpal tunnel syndrome.