Postgraduate medical journal
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Observational Study
Predictors of inhospital mortality following out-of-hospital cardiac arrest: Insights from a single-centre consecutive case series.
Out-of-hospital cardiac arrest (OHCA) has a poor prognosis despite bystander resuscitation and rapid transfer to hospital. Optimal management of patients after arrival to hospital continues to be contentious, especially the timing of emergency coronary angiography±revascularisation. Robust predictors of inhospital outcome would be of clinical value for initial decision-making. ⋯ In our cohort of patients with OHCA, those who achieve ROSC had a survival-to-discharge rate of 58.2%. We identified four predictors of inhospital death, which are readily available at the time of patient presentation. Reliance on ST elevation to decide about coronary angiography and revascularisation may be flawed. More data are required.
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An informant history is critical in the complete cognitive assessments of older adults, but has never been formally assessed. ⋯ The informant history represents a much underused tool in the cognitive assessment of older adults presenting to the ED. The main barrier to informant interviewing in the ED environment appears to be informant availability. Where available, the informant history is easy to extract and provides invaluable information to the assessing physician. The acute care environment is suitable to brief informant interviews using readily available frameworks (AD8). However, the informant history is rarely obtained in this context, and further emphasis on undergraduate and postgraduate medical curricula is warranted.
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Tuberculosis (TB) remains a leading cause of human suffering and mortality despite decades of effective treatment being available. Accurate and timely diagnosis remains an unmet goal. ⋯ Several new developments in TB diagnostics have the potential to positively influence the global campaign against TB. We aim to review the performance of both established as well as new diagnostics for pulmonary TB in adults, and discuss the ongoing challenges.
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Atrial fibrosis plays a key role in the inducibility and persistence of atrial fibrillation. Urotensin II (U-II/UTS2) induces cardiac fibrosis by increasing fibroblast collagen synthesis and increased U-II plasma levels have been reported in patients with atrial fibrosis. Our objective was therefore to evaluate the possible role of the UTS2 gene polymorphisms Thr21Met and Ser89Asn in the genetic susceptibility to atrial fibrillation in a Chinese population. ⋯ Ser89Asn polymorphisms of the UTS2 gene are significantly associated with atrial fibrillation in the Chinese population. Additionally, we demonstrated that genotype Met21Met may have a potential beneficial role in atrial fibrillation.