Medicine
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At present, there is no effective therapy for preventing myocardial ischemia reperfusion injury (MIRI), and it is inevitable. The methods how to effectively decrease MIRI have attracted the attention of medical researches in recent years. Quercetin is a part of natural flavonoids in plant polyphenols. Many studies have found that quercetin has a positive effect on MIRI. ⋯ This preclinical systematic review and meta-analysis will evaluate the effects and mechanisms of quercetin for MIRI animals, and provide more evidence-based guidance for transforming basic research into clinical treatment.
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The aim of this study was to evaluate the effect of a novel 4-dimensional similarity filter (4DSF) on quantitative and qualitative parameters of low-dose dynamic myocardial computed tomography perfusion (CTP) images. In this retrospective study, medical records of 32 patients with suspected or known coronary artery disease who underwent dynamic myocardial CTP at 80 kV were included. The 4DSF reduces noise by averaging voxels that have similar dynamic behavior after adaptive iterative dose reduction 3D (AIDR3D) and deformable image registration were applied. ⋯ Improvement in subjective image quality yielded by 4DSF was higher than that yielded by AIDR3D (homogeneity, 1.0 [3 vs 2]; artefact, 1.5 [3 vs 1.5]; P < .001) in all patients. The 4DSF significantly decreased the SD by 59% (AIDR3D vs 4DSF: 33.5 ± 0.4 vs 13.8 ± 0.4, P < .001), increased the SNR by 134% (AIDR3D vs 4DSF: 4.4 ± 0.2 vs 10.3 ± 0.2, P < .001), and increased the CNR by 131% (AIDR3D vs 4DSF: 1.6 ± 0.2 vs 3.7 ± 0.2, P < .001). The 4DSF improved the qualitative and quantitative parameters of low-dose dynamic myocardial CTP images.
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Observational Study
Association of weekend admission and clinical outcomes in hospitalized patients with sepsis: An observational study.
Sepsis is associated with impaired clinical outcomes. It requires timely diagnosis and urgent therapeutic management. Because staffing during after-hours is limited, we explored whether after-hour admissions are associated with worse clinical outcomes in patients with sepsis. ⋯ Night shift admission, compared to routine-hours, was associated with a higher OR for ICU admission and intubation (ICU admission: OR 1.28 (1.23, 1.32), P < .001; intubation: OR 1.31, 95% CI 1.25, 1.37, P < .001) but with a lower OR for in-hospital mortality (OR 0.93, 19% CI 0.89, 0.97, P = .001). Among hospitalizations with a main diagnosis of sepsis, weekend admissions were associated with higher OR for in-hospital mortality, ICU admission, and intubation. Whether these findings can be explained by staffing-level differences needs to be addressed.
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Idiopathic necrotizing fasciitis (NF) is an infrequent, highly lethal skin infection that spreads rapidly, marked by fascia and subcutaneous tissue necrosis. It occurs in the absence of a known causative factor. Its emergence after sterile orthopedic fixation with unexpected spread to the abdomen may turn to be challenging both as a medical and surgical emergency. ⋯ The idiopathic NF may still potentially occur after a clean ORIF of the hip region. The implementation of intensive guideline-based treatments may show improvements, but the risk of unexpected NF spread to the abdomen should be anticipated, which may increase the mortality rates in diabetic or immunocompromised patients.
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Pulmonary amyloidosis is a rare respiratory disease characterized by amyloid deposition in the lungs. The clinical manifestations of pulmonary amyloidosis are variable and without specific symptoms. ⋯ This case clearly shows that it is difficult to distinguish tracheobronchial amyloidosis from other diseases with manifestations of cough, dyspnea and chest tightness because of their similar symptoms and imaging findings. Thus, the role of transbronchoscopic lung biopsy and histological examination in the diagnosis of tracheobronchial amyloidosis is very important.