Medicine
-
Acute heart failure (HF) is a common cause of hospital admission. This study aims to compare continuous infusion and intermittent boluses of furosemide in treating acute HF. ⋯ The choice of furosemide regime in acute HF remains physician preference. Both bolus and continuous infusion yields satisfactory outcomes.
-
Chronic kidney disease (CKD) is a major global public health issue. Both hyperhomocysteinemia (HHcy) and hyperuricemia are independent risk factors for CKD. In this study, we evaluated the association of HHcy and hyperuricemia with CKD in the middle-aged and elderly populations in Taiwan. ⋯ Furthermore, hyperuricemia and HHcy had significant synergistic association (synergy index, 1.7) with CKD. The ORs of CKD increased with the quartiles of Hcy, independent of hyperuricemia. Hyperuricemia and HHcy had synergistic association with CKD.
-
Multicenter Study Observational Study
Variation in COVID-19 disease severity at hospital admission over time and across hospitals: A multi-institution cohort of Michigan hospitals.
During the spring 2020 COVID-19 surge, hospitals in Southeast Michigan were overwhelmed, and hospital beds were limited. However, it is unknown whether threshold for hospital admission varied across hospitals or over time. Using a statewide registry, we performed a retrospective cohort study. ⋯ Among patients admitted on room air, 75.1% (566/754) had no acute organ dysfunction on admission, and 35.3% (266/754) never developed acute organ dysfunction at any point during hospitalization; there was marked variation in both proportions across hospitals. In-hospital mortality was 13.7% for patients admitted on room air vs 26.3% for patients requiring nasal cannula oxygen. Among patients hospitalized with COVID-19 during the spring 2020 surge in Southeast Michigan, more than half were on room air and a third had no acute organ dysfunction upon admission, but experienced high rates of disease progression and in-hospital mortality.
-
Recent studies have suggested a renal protective effect of coffee consumption against development of chronic kidney disease (CKD), although the results remain inconclusive. We performed a protocol for systematic review and meta-analysis to comprehensively investigate this association by summarizing all available data. ⋯ Coffee consumption may be associated with a lower risk of incident CKD.
-
Lymphatic malformations are rare benign malformations that predominantly occur in the head and neck region. The advent of surgical robots in head and neck surgery may provide beneficial outcomes for pediatric patients. Here, we describe our experiences with transhairline incisions for robot-assisted surgical resection of cervical lymphatic malformations in pediatric patients. ⋯ All 4 patients were successfully treated for their lymphatic malformations, primarily with robotic surgical excisions. Cervical lymphatic malformations in pediatric patients could be accessed, properly visualized, and safely resected with transhairline-approach robotic surgery. Transhairline-approach robotic surgery is an innovative method for meeting clinical needs and addressing esthetic concerns.