Medicine
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Observational Study
Using the Kano model to associate the number of confirmed cases of COVID-19 in a population of 100,000 with case fatality rates: An observational study.
An important factor in understanding the spread of COVID-19 is the case fatality rate (CFR) for each county. However, many of research reported CFRs on total confirmed cases (TCCs) rather than per 100,000 people. The disparate definitions of CFR in COVID-19 result in inconsistent results. It remains uncertain whether the incident rate and CFR can be compared to identify countries affected by COVID-19 that are under (or out of) control. This study aims to develop a diagram for dispersing TCC and CFR on a population of 100,000 (namely, TCC100 and CFR100) using the Kano model, to examine selected countries/regions that have successfully implemented preventative measures to keep COVID-19 under control, and to design an app displaying TCC100 and CFR100 for all infected countries/regions. ⋯ A Kano diagram was drawn to compare TCC100 against CFT (or CFR100) to gain a better understanding of COVID-19. There is a strong association between a higher TCC100 value and a higher CFR100 value. A dashboard was developed to display both CFR100/CFR against TCC100 for countries/regions.
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Living liver donor hilar anatomical variations and impact of variant anatomy on transplant outcomes.
Donor anatomy is an essential part of donor selection and operative planning in living donor liver transplantation. In this study, variations of hilar structures, and the effects of variant anatomy on donor and recipient outcomes were evaluated. Living donor liver transplantations in a single center between January 2013 and December 2020 were retrospectively reviewed. ⋯ When donors with variant anatomy and donors with type 1 anatomy were compared in terms of hilar structure, no significant difference was observed in the frequency of complications and the frequency of serious complications. Biliary variations are more common in individuals with variant portal vein anatomy. Donor anatomic variations are not risk factors for inferior results of recipient survival or donor morbidity.
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Syphilis is a bacterial, systemic infectious disease caused by Treponema pallidum spirochetes, which spread rapidly through the body affecting various organs. The term neurosyphilis (NS) refers to a CNS infection that can occur at any stage of the disease. The lack of a gold standard for the diagnosis of NS greatly hinders diagnosis, which must be based mainly on clinical assessment. ⋯ Symptoms of NS are nonspecific, hence the diagnostic process is not straightforward. Despite the availability of modern diagnostic techniques, establishing a final diagnosis was challenging, but the patient ultimately received appropriate treatment. It is important to remember that syphilis is not only a disease known from history lessons but is still present in modern times and its incidence is increasing.
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Patients undergoing cardiopulmonary resuscitation (CPR) prior to extracorporeal membrane oxygenation (ECMO) can have severely altered physiology, including that of the coagulation pathway. This could complicate the extracorporeal cardiopulmonary resuscitation (ECPR) management. We aimed to show that targeting an activated clotting time (ACT) < 160 seconds does not affect the complication rates in these patients. ⋯ The successful weaning rate differed significantly between the low and conventional ACT groups (92.9% vs 50.0%; P = .019). Maintaining the ACT lower than the conventional ACT in patients requiring ECPR did not show a significant increase in the thromboembolic risk. Therefore, targeting a low ACT should be considered for this particular group of patients.
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Case Reports
Erdheim-Chester disease presenting as meningitis with hypoglycorrhachia: A case report.
Erdheim-Chester disease (ECD) commonly has neurologic manifestations but rarely presents with meningitis and hypoglycorrhachia. Here, were present a case of ECD with a clinical and laboratory presentation initially thought to be bacterial meningitis with sepsis. ⋯ Although only reported in one other case to our knowledge, ECD can present with meningitis with hypoglycorrhachia.