Medicine
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Observational Study
Factors associated with subtherapeutic levels of valproic acid in hospitalized patients with epilepsy: A retrospective cohort study.
Valproic acid (VPA) is a commonly used anti-seizure medication, owing to its efficacy and cost-effectiveness. However, maintaining appropriate serum levels is crucial due to the narrow therapeutic window, as subtherapeutic levels can lead to treatment failure or adverse outcomes. This study aimed to identify the factors associated with subtherapeutic serum levels of valproic acid in patients undergoing treatment. ⋯ This study identified several factors significantly associated with subtherapeutic levels of valproic acid, including males, prior phenytoin use, co-medications, such as topiramate and meropenem, and lower VPA dosages. These findings underscore the importance of careful monitoring and individualized treatment plans to maintain therapeutic VPA levels in clinical practice. Further research is needed to explore the clinical implications and to develop strategies to minimize the risk of subtherapeutic levels in patients receiving VPA.
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Observational Study
Study on the clinical characteristics, treatment, and outcome influencing factors of severe pneumonia complicated with ARDS.
To investigate the clinical characteristics, treatment methods, and factors influencing the prognosis of patients with severe pneumonia complicated by Acute Respiratory Distress Syndrome (ARDS), aiming to provide references for clinical decision-making and improve patient outcomes. A retrospective analysis was conducted on 118 patients with severe pneumonia complicated by ARDS treated at our hospital from June 2018 to December 2022. Based on treatment outcomes, patients were divided into a death group (n = 75) and a survival group (n = 43). ⋯ This indicates that an increase in age and a decrease in oxygenation index are associated with a significantly higher risk of mortality, while shorter mechanical ventilation duration is related to poorer prognosis. Advanced age, lower oxygenation index, and shorter duration of mechanical ventilation are unfavorable prognostic factors in patients with severe pneumonia complicated by ARDS. These findings aid clinicians in identifying high-risk patients, optimizing treatment plans, and improving patient prognosis.
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This study was designed to investigate the effectiveness, safety, and cost-effectiveness of norvancomycin in the management of acute hematogenous osteomyelitis in pediatric patients. We conducted a retrospective study on cases of osteomyelitis in pediatric patients treated with norvancomycin or vancomycin at Hebei Children's Hospital from January 2015 to February 2023. The patients were categorized into the norvancomycin group and the vancomycin group. ⋯ Additionally, compared to the vancomycin group, both the clinical efficacy cost ratio (290.44 vs 437.76) and bacteriological clearance cost ratio (356.14 vs 576.30) were lower in the norvancomycin group. Norvancomycin demonstrates comparable efficacy to the first-line drug vancomycin in treating acute hematogenous osteomyelitis in pediatric patients. Moreover, norvancomycin can significantly mitigate treatment expenses and exhibit favorable cost-effectiveness.
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This study evaluates the diagnostic accuracy of ultrashort echo time (UTE)-MRI for detecting pulmonary nodules and image quality. A total of 46 patients at our hospital underwent unenhanced computed tomography (CT) and UTE-MRI. The image quality and number of nodules detected using CT were used as the gold standards. ⋯ For blood vessels, subsegment blood vessels could also be displayed with clear walls and uniform signals (Kendal Wa = 0.823, P < .001), indicating strong consistency. Compared to CT, UTE-MRI can detect pulmonary nodules with a high detection rate, relatively good image quality, and strong consistency between observers. The development of UTE-MRI can provide a novel imaging method for the detection and follow-up of pulmonary nodules and diagnosis of pneumonia by reducing ionizing radiation.
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An increasing body of evidence suggests that diabetes mellitus (DM) plays a role in sensorineural hearing loss (SNHL). However, the specific causal relationship between DM and SNHL remains partially uncertain. This study aimed to investigate the causal relationship between DM and the risk of SNHL using a Mendelian randomization (MR) study. ⋯ Our study suggested that DM and type 1 DM may be genetically responsible for SNHL. Although our study did not detect a genetic causal relationship between type 2 DM and SNHL, this does not rule out a relationship between them at other mechanistic levels. Further studies are required to confirm the findings and look into the physiological and pathological mechanism underlying these relationships.