Medicine
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Observational Study
Short and long-term mortality of spontaneous bacterial peritonitis in cirrhotic patients.
Spontaneous bacterial peritonitis (SBP) remains a significant concern for patients with cirrhosis. This study aims to reevaluate the trends in both short-term and long-term mortality rates associated with SBP. A retrospective cohort study was conducted using population data obtained from Taiwan's Health and Welfare Data Science Center, Ministry of Health and Welfare. ⋯ Following Cox regression analysis with adjustments for patient age, gender, and underlying medical conditions, the short-term prognostic factors of significance were age (hazard ratio [HR] = 1.03, 95% confidence interval [CI] = 1.01-1.05, P = .001), concurrent sepsis (HR = 2.73, 95% CI = 1.82-4.08, P < .001), and renal function impairment (HR = 3.28, 95% CI = 2.07-5.18, P < .001). Although the 30-day mortality rate for SBP in cirrhotic patients is around 10%, the long-term mortality remains significantly high. Renal function impairment and the presence of concurrent sepsis serve as indicators of poor short-term prognosis in cirrhotic patients with SBP.
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Observational Study
Predictors of active and recurrent bleeding in upper gastrointestinal angiodysplasia: Results from 10-year esophagogastroduodenoscopy of a tertiary center in Taiwan.
Upper gastrointestinal angiodysplasia (UGIA) is a unique mucosal vascular lesion that causes acute or recurrent gastrointestinal bleeding. Despite the increasing incidence of UGIA, the risk factors for bleeding in this condition remain unclear. We investigated the predictors of active and recurrent bleeding among patients with UGIA. ⋯ Multivariate analysis identified diabetes mellitus (DM), chronic kidney disease (CKD), and lesions in the duodenum as significant risk factors for active bleeding (P = .019; P = .006; P = .004). Our cohort study provided real-world data on the clinical and endoscopic features of UGIA. DM, CKD, and lesions in the duodenum were independent predictors of active bleeding.
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Tubular microdiscectomy is one of the most commonly performed surgical procedures for lumbar disc herniation (LDH). This study aimed to investigate the effectiveness of the enhanced recovery after surgery (ERAS) pathway for microdiscectomy in improving perioperative clinical outcomes in patients with LDH. This study retrospectively analyzed the prospectively collected perioperative outcomes of patients in pre-ERAS (January 2020 to December 2021) and post-ERAS (January 2022 to September 2023) groups. ⋯ Additionally, the estimated blood loss (P < .001), drainage tube removal time (P < .001), postoperative drainage volume (P = .002), postoperative first ambulation time (P < .001), and hospitalization costs (P = .032) in the post-ERAS group were significantly lower in the pre-ERAS group. Furthermore, the LBP VAS score was significantly lower on the first day (P = .001) and third days (P = .002) postoperatively in the post-ERAS group, whereas the patient satisfaction rate on the first day (P = .036) postoperatively was significantly higher in the pre-ERAS group. Compared with the conventional pathway, the ERAS pathway in tubular microdiscectomy is associated with better perioperative clinical outcomes in patients with LDH.
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Observational Study
Retrospective cohort study on the safety and efficacy of paclitaxel-coated balloon in the treatment of diabetic subpatellar artery disease.
Paclitaxel can inhibit smooth muscle cell proliferation and migration, and reduce the risk of vascular restenosis after balloon dilation. Our study investigated the safety and efficacy of paclitaxel-coated balloon (PCB) treatment for diabetic subpatellar artery disease. In this study, 140 patients with diabetic subknee arterial disease treated in our hospital from January 2022 to December 2023 were selected as the study objects, and were divided into the control group (conventional balloon interventionization angioplasty) and the observation group (PCB interventionization angioplasty), with 70 cases in each group according to the differences in previous balloon interventionization. ⋯ The improvement rate of walking impairment and 6 minutes walking distance in the observation group were significantly better than those in the control group, the difference was statistically significant (P < .05). There was no significant difference in the occurrence of adverse events between the 2 groups after operation (P > .05). For diabetic patients with subknee arterial disease, PCB treatment can ensure safety and improve clinical symptoms, and has good practical value.
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Observational Study
Blood routine test-based biomarkers is related to bone mineral density in elderly patients with chronic heart failure: A retrospective study.
Our previous studies suggested that bone mineral density (BMD) correlated with the severity of chronic heart failure (HF) as classified by the New York Heart Association (NYHA) and that blood routine test (BRT)-based biomarkers, including hemoglobin, red blood cells (RBCs), lymphocytes, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and systemic immune-inflammation index, were significantly related with BMD in general population. ⋯ BRT-based biomarkers were significantly different among different NYHA groups, which deserves further investigation and application in the future.