Medicine
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Multicenter Study Observational Study
Outcomes of Early Ligation of Patent Ductus Arteriosus in Preterms, Multicenter Experience.
Persistent ductal patency may have serious effects in preterm infants. Analysis of the results of different trials were inconclusive in determining whether medical or surgical closure of the ductus is preferable and what is the best timing for surgical intervention. The aim of this study was to evaluate the effect of timing of surgical closure of patent ductus arteriosus (PDA) on ventilatory, hemodynamic, and nutritional status of preterm infants. ⋯ Full oral feeding was achieved earlier in the early ligation group than in the late group, 29 (15-73) days of life versus 53 (34-118) days of life, respectively (P < 0.05). Body weight at 36 weeks postconceptional age was higher in the early group--2100 (1350-2800) g--than in the late group-1790 (1270-2300) g--(P < 0.05). Our study demonstrated that earlier surgical ligation of the PDA in preterm infants has a more favorable nutritional and ventilatory outcome.
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Observational Study
Dementia Increases Severe Sepsis and Mortality in Hospitalized Patients With Chronic Obstructive Pulmonary Disease.
Dementia increases the risk of morbidity and mortality in hospitalized patients. However, information on the potential effects of dementia on the risks of acute organ dysfunction, severe sepsis and in-hospital mortality, specifically among inpatients with chronic obstructive pulmonary disease (COPD), is limited. The observational analytic study was inpatient claims during the period from 2000 to 2010 for 1 million people who were randomly selected from all of the beneficiaries of the Taiwan National Health Insurance in 2000. ⋯ After controlling for potential confounding factors, dementia was found to significantly increase the odds of severe sepsis and hospital mortality with an adjusted OR (OR) of 1.38 (95% confidence interval [CI] 1.10-1.72) and 1.69 (95% CI 1.18-2.43), respectively. Dementia was also significantly associated with an increased OR of acute respiratory dysfunction (adjusted OR 1.39, 95% CI 1.09-1.77). In hospitalized COPD patients, the presence of dementia may increase the risks of acute respiratory dysfunction, severe sepsis, and hospital mortality, which warrants the attention of health care professionals.
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The purpose of this study was to investigate the relationship of alcohol intoxication to time-to-presentation following injury, fracture type, mechanism of injury leading to fracture, and initial diagnostic radiology interpretation performance of emergency physicians versus diagnostic radiologists in patients who present to the emergency department (ED) and are subsequently diagnosed with fracture. Medical records of 1286 patients who presented to the ED and were diagnosed with fracture who also underwent plain film or computed tomography (CT) imaging were retrospectively reviewed. The subjects were divided into intoxicated and sober groups. ⋯ While the same proportion of intoxicated patients presented more than 24 hours following injury, only intoxicated patients presented with craniofacial and cervical spinal fractures during this period. Alcohol-related injuries are more often associated with head/neck fractures but less extremity injuries. The rate of fractures missed by emergency physicians but later diagnosed by radiologists was the same in intoxicated and sober patients.
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Comparative Study Observational Study
PET/CT-Based Dosimetry in 90Y-Microsphere Selective Internal Radiation Therapy: Single Cohort Comparison With Pretreatment Planning on (99m)Tc-MAA Imaging and Correlation With Treatment Efficacy.
⁹⁰Y PET/CT can be acquired after ⁹⁰Y-microsphere selective radiation internal therapy (SIRT) to describe radioactivity distribution. We performed dosimetry using ⁹⁰Y-microsphere PET/CT data to evaluate treatment efficacy and appropriateness of activity planning from (99m)Tc-MAA scan and SPECT/CT. Twenty-three patients with liver malignancy were included in the study. (99m)Tc-MAA was injected during planning angiography and whole body (99m)Tc-MAA scan and liver SPECT/CT were acquired. ⋯ Tumor absorbed dose calculated by (99m)Tc-MAA SPECT/CT was not a significant predictor for PFS. Activity planning based on (99m)Tc-MAA scan and SPECT/CT can be effectively used as a conservative method. Post-SIRT dosimetry based on ⁹⁰Y-microsphere PET/CT is an effective method to predict treatment efficacy.
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Pathological snapping secondary to posttraumatic subluxation of the extensor tendon at proximal interphalangeal joint (PIPJ) of the finger is rare. Here, we want to describe a patient with snapping of the left small finger at PIPJ due to retinacular ligament injury. A 24-year-old man was admitted because of a 5-year history of a snapping sound in the left small finger. ⋯ At the 6-month follow-up, the patient had regained full range of motion with no discomfort, and there was no sign of recurrence. We stress that when there is snapping over the dorsum of the PIPJ of the finger, the clinician should suspect rupture of the retinacular ligaments, especially in minor trauma patients. Primary repair of retinacular ligaments and dynamic splinting provided satisfactory results without recurrence in our patient.