Annals of medicine
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This study was performed to compare severe clinical outcome between initially asymptomatic and symptomatic infections and to identify risk factors associated with high patient mortality among initially asymptomatic patients. ⋯ The mortality risk was not determined by the initial presence of symptom among hospitalized COVID-19 patients. The CCIS was the most potent predictors for mortality. The clinicians should predict the risk of death by evaluating age and comorbidities but not the initial presence of symptom. Key messages The mortality rate was not different between initially asymptomatic and symptomatic patients. Symptomatic patients were more likely to admitted to the intensive care unit. Age and comorbidities were the potent risk factors for mortality.
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The aim of current systematic review and meta-analysis is to provide insight into the therapeutic efficacy of fecal microbiota transplantation (FMT) for the decolonization of antimicrobial-resistant (AMR) bacteria from the gut. ⋯ More rigorous RCTs with larger sample size and standardized protocols on FMTs for gut decolonization of AMR organisms are warranted.KEY MESSAGEExisting studies in this subject are limited and of low quality with moderate heterogeneity, and do not allow definitive conclusions to be drawn.More rigorous RCTs with larger sample size and standardized protocols on FMTs for gut decolonization of AMR organisms are warranted.
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Meta Analysis
Thoracic sympathectomy for the treatment of primary axillary hyperhidrosis: systematic review and proportional meta-analysis.
Primary hyperhidrosis is a disorder that involves excessive sweat production, which has a negative impact on the quality of life. ⋯ This review demonstrated that thoracic sympathectomy by VATS is a viable and safe option for the treatment of PAH. There was no difference between high and lower levels of resection. However, the estimation of the effect is quite uncertain because the quality of evidence was extremely low.Key messagePure axillary hyperhidrosis has great potential to compromise quality of life.Surgery should be indicated only when clinical treatment fails.Thoracic sympathectomy by video-assisted thoracoscopy is a viable and safe option for the treatment of primary axillary hyperhidrosis.
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Many patients with type 2 diabetes will ultimately require the inclusion of basal insulin in their treatment regimen. Since most people with type 2 diabetes are managed in the community, it is important that primary care providers understand and correctly manage the initiation and titration of basal insulins, and help patients to self-manage insulin injections. Newer, long-acting basal insulins provide greater stability and flexibility than older preparations and improved delivery systems. ⋯ If warranted, switching between basal insulins can be done using simple regimens. The dose of basal insulin should be increased as required up to approximately 0.5-1.0 units/kg/day in some cases. Overbasalization (continuing to escalate dose without a meaningful reduction in fasting plasma glucose) is not recommended; rather re-evaluation of individual therapy, including consideration of more concentrated basal insulin preparations and/or short-acting prandial insulin as well as other glucose-lowering therapies, is suggested.
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Meta Analysis
Statin therapy in chronic viral hepatitis: a systematic review and meta-analysis of nine studies with 195,602 participants.
Conflicting data suggest that statins could cause chronic liver disease in certain group of patients, while improving prognosis in those with chronic viral hepatitis (CVH). ⋯ Not only long-term treatment with statins seems to be safe in patients affected by hepatitis, but also it significantly improves their prognosis.