Annals of medicine
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Prediction models for identifying emergency department (ED) patients at high risk of poor outcome are often not externally validated. We aimed to perform a head-to-head comparison of the discriminatory performance of several prediction models in a large cohort of ED patients. ⋯ Head-to-head validation of 19 prediction models in medical ED patients showed that the RISE UP and COPE score outperformed other models regarding 31-day mortality.
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Second primary malignancies (SPMs) account for an increasing proportion of human malignancies. We estimated the incidence, risk factors and outcomes in lymphoma survivors with SPMs. ⋯ With the improvement of medical standards, the survival of lymphoma patients has been prolonged. However, the incidence of SPM is increasing, particularly among men and older lymphoma survivors. Therefore, more attention should be invested in the SPM to further improve the prognosis of these patients.
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In earlier studies, the health benefits of physical activity have only been related to leisure time physical activity (LTPA). High occupational physical activity (OPA) might even be harmful. The current physical activity recommendations do not separate the OPA and LTPA. We investigated the effect of LTPA and OPA on cardiovascular morbidity and mortality during long-term follow-up. We also examined how heavy work affects the benefits of leisure time exercise. ⋯ Study subjects who were in physically demanding occupations (heavy OPA) seemed to benefit from less LTPA than WHO currently recommends. Thus we suggest targeting different LTPA recommendations to different OPA groups.
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In Colombia, 98% of landmines occur in rural areas, where the main victims of amputation are farmers. The challenges these amputees face in their agricultural work remain unknown. The aim of this study is to determine the mobility and postural limitations these farmers face in carrying out their daily activities. ⋯ In conclusion, the prostheses worn by transtibial amputee farmers are not suitable for working on sloping and uneven terrain, nor for performing postures such as kneeling or squatting. These postures are very common in agricultural and livestock tasks in countries with mountainous areas such as Latin American countries. The recognition of problems reported by farmers transtibial amputees, may help to improve the design of prostheses so that they meet the needs of this population and decrease secondary injuries associated with prosthetic use. This information is useful to identify compensatory postures that facilitate prosthetic adaptation and rehabilitation for amputees.
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To evaluate the clinical outcomes of using the extra-uterine placental transfusion (EPT) approach in very preterm infants (VPIs, gestational age <32 weeks) and compare this to delayed cord clamping (DCC) after birth. ⋯ In twin subgroups, the incidence of NEC was higher in the EPT group when compared to the DCC group and therefore based on an abundance of caution the use of EPT in very preterm twins is not recommended.