The American journal of the medical sciences
-
The shock index (SI) equals the heart rate/systolic blood pressure and has been used to predict clinical outcomes, especially in trauma and surgery patients. The authors reviewed the literature to determine its utility in the management of patients with sepsis and in the prediction of adverse outcomes in these patients. The medical literature was searched using PubMed, Scopus, Web of Science and Google Scholar databases to identify articles in English on the SI in humans. ⋯ It can predict the presence of lactic acidosis. The SI also helps predict the development of organ failure and mortality. Consequently, this easily available bedside measurement has utility in the identification, management and prediction of prognosis in patients with sepsis.
-
Randomized Controlled Trial
Concurrent Neoadjuvant Chemoradiotherapy for Siewert II and III Adenocarcinoma at Gastroesophageal Junction.
This study was conducted to investigate the efficacy and safety of using a concurrent neoadjuvant chemoradiotherapy (a XELOX regimen) to treat adenocarcinoma of the gastroesophageal junction. ⋯ Concurrent neoadjuvant chemoradiotherapy administration increased the rate of R0 resection and demonstrated favorable safety in patients with Siewert II or III adenocarcinoma at the gastroesophageal junction. These results support the use of neoadjunctive chemoradiotherapy in the treatment of adenocarcinoma of the gastroesophageal junction.
-
Underprescription of renin-angiotensin system blockers in moderate to severe chronic kidney disease.
Renin-angiotensin system (RAS) blockers slow the progression of chronic kidney disease (CKD). Despite this, up to 40% of patients with CKD and an indication for RAS blockade do not receive these medications. The purpose of this study was to examine variables associated with the prescription of RAS blockers in patients with CKD and to identify opportunities to increase their use. ⋯ The authors found that a large proportion of patients with CKD and an indication for RAS blockade were not prescribed these medications. For the majority, there was no provider-documented reason explaining why these medications were not prescribed, and the findings suggest that there may be opportunities to increase RAS blocker prescribing.
-
Smoking is a risk factor not only for the development of cancer and coronary heart disease but also for tuberculosis (TB). The aim of this study was to determine the prevalence of smoking in patients with TB, identify demographic and clinical characteristics associated with smoking and to evaluate TB treatment outcomes in the smokers. ⋯ Findings from the current study proved smoking to be one of the main factors associated with the occurrence of TB and significantly reducing the outcomes of TB therapy.
-
Observational Study
The relationship between baseline exhaled nitric oxide levels and acute mountain sickness.
Acute mountain sickness (AMS) is a common disabling condition observed in people ascending to high altitudes. However, a simple predictive test for AMS is not known. The aim of this study was to assess the relationship between baseline exhaled nitric oxide (FENO) and AMS occurrence. ⋯ This prospective observational study suggests that baseline FENO levels may be positively correlated with AMS in healthy Chinese lowlanders.