The American journal of the medical sciences
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Observational Study
Observational, prospective, single-center study: Should body mass index be added to the scoring criteria of hepatic critically ill patients in the intensive care unit.
Obesity has recently become more prevalent, and thus the coexistence of liver cirrhosis with obesity has become very pervasive. The purpose of this study is to investigate the correlation between abnormal body mass index (BMI) (overweight and obese) and clinical outcomes in critically ill cirrhotic patients. ⋯ Despite having similar Child-Pugh (CP) and Sequential Organ Failure Assessment Score (SOFA) scores on admission, obese patients had better outcomes than non-obese patients, demonstrating the obesity paradox. Further research is required on BMI as a predictive score in a patient with critical cirrhosis as an indicator of obesity.
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Heart failure with reduced ejection fraction (HFrEF) is a prevalent kind of heart failure in which a significant amount of the ejection fraction can be repaired, and left ventricular remodeling and dysfunction can be reversed or even restored completely. However, a considerable number of patients still present clinical signs and biochemical features of incomplete recovery from the pathophysiology of heart failure and are at risk for adverse outcomes such as re-deterioration of systolic function and recurrence of HFrEF. Furthermore, it is revealed from a microscopic perspective that even if partial or complete reverse remodeling occurs, the morphological changes of cardiomyocytes, extracellular matrix deposition, and abnormal transcription and expression of pathological genes still exist. ⋯ Based on the unique characteristics of this subgroup and the existence of many unknowns, the academic community defines it as a new category-heart failure with recovered ejection fraction (HFrecEF). Because there is a shortage of natural history data for this population as well as high-quality clinical and basic research data, it is difficult to accurately evaluate clinical risk and manage this population. This review will present the current understanding of HFrecEF from the limited literature.
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The primary purpose of the current study was to examine whether patients with rheumatologic conditions receiving only chronic hydroxychloroquine therapy for their disease are at less risk of developing SARS-CoV-2 infection than a comparative group of patients without rheumatologic conditions. ⋯ Hydroxychloroquine failed to demonstrate a preventative effect against SARS-CoV-2 infection in a large group of patients with rheumatologic conditions compared to patients without rheumatologic conditions.
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The association between statins and incident diabetes mellitus (DM) in observational studies is much larger than that reported from randomized controlled trials. We sought to assess this association using a novel design controlling for selection bias. ⋯ Statin use was strongly associated with incident diabetes when users were compared to non-users but not when continuers were compared to discontinuers. Selection bias confounds the association between statin use and incident diabetes in observational studies.
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Little is known about the prevalence of HFE (homeostatic iron regulator) hemochromatosis in African Americans (AA). ⋯ We conclude that ∼1/25,061 AA >18 y have a hemochromatosis-associated HFE genotype and IO and that ∼1/32,103 AA >18 y have a hemochromatosis-associated HFE genotype and IO-related disease.