The American journal of the medical sciences
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Meta Analysis
The Safety of Intravenous Peripheral Administration of 3% Hypertonic Saline: A Systematic Review and Meta-analysis.
Three percent hypertonic saline (3% HTS) is used to treat several critical conditions such as severe and symptomatic hyponatremia and increased intracranial pressure. It has been traditionally administered through a central venous catheter (CVC). The avoidance of peripheral intravenous infusion of 3% HTS stems theoretically from the concern about the ability of the peripheral veins to tolerate hyperosmolar infusions. The aim of this systematic review and meta-analysis is to assess the rate of complications associated with the infusion of 3% HTS using peripheral intravenous access. ⋯ Peripheral administration of 3% HTS is considered a safe and possibly preferred option as it carries a low risk of complications and is a less invasive procedure compared to CVC.
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Review
Early repolarization: Electrocardiographic cues to distinguish benign from malignant variants.
Historically, early repolarization (ER) has been considered a marker of good health as it is more prevalent in athletes, younger persons, and at slower heart rates. However, contemporary reports, largely based on data from resuscitated sudden cardiac arrest patients, suggest an association between ER and an increased risk for sudden cardiac death and the development of malignant ventricular arrhythmias. Therefore, after we present a brief-case presentation, we intend to review a challenging topic in recognition of malignant variants and propose a four-step comprehensive approach to simplify ECG discrimination when assessing ER changes.
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In patients with community-acquired pneumonia (CAP), the risk and protective factors influencing discharge outcomes have not been fully elucidated. Therefore, we aimed to investigate the factors affecting discharge outcomes and provide a theoretical basis for improving the cure rate of patients with CAP. ⋯ Age > 65 years, the presence of co-morbidities, the presence of admission symptoms such as electrolyte disturbances, and severe pneumonia are associated with a poor discharge outcome, while pathogen-targeted therapy is associated with a good discharge outcome. Patients with CAP with a defined pathogen are more likely to be cured. Our results suggest that accurate and efficient pathogen testing is essential for CAP inpatients.
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To evaluate the degree to which clinical comorbidities or combinations of comorbidities are associated with SARS-CoV-2 breakthrough infection. ⋯ Further measures should be taken to prevent breakthrough infection for individuals with these conditions, such as acquiring additional doses of the SARS-CoV-2 vaccine to boost immunity.