International journal of clinical practice
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Although the relationship of elevated serum uric acid levels and cardiovascular disease has been established in a great number of studies, the causal relevance of this finding remains ambiguous. An approach to evaluate the causal relevance of biomarkers is to exploit the natural randomised allocation of allelic variation in genes affecting their level, also known as Mendelian randomisation. ⋯ Genetic evidence based on conventional and novel Mendelian randomisation approaches suggest a modest, if any, causal effect of serum uric acid concentration on the development of cardiovascular disease, suggesting that further study of uric acid genes is needed in order to elucidate the relationship of serum uric acid levels and cardiovascular disease.
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Int. J. Clin. Pract. · Jan 2018
Observational StudySymptoms at presentation to the emergency department: Predicting outcomes and changing clinical practice?
The type and number of symptoms in emergency patients differ widely. It remains unclear, if outcomes can be predicted by the number of symptoms. Furthermore, it is unknown, whether clinical practice could be influenced by presenting symptoms. ⋯ The number of symptoms did not correlate with the main adverse outcomes (ICU-admission and in-hospital mortality). However, clinical practice was influenced by the nature and number of symptoms. This was shown by associations with hospitalisation, length-of-stay, use of resources and follow-up presentations. Furthermore, the number of symptoms correlated with the caregivers' disease severity ratings and the attributed triage categories. This may indicate that caregivers respond to the number of symptoms by a higher investment in their immediate work-ups and later follow-ups.