Brit J Hosp Med
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Ascites due to liver cirrhosis is a common complication in patients with liver disease, severely affecting their prognosis and quality of life. Traditional treatment methods have significant limitations in managing ascites, highlighting the need for new therapeutic approaches. As an antidiuretic drug, terlipressin has shown good efficacy and potential in treating ascites. ⋯ Additionally, we provide detailed discussions on medication precautions and management strategies for adverse reactions in high-risk patients. Finally, this review outlines future research directions, such as new clinical trial designs, comparisons of terlipressin with other novel drugs, and the exploration of individualized treatment models. These efforts aim to provide references for clinical practice and promote further development in this field.
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Antimicrobial therapy is essential to modern healthcare practice. However, years of injudicious use has contributed to the development of population and individual level harm from antimicrobial resistance. ⋯ Antimicrobial stewardship is the systematic approach to safe and effective use of antimicrobials to optimise outcomes, minimise harm and preserve future therapies. Herein, we consider the significance and importance of antimicrobial stewardship in the frail elderly and suggest ten steps to assist clinicians in the recognition, investigation and management of infection in this group.
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In a globalised world, patients may need to manage and track their health records with healthcare professionals anywhere and anytime with high data privacy and security. Blockchain technology (BcT) provides these necessities. This study aims to provide a general overview of the usability of BcT in healthcare applications. ⋯ BcT can also ensure accurate and timely financial transactions by automating payment processes among providers, insurers, and patients through smart contracts. In conclusion, BcT plays a key role in the healthcare sector. It enables safer, cheaper, more dependable, and more effective pharmacotherapy by providing data security, traceability, and immutability.
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Randomized Controlled Trial
Impact of Propofol Administered before Extubation on Respiratory Adverse Events in Pediatric Patients Undergoing Tonsillectomy and Adenoidectomy: A Randomized Controlled Trial.
Aims/Background Perioperative respiratory adverse events (PRAEs) are common in pediatric anesthesia, especially in otolaryngology procedures. In this randomized controlled trial, we investigated the impact of administering propofol before extubation on PRAEs in pediatric patients undergoing tonsillectomy and adenoidectomy. Methods We enrolled children aged 3 to 8 years old, of American Society of Anesthesiologists (ASA) classes I to III, scheduled for tonsillectomy, and randomly divided them into propofol and control groups. ⋯ Conclusion This trial demonstrated that while administering repeated small doses of propofol before extubation does not significantly reduce respiratory adverse events in children undergoing tonsillectomy and adenoidectomy, it does significantly reduce the incidence of severe coughing, improving postoperative recovery and clinical outcomes. Moreover, propofol helps reduce postoperative agitation, enhancing the safety and effectiveness of postoperative care, and maintaining its valuable clinical role in postoperative management. Clinical Trial Registration ClinicalTrials.gov (NCT05769842).
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Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are antidiabetic agents that effectively lower blood glucose levels in patients with Type 2 Diabetes Mellitus (T2DM). Beyond their glycemic control properties, SGLT2 inhibitors have demonstrated significant cardiovascular benefits, including reductions in major adverse cardiovascular events. However, the limitations of the pivotal trials investigating these outcomes have not been fully explored. This letter aims to critically assess the major randomized clinical trials that evaluated the cardiovascular effects of SGLT2 inhibitors, highlighting both their strengths and limitations.