Brit J Hosp Med
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Aims/Background The Geriatric Nutritional Risk Index (GNRI) is an effective tool for identifying malnutrition, and helps monitor the prognosis of patients undergoing maintenance hemodialysis. However, the association between the GNRI and cardiovascular or all-cause mortality in hemodialysis patients remains unclear. Therefore, this study investigated the correlation of the GNRI with all-cause and cardiovascular mortality in patients undergoing maintenance hemodialysis. ⋯ ROC curve analysis revealed that GNRI, age, and serum creatinine had moderate predictive value for mortality, with GNRI indicating an area under the curve (AUC) of 0.605 for all-cause mortality and 0.565 for cardiovascular mortality. Moreover, the N2 and N3 groups had a significantly reduced risk of cardiovascular mortality compared to the N1 group. Conclusion A lower GNRI is closely associated with a higher risk of all-cause and cardiovascular mortality in hemodialysis patients.
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Aims/Background The background for establishing and verifying a dehydration prediction model for elderly patients with post-stroke dysphagia (PSD) based on General Utility for Latent Process (GULP) is as follows: For elderly patients with PSD, GULP technology is utilized to build a dehydration prediction model. This aims to improve the accuracy of dehydration risk assessment and provide clinical intervention, thereby offering a scientific basis and enhancing patient prognosis. This research highlights the innovative application of GULP technology in constructing complex medical prediction models and addresses the special health needs of elderly stroke patients. ⋯ In the validation set, the AUC was 0.867 with a standard error of 0.025 and a 95% CI of 0.694 to 0.934. The optimal cutoff value here was 0.66, with a sensitivity of 80.16% and a specificity of 85.94%. Conclusion This study successfully established and validated a GULP-based dehydration prediction model for elderly patients with dysphagia following a stroke, demonstrating high application value.
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Aims/Background The relationship between retinal fundus hemorrhage and the severity of coronary artery lesions remains unclear. This study aimed to explore the incidence of fundus hemorrhage in patients at high risk of coronary heart disease (CHD) and to examine its correlation with the SYNTAX score, a tool used to assess the complexity of coronary artery disease. Methods This retrospective study consecutively enrolled patients undergoing coronary angiography (CAG) at Beijing Anzhen Hospital Hospital from June 2019 to January 2020. ⋯ The incidence of fundus hemorrhage was significantly higher in the hSS group compared to the lSS group (21.47% [38/177] vs. 7.56% [53/701], p < 0.001). Multivariate logistic regression analysis identified fundus hemorrhage, body mass index (BMI), and low-density lipoprotein cholesterol (LDL-C) as independent predictors of high SYNTAX scores. Conclusion Fundus hemorrhage is significantly associated with a higher SYNTAX score and may serve as a potential predictor of severe coronary artery lesions in clinical practice.
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Editorial
Finerenone: Do We Really Need an Additional Therapy in Type 2 Diabetes Mellitus and Kidney Disease?
Patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) face considerable cardiorenal morbidity and mortality despite existing therapies. Recent clinical trials demonstrate the efficacy of finerenone, a novel non-steroidal mineralocorticoid receptor antagonist, in reducing adverse renal and cardiovascular outcomes. This editorial briefly reviews the evidence and its implications for clinical practice, advocating the use of finerenone in these high-risk patients in combination with currently established treatment agents.
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Aims/Background Lobar pneumonia is an acute inflammation with increasing incidence globally. Delayed treatment can lead to severe complications, posing life-threatening risks. Thus, it is crucial to determine effective treatment methods to improve the prognosis of children with lobar pneumonia. ⋯ However, 7 days after treatment, the CD3+, CD4+, and CD4+/CD8+ levels increased significantly in the observation group compared to the control group (p < 0.001). Additionally, there was no significant difference in the incidence of adverse reactions in both groups (p > 0.05). Conclusion Pidotimod-assisted erythromycin treatment can significantly improve the treatment efficiency in children with lobar pneumonia, improving clinical signs and symptoms and enhancing the cellular immune function without increasing the risk of adverse drug reactions.