Srp Ark Celok Lek
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A combination of drugs is required for treatment of obese subjects with diabetes, due to multiple pathogenic mechanisms implicated in the development of both diabetes and obesity. ⋯ Sitagliptin can improve diabetes control and induce modest weight loss in obese subjects poorly controlled on insulin glargine and metformin. Titration of insulin glargine to optimal fasting glucose values is a prerequisite of success of this combination therapy.
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Randomized Controlled Trial
Manual versus target-controlled infusion of balanced propofol during diagnostic colonoscopy – A prospective randomized controlled trial.
There is an increasing interest in balanced propofol sedation (BPS) for colonoscopy in outpatient settings. Propofol is a potent anesthetic agent for this purpose and has a narrow therapeutic range, which increases a risk of cardiovascular and respiratory complications in case of improper administration. ⋯ MT is clinically as stable as TCI of propofol for deep sedation during colonoscopy, and endoscopists experienced the same comfort during colonoscopy in both groups. Thus, both combinations are suitable for deep sedation during diagnostic colonoscopy.
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Identification of predictive factors for walking ability with a prosthesis, after lower limb amputation, is very important in order to define patient’s potentials and realistic rehabilitation goals, however challenging they are. ⋯ By using SVM model with four variables (age, FCI, level of amputation, and mobility at admission) we are able to predict the level of ambulation with a prosthesis in lower limb amputees with high accuracy.
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Case Reports
Acute renal failure and hepatocellular damage as presenting symptoms of type II aortic dissection.
Pericardial effusion can be a consequence of a number of pathological conditions, and as such it can cause impaired left ventricular filling followed by decreased cardiac output and blood pressure. This kind of hemodynamic compromise and its consequences are extremely uncommon unless pericardial effusion causes tamponade. ⋯ It is important to underscore the significance of clinical situation of simultaneously existing acute renal and hepatic failures in the setting of a “non-tamponade” pericardial effusion, following a type II aortic dissection. Although most commonly aortic dissection presents itself with typical clinical symptoms or patient history data, it is not that unusual for it to be hidden in an entirely atypical clinical milieu as the one described in this case.
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Observational Study
General ward and pneumonia size as predictors of noninvasive ventilation failure.
Shortage of intensive care beds has led to more frequent use of noninvasive ventilation (NIV) outside respiratory units, and data on NIV efficacy and safety on general wards is lacking. ⋯ Patients with consolidation on chest X-ray and patients treated with NIV outside of dedicated respiratory units are at a higher risk for NIV failure.