Swiss medical weekly
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Swiss medical weekly · Jan 2012
Multicenter Study Clinical TrialEvaluation of a novel in-vitro diagnostic device for the detection of urinary tract infections in diaper wearing children.
Is the novel in-vitro diagnostic device U-Test(®) reliable and secure for urine collection in diaper-wearing children and simultaneous evaluation of the urine collected for the presence of leucocytes and nitrite? ⋯ The evaluation shows that U-Test(®) is a safe and reliable device of high functionality and diagnostic performance for the detection of leucocytes and nitrite directly and without time delay in a child's diaper. This statement is based on a comprehensive comparison of the novel device with accepted diagnostic test systems and procedures based on the same dry chemistry technology. Due to its simplicity of use, U-Test(®) can be considered an alternative to the cumbersome procedures of urine collection by the bag-method or clean-catch followed by dipstick analysis for the presence of leucocytes and nitrite.
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Swiss medical weekly · Jan 2012
Comparative StudyIdentification of older patients at risk of unplanned readmission after discharge from the emergency department - comparison of two screening tools.
The Identification of Senior At Risk (ISAR) and the Triage Risk Stratification Tool (TRST) are the two most studied screening tools to detect high-risk patients for unplanned readmission after an emergency department (ED)-visit. Since their performance was unclear among ED-patients over 75 years, we evaluated their capacities to predict readmission at 1, 3, 6 and 12 months as well as their usefulness in avoiding unnecessary further comprehensive geriatric assessment (CGA) in negative screened patients. ⋯ Both ISAR and TRST tools predicted modestly unplanned readmission after an ED-visit among patients over 75 years. Nevertheless, due to their low specificity and high NPV these screening tools are useful to select elderly ED-patients who can safely return home without any further CGA.
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Swiss medical weekly · Jan 2012
Clinical TrialDiuretic use, RAAS blockade and morbidity in elderly patients presenting to the Emergency Department with non-specific complaints.
Up to 20% of elderly patients present to the emergency department (ED) with non-specific complaints (NSC), such as "generalised weakness", the majority suffering from serious conditions requiring timely intervention. Little is known about the use and influence of diuretics and renin-angiotensin-aldosterone (RAAS) blockade on morbidity in those patients. The hypothesis was tested that the use of diuretics and RAAS blockade could be associated with an increased incidence of serious conditions in those patients. ⋯ Treatment with two or more diuretics, loop diuretics, or a combination therapy with RAAS blockade and diuretics are independently associated with serious condition and therefore should be recognized as "red flags" in elderly patients presenting to the ED with NSC.
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Swiss medical weekly · Jan 2012
The GC, CYP2R1 and DHCR7 genes are associated with vitamin D levels in northeastern Han Chinese children.
Vitamin D deficiency is associated with risk in several diseases. Vitamin D status has high heritability, yet the genetic epidemiology of vitamin D or its metabolites has not been well studied. Our objective was to identify the relationship among three vitamin D-related genes (GC, CYP2R1 and DHCR7/NADSYN1) and the levels of 25(OH)D in northeastern Han Chinese children. ⋯ The two SNPs in GC (rs222020, rs2298849), four SNPs in CYP2R1 (rs10741657, rs10766197, rs12794714 and rs1562902) and two SNPs in DHCR7/NADSYN1 (rs3829251, rs12785878) were significantly associated with plasma 25(OH)D concentrations under both additive and recessive models (P <0.05). The genotypes of the CYP2R1 rs2060793 polymorphism showed positive association with serum 25(OH)D status under all of the three genetic models even after correction for multiple comparison. This population-based study was the first to confirm the strong effects of the GC, CYP2R1 and DHCR7/NADSYN1 loci on circulating 25(OH)D concentrations in northeastern Han Chinese children.
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Swiss medical weekly · Jan 2012
Comparative StudyTENS - an alternative to antiviral drugs for acute herpes zoster treatment and postherpetic neuralgia prevention.
To evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) in treatment of Herpes zoster (HZ), and prevention of postherpetic neuralgia (PHN) compared with antiviral drugs. PHN is frequent complication of HZ and may last for months, its treatment isn't very successful. Nonpharmacological regimens for treatment of HZ and prevention of PHN haven't been evaluated. ⋯ Study suggests TENS may be safe adjunct or even alternative to antiviral drugs for treatment of acute HZ. It looks that TENS may be at least as good as antiviral drugs for treatment of HZ, and it may be better in reducing and preventing PHN - such conclusion would necessitate controlled, prospective study. Use of TENS provided pain relief and resolution of skin lesions with no higher rate of other HZ complications compared to antiviral therapy.