Articles: function.
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Observational Study
Risk factors for the outcome after thrombolysis in acute ischemic stroke - the prominent role of kidney dysfunction: A retrospective cohort observational study.
A complex interplay of factors reflecting the general biological, cardiovascular, neurological, renal, and metabolic status of patients influences the outcome of thrombolysis in stroke patients. This is a retrospective cohort observational study aimed to determine the importance of kidney dysfunction among these factors. Data (demographic, lifestyle, physical examination, laboratory, imaging, including metabolic and cardiovascular risk factors and comorbidities, neurological scores, and outcomes) of all stroke patients who underwent thrombolysis have been registered since January 1, 2016, in an online database. ⋯ Other risk factors most frequently associated with neurological scores were age, international normalized ratio, and cognitive decline. Multivariate analysis revealed estimated glomerular filtration rate (as determined by chronic kidney disease-EPI equation) as a determinant for all but one of these scores, and as the most important determinant for most of them, except for those reflecting the pre-intervention neurological status of the patient. Kidney dysfunction seems to be the most important determinant of the outcome of thrombolysed stroke patients, a result obtained by no other study.
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Fungal infection (FI) is a life-threatening condition in cirrhotic patients. However, a population-based study is required to determine the short-term mortality of these patients. The Taiwan National Health Insurance Database was used to enroll 1214 cirrhotic patients with FIs who were hospitalized between January 1, 2010 and December 31, 2013. ⋯ The overall 30-day and 90-day mortality rates for patients with invasive FIs were 25.7% and 49.9%, respectively (P < .001). After adjusting for sex, age, and other comorbidities, the following 90-day mortality prognostic factors were statistically different: renal function impairment (hazard ratio = 1.98, 95% confidence interval = 1.05-3.70, P = .034), concurrent with bacterial infections (hazard ratio = 1.75, 95% CI = 1.07-2.88, P = .027). Half of the cirrhotic patients died within 90-daysdue to invasive FIs, highlighting the importance of renal function impairment and concurrent with bacterial infections as an important prognostic factor.
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Observational Study
Laparoscopy-assisted peritoneal dialysis catheter placement using a modified minimally invasive approach: A retrospective observational study.
Peritoneal dialysis is a reliable and effective treatment for end-stage kidney disease. However, inadequate catheter insertion can lead to mechanical dysfunction, which remains an unresolved problem. In this study, we present the initial results of a modified laparoscopic approach. ⋯ The median peritoneal dialysis catheter-free survival was 25.96 ± 4.02 months. The catheter-free survival rate was 92.11%. The modified laparoscopic approach has been demonstrated to be a safe and effective option, and initial studies have indicated that it offers several benefits over traditional methods, including a straightforward procedure with a brief duration, minimal complications, and brief hospital stay.