Articles: ninos.
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Revista médica de Chile · Feb 2021
Review[Performance of formulas for the evaluation of 24-hour urine collections using urine creatinine excretion].
Creatinine excretion is widely used as a method to evaluate the adequacy of urine collection in different clinical settings. Many factors influence its elimination, such as protein intake, exercise, muscle mass, age, and sex, among many others. As 24-hour urine collections can be cumbersome, several equations have been developed to aid clinicians to correctly interpret results derived from them. In this review article, we report the factors that can modify creatinine excretion and we evaluate the accuracy of different published equations to estimate 24-hour urine creatinine excretion.
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J Coll Physicians Surg Pak · Feb 2021
Comparative StudyIs Spontaneous Pneumomediastinum a Poor Prognostic Factor in Covid-19?
To determine the risk factors for spontaneous pneumomediastinum (SPM), its clinical course and effect on prognosis in patients with Coronavirus disease-19 (COVID-19) pneumonia. ⋯ SPM development in a patient with COVID-19 pneumonia is a sign that the prognosis will not be good, and these patients need a more aggressive treatment. Key Words: Spontaneous pneumomediastinum, COVİD-19, Pneumothorax, Real-time polymerase chain reaction, Subcutaneous emphysema.
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The glucocorticoid dexamethasone is the standard of care in critically ill patients with COVID-19 to suppress the inappropriately heightened inflammatory response (cytokine storm), but the Janus kinase inhibitor baricitinib combined with remdesivir has received emergency use authorization for the same indication. As of this writing, in a hospitalized patient with COVID-19 who has evidence of pneumonitis or hypoxia, we recommend using either regimen, but not both together. Both regimens have shown benefit in randomized controlled trials, but we cannot state with certainty that either is superior to the other, nor whether they should be used together. Further trials are underway.
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J Coll Physicians Surg Pak · Feb 2021
The Effect of COVID-19 Pandemic on Performance of Postgraduate Medical Trainee Doctors: A Nationwide Epidemiological Study in Pakistan.
To find out various organizational, personal, and systemic factors influencing the performance of the postgraduate trainee doctors in managing COVID-19 pandemic. ⋯ The effect of COVID-19 on performance of postgraduate doctors was multi-factorial. Significant risk factors were presence of a comorbidity, allergic and autoimmune disorders, and confirmed COVID-19 due to exposure. Key Words: COVID 19, Postgraduate trainee, Pandemic, Comorbidity, PCR.
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J Coll Physicians Surg Pak · Feb 2021
Clinical Outcomes and Prognostic Factors in HER-2 Positive Breast Cancer with Brain Metastasis: A Single-centre Experience.
To determine the characteristics and prognosis of brain metastasised HER-2 positive breast cancer (BC) patients. ⋯ Patients with ECOG PS score of 0-1 at the time of the BM had 19 months median overall survival (OS), while patients with ECOG PS score of 2 had 8 months (p <0.01). Median OS after BM was 32 and 14 months for patients with one BM and patients with multiple BM, respectively (p <0.01). Multivariate cox regression analyses revealed that time to progression of BM was shorter in patients with high-grade tumors compared to patients with low-grade tumors (p= 0.048), and in patients with de-novo metastasis compared to patients without de-novo metastasis (p= 0.003). Conclusıon: Tumor grade and de-novo metastasis (extracranial metastasis at the time of diagnosis) are independent predictive factors that may cause the earlier occurrence of BM and affect mortality in BC patients. Key Words: Brain metastasis, Breast cancer, HER-2 positive, Metastasis.