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Gross posted an update 9 months ago
The aim of the current study was to evaluate whether tubular markers kidney injury molecule-1 (KIM-1) and N-acetyl-ß-glucosaminidase (NAG) are related to acute kidney injury (AKI) and severe disease in patients with COVID-19.
In this prospective observational clinical trial we examined a cohort of 80 patients with proof of acute respiratory infection and divided them into a COVID-19 cohort (n = 54) and a control cohort (n = 26). KIM-1 and NAG were measured from urine samples collected in the emergency department. We assessed the development of AKI, admission to the intensive care unit (ICU) and intrahospital death as clinical endpoints. Urinary KIM-1 and NAG were not significantly different between patients with SARS-CoV-2 and those with other respiratory infections (each p = n.s.). Eight patients from the COVID-19 cohort and five of the non-COVID-19-patients suffered from acute kidney injury during their stay. Nine COVID-19 patients and two non-COVID-19 patients were admitted to the ICU. KIM-1 was significantly elevated in COVID-19 patients with, compared to those without AKI (p = 0.005), as opposed to NAG and creatinine (each p = n.s.). Furthermore, KIM-1 was significantly elevated in the patients with COVID-19 that had to be transferred to the ICU (p = 0.015), in contrast to NAG and creatinine (each p = n.s.).
Assessing KIM-1 in patients with COVID-19 might provide additional value in recognizing AKI at an early stage of disease. Further, KIM-1 might indicate higher risk for clinical deterioration as displayed by admission to the ICU.
Assessing KIM-1 in patients with COVID-19 might provide additional value in recognizing AKI at an early stage of disease. Further, KIM-1 might indicate higher risk for clinical deterioration as displayed by admission to the ICU.
To confirm that a multi-component physical activity index (PAI), with physical activity (PA)-related behaviors and performance measures, enhances PA assessment for adults with cancer history (“survivors”) vs. for the general population for key health variables.
Data from 2011 to 2014 NHANES were analyzed (n = 9620 adults, including 866 survivors). We generated PAI scores by calculating subscales for activity-related behaviors (i.e., moderate-to-vigorous PA and TV viewing hours/sedentary time) (n/8) and performance (i.e., cardiorespiratory fitness and muscle strength) (n/8), then combined for an overall PAI score (n/16 points). Dependent variables (self-reported health, multimorbidity, and functional limitations) were dichotomized and tested with logistic regression to estimate associations with PAI variables.
Survivors obtaining 22.5 + MET hours/week of PA were >5× more likely to report excellent health than non-exercisers (OR = 5.5, 95% CI 3.27-9.28). We observed a general decrease in likelihood of multimorbidity and functional limitations with increasing PA. Models with the combined score showed that higher PAI scores had larger positive associations with all three for all adults. Survivors with higher PAI scores were >30% more likely to report excellent self-rated health (OR = 1.3, 95% CI 1.2-1.4) and 20% less likely to report multimorbidity and functional limitations compared to survivors with lower PAI scores, considering covariates.
Greater PA-related behavior and performance was beneficial for adults irrespective of cancer history. However, using a combined score elucidates unique needs and benefits for survivors vs. for general population.
Using a multi-component approach to PA assessment could help in developing validated tools to plan exercise programs and interventions for survivors.
Using a multi-component approach to PA assessment could help in developing validated tools to plan exercise programs and interventions for survivors.
Chronic pain management services have historically been under-resourced in Ireland. There is no agreed model of care for chronic pain management services in Ireland. Previous studies have assessed the extent of services in Ireland without examining waiting times for access to services.
This study aimed to quantify the extent of, geographical distribution of and waiting times for access to publicly funded chronic pain management services in Ireland.
Using the British Pain Society’s Core Standards for Pain Management Services in the UK (2015) and International Association for the Study of Pain (IASP) recommendations, a questionnaire was devised. Publically funded departments in Ireland were contacted and questionnaires completed. Waiting list data was publicly available and obtained from the National Treatment Purchase Fund website.
There was a 100% response rate. Sixteen publicly funded chronic pain management services wereidentified. There are 27 chronic pain management consultants (16.6 whole time eq staff is of particular concern for Irish services. selleck chemicals llc Patient access is limited as evidenced by significant waiting lists. In order to improve access to care and bring services in line with international recommendations, increased resources are needed.
To determine if alcohol consumption is a risk factor for obstructive sleep apnea (OSA) and nocturnal oxygen desaturation.
This case-control study evaluated patients with confirmed OSA and a control group using polysomnography (PSG). Two doctors who have worked in this field for more than 5years provided a blinded interpretation of the patients’ monitoring results. Logistic regression models were used to identify the odds ratio (OR) for alcohol consumption on OSA.
A total of 793 patients were enrolled in this study. Compared with those who did not consume alcohol, those consuming alcohol had a higher risk of OSA (OR 2.03, 95% CI 1.30-3.17) after adjustment. Regarding the risk of OSA after adjusting for former drinkers and current ones, the ORs were 1.96 (95% CI 1.19-3.22) and 2.22 (95% CI 1.06-4.63), respectively. And the P for trend = 0.002. The β of former drinkers and the current ones were 3.448 and 4.560 after adjustment; P for trend was 0.006. The relationship may have gender difference, and alcohol consumption was associated with AHI in female significantly (β = 10.190 and 15.395 for former and current drinkers, respectively, in females after adjustment, P for trend = 0.002).
In this study, we found that alcohol consumption was an independent risk factor of OSA and OSA with hypoxia, and alcohol consumption was related to AHI significantly after adjustment, especially in female. In order to reduce the risk and severity of OSA, it is suggested that people should avoid drinking, and drinkers should abstain from drinking.
In this study, we found that alcohol consumption was an independent risk factor of OSA and OSA with hypoxia, and alcohol consumption was related to AHI significantly after adjustment, especially in female. In order to reduce the risk and severity of OSA, it is suggested that people should avoid drinking, and drinkers should abstain from drinking.