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  • Kjer posted an update 1 year, 5 months ago

    OBJECTIVE To compare the growth and neurodevelopmental outcomes at 12 to 18 months of corrected age in preterm infants (gestation less then 35 wks) born appropriate for gestation (AGA) with those born small for gestation (SGA). METHODOLOGY This cross sectional, study assessed the growth outcomes in terms of underweight, stunting, microcephaly, overweight and obesity. Development delay was defined as developmental quotient less then 70 on DASII. RESULTS Out of 178 infants enrolled in the study 119 were AGA and 59 were SGA. The mean gestational age of the study cohort was 30.45 (2.08) weeks. More infants in the SGA group were underweight (59.3% vs. 37.8%, RR 1.79, 95% CI 1.16-2.74), stunted (62.7% vs. 30.25%, RR 2.19, 95% CI 1.42-3.36) and had higher incidence of motor (6.7% vs.0.8%, RR 2.5, 95% CI 1.5-4.1) and mental development (3% vs. 0, RR 3.1, 95% CI 2.5-3.8) delay. CONCLUSIONS Preterm SGA infants are at an increased risk of underweight, stunting, motor and mental development delay when compared with preterm AGA infants in early childhood.OBJECTIVE To investigate the status of oxygen monitoring in Special Newborn Care Units. METHODS Observations were made and records reviewed of infants on oxygen in all four Special Newborn Care Units of a state delivering a model program for retinopathy of prematurity. Multiple choice questions were administered to nurses, semi-structured interviews conducted with pediatricians, ophthalmologists and senior nurses. RESULTS All units had more than 100% occupancy. The number of functioning pulse oximeters was 73% of that recommended. None of the units had air-oxygen blenders. The upper oxygen saturation alarm was set accurately only for 1 out of 18 babies receiving oxygen and none of the infants had continuous saturation monitoring. 84% of nurses did not know optimal oxygen saturation targets. Most interviewees attributed suboptimal care to overcrowding. CONCLUSION Compressed air, air-oxygen blenders, sufficient functioning pulse oximeters, rational admission policies and training of nurses are needed to improve oxygen related practices.Objectives We investigated the clinical significance of ACTH stimulation during adrenal venous sampling (AVS) by surgical outcome of primary aldosteronism (PA). Design Multicenter retrospective study by Japan PA study. Method We allocated 314 patients with both basal and ACTH-stimulated AVS data who underwent adrenalectomy to three groups basal lateralization index (LI) ≥2 with ACTH-stimulated LI ≥4 on the ipsilateral side (Unilateral (U) to U group, n = 245); basal LI 8.3), but not ACTH-stimulated LI. These results were similar even when we defined each group based on a cut-off value of 4 for basal LI. Conclusions Although PA patients in U to B group had worse surgical outcomes than did those in U to U group, basal LI could discriminate among patients with better surgical outcomes in U to B group.BACKGROUND Fatalities occur rarely in dental offices. Implications for clinicians may be deducted from internet reports and scientific publications about deaths in dental offices. OBJECTIVE Data involving deaths in dental facilities were analyzed using Google as well as the PubMed database. Comparing both sources, it is examined how internet data may enhance knowledge about deaths in dental offices obtainable from scientific medical publications, which causes of death are published online and in which way respective life-threatening emergencies may be prevented. MEDICA16 nmr METHODS To retrieve relevant information Google was country specifically searched for deaths in the dental practice using keywords “death at the dentist”, “death in dental practice” and “dying at the dentist”. For PubMed keywords “dentistry and mortality”, “death and dental treatment”, “dentistry and fatal outcome” and “death and dentistry” were searched. Deaths associated with dental treatment in a dental facility, an attributable cause of death and us procedures, such as sedation-aided treatments, performed solely by the dentist, the risk of treatment induced life-threatening emergencies may be reduced. CLINICALTRIALAIMS We estimated the rate of renal artery adverse events following renal denervation with the most commonly applied radiofrequency catheter system based on a comprehensive review of published reports. METHODS AND RESULTS We reviewed 50 published renal denervation (RDN) trials reporting on procedural safety including 5,769 subjects with 10,249 patient-years of follow up. Twenty-six patients with renal artery stenosis or dissection (0.45%) were identified of which 24 patients (0.41%) required renal artery stenting. The primary meta-analysis of all reports indicated an 0.20% pooled annual incidence rate of stent implantation (95% CI 0.12 to 0.29% per year). Additional sensitivity analyses yielded consistent pooled estimates (range 0.17% to 0.42% per year). Median time from RDN procedure to all renal intervention was 5.5 months (range 0 to 33 months) and 79% of all events occurred within 1 year of the procedure. A separate review of 14 clinical trials reporting on prospective follow up imaging using either magnetic resonance imaging, computed tomography or angiography following RDN in 511 total subjects identified just one new significant stenosis (0.20%) after a median of 11 months post procedure (1 to 36 months). CONCLUSIONS Renal artery re-intervention following renal denervation with the most commonly applied RF renal denervation system (Symplicity™) is rare. Most events were identified within 1 year.AIMS This analysis presents the final 5-year results of the I-LOVE-IT 2 trial, a noninferiority study comparing BP- sirolimus-eluting stent (SES) with DP-SES in patients with coronary artery disease. METHODS AND RESULTS Overall, 2737 Chinese patients eligible for coronary stenting were treated with BP- or DP-SES in a 21 ratio. Patients who were randomized to BP-SES group were additionally re-randomized to receive either 6-month or 12-month dual antiplatelet therapy (DAPT) in a 11 ratio. The primary endpoint was 12-month target lesion failure (TLF cardiac death, target vessel myocardial infarction, or clinically indicated target lesion revascularization). At five years, overall follow-up rate was 90.8%, and the cumulative incidence of TLF as the primary endpoint was similar between BP-SES and DP-SES (hazard ratio [HR] 1.01; 95% confidence interval [CI] 0.79 to 1.28), as was that for patient-oriented composite endpoint (PoCE all-cause death, all MI and any revascularization) (HR 1.03, 95% CI 0.86 to 1.23), or definite/probable ST (HR 1.

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