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61.
Marwan SM Al-Nimer 《World journal of diabetes》2022,13(5):417-419
Hyperandrogenism and hyperinsulinemia have resulted from dysfunction of the theca cell of the ovary and adipose tissue and each one potentiates the other in patients with androgen excess disorders e.g., polycystic ovary disease and idiopathic hirsutism. Possible external and/or internal triggers can produce such cellular dysfunction. There is evidence that sodium valproate acts as a trigger of cellular dysfunction and produces both hyperinsulinemia and hyperandrogenism. Therefore, the elimination of these triggers can help the patients to recover from hyperinsulinemia, insulin resistance and hyperandrogenism. 相似文献
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R C Thompson S J Finck J P Leventhal R E Safford 《Mayo Clinic proceedings. Mayo Clinic》1991,66(4):391-394
Cardiac tamponade can manifest as profound hypoxemia from intracardiac shunting across a patent foramen ovale. As a consequence, pulmonary embolus can be erroneously diagnosed. As demonstrated in the case described herein, transesophageal echocardiography can be useful in determining the correct diagnosis, especially if transthoracic echocardiography is technically limited. In our patient, the findings on transesophageal echocardiography also helped determine the appropriate treatment. The relative inaccessibility of the pericardial effusion to needle drainage prompted open surgical drainage. 相似文献
64.
Ilias Nikolakopoulos MD James W. Choi MD Khaldoon Alaswad MD Jaikirshan J. Khatri MD Oleg Krestyaninov MD Dmitrii Khelimskii MD Robert W. Yeh MD PhD Farouc A. Jaffer MD PhD Catalin Toma MD Mitul Patel MD Ehtisham Mahmud MD Nicholas J. Lembo MD Manish Parikh MD Ajay J. Kirtane MD SM Ziad A. Ali MD Fotis Gkargkoulas MD Barry Uretsky MD Abdul M. Sheikh MD Evangelia Vemmou MD Iosif Xenogiannis MD Bavana V. Rangan BDS MPH Santiago Garcia MD Shuaib Abdullah MD Subhash Banerjee MD M. Nicholas Burke MD Emmanouil S. Brilakis MD PhD Dimitri Karmpaliotis MD PhD 《Catheterization and cardiovascular interventions》2021,97(4):658-667
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Justin R. Kingery Paul BF Martin Ben R. Baer Laura C. Pinheiro Mangala Rajan Adrienne Clermont Sabrina Pan Khoi Nguyen Khalid Fahoum Graham T. Wehmeyer Mark N. Alshak Han A. Li Justin J. Choi Martin F. Shapiro Margaret L. McNairy Monika M. Safford Parag Goyal 《Journal of general internal medicine》2021,36(8):2378
BackgroundThe clinical course of COVID-19 includes multiple disease phases. Data describing post-hospital discharge outcomes may provide insight into disease course. Studies describing post-hospitalization outcomes of adults following COVID-19 infection are limited to electronic medical record review, which may underestimate the incidence of outcomes.ObjectiveTo determine 30-day post-hospitalization outcomes following COVID-19 infection.DesignRetrospective cohort studySettingQuaternary referral hospital and community hospital in New York City.ParticipantsCOVID-19 infected patients discharged alive from the emergency department (ED) or hospital between March 3 and May 15, 2020.MeasurementOutcomes included return to an ED, re-hospitalization, and mortality within 30 days of hospital discharge.ResultsThirty-day follow-up data were successfully collected on 94.6% of eligible patients. Among 1344 patients, 16.5% returned to an ED, 9.8% were re-hospitalized, and 2.4% died. Among patients who returned to the ED, 50.0% (108/216) went to a different hospital from the hospital of the index presentation, and 61.1% (132/216) of those who returned were re-hospitalized. In Cox models adjusted for variables selected using the lasso method, age (HR 1.01 per year [95% CI 1.00–1.02]), diabetes (1.54 [1.06–2.23]), and the need for inpatient dialysis (3.78 [2.23–6.43]) during the index presentation were independently associated with a higher re-hospitalization rate. Older age (HR 1.08 [1.05–1.11]) and Asian race (2.89 [1.27–6.61]) were significantly associated with mortality.ConclusionsAmong patients discharged alive following their index presentation for COVID-19, risk for returning to a hospital within 30 days of discharge was substantial. These patients merit close post-discharge follow-up to optimize outcomes.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-021-06924-0.KEY WORDS: COVID-19, mortality, re-admission, discharge 相似文献
67.
Weisdorf DJ; Verfaillie CM; Davies SM; Filipovich AH; Wagner JE Jr; Miller JS; Burroughs J; Ramsay NK; Kersey JH; McGlave PB 《Blood》1995,85(12):3452-3456
Delay in hematologic recovery after bone marrow transplantation (BMT) can extend and amplify the risks of infection and hemorrhage, compromise patients' survival, and increase the duration and cost of hospitalization. Because current studies suggest that granulocyte- macrophage (GM) colony-stimulating factor (CSF) may potentiate the sensitivity of hematopoietic progenitor cells to G-CSF, we performed a prospective, randomized trial comparing GM-CSF (250 micrograms/m2/d x 14 days) versus sequential GM-CSF x 7 days followed by G-CSF (5 micrograms/kg/d x 7 days) as treatment for primary or secondary graft failure after BMT. Eligibility criteria included failure to achieve a white blood cell (WBC) count > or = 100/microL by day +21 or > or = 300/microL by day +28, no absolute neutrophil count (ANC) > or = 200/microL by day +28, or secondary sustained neutropenia after initial engraftment. Forty-seven patients were enrolled: 23 received GM-CSF (10 unrelated, 8 related allogeneic, and 5 autologous), and 24 received GM- CSF followed by G-CSF (12 unrelated, 7 related allogeneic, and 5 autologous). For patients receiving GM-CSF alone, neutrophil recovery (ANC > or = 500/microL) occurred between 2 and 61 days (median, 8 days) after therapy, while those receiving GM-CSF+G-CSF recovered at a similar rate of 1 to 36 days (median, 6 days; P = .39). Recovery to red blood cell (RBC) transfusion independence was slow, occurring 6 to 250 days (median, 35 days) after enrollment with no significant difference between the two treatment groups (GM-CSF: median, 30 days; GM-CSF+G- CSF; median, 42 days; P = .24). Similarly, platelet transfusion independence was delayed until 4 to 249 days (median, 32 days) after enrollment, with no difference between the two treatment groups (GM- CSF: median, 28 days; GM-CSF+G-CSF: median, 42 days; P = .38). Recovery times were not different between patients with unrelated donors and those with related donors or autologous transplant recipients. Survival at 100 days after enrollment was superior after treatment with GM-CSF alone. Only 1 of 23 patients treated with GM-CSF died versus 7 of 24 treated with GM-CSF+G-CSF who died 16 to 84 days (median, 38 days) after enrollment, yielding Kaplan-Meier 100-day survival estimates of 96% +/- 8% for GM-CSF versus 71% +/- 18% for GM-CSF+G-CSF (P = .026). These data suggest that sequential growth factor therapy with GM-CSF followed by G-CSF offers no advantage over GM-CSF alone in accelerating trilineage hematopoiesis or preventing lethal complications in patients with poor graft function after BMT.(ABSTRACT TRUNCATED AT 400 WORDS) 相似文献
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Lisa G. Suter MD Shu-Xia Li PhD Jacqueline N. Grady MS Zhenqiu Lin PhD Yongfei Wang MS Kanchana R. Bhat MPH Dima Turkmani DrPH MBA Steven B. Spivack MPH Peter K. Lindenauer MD MSc Angela R. Merrill PhD Elizabeth E. Drye MD SM Harlan M. Krumholz MD SM Susannah M. Bernheim MD MHS 《Journal of general internal medicine》2014,29(10):1333-1340