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《Pancreatology》2022,22(5):665-670
Background and objectivesHyperlipasemia is highly prevalent among coronavirus disease 2019 (COVID-19) patients. The aim of this study was to assess the effect of lipase activity, measured at the time of admission, on the clinical course and mortality in COVID-19 patients.MethodsThe population of this study comprised 12,139 patients who were hospitalized due to COVID-19 between June 2020 and June 2021 in a pandemic hospital. Of these, 8819 patients were excluded from the study due to missing data, four patients were excluded due to a diagnosis of acute pancreatitis (according to the revised Atlanta criteria), and 72 patients were excluded due to alcohol use or having a history of chronic pancreatitis. The final study sample consisted of the remaining 3244 COVID-19 patients. Laboratory results, intensive care unit (ICU) follow-up periods, the need for mechanical ventilation, and mortality rates were compared between the normal lipase activity and high lipase activity groups.ResultsThere were 968 (29.8%) patients with high lipase activity at the time of admission. The rate of ICU admission was 36.1% vs. 9.9% (p < 0.001), mechanical ventilation requirement rates were 33.7% vs. 8.3% (p < 0.001), and mortality rates were as 24.6% vs. 6.4% (p < 0.001) in the high lipase activity group compared to the normal lipase activity group. Multivariate regression analysis revealed that high lipase activity was an independent factor in predicting mortality in hospitalized COVID-19 patients (odds ratio [OR]: 3.191, p < 0.001).ConclusionElevated lipase activity without acute pancreatitis at the time of admission in COVID-19 patients was determined as an independent predictor of poor prognosis. 相似文献
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目的 前房注射卡波姆建立大鼠高眼压模型,观察卡波姆升眼压效果及对大鼠眼前节和视网膜的影响。方法 随机选取30只SD大鼠,注射前3 d早晚测量基线眼压。右眼定为实验眼,左眼定为对照眼,右眼放出房水后将30 μL的5 g·L-1卡波姆混悬液注入前房,每日早10时、晚22时在大鼠清醒状态下测量眼压。每周进行双眼眼前节照相并对比。4周末处死26只大鼠(另4只持续观察眼压变化至注射后9周)并取双眼眼球行HE染色,观察实验眼与对照眼视网膜形态,对比视网膜厚度及房角形态。结果 注射前,实验眼白天和夜间眼压分别为(11.10±0.90)mmHg(1 kPa=7.5 mmHg)和(11.92±1.07)mmHg,对照眼分别为(11.22±1.07)mmHg和(11.76±1.08)mmHg;实验眼与对照眼相比,白天、夜间眼压差异均无统计学意义(均为 P>0.05);白天与夜间眼压相比,实验眼、对照眼差异均有统计学意义(均为P<0.05)。卡波姆在前房中呈现出弥散型和沉积型两种存在方式,弥散型和沉积型大鼠1周内眼压分别为(17.83±3.54)mmHg和(13.00±1.55)mmHg,两者相比差异具有统计学意义(P<0.05)。注射后第1天至第19天,实验眼与对照眼白天眼压相比差异均具有统计学意义(均为P<0.05);注射后第1天至第27天,实验眼与对照眼夜间眼压相比差异均具有统计学意义(均为P<0.05)。实验眼视网膜形态发生改变,注射后4周视网膜厚度为(254.70±21.80)μm,与对照眼的(346.73±24.63)μm相比,差异有统计学意义(P=0.00)。实验眼前房充满卡波姆及虹膜的混合成分,紧贴角膜内皮并延伸至房角,堵塞小梁网结构,正常虹膜形态消失;对照眼房角形态正常。结论 前房注射卡波姆建立大鼠高眼压模型,可维持高眼压4周以上,昼夜眼压差异较为明显,夜间眼压较白天更高,4周后视网膜出现高眼压损伤后的表现。 相似文献
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《Patient education and counseling》2022,105(7):2005-2011
ContextHuman connection can reduce suffering and facilitate meaningful decision-making amid the often terrifying experience of hospitalization for advanced cancer. Some conversational pauses indicate human connection, but we know little about their prevalence, distribution or association with outcomes.PurposeTo describe the epidemiology of Connectional Silence during serious illness conversations in advanced cancer.MethodsWe audio-recorded 226 inpatient palliative care consultations at two academic centers. We identified pauses lasting 2+ seconds and distinguished Connectional Silences from other pauses, sub-categorized as either Invitational (ICS) or Emotional (ECS). We identified treatment decisional status pre-consultation from medical records and post-consultation via clinicians. Patients self-reported quality-of-life before and one day after consultation.ResultsAmong all 6769 two-second silences, we observed 328 (4.8%) ECS and 240 (3.5%) ICS. ECS prevalence was associated with decisions favoring fewer disease-focused treatments (ORadj: 2.12; 95% CI: 1.12, 4.06). Earlier conversational ECS was associated with improved quality-of-life (p = 0.01). ICS prevalence was associated with clinicians' prognosis expectations.ConclusionsConnectional Silences during specialist serious illness conversations are associated with decision-making and improved patient quality-of-life. Further work is necessary to evaluate potential causal relationships.Practice implicationsPauses offer important opportunities to advance the science of human connection in serious illness decision-making. 相似文献