Subcutaneous implantable cardioverter-defibrillator placement in a patient with a preexisting transvenous implantable cardioverter-defibrillator

A grant from the One-University Open Access Fund at the University of Kansas was used to defray the author's publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml

Evaluation of Glycated Albumin (GA) and GA/Hba1c Ratio for Diagnosis of Diabetes and Glycemic Control: A Comprehensive Review

Diabetes Mellitus (DM) is a group of metabolic diseases characterized by chronic high blood glucose concentrations (hyperglycemia). When it is left untreated or improperly managed, it can lead to acute complications including diabetic ketoacidosis and non-ketotic hyperosmolar coma. In addition, possible long-term complications include impotence, nerve damage, stroke, chronic kidney failure, cardiovascular disease, foot ulcers, and retinopathy. Historically, universal methods to measure glycemic control for the diagnosis of diabetes included fasting plasma glucose level (FPG), 2-h plasma glucose (2HP), and random plasma glucose. However, these measurements did not provide information about glycemic control over a long period of time. To address this problem, there has been a switch in the past decade to diagnosing diabetes and its severity through measurement of blood glycated proteins such as Hemoglobin A1c (HbA1c) and glycated albumin (GA). Diagnosis and evaluation of diabetes using glycated proteins has many advantages including high accuracy of glycemic control over a period of time. Currently, common laboratory methods used to measure glycated proteins are high-performance liquid chromatography (HPLC), immunoassay, and electrophoresis. HbA1c is one of the most important diagnostic factors for diabetes. However, some reports indicate that HbA1c is not a suitable marker to determine glycemic control in all diabetic patients. GA, which is not influenced by changes in the lifespan of erythrocytes, is thought to be a good alternative indicator of glycemic control in diabetic patients. Here, we review the literature that has investigated the suitability of HbA1c, GA and GA:HbA1c as indicators of long-term glycemic control and demonstrate the importance of selecting the appropriate glycated protein based on the patient’s health status in order to provide useful and modern point-of-care monitoring and treatment

Clinical Performance of RT-PCR and Chest CT Scan for Covid-19 Diagnosis; A Systematic Review

Context: Due to their availability and rapid turnaround time, the supplemental role of chest computed tomography (CT) scan and real-time polymerase chain reaction (RT-PCR) is growing for early diagnosis of patients with COVID-19. However, due to the low efficiency of viral nucleic acid detection as well as low specificity of chest CT scan for detecting COVID-19 pneumonia, both methods show incomplete clinical performance for proper COVID-19 disease diagnosis. The purpose of this review was to compare the clinical performance of two methods and to evaluate the diagnostic values of chest CT scan and RT-PCR for suspected COVID-19 patients. Evidence acquisition: We systemically searched PubMed, Cochrane, from December 2019 to the end of April 2020. Clinical research papers in goal fields that reviewed COVID-19 patients, whom chest CT scan, and PCR testing were performed together were included. Results: In total, we found 536 studies; and finally168 studies were shortlisted. Following title and abstract screening, we reached 83 studies based on the inclusion and exclusion criteria. Conducted screen by the full text covered 28 studies, which led to data extraction. By the full-text assessment of 28 included studies, we found 4486 assessed patients. Totally, 3164 patients had positive chest CT scans, and 3014 patients had positive PCR results. The finding showed that recent studies on the diagnostic performance of RT-PCR and chest CT scan have commonly been reported from China. Conclusion: The results from this review indicate that the chest CT scan should be used for symptomatic and hospitalized patients. Moreover, chest CT scan should not be used as a primary screening tool for diagnosing COVID-19. Application of RT-PCR as the first line diagnosis is still recommended

Sympathetic skin response in chronic renal failure patients

زمینه و هدف: نوروپاتی یورومیک یکی از شایع ترین عوارض نارسایی مزمن کلیوی است که علاوه بر اختلال سیستم عصبی سمپاتیک، نوروپاتی محیطی نیز اتفاق می افتد. تست پاسخ پوستی سمپاتیکی یک تست غیر تهاجمی و ســـاده جهت بررسی فعالیت غدد عرقی اکرین پوست در اثر تحریک سمپاتیکی می باشد. هدف از این مطالعه بررسی اختلال سیستم عصبی اتونوم در بیماران مبتلا به نارسایی کلیوی به وسیله تست SSR و مقایسه نتایج آن با علائم بالینی اتونومیک بود. مواد و روشها: در این مطالعه تست پاسخ پوستی سمپاتیکی بر روی 35 فرد سالم و 31 فرد بیمار مبتلا به نارسایـی مزمـن کلیـــوی که همودیالیزمنظم می شدند انجام شد. نتایج: پاسخ پوستی سمپاتیکی در12 فرد بیمار (7/38) محو ((Absent و در 23 فرد بیمار (74) غیر طبیعی بود. همبستگی خوبی بین تست پاسخ پوستی سمپاتیکی غیر طبیعی و علائم دیس اتونومیک بالینی مشاهده نشد ولی به نظر می رسد که در نارسایی مزمن کلیوی غیر طبیعی شدن پاسخ پوستی سمپاتیکی قبل از ظهور علائم بالینی دیس اتـــونومی رخ می دهـــد. سن، جنس،‌ طول مدت همودیالیز و طــــول تاریخچه نارسایی مزمن کلیوی بیمـــاران اثـــری روی پاسخ پوستـــی سمپاتیکی نداشت. ولی بــه نظر می رسد که تعــــداد دفعـــات دیالیز در هفتـــه روی پــــاسخ پوستی سمپاتیکی تأثیرگذار است. نتیجه گیری: می توان چنین نتیجه گرفت که در نارسایی مزمن کلیوی اختلال سیستم اتونومیکی محیطی شایع است و دیالیزکافی در بهبودی آن مؤثر می باشد.

Impact of Body Mass Index on the Association of Ankle-Brachial Index With All-Cause and Cardiovascular Mortality Results from the National Health and Nutrition Examination Survey

A grant from the One-University Open Access Fund at the University of Kansas was used to defray the author's publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.Objective To assess the influence of body-mass index (BMI) on the association of ankle-brachial index (ABI) with mortality. Patients and Methods We conducted a prospective study of National Health and Nutrition Examination Survey participants enrolled from January 1, 1999 to December 31, 2002 with BMI and ABI data available. ABI categories were 1.3 (high). BMI categories were <30 kg/m2 (nonobese) and ≥30 kg/m2 (obese). Cardiovascular (CV) and all-cause mortality were assessed by National Death Index records. Cox proportional-hazards models and Kaplan-Meier survival estimates were used to compare groups. Results In total, 4614 subjects were included, with mean age 56±12 years and BMI 28±6 kg/m2. Median follow-up was 10.3 years (interquartile range [IQR]: 9.3 to 11.4 years). Low and high ABI were present in 7% and 8%, respectively. After adjustment, low ABI was associated with increased all-cause and CV mortality in nonobese (hazard ratio [HR] 1.5, 95% CI, 1.1-2.1 for all-cause and 3.0 [1.8-5.1] for CV mortality) and obese individuals (1.8 [1.2-2.7] and 2.5 [1.2-5.6], respectively) compared with reference. High ABI was associated with increased CV mortality in nonobese (2.2 [1.1-4.5]) but not obese patients; it was not associated with all-cause mortality overall or when stratified by BMI. Conclusion In a US cohort, weight influenced the prognostic significance of high ABI. This may be related to technical factors reducing compressibility of the calf arteries in obese persons compared with those who are nonobese.The University of Kansas (KU) One University Open Access Author Fund sponsored jointly by the KU ProvostKU Vice Chancellor for Research & Graduate StudiesKUMC Vice Chancellor for Research and managed jointly by the Libraries at the Medical Center and KU - Lawrence.KUMC Vice Chancellor for Research and managed jointly by the Libraries at the Medical Center and KU - Lawrenc

Agreement between Lenstar and Pentacam in Keratometry and Anterior Chamber Depth Measurements

Purpose:  To compare keratometry and anterior chamber depth (ACD) measurements performed using Lenstar LS 900 (Haag-Streit AG, Switzerland) and the Pentacam (Oculus, Weltzar, Germany) devices in healthy eyes.Method: Sixty eyes of 30 healthy volunteers were included in this prospective study. Keratometry and ACD measurements were obtained using Lenstar, followed by Pentacam on the same day.  The readings of the two instruments were compared to evaluate their agreement.Results: The mean age of participants was 40.01 ± 12.29 years (Range 10 to 65years).  The mean ACD was 2.762 ± 0.281 millimeters when measured using Lenstar and 2.801 ± 0.273 millimeters when measured with Pentacam (P = 0.03). The average mean keratometry was 44.45 ± 1.65 diopter when measured with Lenstar and 44.16 ± 1.55 diopter when measured using  Pentacam (P &lt; 0.001). The Bland-Altman plots demonstrated a wide range of inter-device differences in mean keratectomy and also ACD measurements between the two devices.Conclusion: Our findings suggest that the ACD and keratometry measurements obtained using the Lenstar and Pentacam devices might not be interchangeable.Key words: Anterior Chamber; Cornea; Pentacam; Lenstar