164 research outputs found
Prognosis and serum creatinine levels in acute renal failure at the time of nephrology consultation: an observational cohort study
The aim of this study is to evaluate the association between acute
serum creatinine changes in acute renal failure (ARF), before specialized
treatment begins, and in-hospital mortality, recovery of renal function, and
overall mortality at 6 months, on an equal degree of ARF severity, using the
RIFLE criteria, and comorbid illnesses. METHODS: Prospective cohort study of 1008
consecutive patients who had been diagnosed as having ARF, and had been admitted
in an university-affiliated hospital over 10 years. Demographic, clinical
information and outcomes were measured. After that, 646 patients who had
presented enough increment in serum creatinine to qualify for the RIFLE criteria
were included for subsequent analysis. The population was divided into two groups
using the median serum creatinine change (101%) as the cut-off value.
Multivariate non-conditional logistic and linear regression models were used.
RESULTS: A >or= 101% increment of creatinine respect to its baseline before
nephrology consultation was associated with significant increase of in-hospital
mortality (35.6% vs. 22.6%, p < 0.001), with an adjusted odds ratio of 1.81 (95%
CI: 1.08-3.03). Patients who required continuous renal replacement therapy in the
>or= 101% increment group presented a higher increase of in-hospital mortality
(62.7% vs 46.4%, p = 0.048), with an adjusted odds ratio of 2.66 (95% CI:
1.00-7.21). Patients in the >or= 101% increment group had a higher mean serum
creatinine level with respect to their baseline level (114.72% vs. 37.96%) at
hospital discharge. This was an adjusted 48.92% (95% CI: 13.05-84.79) more serum
creatinine than in the < 101% increment group. CONCLUSION: In this cohort,
patients who had presented an increment in serum level of creatinine of >or= 101%
with respect to basal values, at the time of nephrology consultation, had
increased mortality rates and were discharged from hospital with a more
deteriorated renal function than those with similar Liano scoring and the same
RIFLE classes, but with a < 101% increment. This finding may provide more
information about the factors involved in the prognosis of ARF. Furthermore, the
calculation of relative serum creatinine increase could be used as a practical
tool to identify those patients at risk, and that would benefit from an intensive
therapy
Climate and land-use changes effects on the distribution of a regional endemism: Melanophryniscus sanmartini (Amphibia, Bufonidae)
Vaccinia virus-mediated intra-tumoral expression of matrix metalloproteinase 9 enhances oncolysis of PC-3 xenograft tumors
Preparation of a Trp-BODIPY fluorogenic amino acid to label peptides for enhanced live-cell fluorescence imaging
Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)
Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic
Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences
The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported
by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on
18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based
researchers who signed it in the short time span from 20 September to 6 October 2016
Photoexcitation and ionization in carbon dioxide: Theoretical studies in the separated-channel static-exchange approximation
Diversidad, distribución espacio-temporal y turnos de vocalización de anuros (Amphibia, Anura) en un área ecotonal del nordeste de Argentina
Anurofauna (Amphibia, Anura) em um remanescente de Floresta Ombrófila Mista no Estado de Santa Catarina, Sul do Brasil
- …