-
Sherrill Tarp posted an update 1 day, 6 hours ago
The MitraClip system is used for patients with severe mitral regurgitation (MR) who are at high risk for open surgery. However, some patients need surgical revision for various complications. The acute outcome of MitraClip treatment for atrial functional MR (aFMR) is scarcely reported. Herein, we describe a rare case of an 80-year-old woman treated with a MitraClip for aFMR with mitral annular dilatation and failed leaflet adaptation. The patient suffered from single leaflet device attachment (SLDA) and posterior leaflet injury 3 days posttreatment. The patient successfully underwent mitral valve replacement. The postoperative pulmonary hypertension was markedly improved and the left atrial volume was reduced. A MitraClip should be carefully used for aFMR with mitral annular dilatation and failed leaflet adaptation as it may cause SLDA.
While the Patient-Reported Outcomes Measurement Information System (PROMIS) is mainly designed for computer adaptive testing, its static short forms (SF) are used when a paper-pencil format is preferred or item banks are not yet translated into the target language. This study examined the measurement properties of the German PROMIS-SF for pain intensity (PAIN), pain interference (PI) and physical function (PF) in total hip arthroplasty (THA) patients.
SF were collected before and 12 months post-surgery. Higher scores indicate more PAIN, higher PI and better PF. Oxford Hip Score (OHS) was the main reference measure. Six months post-surgery, a subsample completed the SF twice within 14 days to test reliability.
Of 172 eligible patients, 147 consented to participate and received questionnaires; 132 (74 males) returned baseline questionnaires (mean age 65.8 ± 10.2 years) and 116, 12-month questionnaires. Forty-five patients provided test-retest data. Correlations of all SF with OHS were large (│r│ ≥ 0.7; coor use, although patients’ improvement in physical function might be underestimated due to the large follow-up PF score ceiling effects.
To compare the effectiveness of cyclophosphamide and rituximab in the treatment of patients with systemic sclerosis with pulmonary involvement (SSc-ILD).
Symptoms and the respiratory function parameters of 34 patients receiving cyclophosphamide and 27 patients receiving rituximab for at least 24months between 1996 and 2018 were compared.
It was observed that symptoms including cough, Raynaud’s phenomenon, digital ulceration, diarrhea, and dysphagia, but not dyspnea, recovered statistically significantly more in the rituximab group (p = 0.004, p = 0.001, p = 0.006, p = 0.005, and p < 0.001, respectively; for dyspnea p = 0.11). When differences in FVC and FVC% values were compared with baseline, it was found that there was a statistically significant increase in FVC (mL) (p = 0.02) and FVC% (p = 0.002) values after 12months of treatment in patients receiving cyclophosphamide compared with those receiving rituximab. When differences in DL
and DL
% values from baseline were compared, a statistically s DLCO. Key Points • Both cyclophosphamide and rituximab treatments were effective in controlling dyspnea and worsened pulmonary function in SSc-ILD. • The effect of cyclophosphamide is more prominent on FVC and rituximab is more effective on DLCO.
Infectious diseases are a leading cause of hospitalization during childhood. The various mitigation strategies implemented to control the coronavirus disease (COVID-19) pandemic could have additional, unintended benefits for limiting the spread of other infectious diseases and their associated burden on the health care system.
We conducted an interrupted time-series analysis using population-wide hospitalization data for the state of Victoria, Australia. Infection-related hospitalizations for children and adolescents (aged <18 years, total source population ∼1.4 million) were extracted using pre-defined International Classification of Diseases 10th Revision Australian Modification (ICD-10-AM) codes. The change in weekly hospitalization rates (incidence rate ratio, IRR) for all infections following the introduction of pandemic-related restrictions from 15 March 2020 was estimated.
Over 2015-19, the mean annual incidence of hospitalization with infection among children less than 18 years was 37 per 100s, sustainable measures, such as improved hand hygiene, could reduce the burden of severe childhood infection post-pandemic and the social and economic costs of hospitalization.Introduction Healthcare workers’ work performance and mental health are associated with positive mental health outcomes and directly related to increased productivity and decreased disability costs. Methods We conducted a systematic review to identify factors associated with work performance of healthcare workers during a pandemic and conducted a meta-analysis of the prevalence of mental health outcomes in this context. Primary papers were collected and analysed using the Population/Intervention/Comparison/Outcome framework and using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. To critically appraise the studies included in the review, we used the AXIS appraisal tool to assess each cross-sectional study’s quality. Results The study identified nine factors associated with the work performance and mental health of healthcare workers, including experiencing feelings of depression, anxiety, having inadequate support, experiencing occupational stress, decreased productivity, lack of workplace preparedness, financial concerns associated with changes in income and daily living, fear of transmission and burnout/fatigue. Conclusion There is a rapidly rising need to address the work performance and mental health of healthcare workers providing timely care to patients. Regular and sustained interventions, including the use of information and communication technologies such as telehealth, are warranted.The aim of this study is to implement lifetime attributable risk (LAR) predictions for radiation induced cancers for Swedish cohorts of patients of various age and sex, undergoing diagnostic investigations by nuclear medicine methods.
Calculations are performed on Swedish groups of patients with Paget’s disease and with bone metastases from prostatic cancer and diagnosed with bone scintigraphy with an administration of 500 MBq 99mTc-phosphonate.
The inclusion of patient survival rates into the calculations lowers the induced radiation cancer risk, as it takes into account that cohorts of patients have shorter predicted survival times than the general population.
LAR estimations could be valuable for referring physicians, nuclear medicine physicians, nurses, medical physicists, radiologists, and oncologists and as well as ethical committees for risk estimates for specific subgroups of patients. learn more Caution is however advised with respect to application of LAR predictions to individuals (because of individual sensitivities, circumstances, etc.