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Fiscal Investigation Avoidance as well as Control of Nosocomial Microbe infections: Research Method.
not a good choice in this group of patients as they will ultimately require an arteriovenous fistula. Subcutaneous leadless cardiac device insertion might be a better option in patients with advanced CKD. Copyright 2020, Hossain et al.Background Studies have shown that a low serum uric acid (SUA) level associates with Parkinson's disease (PD), but many of them did not exclude patients with impaired renal function. Studies on the association between serum bilirubin level and PD also are limited. This study determined the association between SUA level, SUA/serum creatinine (SCr) ratio and serum bilirubin levels in PD patients with normal renal and liver functions. Methods The PD patients from a neurological clinic, and the controls from the club for the elderly, were recruited into this study. The PD stage and motor and non-motor function were determined by the Hoehn-Yahr (H&Y) scale and unified Parkinson's disease rating scale (UPDRS), respectively. learn more Results Sixty-one PD patients and 135 controls participated. The SUA/SCr ratio, but not SUA, was significantly lower in the PD patients than in the controls (4.12 ± 0.90 vs. 4.59 ± 1.04, P = 0.003). Serum total bilirubin (TB) and indirect bilirubin (IDB) were significantly higher in the PD patients (7.92 ± 3.67 µmol/L vs. 6.59 ± 2.78 µmol/L, P = 0.003 and 4.52 ± 2.48 µmol/L vs. 3.26 ± 1.82 µmol/L, P less then 0.001), respectively. Serum TB and IDB, but not SUA or SUA/SCr ratio, were associated negatively with PD stages (P = 0.010 and P = 0.014, respectively). There was no association between TB, IDB, SUA or SUA/SCr ratio and PD disease duration or motor subtypes. No significant correlation was found between SUA or SUA/SCr ratio, serum TB and IDB. Conclusion The SUA/SCr ratio is more sensitive than SUA in determining their association with PD. The high serum TB and IDB levels in PD patients compared with the controls suggest that serum bilirubin might play a role in the pathogenesis of PD. However, the lack of association between SUA or the SUA/SCr ratio and serum TB or IDB suggests that these two biomarkers play a different role in the etiopathogenesis of PD. Copyright 2020, Songsomboon et al.Background Patients with type 2 diabetes mellitus (T2DM) are at increased risk for impairments in diastolic relaxation and heart failure with preserved ejection fraction (EF). Recent clinical data suggest that several sodium glucose transporter-2 (SGLT2) inhibitors are found to reduce cardiovascular disease (CVD) events in elderly diabetic patients, but the effect of tofogliflozin, one of the SGLT2 inhibitors, on CVD is unknown. We retrospectively investigated the effect of tofogliflozin on cardiac function in elderly patients with T2DM. Methods Patients received 20 mg of tofogliflozin daily for 1 month. EF, ratio of early filling to atrial filling (E/A), a change in mitral inflow E and mitral e' annular velocities (E/e'), left atrial dimension (LAD) and maximal diameter of inferior vena cava (IVCmax) were measured between baseline and 1 month after the administration of tofogliflozin. Results Body weight, systolic and diastolic blood pressures significantly decreased, while renin and aldosterone level significantly increased after 1 month of tofogliflozin treatment. Most of the physiological parameters and the level of serum electrolyte did not change significantly. E/A, E/e' and LAD significantly decreased, while no significant changes were observed in EF and IVCmax. The interactions of E/e' between time, gender and age were not significant. Conclusion The present study suggested that tofogliflozin improved left ventricular diastolic function irrespective of gender and age, while preserving IVC, renal function and electrolyte balance. Copyright 2020, Higashikawa et al.Background Patients with diabetes mellitus (DM) exhibit alterations in their immune response when infected by several types of micro-organisms. The increased susceptibility of diabetics to infections is particularly related to abnormalities in the function of neutrophils such as chemotaxis, adhesion and intracellular killing, leading to increased mortality rates. Aims of the study were to assess the phagocytic activity and the expression of antigens HLA-DR and CD64 of monocytes and neutrophils in diabetics with sepsis and evaluate their significance as prognostic factors. Methods This is an observational prospective study conducted in a tertiary medical center, referring to a population of 51 diabetic patients who were treated for sepsis. Samples of whole blood were received from the selected patients and were evaluated for the expression of surface antigens HLA-DR and CD64 on monocytes and neutrophils, and for their phagocytic activity as well. Results Alterations in the phagocytic activity were found in theR on monocytes were significantly related to outcome. Further evaluation of these results with large prospective studies is warranted. Copyright 2020, Lekka et al.Background The aim of this study was to evaluate the utility of collapsibility of the internal jugular veins (IJVs) and subclavian veins (SCVs) in comparison with collapsibility of the inferior vena cava (IVC) in patients receiving pressure support ventilation. Methods Patients receiving pressure support ventilation were prospectively enrolled when fluid bolus administration was clinically indicated. The antero-posterior diameters of IJVs, SCVs and IVC were measured. Fluid responsiveness was defined as an 8% increase in stroke volume calculated with arterial pulse contour analysis after a passive leg raising maneuver. Results Twenty-seven patients (34 measurements) were included. Eighteen measurements were deemed fluid responsive. The area under the receiver operating characteristic curve of collapsibility of the right IJV antero-posterior diameter was 0.88 (95% confidence interval (CI) 0.75 - 0.99), while the area under the ROC curves for the antero-posterior diameter of the left IJV, right SCV, left SCV and the IVC were 0.57 (95% CI 0.37 - 0.77), 0.61 (95% CI 0.41 - 0.80), 0.55 (95% CI 0.35 - 0.76) and 0.57 (95% CI 0.37 - 0.77), respectively. Conclusions These results suggest that collapsibility of the right IJV is a useful predictor of fluid responsiveness in patients receiving pressure support ventilation. Collapsibility of the IVC did not predict fluid responsiveness in these patients. Copyright 2020, Iizuka et al.
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