Notes

Predictive valuation on remaining atrial function for latent paroxysmal atrial fibrillation because the reason behind embolic stroke of undetermined supply.
001]. After adjusting the covariates, SMI and GNRI were the factors associated with all-cause mortality in all patients [SMI adjusted HR (aHR) = 2.39, p = 0.036; GNRI aHR = 2.21, p = 0.006]; however, these findings were not observed among HD patients with ACS, and only diabetes was significantly associated with all-cause mortality (diabetes aHR = 3.50, p = 0.031). HD patients with ACS had a significantly higher rate of in-hospital and long-term mortality than non-HD patients. Although sarcopenia and malnutrition were related to mortality and were more common in HD patients, sarcopenia and malnutrition had a lower impact than diabetes on the long-term prognosis of HD patients with ACS.Advance care planning (ACP) is a key element of palliative care even in patients with heart failure (HF); however, the complexity of the clinical trajectory hampers its early introduction. We retrospectively evaluated the state of implementation and the quality of ACP from the penultimate hospitalization in patients with HF who died after repeated hospitalizations. Of the 1117 patients admitted to Saga University Hospital from 2007 to 2016, we excluded 934 patients who survived after discharge or changed hospital, 78 patients who died for a reason other than HF, 42 patients who died during their first HF hospitalization, and 23 patients who died during hospitalization in another hospital. The electronic medical records of the remaining 40 patients were evaluated by three trained physicians on the recently provided 12 recommended elements of ACP, using a 5-point Likert scale (1 = very poor to 5 = excellent). The mean ratings of the 12 ACP elements ranged from 1.0 to 1.9. A do not attempt resuscitation (DNAR) order was issued to 10 patients (25%) just before they died. Of the remaining 30 patients not issued a DNAR order, cardiopulmonary resuscitation was attempted for 23 (76.7%) patients. Among patients with HF who eventually died after repeated hospitalizations, ACP even after the penultimate hospitalization was not evaluated highly. It resulted in a DNAR order in the last few days, a CPR as if their death was sudden and unexpected at the final moment, or CPAOA.
High dose methotrexate (HDMTX) acute kidney injury (AKI) results in prolonged hospitalization and treatment delays. Using a pharmacologically-based approach, HDMTX was administered with standard combination therapy to patients with osteosarcoma; nephrotoxicity was assessed.

Patients were randomized by cycle to 4h or 12h HDMTX (12g/m
) infusions administered with hydration, alkalization and leucovorin rescue. Urinalysis, AKI biomarkers, and estimated glomerular filtration rate using serum creatinine or cystatin C (GFR
or GFR
) were obtained. this website Serum and urine methotrexate concentrations [MTX] were measured.

Patients (n = 12), median (range) age 12.4 (5.7-19.2) years were enrolled; 73 MTX infusions were analyzed. Median (95% Confidence Interval) serum and urine [MTX] were 1309 (1190, 1400) µM and 16.4 (14.7, 19.4)mM at the end of 4h infusion and 557 (493, 586)µM and 11.1 (9.9, 21.1)mM at the end of 12h infusion. Time to serum [MTX] < 0.1µM was 83 (80.7, 90.7)h and 87 (82.8, 92.4)h for 4 and 12h infusions. GFR
was highly variable, increased after cisplatin, and exceeded 150ml/min/1.73m
. GFR
was less variable and decreased at the end of therapy. AKI biomarkers were elevated indicating acute tubular dysfunction, however, did not differ between 4 and 12h infusions. Radiographic and histological response were similar for patients receiving 4h or 12h infusions; the median percent tumor necrosis was > 95%.

Reducing peak serum and urine MTX concentration by prolonging the infusion duration did not alter risk of acute kidney injury. GFR
was decreased at the end of therapy. Proteinuria and elevations in AKI biomarkers indicate that direct tubular damage contributes to HDMTX nephrotoxicity.

NCT01848457.
NCT01848457.
To evaluate the pharmacokinetic properties of UGN-101, a mitomycin-containing reverse thermal gel used as primary chemoablative treatment for low-grade upper tract urothelial carcinoma (UTUC), in a subset of patients participating in a phase 3 clinical trial.

Pharmacokinetic parameters (C
, T
, AUC
, λz, t
, and AUC
) were evaluated in six participants (male or female, ≥ 18years) with biopsy-proven, low-grade UTUC who received the first of 6 once-weekly instillations of UGN-101 to the renal pelvis and calyces via retrograde ureteral catheter. Plasma samples were collected prior to instillation and 30min, 1, 2, 3, 4, 5, and 6h post-instillation. Safety was assessed by laboratory evaluations, physical exam, and adverse event monitoring.

The mean age of the six participants was 69years; most were male (5/6) and Caucasian (5/6). Mean (SD) C
was 6.24 (4.11) ng/mL and mean T
was 1.79 (1.89) hours after instillation. Mean apparent t
following instillation was 1.27 (0.63) hours. Mean total systemic exposure to mitomycin up to 6h post-instillation was 20.30 (19.69) ngh/mL. At 6h post-instillation, mitomycin plasma concentrations of 5/6 participants were < 2ng/mL. There were no clinically important adverse events or changes in laboratory values in any participant after a single instillation of UGN-101.

The reverse thermal gel formulation of UGN-101 is associated with higher concentration and extended dwell time of mitomycin in contact with the urothelium of the upper urinary tract while limiting systemic absorption of mitomycin.

NCT02793128; registered June 8, 2016.
NCT02793128; registered June 8, 2016.
There are contentious data about the role calcium pyrophosphate (CPP) crystals and chondrocalcinosis (CC) play in the progression of osteoarthritis (OA), as well as in the outcomes after knee arthroplasty. Hence, the purpose of this systematic review was to analyse the clinical and functional outcome, progression of OA and prosthesis survivorship after unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) in patients with CC compared to patients without CC.

A systematic review of the literature in PubMed, Medline, Embase and Web of Science was performed using the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" (PRISMA) guidelines. Articles which reported the outcome and survival rates of prosthesis after TKA or UKA in patients with CC were included.

A total of 3718 patient knees were included in eight selected publications, with a median sample sizes of 234 knees (range 78-1000) and 954 knees (range 408-1500) for publications including UKA and TKA, respectively.
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