Notes

Effect of arterial o2 incomplete pressure inflection point in Venoarterial extracorporeal membrane layer oxygenation regarding crisis heart failure support.
Multivariate analysis showed strong association of these features with the risk of surgery but failed to reach statistical significance.

US features may potentially be used as point-of-care tools to aid clinicians in the assessment of the surgical risk in patients with Stricturing Crohn's Disease.
US features may potentially be used as point-of-care tools to aid clinicians in the assessment of the surgical risk in patients with Stricturing Crohn's Disease.
Opioid use is a topic of growing concern among patients with non-alcoholic fatty liver disease (NAFLD). Given safety concerns of opioids, proactively identifying subgroups of patients with an increased probability of opioid use may encourage practitioners to recommend alternative therapies for pain, thus reducing the likelihood of opioid misuse. This work assessed the prevalence and patient characteristics associated with opioid use in a real-world cohort of patients with NAFLD.

TARGET-NASH, an observational study of participants at 55 academic and community sites in the United States, includes patients with NAFLD defined by pragmatic case definitions. Opioid use was defined as any documented opioid prescriptions in the year prior to enrollment. The association between patient characteristics and the odds of opioid use were modeled with stepwise multivariable logistic regression and tree ensemble methods (CART/Boosted Tree).

The cohort included 3,474 adult patients with NAFLD including 18.2% with documented opioid use. Variables associated with opioid use included presence of cirrhosis (OR 1.47, 95% CI 1.12-1.92), BMI ≥32 kg/m2 (OR 1.31, 95% CI 1.06-1.61), depression (OR 1.87, 95% CI 1.50-2.33) and anxiety (OR 1.61, 95% CI 1.30-2.01). In the boosted tree analysis, history of back pain, abdominal pain, BMI and depression had the greatest relative importance in predicting opioid use.

Prescription opioids were used in nearly one of five patients with NAFLD. Given the safety concerns of opioids in patients with NAFLD, alternative therapies including low dose acetaminophen and non-pharmacologic treatments should be considered for these patients.
Prescription opioids were used in nearly one of five patients with NAFLD. Given the safety concerns of opioids in patients with NAFLD, alternative therapies including low dose acetaminophen and non-pharmacologic treatments should be considered for these patients.
Isolated growth hormone deficiency (IGHD) is a relatively common disorder. Current diagnostic protocol requires a brain magnetic resonance imaging (MRI) study of the hypothalamus and the hypophysis to determine the cause after establishment of the diagnosis. This study aimed to examine the yield of brain MRI in the evaluation of children with IGHD and to define clinical and laboratory parameters that justify its performance.

A retrospective chart review of all children (<18 years) diagnosed with IGHD was conducted at 3 pediatric endocrinology units between 2008 and 2018.

The study included 192 children (107 boys) with confirmed IGHD. The mean age ± standard deviation (SD) at diagnosis was 8.2 ± 3.7 years (median 8.5 years, range 0.8-15.9). The mean height SD score (SDS) at diagnosis was -2.25 ± 0.73. The mean height deficit SDS (defined as the difference between height SDS at diagnosis and mid-parental height SDS) was -1.7 ± 0.9. Fifteen children (7.8%) had pathological MRI findings. No space-occupying lesion was detected. Children with pathological MRIs had greater height deficit SDS and lower peak growth hormone levels on provocative tests compared to children with normal MRIs -2.3 ± 1.2 vs. -1.6 ± 0.8 (p = 0.02) and 4.4 ± 1.9 vs. 5.7 ± 1.3 (p = 0.01), respectively.

Our preliminary data indicate that most brain MRIs performed for routine evaluation of children with IGHD are not essential for determining cause. Tofacitinib Further studies with larger cohorts are needed in order to validate this proposed revision of current protocols.
Our preliminary data indicate that most brain MRIs performed for routine evaluation of children with IGHD are not essential for determining cause. Further studies with larger cohorts are needed in order to validate this proposed revision of current protocols.
Diabetic retinopathy (DR) is one of the major vision-threatening causes worldwide. Searching for an individualized therapeutic strategy to prevent its progress is challenging.

This work aimed to investigate the association of angiogenesis-inducer vascular endothelial growth factor (VEGF) gene family and related receptor variants (rs833069, rs12366035, rs7664413, rs7993418, and rs2305948) with susceptibility of DR and the response to 1 dose of aflibercept treatment in type 2 diabetes mellitus (T2DM).

Consecutive eligible patients with T2DM (n = 125) and 110 unrelated controls were enrolled in this preliminary prospective case-controlled study. Genotyping was identified using TaqMan real-time PCR. Adjusted odds ratio (OR) with 95% confidence interval (CI) was applied to assess the strength of the association with the clinical/ophthalmological characteristics and early response to intravitreal aflibercept treatment in terms of improved visual acuity (BCVA) and central macular thickness (CMT).

We found thr DR patients in the study population.
Polymorphisms of the studied VEGF/receptors could be considered as genetic risk factors of DM/DR development and could play an important role in aflibercept early response for DR patients in the study population.Background The COVID19-pandemic poses challenges to the medical system and especially to endoscopic staff and patients. National, European and International societies provided recommendations on how to safely perform endoscopic procedures during the current pandemic. Until now, the effect of the current pandemic on tertiary endoscopy centers has not been reported. Objective To analyze the influence of the early SARS-CoV2- pandemic on endoscopic care and work flow in two European tertiary endoscopy units. Methods Data from two tertiary endoscopy units (Katowice, Munich) were retrospectively collected during the early pandemic and compared to an equivalent pre-pandemic period. Data include procedures, complications, benchmarks, and influence on endoscopy training. Results During the early pandemic, we noted a highly significant decrease (49.1%) in the overall number of all endoscopies with a significant increase in therapeutic procedures. Besides, there were no significant differences in the number of urgent ERCP or interventional EUS procedures.
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