Therapeutics and Clinical Risk Management最新文献

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Thoracic Paravertebral Block Decreased Body Temperature in Thoracoscopic Lobectomy Patients: A Randomized Controlled Trial. 胸腔镜肺叶切除术患者椎旁阻滞降低体温:一项随机对照试验。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2023-01-01 DOI: 10.2147/TCRM.S392961
Yanhong Yan, Jiao Geng, Xu Cui, Guiyu Lei, Lili Wu, Guyan Wang
{"title":"Thoracic Paravertebral Block Decreased Body Temperature in Thoracoscopic Lobectomy Patients: A Randomized Controlled Trial.","authors":"Yanhong Yan,&nbsp;Jiao Geng,&nbsp;Xu Cui,&nbsp;Guiyu Lei,&nbsp;Lili Wu,&nbsp;Guyan Wang","doi":"10.2147/TCRM.S392961","DOIUrl":"https://doi.org/10.2147/TCRM.S392961","url":null,"abstract":"<p><strong>Purpose: </strong>Thoracic paravertebral block (TPVB) may be highly beneficial for thoracoscopic lobectomy patients, but it may increase the risk of hypothermia. Apart from its anesthetic-reducing effects, this randomized controlled trial aimed to investigate the hypothermic effect of TPVB, and thus optimize its clinical use.</p><p><strong>Patients and methods: </strong>Adult patients were randomly allocated to two groups: TPVB + general anesthesia (GA) group or GA group. In the TPVB+GA group, the block was performed after GA induction by an experienced but unrelated anesthesiologist. Both the lower esophageal and axillary temperature were recorded at the beginning of surgery (T<sub>0</sub>) and every 15 min thereafter (T<sub>1</sub>-T<sub>8</sub>), and the end of surgery (T<sub>p</sub>). The primary outcome was the lower esophageal temperature at T<sub>p</sub>. The secondary outcomes included lower esophageal temperature from T<sub>0</sub>-T<sub>8</sub> and axillary temperature from T<sub>0</sub>-T<sub>p</sub>. The total propofol, analgesics, and norepinephrine consumption and the incidence of adverse events were also recorded.</p><p><strong>Results: </strong>Forty-eight patients were randomly allocated to the TPVB+GA (n=24) and GA (n=24) groups. The core temperature at the end of the surgery was lower in the TPVB+GA group than the GA group (35.90±0.30°C vs 36.35±0.33°C, P<0.001), with a significant difference from 45 min after the surgery began until the end of the surgery (P<0.05). In contrast, the peripheral temperature showed a significant difference at 60 min after the surgery began till the end (P<0.05). TPVB+GA exhibited excellent analgesic and sedative-sparing effects compared to GA alone (P<0.001), though it increased norepinephrine consumption due to hypotension (P<0.001).</p><p><strong>Conclusion: </strong>Although thorough warming strategies were used, TPVB combined with GA remarkably reduced the body temperature, which is an easily neglected side effect. Further studies on the most effective precautions are needed to optimize the clinical use of TPVB.</p>","PeriodicalId":48769,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"19 ","pages":"67-76"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2e/a1/tcrm-19-67.PMC9880011.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10576336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Advances in Prepectoral Breast Reconstruction. 前乳房重建的研究进展。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2023-01-01 DOI: 10.2147/TCRM.S404799
Jiaheng Xie, Wei Yan, Zhechen Zhu, Ming Wang, Jingping Shi
{"title":"Advances in Prepectoral Breast Reconstruction.","authors":"Jiaheng Xie,&nbsp;Wei Yan,&nbsp;Zhechen Zhu,&nbsp;Ming Wang,&nbsp;Jingping Shi","doi":"10.2147/TCRM.S404799","DOIUrl":"https://doi.org/10.2147/TCRM.S404799","url":null,"abstract":"<p><p>Breast reconstruction can be divided into prepectoral breast reconstruction (PPBR) and subpectoral breast reconstruction (SPBR) according to the implant plane. The original prepectoral breast reconstruction was abandoned for a long time due to the frequent and severe complications. Now, advances in materials technology and improved methods of mastectomy have made safe prepectoral breast reconstruction possible. Moreover, a number of studies have gradually demonstrated the advantages of prepectoral breast reconstruction. As prepectoral breast reconstruction becomes more and more attractive, it is time to review the current advances in prepectoral breast reconstruction.</p>","PeriodicalId":48769,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"19 ","pages":"361-368"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fa/b8/tcrm-19-361.PMC10122485.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9389878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of Patients' Characteristics and Treatment Profile of People Who Use Drugs (PWUDs) with and without a Co-Diagnosis of Viral Hepatitis C: A Real-World Retrospective Italian Analysis. 有和没有共同诊断为病毒性丙型肝炎的吸毒者(PWUDs)的患者特征和治疗概况分析:一项真实世界的回顾性意大利分析。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2023-01-01 DOI: 10.2147/TCRM.S409134
Felice Alfonso Nava, Alessandra Mangia, Marco Riglietta, Lorenzo Somaini, Francesco Giuseppe Foschi, Ernesto Claar, Ivana Maida, Claudio Ucciferri, Francesca Frigerio, Candido Hernandez, Melania Dovizio, Valentina Perrone, Luca Degli Esposti, Massimo Puoti
{"title":"Analysis of Patients' Characteristics and Treatment Profile of People Who Use Drugs (PWUDs) with and without a Co-Diagnosis of Viral Hepatitis C: A Real-World Retrospective Italian Analysis.","authors":"Felice Alfonso Nava,&nbsp;Alessandra Mangia,&nbsp;Marco Riglietta,&nbsp;Lorenzo Somaini,&nbsp;Francesco Giuseppe Foschi,&nbsp;Ernesto Claar,&nbsp;Ivana Maida,&nbsp;Claudio Ucciferri,&nbsp;Francesca Frigerio,&nbsp;Candido Hernandez,&nbsp;Melania Dovizio,&nbsp;Valentina Perrone,&nbsp;Luca Degli Esposti,&nbsp;Massimo Puoti","doi":"10.2147/TCRM.S409134","DOIUrl":"https://doi.org/10.2147/TCRM.S409134","url":null,"abstract":"<p><strong>Purpose: </strong>Hepatitis C virus (HCV) spreads from contact with blood of an infected person. HCV infections are common among people who use drugs (PWUDs), when sharing needles, syringes, or other equipment for injected drugs. The advent of pangenotypic direct-antiviral agents (DAA) in 2017 transformed the treatment landscape for HCV, but PWUDs remain a complex and hard-to-treat population with high risk of HCV reinfection. The aim of this real-world analysis was to characterize the demographic and clinical features of PWUDs in Italy, also focusing on comorbidity profile, treatment with DAAs, resource consumptions for the National Health System (NHS).</p><p><strong>Patients and methods: </strong>During 01/2011-06/2020, administrative databases of Italian healthcare entities, covering 3,900,000 individuals, were browsed to identify PWUDs with or without HCV infection. Among HCV+ patients, a further stratification was made into treated and untreated with DAAs. The date of PWUD or HCV first diagnosis or DAA first prescription was considered as index-date. Patients were then followed-up for one year. Alcohol-dependency was also investigated.</p><p><strong>Results: </strong>Total 3690 PWUDs were included, of whom 1141 (30.9%) PWUD-HCV+ and 2549 (69.1%) PWUD-HCV-. HCV-positive were significantly older (43.6 vs 38.5 years, p < 0.001), had a worse comorbidity profile (Charlson-index: 0.8 vs 0.4, p < 0.001), and high rates of psychiatric, respiratory, dermatological, musculoskeletal diseases and genitourinary (sexually transmitted) infections. Moreover, they received more drug prescriptions (other than DAAs, like anti-acids, antiepileptics, psycholeptics) and had undergone more frequent hospitalization, predominantly for hepatobiliary, respiratory system and mental disorders. DDA-untreated had significantly higher Charlson-index than DAA-treated (0.9 vs 0.6, p = 0.003). Alcoholism was found in 436 (11.8%) cases.</p><p><strong>Conclusion: </strong>This Italian real-world analysis suggests that PWUDs with HCV infection, especially those untreated with DAAs, show an elevated drug consumption due to their complex clinical profile. These findings could help to ameliorate the healthcare interventions on PWUDs with HCV infection.</p>","PeriodicalId":48769,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"19 ","pages":"645-656"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/6f/tcrm-19-645.PMC10408688.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9973594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison and Optimization of Cardiovascular Risk Scores in Predicting the 4-Year Outcome of Patients with Obstructive Coronary Arteries Disease. 预测阻塞性冠状动脉疾病患者4年预后的心血管风险评分的比较与优化
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2023-01-01 DOI: 10.2147/TCRM.S404351
Taichun Qiu, Chunxiao Liang, Bing Ming, Gaoyuan Liu, Furong Zhang, Ruxue Zeng, Dongmei Xie, Qing Zou
{"title":"Comparison and Optimization of Cardiovascular Risk Scores in Predicting the 4-Year Outcome of Patients with Obstructive Coronary Arteries Disease.","authors":"Taichun Qiu,&nbsp;Chunxiao Liang,&nbsp;Bing Ming,&nbsp;Gaoyuan Liu,&nbsp;Furong Zhang,&nbsp;Ruxue Zeng,&nbsp;Dongmei Xie,&nbsp;Qing Zou","doi":"10.2147/TCRM.S404351","DOIUrl":"https://doi.org/10.2147/TCRM.S404351","url":null,"abstract":"<p><strong>Objective: </strong>How well cardiovascular risk models perform in selected atherosclerosis patients for predicting outcomes is unknown. We sought to compare the performance of cardiovascular risk models (Framingham, Globorisk, SCORE2 & SCORE2-OP, and an updated new model) in predicting the 4-year outcome of patients with obstructive coronary artery disease (CAD).</p><p><strong>Methods: </strong>Patients with suspected CAD who underwent coronary computed tomography angiography (CCTA) were recruited. Obstructive CAD was defined from CCTA as ≥ 50% stenosis. Computed tomography images, the scores of the cardiovascular risk models, and 4-year composite endpoints were assessed. Whether the patients underwent revascularization within 60 days after CCTA was also recorded. Multivariate regression analysis and receiver operating characteristics (ROC) curve analysis were performed.</p><p><strong>Results: </strong>A total of 95 patients (mean age: 69.5 ± 10.33 years; 69 males) with obstructive CAD were included in this study. After the ROC analysis, the Framingham, Globorisk, SCORE2 & SCORE2-OP risk score showed prediction values with AUC 0.628 (95% CI: 0.532-0.725), 0.647 (95% CI: 0.542-0.742), 0.684 (95% CI: 0.581-0.776), respectively. Multivariate regression analysis showed that, among the three risk models, only SCORE2 & SCORE2-OP risk score was associated with composite endpoints (hazard ratio: 1.050; 95% CI: 1.021-1.079; <i>p</i> = 0.001) after adjusting for confounding factors. The AUC of the new risk model by combing SCORE2 & SCORE2-OP risk score with revascularization and the number of obstructive vessels in predicting composite endpoints reached 0.898 (95% CI: 0.819-0.951).</p><p><strong>Conclusion: </strong>The SCORE2 & SCORE2-OP risk score combined with the number of obstructive vessels and revascularization is predictive for adverse outcomes in patients with obstructive CAD.</p>","PeriodicalId":48769,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"19 ","pages":"319-328"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1a/46/tcrm-19-319.PMC10082600.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9652640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing Quality-of-Life of Patients Taking Mirabegron for Overactive Bladder. 评估服用米拉贝隆治疗膀胱过动症患者的生活质量。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2023-01-01 DOI: 10.2147/TCRM.S269318
Christina Shaw, William Gibson
{"title":"Assessing Quality-of-Life of Patients Taking Mirabegron for Overactive Bladder.","authors":"Christina Shaw,&nbsp;William Gibson","doi":"10.2147/TCRM.S269318","DOIUrl":"https://doi.org/10.2147/TCRM.S269318","url":null,"abstract":"<p><p>Lower urinary tract symptoms (LUTS), including urgency, frequency, and urgency incontinence, are highly prevalent in the general population and increase in prevalence with increasing age. All LUTS, but notable urgency and urgency incontinence, are associated with negative impact on quality-of-life (QoL), with multiple aspects of QoL affected. Urgency and urgency incontinence are most commonly caused by overactive bladder (OAB), the clinical syndrome of urinary urgency, usually accompanied by increased daytime frequency and/or nocturia in the absence of infection or other obvious etiology, which may be treated with conservative and lifestyle interventions, bladder antimuscarinic drugs, and, more recently, by mirabegron, a β3 agonist. This narrative review describes the impact of OAB on QoL, quantifies this impact, and outlines the evidence for the use of mirabegron in the treatment of, and improvement in QoL in, people with OAB.</p>","PeriodicalId":48769,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"19 ","pages":"27-33"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/56/tcrm-19-27.PMC9840370.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10595227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Heterogeneity of CD40 Expression in Different Types of High-Risk Endometrial Cancer Affects Discordant Prognostic Outcomes. 不同类型高危子宫内膜癌中CD40表达的异质性影响不一致的预后结果
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2023-01-01 DOI: 10.2147/TCRM.S416220
Na Zhao, Bowen Sun, Yuan Cheng, Jianliu Wang
{"title":"Heterogeneity of CD40 Expression in Different Types of High-Risk Endometrial Cancer Affects Discordant Prognostic Outcomes.","authors":"Na Zhao,&nbsp;Bowen Sun,&nbsp;Yuan Cheng,&nbsp;Jianliu Wang","doi":"10.2147/TCRM.S416220","DOIUrl":"https://doi.org/10.2147/TCRM.S416220","url":null,"abstract":"<p><strong>Background: </strong>The role of immune checkpoint inhibitors in endometrial cancer is limited. At present, the anti-programmed cell death protein 1 (anti-PD-1) antibody is only used in patients with recurrence or metastasis. CD40 is an important immune checkpoint, which is expressed in tumor cells and immune cells, but its distribution characteristics in endometrial carcinoma have not been explored.</p><p><strong>Methods: </strong>Sixty-eight cases of primary endometrial carcinoma treated in Peking University People's Hospital from January 2010 to December 2020 were collected, including 28 cases of poorly differentiated endometrioid adenocarcinoma, 23 cases of serous carcinoma and 17 cases of clear cell carcinoma. The relationship of CD40 expression and PD-L1 expression with their prognosis was analyzed by immunohistochemistry.</p><p><strong>Results: </strong>We found that CD40 had higher expression in non-endometrioid endometrial carcinoma, which lead to the worse prognosis. The effect of high expression of CD40 on the prognosis of endometrioid adenocarcinoma was not significantly different, and most patients with good prognosis. We found that the proportion of CD40 distribution in tumor cells and immune cells may be associated with this heterogeneity.</p><p><strong>Conclusion: </strong>The expression of CD40 in different endometrial cancers may indicate the difference prognosis, which may become a potential target for drug treatment of non-endometrioid endometrial carcinoma.</p>","PeriodicalId":48769,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"19 ","pages":"549-556"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/0f/tcrm-19-549.PMC10317534.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10159490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diffusion Tensor Imaging for Evaluating Postoperative Outcomes of Supratentorial Glioma in the Motor Function Area [Letter]. 弥散张量成像评价幕上胶质瘤术后运动功能区预后[j]。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2023-01-01 DOI: 10.2147/TCRM.S428676
Theo Moraes Teixeira, Luis Filipe de Souza Godoy, Wellingson Silva Paiva
{"title":"Diffusion Tensor Imaging for Evaluating Postoperative Outcomes of Supratentorial Glioma in the Motor Function Area [Letter].","authors":"Theo Moraes Teixeira,&nbsp;Luis Filipe de Souza Godoy,&nbsp;Wellingson Silva Paiva","doi":"10.2147/TCRM.S428676","DOIUrl":"https://doi.org/10.2147/TCRM.S428676","url":null,"abstract":"","PeriodicalId":48769,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"19 ","pages":"579-580"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/38/80/tcrm-19-579.PMC10348315.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9823643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Efficacy and Safety of Avanafil During a Treatment of Male Erectile Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 阿那非治疗男性勃起功能障碍的有效性和安全性:随机对照试验的系统回顾和荟萃分析。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2023-01-01 DOI: 10.2147/TCRM.S419408
Syah Mirsya Warli, Steven Steven, Dhirajaya Dharma Kadar, Fauriski Febrian Prapiska, Ginanda Putra Siregar
{"title":"The Efficacy and Safety of Avanafil During a Treatment of Male Erectile Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Syah Mirsya Warli,&nbsp;Steven Steven,&nbsp;Dhirajaya Dharma Kadar,&nbsp;Fauriski Febrian Prapiska,&nbsp;Ginanda Putra Siregar","doi":"10.2147/TCRM.S419408","DOIUrl":"https://doi.org/10.2147/TCRM.S419408","url":null,"abstract":"<p><strong>Purpose: </strong>Erectile dysfunction (ED) contributes to a large burden and impairs the quality of life among males. Avanafil appears to be a promising treatment for ED; however, its efficacy and safety profile remain unclear. This study aimed to evaluate the efficacy and safety of avanafil for the treatment of ED.</p><p><strong>Patients and methods: </strong>An extensive search of PubMed, ScienceDirect, Web of Science, and Embase databases with 11 publications was performed, with outcomes evaluated are International Index of Erectile Function - Erectile Function (IIEF-EF), Sexual Encounter Profile (SEP), and Treatment-Emergent Adverse Events (TEAE). Statistical parameter Mean Difference (MD) and Risk Ratio (RR) with 95% Confidence Interval (CI) were used to measure effect size.</p><p><strong>Results: </strong>The pooled estimates demonstrated that changes in IIEF-EF function (MD=4.39, 95% CI [3.41, 5.37], p<0.001), SEP-2 (RR=3.43, 95% CI [2.79, 4.22], p<0.001), SEP-3 (RR=2.30, 95% CI [2.01, 2.62], p<0.001), and TEAE (RR=1.49, 95% CI [1.12, 1.96], p=0.005) were significantly higher in the avanafil group than in the placebo group. Moreover, 200 mg avanafil was superior to that mg 100 mg-avanafil, indicated by the IIEF-EF score (MD=-1.15, 95% CI [-1.40, -0.89], p<0.001). In contrary, there were no significant differences in SEP-2 (RR=0.90, 95% CI [0.75, 1.08], p=0.26), SEP-3 (RR=0.92, 95% CI [0.81, 1.05], p=0.21) and TEAE (RR=1.00, 95% CI [0.87, 1.15], p=0.99) for both 100 mg and 200 mg doses.</p><p><strong>Conclusion: </strong>This review highlights the potential use of this drug in ED treatment. Further large-scale Randomized Controlled Trials investigations involving various racial groups are required to confirm these findings.</p>","PeriodicalId":48769,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"19 ","pages":"629-644"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/a8/tcrm-19-629.PMC10362898.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9865130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Central Oxygen Venous Saturation and Mortality in Patients Undergoing Coronary Artery Bypass Grafting. 冠状动脉旁路移植术患者的中心静脉氧饱和度和死亡率。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2023-01-01 DOI: 10.2147/TCRM.S407454
María A Rodríguez-Scarpetta, Andrés M Sepúlveda-Tobón, Jorge E Daza-Arana, Heiler Lozada-Ramos, Rodrigo A Álzate-Sánchez
{"title":"Central Oxygen Venous Saturation and Mortality in Patients Undergoing Coronary Artery Bypass Grafting.","authors":"María A Rodríguez-Scarpetta,&nbsp;Andrés M Sepúlveda-Tobón,&nbsp;Jorge E Daza-Arana,&nbsp;Heiler Lozada-Ramos,&nbsp;Rodrigo A Álzate-Sánchez","doi":"10.2147/TCRM.S407454","DOIUrl":"https://doi.org/10.2147/TCRM.S407454","url":null,"abstract":"<p><strong>Purpose: </strong>Central venous oxygen saturation (ScvO<sub>2</sub>) has been reported as a prognostic marker of in-hospital mortality when it is below 60% in certain situations. Nevertheless, it has not been widely reported in patients undergoing coronary artery bypass graft (CABG). The study determined the association between ScvO<sub>2</sub> and in-hospital mortality in patients undergoing CABG in a high-complexity health institution in Santiago de Cali, Colombia.</p><p><strong>Patients and methods: </strong>A retrospective cohort study was conducted with patients undergoing isolated CABG. The subject sample included 515 subjects aged 18 years or older. Exposure was defined as ScvO<sub>2</sub> <60% upon admission to the intensive care unit (ICU) following surgery. The major outcome was mortality rates after 30 days. Furthermore, exposure variables were measured at preoperative, intra-operative, and postoperative time points.</p><p><strong>Results: </strong>A total of 103 exposed and 412 unexposed subjects were included. The final model revealed a higher mortality risk in individuals with ScvO<sub>2</sub> <60% upon ICU admission compared with those with higher saturation levels (relative risk 4.2, 95% confidence interval: 2.4-7.2; <i>p</i> = 0.001). Values were adjusted using variables such as age (>75 years), low socioeconomic stratum, chronic kidney failure before surgery, unstable angina before surgery, ischemia time (>60 min), and intra-operative inotrope use. The primary cause of death was cardiogenic shock (54.7%), followed by sepsis (25.0%) and postoperative bleeding (17.2%).</p><p><strong>Conclusion: </strong>The study identified an association between ScvO<sub>2</sub> <60% and in-hospital mortality in patients undergoing CABG.</p>","PeriodicalId":48769,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"19 ","pages":"447-454"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/11/tcrm-19-447.PMC10246565.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9609865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Empagliflozin in Adults with Chronic Kidney Disease (CKD): Current Evidence and Place in Therapy. 恩格列净治疗成人慢性肾脏疾病(CKD):目前的证据和在治疗中的地位
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2023-01-01 DOI: 10.2147/TCRM.S398163
Gates B Colbert, Hector M Madariaga, Anna Gaddy, Mohamed E Elrggal, Edgar V Lerma
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引用次数: 1
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