Das antepartuale und subpartuale CTG bei Beckenendlage

Ohne Zusammenfassung     

Serum creatinine to absolute lymphocyte count ratio effectively risk stratifies patients who require intensive care in hospitalized patients with coronavirus disease 2019

Patients with preexisting kidney disease or acute kidney injury had poorer outcomes in coronavirus disease 2019 (COVID-19) illness. Lymphopenia was associated with more severe illness. Risk stratification with simple laboratory tests may help appropriate site patients in a cost-effective manner and ease the burden on healthcare systems. We examined a ratio of serum creatinine level to absolute lymphocyte count at presentation (creatinine-lymphocyte ratio, CLR) in predicting outcomes in hospitalized patients with COVID-19. We analyzed 553 consecutive polymerase chain reaction-positive SARS-COV-2 hospitalized patients. Patients with end-stage kidney disease were excluded. Serum creatinine and full blood count (FBC) examination were obtained within the first day of admission. We examined the utility of CLR in predicting adverse clinical outcomes (requiring intensive care, mechanical ventilation, acute kidney injury requiring renal replacement therapy or death). An optimized cutoff of CLR > 77 was derived for predicting adverse outcomes (72.2% sensitivity, and 83.9% specificity). Ninety-seven patients (17.5%) fell within this cut off. These patients were older and more likely to have chronic medical conditions. A higher proportion of these patients had adverse outcomes (13.4% vs 1.1%, P < .001). On receiver operating curve analyses, CLR predicted patients who had adverse outcomes well (area under curve [AUC] = 0.82, 95%CI 0.72–0.92), which was comparable to other laboratory tests like serum ferritin, C-reactive protein and lactate dehydrogenase. Elevated CLR on admission, which may be determined by relatively simple laboratory tests, was able to reasonably discriminate patients who had experienced adverse outcomes during their hospital stay. This may be a simple and cost-effective means of risk stratification and triage.     

Enhanced creativity in bipolar disorder patients: a controlled study

OBJECTIVE: Associations between eminent creativity and bipolar disorders have been reported, but there are few data relating non-eminent creativity to bipolar disorders in clinical samples. We assessed non-eminent creativity in euthymic bipolar (BP) and unipolar major depressive disorder (MDD) patients, creative discipline controls (CC), and healthy controls (HC). METHODS: 49 BP, 25 MDD, 32 CC, and 47 HC (all euthymic) completed four creativity measures yielding six parameters: the Barron-Welsh Art Scale (BWAS-Total, and two subscales, BWAS-Dislike and BWAS-Like), the Adjective Check List Creative Personality Scale (ACL-CPS), and the Torrance Tests of Creative Thinking--Figural (TTCT-F) and Verbal (TTCT-V) versions. Mean scores on these instruments were compared across groups. RESULTS: BP and CC (but not MDD) compared to HC scored significantly higher on BWAS-Total (45% and 48% higher, respectively) and BWAS-Dislike (90% and 88% higher, respectively), but not on BWAS-Like. CC compared to MDD scored significantly higher (12% higher) on TTCT-F. For all other comparisons, creativity scores did not differ significantly between groups. CONCLUSIONS: We found BP and CC (but not MDD) had similarly enhanced creativity on the BWAS-Total (driven by an increase on the BWAS-Dislike) compared to HC. Further studies are needed to determine the mechanisms of enhanced creativity and how it relates to clinical (e.g. temperament, mood, and medication status) and preclinical (e.g. visual and affective processing substrates) parameters.     

Increasing use of anticoagulants in Germany and its impact on hospitalization rates for genitourinary bleeding

Journal of Thrombosis and Thrombolysis - The aim of the study was to compare nationwide time trends of prescribed oral anticoagulants (OAC) with the time trend of genitourinary bleedings (GUB) in...     

Cross-sectional echocardiographic measurement of right atrial and right ventricular size in children with atrial septal defect before and after surgery

Summary A total of 25 children operated on for atrial septal defect were studied by cross-sectional echocardiography before and after operation. Right atrial and right ventricular dimensions and areas were measured preoperatively and 1–4 years (median, 32 months) postoperatively. The length, width, and area of the right atrium (RA) and the right ventricle (RV) were measured in the apical and the subcostal four-chamber views. The dimension of the RV outflow tract (RVOT) was measured in the parasternal short-axis view.Preoperatively, all group mean values except the subcostal four-chamber length of the RV were significantly larger than normal.After surgery, there was a significant decrease in all of the parameters studied, except for RV length. The mean postoperative values of RA measurements in the apical four-chamber view and of RVOT were still significantly larger than normal. The RV four-chamber measurements except the apical four-chamber length were not significantly enlarged. The greatest decrease in RA and RV size occurred in the first postoperative year. Longer follow-up periods did not change the measurements significantly.     

Immediate cementless total hip arthroplasty for the treatment of active tuberculosis

We report the results of a primary total hip arthroplasty (THA) in 7 patients with advanced active tuberculous arthritis of the hip and had lost the chance of preserving the hip without replacement surgery. Tuberculosis was confirmed in all cases by the culture or histological examination. All patients were treated with primary THA followed by antituberculous medications for 1 year. Cementless stems and sockets were used in all patients. The average follow-up period was 4.8 years. The reactivation of the infection was not detected in all cases. The result was excellent in all patients according to the Harris Hip Score. Total hip arthroplasty in the tuberculous hip is a safe procedure and produces superior functional results compared with resection arthroplasty or arthrodesis. The results of primary THA in the selected patients was satisfactory as they rapidly recover from the disease.     

Significance of lipids in the diagnosis of coronary heart disease in patient groups and individuals

Several epidemiologic studies confirmed the significance of the risk ratio cholesterol/HDL-cholesterol in predicting coronary heart disease. Therefore we examined the lipid values of 364 men and 133 females who underwent coronary arteriography because of angina pectoris and/or pathological ECG changes at rest or during exercise stress testing. Although patients with coronary heart disease showed higher cholesterol (male 238 mg/dl vs. 210 mg/dl, female 251 mg/dl vs. 219 mg/dl, p less than 0.001), higher triglycerides (male 204 mg/dl vs. 162 mg/dl, female 179 mg/dl vs. 125 mg/dl, p less than 0.001) and significantly lower HDL-cholesterol levels (male 39.9 mg/dl vs. 44 mg/dl, female 45.9 mg/dl vs. 54.9 mg/dl, p less than 0.01) than the control group, lipid values did not lead to a good discrimination between patients with or without coronary heart disease. The patients' histories and ECGs showed a higher sensitivity (male 83%/male 85%) and specificity (male 81%/female 83%) than the lipids (sensitivity male 57%/female 67%, specificity male 55%/female 74%). We conclude from our results that blood lipids, the risk ratio cholesterol/HDL-cholesterol and other risk factors are diagnostic tools which have to be handled with caution when applied to the individual patient with suspected coronary heart disease.