BACKGROUND Atrial fibrillation(AF)is a prevalent cardiac arrhythmia associated with significant morbidity and mortality,particularly in patients with concomitant renal dysfunction.Anticoagulation therapy reduces the r...BACKGROUND Atrial fibrillation(AF)is a prevalent cardiac arrhythmia associated with significant morbidity and mortality,particularly in patients with concomitant renal dysfunction.Anticoagulation therapy reduces the risk of thromboembolic complications in AF but presents challenges in patients with renal impairment due to altered pharmacokinetics and increased bleeding risk.AIM To support clinicians in navigating the complexities of anticoagulation in this high-risk population,ensuring optimal outcomes.METHODS The present review followed PRISMA guidelines.Data extraction was conducted using a standardized template that captured key study characteristics:Population demographics,renal function metrics,anticoagulant dosing strategies,and primary and secondary outcomes.For quality assessment,we employed the Cochrane Risk of Bias 2.0 tool for randomized controlled trials.Observational studies were appraised using the Newcastle-Ottawa Scale.RESULTS We analyze data from 16 studies to provide recommendations on optimal anticoagulation strategies,balancing thrombotic and bleeding risks.Current evidence supports the preferential use of apixaban in moderate chronic kidney disease and cautiously in end-stage renal disease,emphasizing the importance of individualized therapy.CONCLUSION The management of anticoagulation in AF patients with renal dysfunction is challenging but critical for reducing stroke risk.展开更多
<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Recently, among child disability disorders nervous system diseases are preva...<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Recently, among child disability disorders nervous system diseases are prevailing 19.5%, while mental disorders are 14.3% and congenital malformations 21%. In most cases, children’s neurological disability is associated with pathology during the perinatal period, while 24% of patients have a cerebral impairment. Premature newborns perished 30 to 35 times more often than in-time newborns, and perinatal mortality in case of premature pregnancies is 30 to 40 times higher than in term delivery. </span><b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"> This article is studying catamnestic observation of premature newborns with nervous sys</span><span style="font-family:Verdana;">tem injury and with perinatal pathology in Kyrgyzstan for the period</span><span style="font-family:Verdana;"> 2020-2021. Preterm newborns’ anthropometric characteristics and main diagnoses associated with diseases in the gestational period were shown. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">A comprehensive clinical and laboratory examination including premature newborns health dynamic monitoring with gestational age from 28 to 36 weeks, who were treated in the neonatal pathology department of the Regional Maternity Hospital in Osh for the period from 2020-2021 were carried out. Literature review analysis from PubMed database, MEDLINE, EMBASE, Science Direct, Google Scholar, and clinical trials performed. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">after clinical examination, it was revealed that pregnancy and childbirth in all mothers of the studied group passed with complications.</span><b> </b><span style="font-family:Verdana;">In mothers of the studying group, the most common pathologies during pregnancy were chronic fetal hypoxia 49 (58.4%), acute respiratory infections 28 (33.4%), the threat of termination of pregnancy 20 (23.9%), preeclampsia 16 (19.11%), sexually transmitted infections 9 (10.8%), pyelonephritis 14 (16.7%), polyhydramnios 9 (10.8%), 71 children (84.6%) were born with asphyxiation and 25 children extracted by cesarean section with varying degrees of severity.</span><b><span style="font-family:Verdana;"> Conclusions: </span></b><span style="font-family:Verdana;">Depending on the severity of the perinatal lesion of the nervous system and pathological factor effects, it is very important to start early habilitation measures with preterm newborns who are at risk of developmental delay deviations, and to exit disabling disorders.</span></span>展开更多
To the Editor:Total pancreatectomy with islet cell autotransplantation(TPIAT)is a viable treatment option upon failed endoscopic and medical therapy for patients with chronic pancreatitis.This procedure involves surgi...To the Editor:Total pancreatectomy with islet cell autotransplantation(TPIAT)is a viable treatment option upon failed endoscopic and medical therapy for patients with chronic pancreatitis.This procedure involves surgical removal of the entire pancreas,isolation of islet cells and reinfusion of these cells into the liver via portal vein[1,2].The risk of contamination to the final islet cell product can occur at several stages of the isolation procedure[3].In order to ensure the sterility of the islet cell product,multiple samples from the preservation and cannulation solution,and the final islet cell product are sent for bacterial cultures.Prior studies have found variable clinical consequences of these cultures on infectious com-plications or graft function[3-9].Herein we aimed to determine the incidence of infection in 60 days post-TPIAT and its association with the culture data.展开更多
文摘BACKGROUND Atrial fibrillation(AF)is a prevalent cardiac arrhythmia associated with significant morbidity and mortality,particularly in patients with concomitant renal dysfunction.Anticoagulation therapy reduces the risk of thromboembolic complications in AF but presents challenges in patients with renal impairment due to altered pharmacokinetics and increased bleeding risk.AIM To support clinicians in navigating the complexities of anticoagulation in this high-risk population,ensuring optimal outcomes.METHODS The present review followed PRISMA guidelines.Data extraction was conducted using a standardized template that captured key study characteristics:Population demographics,renal function metrics,anticoagulant dosing strategies,and primary and secondary outcomes.For quality assessment,we employed the Cochrane Risk of Bias 2.0 tool for randomized controlled trials.Observational studies were appraised using the Newcastle-Ottawa Scale.RESULTS We analyze data from 16 studies to provide recommendations on optimal anticoagulation strategies,balancing thrombotic and bleeding risks.Current evidence supports the preferential use of apixaban in moderate chronic kidney disease and cautiously in end-stage renal disease,emphasizing the importance of individualized therapy.CONCLUSION The management of anticoagulation in AF patients with renal dysfunction is challenging but critical for reducing stroke risk.
文摘<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Recently, among child disability disorders nervous system diseases are prevailing 19.5%, while mental disorders are 14.3% and congenital malformations 21%. In most cases, children’s neurological disability is associated with pathology during the perinatal period, while 24% of patients have a cerebral impairment. Premature newborns perished 30 to 35 times more often than in-time newborns, and perinatal mortality in case of premature pregnancies is 30 to 40 times higher than in term delivery. </span><b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"> This article is studying catamnestic observation of premature newborns with nervous sys</span><span style="font-family:Verdana;">tem injury and with perinatal pathology in Kyrgyzstan for the period</span><span style="font-family:Verdana;"> 2020-2021. Preterm newborns’ anthropometric characteristics and main diagnoses associated with diseases in the gestational period were shown. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">A comprehensive clinical and laboratory examination including premature newborns health dynamic monitoring with gestational age from 28 to 36 weeks, who were treated in the neonatal pathology department of the Regional Maternity Hospital in Osh for the period from 2020-2021 were carried out. Literature review analysis from PubMed database, MEDLINE, EMBASE, Science Direct, Google Scholar, and clinical trials performed. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">after clinical examination, it was revealed that pregnancy and childbirth in all mothers of the studied group passed with complications.</span><b> </b><span style="font-family:Verdana;">In mothers of the studying group, the most common pathologies during pregnancy were chronic fetal hypoxia 49 (58.4%), acute respiratory infections 28 (33.4%), the threat of termination of pregnancy 20 (23.9%), preeclampsia 16 (19.11%), sexually transmitted infections 9 (10.8%), pyelonephritis 14 (16.7%), polyhydramnios 9 (10.8%), 71 children (84.6%) were born with asphyxiation and 25 children extracted by cesarean section with varying degrees of severity.</span><b><span style="font-family:Verdana;"> Conclusions: </span></b><span style="font-family:Verdana;">Depending on the severity of the perinatal lesion of the nervous system and pathological factor effects, it is very important to start early habilitation measures with preterm newborns who are at risk of developmental delay deviations, and to exit disabling disorders.</span></span>
文摘To the Editor:Total pancreatectomy with islet cell autotransplantation(TPIAT)is a viable treatment option upon failed endoscopic and medical therapy for patients with chronic pancreatitis.This procedure involves surgical removal of the entire pancreas,isolation of islet cells and reinfusion of these cells into the liver via portal vein[1,2].The risk of contamination to the final islet cell product can occur at several stages of the isolation procedure[3].In order to ensure the sterility of the islet cell product,multiple samples from the preservation and cannulation solution,and the final islet cell product are sent for bacterial cultures.Prior studies have found variable clinical consequences of these cultures on infectious com-plications or graft function[3-9].Herein we aimed to determine the incidence of infection in 60 days post-TPIAT and its association with the culture data.
