scholarly journals Hospital-Acquired Serum Ionized Calcium Derangements and Their Associations with In-Hospital Mortality

Medicines ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. 70
Author(s):  
Charat Thongprayoon ◽  
Panupong Hansrivijit ◽  
Tananchai Petnak ◽  
Michael A. Mao ◽  
Tarun Bathini ◽  
...  

Background: The objective of this study was to report the incidence of in-hospital serum ionized calcium derangement and its impact on mortality. Methods: We included 12,599 non-dialytic adult patients hospitalized at a tertiary medical center from January 2009 to December 2013 with normal serum ionized calcium at admission and at least 2 in-hospital serum ionized calcium values. Using serum ionized calcium of 4.60–5.40 mg/dL as the normal reference range, in-hospital serum ionized calcium levels were categorized based on the presence of hypocalcemia and hypercalcemia in hospital. We performed logistic regression to assess the relationship of in-hospital serum ionized calcium derangement with mortality. Results: Fifty-four percent of patients developed new serum ionized calcium derangements: 42% had in-hospital hypocalcemia only, 4% had in-hospital hypercalcemia only, and 8% had both in-hospital hypocalcemia and hypercalcemia. In-hospital hypocalcemia only (OR 1.28; 95% CI 1.01–1.64), in-hospital hypercalcemia only (OR 1.64; 95% CI 1.02–2.68), and both in-hospital hypocalcemia and hypercalcemia (OR 1.73; 95% CI 1.14–2.62) were all significantly associated with increased in-hospital mortality, compared with persistently normal serum ionized calcium levels. Conclusions: In-hospital serum ionized calcium derangements affect more than half of hospitalized patients and are associated with increased in-hospital mortality.

2021 ◽  
Vol 12 (2) ◽  
pp. 204380872110199
Author(s):  
Si-Sheng Huang ◽  
Cheng-Chen Chang

Impaired insight in patients with schizophrenia results in less satisfactory clinical outcomes. This study was conducted to investigate the relationship between insight and individual psychopathological dimensions in inpatients with schizophrenia using a self-report questionnaire. In this study, 90 patients with schizophrenia aged 18–75 years admitted in the acute psychiatric ward of a medical center in Taiwan were enrolled. Patient insight was measured using the Self-Appraisal of Illness Questionnaire (SAIQ), and psychopathological dimensions were measured using the Positive and Negative Syndrome Scale (PANSS) and its five-factor structure model. A higher SAIQ score indicates greater insight. In bivariate correlation analyses, statistically significant correlations were observed between age, single marital status, educational level, and positive, excited, and depressed symptom factor of the PANSS and SAIQ score. In regression analyses, age and excited and depressed symptom factors were significantly associated with SAIQ score. No significant association was observed between insight and neurocognitive functions. Considering demographic characteristics, psychopathology, and neurocognition, in the acute phase of schizophrenia, younger patients with less severe excited symptoms and more severe depressive symptoms had greater insight.


2021 ◽  
Vol 13 (1) ◽  
pp. 17-25
Author(s):  
Nur Maimun ◽  
Arnawilis ◽  
Cindy Feby Fayza ◽  
Nur Asikin

Patient as service users have right and obligations to be hospitalized and patients also have the right to medical information in receiving medical practice services. This study aims to determine the relationship between patient attitudes towards the rights and obligations of being hospitalized in the hospital Pekanbaru Medical Center (PMC). This research method using observational analytic method with cross sectional design. The total sample used in this study 107 sample were taken as simpel random sampling. Chi square test is used to determine the relationship between variables. The data were processed using SPSS statistical software and analyzed using univariate and bivariate analyzes. Of the result obtained of the study namely the relationship between patient attitude to the rights and obligations of patient with chi-suare obtained pvalue 0.016 (<0,05), the relationship of attitude patients to the rights and obligations of choosing a doctor and class of patient care with chi-square obtained pvalue 0,070 (<0,05), the relationship of patient attitudes to the right and obligations of confidentiality of disease by inpatient medical staff with chi-square obtained pvalue 0,000 (<0,05), the relationship of patient attitudes to the rights and obligations of consent to the patient treatment with chi-square obtained pvalue 0,000 (<0,05), the relationship of patient attitudes to the right and obligation of patient safety with chi-square obtained pvalue 0,000 (<0,05), the relationship between patient attitudes towards the right and obligations of patient safety with chi-square obtained pvalue 0,000 (<0,05). Suggestions in order to protect what has been achieved in this case is his ability as effort of service is getting better in the future Keyword : Attitudes of patient, Rights and Obligations inpatient, Hospital


2020 ◽  
pp. 1-5
Author(s):  
O. Addison

Background: High levels of intramuscular adipose tissue and low levels of capillarization are both predicative of low muscle and mobility function in older adults, however little is known about their relationship. Objectives: The purpose of this study was to examine the relationship of intramuscular adipose tissue and capillarization in older adults. Setting: An outpatient medical center. Participants: Forty-seven sedentary adults (age 59.9 ± 1.0 years, BMI 32.0 ± 0.7 kg/m2, VO2max 22.4 ± 0.7 ml/kg/min); Measurements: All participants underwent CT scans to determine intramuscular adipose tissue and muscle biopsies to determine capillarization in the mid-thigh. A step-wise hierarchical linear regression analysis was used to examine the contributions of age, sex, race, body mass index, 2-hour postprandial glucose, VO2max, and muscle capillarization, to the variability in intramuscular adipose tissue. Results: The predictors as a group accounted for 38.1% of the variance in intramuscular adipose tissue, with body mass index and capillarization each significantly contributing to the final model (P<0.001). The part correlation of body mass index with intramuscular adipose tissue was r = 0.47, and the part correlation of capillarization with intramuscular adipose tissue was r = 0.39, indicating that body mass index and capillarization explained 22.1%, and 15.2% of the variance in intramuscular adipose tissue. Conclusions: While increased muscle capillarization is typically thought of as a positive development, in some clinical conditions, such as tendinopathies, an increase in capillarization is part of the pathological process related to expansion of the extracellular matrix and fibrosis. This may also be an explanation for the surprising finding that high capillarization is related to high levels of intramuscular adipose tissue. Future studies are necessary to determine the relationship of changes in both capillarization and intramuscular adipose tissue after interventions, such as exercise.


Blood ◽  
1951 ◽  
Vol 6 (12) ◽  
pp. 1234-1239 ◽  
Author(s):  
SHEILA T. CALLENDER ◽  
L. G. LAJTHA

Abstract 1. Normal gastric juice (intrinsic factor) and vitamin B12 together form a thermolabile hemopoietic factor which ripens megaloblasts in vitro, both gastric juice and B12 alone being inactive. 2. The hemopoietic factor in normal serum which ripens megaloblasts in vitro also appears to be thermolabile, heating to 56 C. for 2 hours destroying some of its activity. 3. The relationship of these factors is discussed and an extra-gastric as well as a gastric source of intrinsic factor is postulated.


2020 ◽  
Vol 8 (3) ◽  
pp. 37 ◽  
Author(s):  
Wisit Cheungpasitporn ◽  
Charat Thongprayoon ◽  
Api Chewcharat ◽  
Tananchai Petnak ◽  
Michael A. Mao ◽  
...  

Background and Objectives: This study aimed to report the incidence of hospital-acquired dysmagnesemia and its association with in-hospital mortality in adult general hospitalized patients. Materials and Methods: We studied 26,020 adult hospitalized patients from 2009 to 2013 who had normal admission serum magnesium levels and at least two serum magnesium measurements during hospitalization. The normal range of serum magnesium was 1.7–2.3 mg/dL. We categorized in-hospital serum magnesium levels based on the occurrence of hospital-acquired hypomagnesemia and/or hypermagnesemia. We assessed the association between hospital-acquired dysmagnesemia and in-hospital mortality using multivariable logistic regression. Results: 28% of patients developed hospital-acquired dysmagnesemia. Fifteen per cent had hospital-acquired hypomagnesemia only, 10% had hospital-acquired hypermagnesemia only, and 3% had both hospital-acquired hypomagnesemia and hypermagnesemia. Compared with patients with persistently normal serum magnesium levels in hospital, those with hospital-acquired hypomagnesemia only (OR 1.77; p < 0.001), hospital-acquired hypermagnesemia only (OR 2.31; p < 0.001), and both hospital-acquired hypomagnesemia and hypermagnesemia (OR 2.14; p < 0.001) were significantly associated with higher in-hospital mortality. Conclusions: Hospital-acquired dysmagnesemia affected approximately one-fourth of hospitalized patients. Hospital-acquired hypomagnesemia and hypermagnesemia were significantly associated with increased in-hospital mortality.


Author(s):  
I. A. Tsanava ◽  
S. V. Bulgakova ◽  
A. V. Melikova

Manifest hypothyroidism occurs in more than 5 % of the population, while prevalence of subclinical hypothyroidism is much higher and reaches 15 %. In the practice of an endocrinologist, in most cases, the diagnosis and treatment of manifest hypothyroidism does not raise questions, while subclinical changes in thyroid hormones quite often generate a lot of discussions. The generally accepted reference range for TSH up to 4.50 μIU / ml is in conflict with data showing that more than 95 % of healthy people with euthyroidism have serum TSH levels up to 2.5 μIU / ml. At the same time, a lot of data has been accumulated on the effect of even slightly altered levels of thyroid hormones and TSH on various tissues, organs and systems of the body, especially on the cardiovascular, nervous and reproductive systems. This review analyzes the results of studies aimed at studying the relationship of subclinical hypothyroidism with cardiovascular and metabolic disorders, cognitive disorders, pathology of pregnant women.


2020 ◽  
Vol 56 (1) ◽  
pp. 11-16
Author(s):  
Jolanta Stacherzak-Pawlik ◽  
Marlena Najmrocka

The aim of the study was to analyze vitamin D concentrations in the blood of 246 men aged 16–89 in the period from September 2017 to February 2018. As the material for research used the results of 25(OH)D concentration determinations from the Laboratory of the Lower Silesian Medical Center DOLMED S.A. The assays were performed using the Roche Diagnostics – Cobas e410 immunochemical analyzer. Vitamin D test was used. It is the competence assay, which is based on the phenomenon of ectrochemiluminescence (ECLI). The analysis showed that the average concentration of vitamin D in the body of the studied patients was 27.7 ng/ml. 6% of men tested had a deficit, 26% had a deficiency, and 27% had hypovitaminosis. The concentration of the housing in the reference range were observed in 41% of research. The relationship between age and 25 (OH) D concentration was demonstrated. With increasing age, the concentration of vitamin D increases. In the population studied, there were no concentrations higher than 80 ng/ml. The relationship between calcidiol concentration and the month in which the study was performed was also demonstrated. The statistical analysis of the obtained data was made using Statistica version 13 and Microsoft Excel 2016.


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