Blend photo advice for endovascular recanalization involving sideline occlusive disease

BACKGROUND There are no sufficient data available on the use of febuxostat in patients undergoing dialysis. AIM We investigated the efficacy and tolerability of febuxostat in gout patients on dialysis. METHODS We retrospectively reviewed clinical and laboratory data available from a referral center from January 2012 to December 2018. We included gout patients who initiated febuxostat during dialysis. Data regarding serum uric acid levels before and after the febuxostat treatment and clinical information such as gout attack after febuxostat initiation, as well as adverse events involving febuxostat treatment, were obtained from medical records. RESULTS Among 62 patients who were treated with febuxostat for over three months, 45 were undergoing hemodialysis (HD) and 17 were undergoing peritoneal dialysis (PD). The mean serum uric acid level was significantly reduced three months after treatment (3.71 ± 1.32 mg/dL) compared with that at the pretreatment level (9.36 ± 2.06 mg/dL) (p less then 0.001). The serum uric acid level was observed to be significantly reduced at three months in both HD and PD patients and subsequently remained at a significantly reduced level for 12 months. Of the 62 patients, only 2 stopped febuxostat due to its adverse effects. Initial dose of 80 mg per day was associated with higher adverse events compared to dose of 20-40 mg per day (OR=8.25, 95% CI=1.90-35.97, p=0.006). CONCLUSIONS Febuxostat is efficacious and well-tolerated in gout patients on dialysis. Febuxostat taken at dose of 20-40 mg per day might be appropriate initial dose in patients undergoing dialysis. This article is protected by copyright. RBPJ Inhibitor-1 Notch inhibitor All rights reserved. This article is protected by copyright. All rights reserved.AIMS AND OBJECTIVES To gain knowledge of prevention and use of restraints in provision of medical care to people with intellectual disability. To this end, we explore how learning disability nurses in community services support the individual through medical examinations when facing resistance. BACKGROUND Despite increased focus on limiting restraints, there is a lack of knowledge of how restraints are prevented and used in the delivery of physical health care to people with intellectual disability. DESIGN We used an ethnographic comparative case design (n = 6). METHODS The study was carried out in Norway. The analysis is based on data from semi-structured interviews, participant observation and document studies, in addition to health sociological perspectives on how to support individuals to make their body available for medical examination and intervention. The SRQR checklist was used. RESULTS Learning disability nurses strove to ensure that examinations were carried out on the individual's terms, supportinring the least restrictive and most compassionate care possible. © 2020 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.AIMS AND OBJECTIVES To examine the impact of caregivers' street clothes on people living in special care units (SCUs). We hypothesised that caregivers wearing street clothes would improve residents' relationships with other residents and caregivers and, as a consequence, would improve their quality of life. BACKGROUND Environmental factors have been recognised as important elements in the care of people with dementia. Among these factors, the importance of the caregivers' appearance and more particularly their street clothes has been raised. DESIGN The Street Clothes study (STRECLO) was designed as a multicentre crossover observational study. METHOD This study was conducted in two volunteer nursing homes. It involved videotaping residents (N = 24) over a 6-month period caregivers wore uniform and then street clothes for two consecutive three-month periods. Three outcome measures were observed as follows (a) behaviours of residents, (b) contents of conversations and (c) proximal interactions between residents and caregivers. The STROBE checklist was used to ensure quality reporting during this observational study. RESULTS When caregivers wore street clothes, we observed the following (a) greater solicitation and less anxiety in residents, (b) content of conversations between residents and caregivers included more personal and less health information, and (c) more proximal interaction between caregivers and residents. CONCLUSION To our knowledge, this is the first study which investigated the long-term effects on residents of SCU caregivers wearing street clothes. Our study demonstrated the potential benefit of not wearing uniform on the quality of life of institutionalised people with dementia. RELEVANCE TO CLINICAL PRACTICE Given the budgetary constraints faced by nursing homes, wearing street clothes for caregivers could be readily applied to clinical practice and represents a promising way to increase the quality of life of dementia residents and their families. © 2020 John Wiley & Sons Ltd.OBJECTIVE The potential role of education attained after the age of 50, for example, vocational training or recreational courses, in cognitive reserve has been unexplored. We examined the cross-sectional and prospective associations between late life education (LLE) and global cognitive function in older adults. METHODS A total of 5306 participants (50+ years) in The Irish Longitudinal Study of Ageing answered questions about highest level of education completed and LLE (2010). Cognitive function was defined as the number of errors on the Montreal cognitive assessment (MoCA) assessed in 2010 and 2014. The association between LLE and MoCA-errors was examined using Poisson regression stratified by level of education. Sensitivity analyses were done to examine reverse causation and selection bias. RESULTS In those with primary/no (n = 1312, incidence rate ratio [IRR] = 0.83, 95%CI = 0.70-0.99) and secondary education (n = 2208, IRR = 0.88, 95%CI = 0.80-0.97), but not tertiary education (n = 1786, IRR = 0.93, CI = 0.86-1.00), participating in LLE was associated with lower rate of MoCA errors. The prospective association between LLE and 4-year change in MoCA-errors was (borderline) statistically significant in those with primary/no education only (IRR = 0.86, CI = 0.74-1.00). Sensitivity analyses supported robustness of the findings. CONCLUSIONS LLE may contribute to cognitive reserve and be a useful intervention to mitigate the increased risk of cognitive decline associated with low levels of education. © 2020 John Wiley & Sons Ltd.