Impact of specialized renal technologists on optimizing delivery of continuous kidney replacement therapy in critical care areas a retrospective study.

BACKGROUND: Continuous renal replacement therapy (CKRT) is delivered to some of the most critically ill patients in hospitals. This therapy is expensive and requires coordination of multidisciplinary teams to ensure the prescribed dose is delivered. With increased demands on the critical care nursing staff and increased complexities of patients admitted to critical care units, we evaluated the role of specialized renal technologists in ensuring the prescribed dose is delivered. Therefore, the aim of this study is to investigate the impact of supporting intensive care unit nurses with specialized renal technologists on optimizing efficiency of CKRT sessions in the United Arab Emirates. METHODS: This is a retrospective study that compared critically ill patients on CKRT overseen by specialized renal technologists versus who are non-covered in the year 2021. RESULTS: A total of 331 sessions on 158 patients were included in the study. The mean filter life was longer in specialized renal technologists-covered patients compared to the non-covered group (66 vs. 59 h, p = 0.019). After adjustment by multiple regression analysis for risk factors (i.e., age, gender, mechanical ventilation, sepsis, mean arterial pressure, vasopressors, and SOFA) that may affect CKRT machines' filter life, presence of a specialized renal technologists resulted in significantly longer filter life (co-efficient 0.129; CI 95% 1.080, 11.970; p-value: 0.019). CONCLUSION: Our study suggests that specialized renal technologists play a vital role in prolonging CKRT machine's filter life span and optimizing CKRT machine's efficiency. Further research should focus on other potential benefits of having specialized renal technologists performing CKRT sessions, and to confirm the finding of this study. Additionally, a cost-benefit analysis could be conducted to determine the economic impact of having specialized teams performing CKRT.

Learning styles, academic performance and mental health among medical students in King Faisal University, Saudi Arabia.

OBJECTIVE: To assess the prevalence of various learning styles and their correlation with academic performance and mental health of medical students. METHODS: The cross-sectional study was conducted at the King Faisal University, Houfof, Saudi Arabia, from January to June 2019, and comprised medical students regardless of gender or the academic year. Data was collected using the Visual Aural Read/write Kinesthetic questionnaire. Depression Anxiety Stress Scales-21 was used to assess mental health. Data was analysed using SPSS 22. RESULTS: Of the 315 students, 179(57%) were males and 136(43%) were females. Overall, 152(48.3%) subjects preferred multimodal, while 163(51.7%) preferred unimodal style; 93(29%) aural, 53(16.8%) visual, 11(3.5%) read/write and 6(1.9%) kinesthetic. Males preferred visual and quardimodal styles of learning, while females preferred aural learning (p<0.05). Academic achievement was associated with learning style (p<0.05), but no relationship was observed between depression scores and learning styles (p>0.05). CONCLUSIONS: The most preferred learning styles among medical students were found to be aural and bimodal.

Early use of tocilizumab in the prevention of adult respiratory failure in SARS-CoV-2 infections and the utilization of interleukin-6 levels in the management.

Respiratory failure in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection appears related to cytokine release syndrome that often results in mechanical ventilation (MV). We investigated the role of tocilizumab (TCZ) on interleukin-6 (IL-6) trends and MV in patients with SARS-CoV-2. In this longitudinal observational study, 112 patients were evaluated from 1 February to 31 May 2020. TCZ was administered followed by methylprednisolone to patients with >3L oxygen requirement and pneumonia severity index score ≤130 with computed tomography scan changes. IL-6, C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), D-dimer, and procalcitonin were monitored on days 0, 3, and 6 of therapy. Statistical analyses were performed with significance ≤0.05. Eighty out of 112 SARS-CoV-2-positive patients (45 males, 56.96%; 34 females, 43.04%) were included in this study. Seven patients expired (8.75%) and nine patients required MV (11.25%). Median IL-6 levels pre-administration of TCZ was 342.50 (78.25-666.25) pg/mL compared with post-administration on day 3 (563; 162-783) pg/mL (P < .00001). On day 6, the median dropped to 545 (333.50-678.50) pg/mL compared with day 3 (P = .709). CRP, ferritin, LDH, and D-dimer levels were reduced after TCZ therapy. Early use of TCZ may reduce the need for MV and decrease CRP, ferritin, LDH, and D-dimer levels. The sequential use of methylprednisolone for 72 hours seems to potentiate the effect and prolong the suppression of the cytokine storm. IL-6 levels may be helpful as a prognostic tool.

Gender Disparity in Lipid Target Achievements in High and Very High Atherosclerotic Cardiovascular Disease Risk Patients in the Arabian Gulf.

BACKGROUND: Few studies assessed gender disparity in lipid goal attainment in the Arabian Gulf. Hence, we estimated gender gaps in lipid target achievements among patients at high and very high atherosclerotic cardiovascular disease (ASCVD) risk in the Centralized Pan-Middle East Survey on the undertreatment of hypercholesterolemia (CEPHEUS). METHODS: The study (conducted between November 22, 2009 and July 7, 2010) included 4,384 patients (≥18 years) on lipid lowering drugs at high and very ASCVD risk status from outpatient clinics of 177 specialists and primary care physicians in 6 Arabian Gulf countries. RESULTS: The overall mean age was 57±11 years and 40% (n=1763) were women. Women were more likely to have diabetes mellitus (84 vs 71%; p <0.001) and metabolic syndrome (49 vs 35%; p <0.001) compared with males. Women were less likely to achieve their low-density lipoprotein cholesterol (LDLC) (28 vs 32%; p = 0.002), high-density lipoprotein cholesterol (HDL-C) (42 vs 50%; p <0.001), and apolipoprotein B (Apo B) (38 vs 42%; p = 0.015) targets compared with men. In the very high ASCVD risk cohort, women were significantly less likely to achieve their LDL-C (20 vs 30%; p <0.001), non- HDL-C (34 vs 39%; p = 0.001) and Apo B (34 vs 41%; p <0.001) therapeutic targets compared with men. CONCLUSION: Women in the Arabian Gulf were less likely to achieve their lipid targets than men. The difference was more significant in the very high ASCVD risk group.