Characteristics, treatment and delirium incidence of older adults hospitalized with COVID-19: a multicentre retrospective cohort study.

Background: The COVID-19 pandemic has affected older adults disproportionately, and delirium is a concerning consequence; however, the relationship between delirium and corticosteroid use is uncertain. The objective of the present study was to describe patient characteristics, treatments and outcomes among older adults hospitalized with COVID-19, with a focus on dexamethasone use and delirium incidence.

Methods: We completed this retrospective cohort study at 7 sites (including acute care, rehabilitation and long-term care settings) in Toronto, Ontario, Canada.

Comorbid and inflammatory characteristics of genetic subtypes of clonal hematopoiesis.

CH may be associated with broader ill health (worse performance status, increased and potentially novel comorbidities). Serum interleukin-6 is elevated in people with CH and genetic subtypes, providing a view of the human systemic inflammatory landscape of CH.

Use of the Consultation Letter Rating Scale among Geriatric Medicine Postgraduate Trainees.

Objectives: The implementation of competency-based evaluations increases the emphasis on in-training assessment. The Consultation Letter Rating Scale (CLRS), published by the Royal College of Physicians and Surgeons of Canada, is a tool that assesses written-communication competencies. This multisite project evaluated the tool's validity, reliability, feasibility, and acceptability for use in postgraduate geriatric medicine training.

Human UDP-glucuronosyltransferase (UGT) 2B10 in drug N-glucuronidation: substrate screening and comparison with UGT1A3 and UGT1A4.

Recent observations revealed that human UDP-glucuronosyltransferase (UGT) 2B10 catalyzes N-glucuronidation of amine-containing compounds. Knowledge of the substrate specificity and clinical significance of UGT2B10 is still limited. The purpose of this study was to expand the knowledge of UGT2B10 substrates and to evaluate its significance in drug clearance.

Quantitative analysis of UDP-glucuronosyltransferase (UGT) 1A and UGT2B expression levels in human livers.

UDP-glucuronosyltransferases (UGTs) catalyze glucuronidation of a variety of xenobiotics and endobiotics. UGTs are divided into two families, UGT1 and UGT2. The purpose of this study was to estimate the absolute expression levels of each UGT isoform in human liver and to evaluate the interindividual variability.

From functional pulmonary atresia to right ventricular restriction. Long term follow up of Uhl's anomaly.

We report a 14 year old boy who presented as a neonate with functional pulmonary atresia due to Uhl's disease with emphasis on the later detection of restrictive right ventricular physiology.

Factors affecting access to drug therapy in the elderly.

We conducted a literature search to examine the factors that affect the access of elderly individuals to drug therapy. Factors which influenced access included physical and psychological patient factors (vision, hearing, motor control, swallowing ability, education, cognition, autoagism, any psychiatric disorders present), physician factors (education, agism, lack of adequate research in the elderly, patient and caregiver expectations) and, finally, environmental factors (health insurance and economic issues). All of these factors interact in a complex fashion and may influence optimal drug therapy in the elderly.

N-linked sugar chain of 55-kDa royal jelly glycoprotein.

An N-linked sugar chain from 55-kDa royal jelly glycoprotein (RJGP), which maintains the high viability of rat liver primary cultured cell and is a different molecular species from 350-kDa RJGP [Kimura et al., Biosci. Biotech.

A symptomatic atypical mycobacterial infection masquerading as a vascular ring on chest x-ray.

Atypical mycobacterium is rare in children. There are few case reports of childhood pulmonary diseases caused by atypical mycobacterium. The case of a 20-month-old boy who had stridor and respiratory distress is presented.

Synthesis of (E)-δ-hydroxy-β,γ-dehydroα-amino acids, a new class of vinylglycines by the rearrangement ofβ acetoxyallylglycine derivatives.

The efficient synthesis ofδ-hydroxy-β,γ-dehydroα-amino acids (1) was achieved by the hybrid process, in which the Pd(II)-assisted rear-rangement ofβ-acetoxyallylglycine ester (6) afforded the corresponding (E)-δ-acetoxyvinylglycine derivatives (7) in a moderate yield. The chemo- and stereo-selective hydrolysis of7 was accomplished by the use of microbial lipase (Amano PS) to afford the allylic alcohol (8), which was transformed into1 in two step sequence.

Treatment of atrial ectopic tachycardia in infants < 6 months old.

Nineteen infants < 6 months old who had atrial ectopic tachycardia (AET) were treated with antiarrhythmic drugs. AET was controlled with digoxin in 1 patient, propafenone in 2, digoxin with propafenone in 9, digoxin with amiodarone in 4, and digoxin with propafenone and amiodarone in 2; radiofrequency ablation was performed in 1 drug-resistant case. AET resolved in 14 of 15 infants within 1 year.

Effects of Sugar Acids on the Functions of Ribulose Bisphosphate Carboxylase/Oxygenase: Differentiation of Two Different Ligand-binding Modes of the Catalytic Sites.

The effects of sugar acids on the kinetics and the protein conformation of ribulose 1,5-bisphosphate carboxylase/oxygenase (RuBisCO) were examined to differentiate the ligand-binding modes of the catalytic sites. D-Glucarate, L-glucarate, and mucate inhibited the carboxylase activity of RuBisCO competitively with respect to ribulose 1,5-bisphosphate. Their inhibition constants were 2.

Persistence of atrioventricular valve regurgitation and electrocardiographic abnormalities following transient myocardial ischemia of the newborn.

To determine the sequelae of transient myocardial ischemia (TMI) in term infants, we reviewed clinical and investigative data in 59 infants (37 male, 22 female) with structurally normal hearts admitted over the 2-year period of 1983-1985. Twenty-three were diagnosed prior to admission as cases of birth asphyxia (5-min Apgar score less than 6), and 36 had signs of persistent fetal circulation with electrocardiographic (ECG) changes of ischemia greater than 24 h after birth. Murmurs of atrioventricular valve regurgitation (AVVR), detected in 28 patients, were confirmed in 23 of the 24 patients investigated.

Echocardiographic and Doppler evaluation of the aortic arch and brachiocephalic vessels in cerebral and systemic arteriovenous fistulas.

Congenital arteriovenous fistulas presenting in the newborn period pose difficult diagnostic problems and simulate structural heart disease. Angiocardiography, when performed, demonstrates enlarged brachiocephalic vessels and rapid cerebral venous return. The value of echocardiographic imaging and measurement of the aortic arch and brachiocephalic vessels, and evaluation of the Doppler flow profile in these vessels as a means of making a rapid diagnosis of cerebral or thoracic arteriovenous fistula, was therefore assessed in 10 infants with these diagnoses seen over a 4 year period (1983 to 1987).

Early and late results of a protocol for simple transposition leading to an atrial switch (Mustard) repair.

Inferences: A treatment protocol for patients with simple transposition, consisting of initial balloon atrial septostomy and leading to a delayed atrial switch repair of the Mustard type, in good circumstances, results in survivorship at 1 month, 1 year, 10 years, and 20 years of 95% (95% confidence limits [CL] 90% to 97%), 90% (95% CL 84% to 94%), 83% (95% CL 74% to 90%), and 80% (95% CL 70% to 88%), respectively. Low birth weight adversely affects survivorship. Hypoxia or heart failure accounts for most deaths within the first month and before the atrial switch (Mustard) repair.

Results with the Mustard operation in simple transposition of the great arteries 1963-1985.

From May 1963 to December 1985, 329 infants and children underwent repair of simple transposition of the great arteries (TGA) using Mustard's technique. To assess improvement, the patients were separated into two groups by date of operation: Group I, May 1963 to December 1973 (N = 106), and Group II, January 1974 to December 1985 (N = 223). The operative mortality was 11 (10.

Synthetic patch angioplasty for repair of coarctation of the aorta: experience with aneurysm formation.

Patch graft angioplasty is an accepted technique for the repair of some forms of coarctation and for recoarctation. Since 1970, 63 patients at our institution underwent 65 operations for repair of coarctation (ages 3 days to 32 years); in 27 it was the initial operation and 38 needed surgery for recoarctation. Average follow-up was 3.

Pulmonary artery banding.

Two hundred nine children with congenital heart defects characterized by excessive pulmonary blood flow underwent pulmonary artery banding at The Hospital for Sick Children from January, 1972, through December, 1982. The indications for banding, rather than complete repair, varied with the type of cardiac defect as well as with the year of presentation to our hospital. A simplified method of estimating required band circumference has been developed for infants with ventricular septal defect, with or without major intracardiac mixing disorders.

Space-occupying lesions of the myocardium: role of two-dimensional echocardiography in detection of cardiac tumors in children.

Four patients with space-occupying myocardial lesions were studied using electronically focused high-resolution two-dimensional echocardiography. In two patients with clusters of high-intensity echoes at various depths on the epicardial surface, histology confirmed the diagnosis of lymphosarcoma, showing patchy, malignant infiltrates of different thickness. The remaining two patients had very different features: the lesions appeared to be intrinsic to the posterior left ventricular wall.

Unmet need for pediatric cardiology services and correlates of referral in Ontario, 1975-1977.

We collected data on 930 neonates with structural congenital heart disease seen during 1975-1977 at the existing pediatric cardiac referral and treatment centers in Ontario. Estimates were made of unmet need for pediatric cardiology services in Ontario. The data showed that a number of counties had significantly low referral rates and that at least 25% of the newborns with severe structural heart disease (that is, 75 newborns each year) were not seen by pediatric cardiologists, although the children would benefit from prompt assessment and rapid treatment under specialist supervision.

Surgical management of patent ductus arteriosus in newborn infants of low birthweights. A review of 33 cases.

Thirty-three infants with low birthweights (<2500 g) and respiratory distress had ligation of a patent ductus arteriosus. During a 30-month period there were no deaths resulting from the operation, but 11 (33%) eventually died from complications of immaturity.