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Critically ill patients with cirrhosis and liver failure not uncommonly have hypotension due to multifactorial reasons, that include hyperdynamic state with increased cardiac index, low systemic vascular resistance due to portal hypertension, following the use of beta blocker or diuretic therapy, and severe sepsis. These changes are mediated by microvascular alterations in the liver, systemic inflammation, activation of renin angiotensin aldosterone system, and vasodilatation due to endothelial dysfunction. Hemodynamic assessment includes measuring inferior vena cava indices, cardiac output and systemic vascular resistance using point-of-care ultrasound (POCUS), in addition to arterial waveform analysis, or pulmonary artery pressures, and lactate clearance to guide fluid resuscitation.

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Introduction: Real-world data from patients with chronic kidney disease (CKD) are limited, particularly regarding clinical management, treatment patterns and health-related quality of life (HRQoL) in the context of new therapies and updated standard of care guidelines.

Methods: DISCOVER CKD is an observational cohort study enrolling adult patients with CKD, defined by an International Classification of Diseases, 10th Revision code, or with two estimated glomerular filtration rate measures < 75 ml/min/1.73 m recorded 91-730 days apart.

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Heart failure with reduced ejection fraction is a syndrome consisting of symptoms (dyspnoea, fatigue, swelling) and/or signs of congestion (pulmonary crackles, oedema). It is caused by structural and/or functional pathologies, most commonly ischaemic heart disease, entailing elevated cardiac filling pressures and can result in low cardiac output. Medical treatment has evolved during the recent decades as outlined in this review, and a 4-pillar treatment strategy is recommended including a renin-angiotensin-aldosterone system blocker or sacubitril/valsartan, a betablocker, a mineralocorticoid antagonist, and an SGLT2 inhibitor.

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Human malaria, caused by Plasmodium parasites, is a fatal disease that disrupts the host's physiological balance and affects the neuroendocrine system. This review explores how malaria influences and is influenced by hormones. Malaria activates the Hypothalamus-Pituitary-Adrenal axis, leading to increased cortisol, aldosterone, and epinephrine.

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Article Synopsis
  • Extensive burn injuries need personalized fluid resuscitation protocols to prevent shock and reduce swelling, leading to efforts to improve treatment methods through mathematical modeling of burn physiology.
  • The research developed an advanced mathematical model that integrates cardiovascular, hormonal, and kidney function systems to enhance predictions about fluid regulation in burn patients.
  • The model was validated against experimental data from animals and clinical data from human burn patients, successfully predicting key health indicators like cardiac output and urinary output.
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