Explore the vast range of titles available.

Background Data on the relationship between potassium intake and major cardiovascular events (MACE) in patients with diabetes are scarce. We aim to study the association between estimated potassium intake and risk of MACE in individuals with type 2 diabetes. Methods The discovery cohort consisted of 1572 participants with type 2 diabetes from a secondary hospital. The validation cohort consisted of 1430 participants with diabetes from a multicenter study (Chronic Renal Insufficiency Cohort, CRIC). Potassium intake was estimated from potassium in spot urine using Kawasaki formula and in 24-h urine collection in two cohorts, respectively. The primary outcome was MACE defined as a composite of myocardial infarction, stroke and cardiovascular death. Results During a median of 8.2 years of follow-up, 341 MACE events were identified in discovery cohort. Compared to the lowest tertile, participants with potassium intake in the top tertile had 34% lower risk for MACE after adjustment for cardio-renal risk factors (adjusted hazard ratio, aHR [95% CI], 0.66 [0.49–0.89]). This inverse association was more pronounced in participants with normal or moderately elevated albuminuria as compared to those with severely elevated albuminuria (urine albumin-to-creatinine ratio > 300 mg/g, p for interaction < 0.05). In consistence, a higher potassium intake was independently associated with a lower risk of MACE in CRIC participants with diabetes and moderately elevated albuminuria (aHR 0.61 [0.42–0.90], top vs. lowest tertile). Conclusions A high level potassium intake estimated from urine potassium excretion was independently associated with a low risk of MACE in patients with type 2 diabetes. Increasing potassium intake may be a potential effective strategy for cardiovascular risk reduction beyond controlling traditional risk factors.

This study evaluates the association between antivirals (Molnupiravir and Nirmatrelvir-Ritonavir) and all-cause and respiratory mortality and organ dysfunction among high-risk COVID-19 patients during an Omicron outbreak. Two cohorts, Nirmatrelvir-Ritonavir versus control and Molnupiravir versus control, were constructed with inverse probability treatment weighting to balance baseline characteristics. Cox proportional hazards models evaluated the association of their use with all-cause mortality, respiratory mortality, and all-cause sepsis (a composite of circulatory shock, respiratory failure, acute liver injury, coagulopathy, and acute liver impairment). Patients recruited were hospitalized and diagnosed with the COVID-19 Omicron variant between February 22, 2022 and April 15, 2022, and followed up until May 15, 2022. The study included 17,704 patients. There were 4.67 and 22.7 total mortalities per 1000 person-days in the Nirmatrelvir-Ritonavir and control groups respectively before adjustment (weighted incidence rate ratio, − 18.1 [95% CI − 23.0 to − 13.2]; hazard ratio, 0.18 [95% CI, 0.11–0.29]). There were 6.64 and 25.9 total mortalities per 1000 person-days in the Molnupiravir and control groups respectively before adjustment (weighted incidence rate ratio per 1000 person-days, − 19.3 [95% CI − 22.6 to − 15.9]; hazard ratio, 0.23 [95% CI 0.18–0.30]). In all-cause sepsis, there were 13.7 and 35.4 organ dysfunction events per 1000 person-days in the Nirmatrelvir-Ritonavir and control groups respectively before adjustment (weighted incidence rate ratio per 1000 person-days, − 21.7 [95% CI − 26.3 to − 17.1]; hazard ratio, 0.44 [95% CI 0.38–0.52]). There were 23.7 and 40.8 organ dysfunction events in the Molnupiravir and control groups respectively before adjustment (weighted incidence ratio per 1000 person-days, − 17.1 [95% CI, − 20.6 to − 13.6]; hazard ratio, 0.63 [95% CI 0.58–0.69]). Among COVID-19 hospitalized patients, use of either Nirmatrelvir-Ritonavir or Molnupiravir compared with no antiviral use was associated with a significantly lower incidence of 28-days all-cause and respiratory mortality and sepsis.

Stroke survivors exhibit muscular characteristics that can influence motor function, mobility, and balance outcomes. This study aimed to quantify the muscle strength (MST) and stiffness of ankle dorsiflexors (ADF) and plantar-flexors (APF) and compare them between stroke survivors and healthy older adults, and to identify the correlation between the muscle properties of ankle muscles and stroke-related outcomes. This cross-sectional study assessed outcomes using outcome tools/measures, including a handheld dynamometer and MyotonPRO for assessing the muscle properties of the tibialis anterior (TA) and medial gastrocnemius (MG), Fugl-Meyer motor assessment of lower extremity (FMA-LE), Berg balance scale (BBS), timed up and go test (TUG), 10 m walk test (10mWT), limit of stability (LOS) test, and Oxford participation and activities questionnaire (OxPAQ). Total of 65 chronic stroke survivors and 31 healthy controls participated. The MST of the ADF demonstrated a significant positive correlation with that of APF. Additionally, the MST of the ADF and APF demonstrated significant positive correlations with motor control and certain aspects of postural stability. Conversely, it exhibited a significant negative correlation with functional mobility and walking capacity. The TA and MG stiffness was significantly negatively correlated with various aspects of postural stability. Significant differences in the ankle MST were observed between healthy individuals and stroke survivors.

Viral infections, including those leading to sepsis, are common but often overlooked in clinical practice, yet the treatment strategies for viral sepsis remain inadequately defined. This study aims to investigate the effectiveness of antivirals nirmatrelvir-ritonavir and molnupiravir in the treatment of culture-negative sepsis. This retrospective cohort study was conducted across public hospitals in Hong Kong. We included patients diagnosed with COVID-19 between February 22, 2022, and June 30, 2023, who had no secondary bacterial or fungal infections. Propensity score matching was used to assess the efficacy of the antivirals nirmatrelvir-ritonavir and molnupiravir in patient subgroups with or without organ dysfunction at hospital admission, including circulatory shock, respiratory failure, acute kidney injury, coagulopathy, acute liver impairment, a composite of all organ dysfunctions, or no organ dysfunction. Key outcomes were in-hospital mortality and length of stay, reported as hazard ratios (HR) and mean differences, respectively. The study included 15,599 COVID-19 patients with a mean age of 75.1 (SD 15.9) years. Molnupiravir treatment was associated with a significantly lower risk of mortality in patients in both the presence of any organ dysfunction (HR 0.75, 95% CI 0.58 to 0.96) and without organ dysfunction (HR 0.29, 95% CI 0.15-0.56). Nirmatrelvir-ritonavir was associated with decreased mortality with respiratory failure (absolute risk difference: 9.5%, 95% CI 6.26-12.72) and without organ dysfunction (HR 0.17, 95% CI 0.05-0.56). Antivirals also reduced the length of hospital stay; nirmatrelvir-ritonavir reduced length of stay in respiratory failure by an average of 3.37 (95% CI 2.32-4.42) days, acute kidney injury by 7.25 (95% CI 2.97-11.52) days, and coagulopathy by 7.04 (95% CI 2.99-4.05) days. Molnupiravir reduced the length of stay in acute kidney injury by an average of 6.7 (95% CI 2.39-11.08) days and coagulopathy by 5.68 (95% CI 1.20-10.16) days. Antivirals reduced mortality among hospitalized COVID patients, with the greatest reduction observed in patients without organ dysfunction. Antivirals were also effective in reducing the length of hospital stay.