Comparison of the Diagnostic Accuracies of Procalcitonin and C-Reactive Protein for Spontaneous Bacterial Peritonitis in Patients with Cirrhosis: A Systematic Review and Meta-Analysis.

: Spontaneous bacterial peritonitis (SBP) is both a prevalent and severe complication among individuals with cirrhosis. This systematic review and meta-analysis was designed to evaluate the diagnostic accuracy of procalcitonin (PCT) and compare it to C-reactive protein (CRP) in cirrhotic patients with suspected SBP. : We performed an extensive literature review utilizing databases including MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials.

Artificial Intelligence-Enabled ECGs for Atrial Fibrillation Identification and Enhanced Oral Anticoagulant Adoption: A Pragmatic Randomized Clinical Trial.

Background: Atrial fibrillation (AF) is often underdiagnosed and undertreated by noncardiologists. This study evaluated whether artificial intelligence-enabled ECG (AI-ECG) alerts could improve AF diagnosis and non-vitamin K antagonist oral anticoagulant prescriptions by noncardiologists.

Methods: In this open-label, cluster randomized controlled trial (NCT05127460) at 2 hospitals in Taiwan, noncardiologists were randomized to an intervention group (AI-ECG alerts) or control group (usual care).

Economic analysis of an AI-enabled ECG alert system: impact on mortality outcomes from a pragmatic randomized trial.

Findings from a previous study (ClinicalTrials.gov: NCT05118035) demonstrated that an AI-enabled electrocardiogram (AI-ECG), combining AI reports and physician alerts, effectively identified hospitalized patients at high risk of mortality and reduced all-cause mortality. This study evaluates its cost-effectiveness from the health payer's perspective in Taiwan over a 90-day post-intervention period.

Impact of Obesity on the Long-Term Outcomes of Advanced Therapies in IBD: A Real-World Study in Taiwan.

Purpose: Obesity has emerged as a factor influencing outcomes in inflammatory bowel disease (IBD), yet its effect on the persistence of advanced biologic therapies, especially in Asian populations, remains unclear. This study evaluates obesity's impact on clinical outcomes and treatment persistence among Taiwanese IBD patients on advanced biologic therapies.

Methods: This retrospective cohort study was conducted at Chang Gung Memorial Hospital, Taiwan, involving IBD patients on advanced biologics between October 2015 and October 2024.

Advanced Therapies in Elderly Patients With Inflammatory Bowel Disease: A Comparative Retrospective Cohort Study in Taiwan.

Purpose: Inflammatory Bowel Disease (IBD) predominantly affects younger individuals, but emerging data indicates a shift toward older populations. Elderly-onset IBD (diagnosed at 60 years or older) differs from younger-onset IBD, presenting with atypical symptoms and higher risks of infections and malignancies. However, drug persistence is underexplored in the elderly IBD group, warranting further investigation to optimize treatment strategies for this demographic.

Monitoring serum potassium concentration in patients with severe hyperkalemia: the role of bloodless artificial intelligence-enabled electrocardiography.

Background: Severe hyperkalemia is a life-threatening emergency requiring prompt management and close surveillance. Although artificial intelligence-enabled electrocardiography (AI-ECG) has been developed to rapidly detect hyperkalemia, its application to monitor potassium (K) levels remains unassessed. This study aimed to evaluate the effectiveness of AI-ECG for monitoring K levels in patients with severe hyperkalemia.

Recurrent falls as the presentations of Gitelman syndrome in an octogenarian.

Gitelman syndrome (GS) is the most common hereditary renal tubular disorder, with a higher carrier frequency among Asians often overlooked in older adults. Electrolyte imbalances, such as those seen in GS, are crucial considerations for older adults experiencing recurrent falls. We described an 83-year-old diabetic female on metformin, who was admitted due to recurrent falls with the preceding dizziness and palpitations when standing.

A case of Sjögren's syndrome with selective anion exchanger 1 defect causing distal renal tubular acidosis.

Distal renal tubular acidosis (dRTA) is a significant clinical expression of Sjögren's syndrome (SS). While SS-related dRTA is traditionally linked to impaired H-ATPase, we report a unique case demonstrating selectively decreased anion exchanger 1 (AE1) expression with preserved H-ATPase expression. A 16-year-old girl with SS presented with muscle weakness, difficulty in ambulation, and severe hypokalemia.

Point-of-Care Potassium Measurement vs Artificial Intelligence-Enabled Electrocardiography for Hyperkalemia Detection.

Background: Hyperkalemia can be detected by point-of-care (POC) blood testing and by artificial intelligence- enabled electrocardiography (ECG). These 2 methods of detecting hyperkalemia have not been compared.

Objective: To determine the accuracy of POC and ECG potassium measurements for hyperkalemia detection in patients with critical illness.

Persistent renal dysfunction post-chemotherapy: a diagnostic conundrum in pediatric cancer survivorship - a case report.

Background: Late-onset type II Bartter syndrome is an exceedingly rare condition, with only six documented cases presenting symptoms and signs beyond infancy. We report a unique case of late-onset type II Bartter syndrome with an atypical presentation and clinical course following chemotherapy treatment during childhood.

Case Presentation: A 10-year-old boy, diagnosed with hepatoblastoma at age 2 and treated with cisplatin and epirubicin, presented with polyuria, polydipsia, failure to thrive, and electrolyte imbalances.

AI-enabled electrocardiography alert intervention and all-cause mortality: a pragmatic randomized clinical trial.

The early identification of vulnerable patients has the potential to improve outcomes but poses a substantial challenge in clinical practice. This study evaluated the ability of an artificial intelligence (AI)-enabled electrocardiogram (ECG) to identify hospitalized patients with a high risk of mortality in a multisite randomized controlled trial involving 39 physicians and 15,965 patients. The AI-ECG alert intervention included an AI report and warning messages delivered to the physicians, flagging patients predicted to be at high risk of mortality.

Artificial intelligence-enabled electrocardiography contributes to hyperthyroidism detection and outcome prediction.

Background: Hyperthyroidism is frequently under-recognized and leads to heart failure and mortality. Timely identification of high-risk patients is a prerequisite to effective antithyroid therapy. Since the heart is very sensitive to hyperthyroidism and its electrical signature can be demonstrated by electrocardiography, we developed an artificial intelligence model to detect hyperthyroidism by electrocardiography and examined its potential for outcome prediction.

The screening, diagnosis, and management of patients with autosomal dominant polycystic kidney disease: A national consensus statement from Taiwan.

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited cause of end-stage kidney disease (ESKD) worldwide. Guidelines for the diagnosis and management of ADPKD in Taiwan remains unavailable. In this consensus statement, we summarize updated information on clinical features of international and domestic patients with ADPKD, followed by suggestions for optimal diagnosis and care in Taiwan.

Novel Prediction Score for Arterial-Esophageal Fistula in Patients with Esophageal Cancer Bleeding: A Multicenter Study.

Purpose: To develop and internally validate a novel prediction score to predict the occurrence of arterial-esophageal fistula (AEF) in esophageal cancer bleeding.

Methods: This retrospective cohort study enrolled patients with esophageal cancer bleeding in the emergency department. The primary outcome was the diagnosis of AEF.

A novel prognostic model to predict mortality in patients with acute-on-chronic liver failure in intensive care unit.

Acute-on-chronic liver failure (ACLF) implies high short-term mortality rates and usually requires intensive care unit (ICU) admission. Proper prognosis for these patients is crucial for early referral for liver transplantation. The superiority of CLIF-C ACLF score in Asian patients with ACLF admitted to an ICU remains inconclusive when compared to other scoring systems.

Prognostic Factors in Children with Acute Kidney Injury Requiring Continuous Renal Replacement Therapy.

Introduction: This study aimed to evaluate prognostic factors and outcomes in a single-center PICU cohort that received continuous renal replacement therapy (CRRT).

Methods: This retrospective study analyzed clinical characteristics, laboratory data, and outcomes. Ninety-day mortality and advanced chronic kidney disease (CKD) (eGFR <60 mL/min/1.

Phenotype, genotype, and clinical outcome of Taiwanese with congenital nephrotic syndrome.

Background/purpose: Congenital nephrotic syndrome (CNS) is one of the important causes of end-stage kidney disease in children. Studies on the genotype, phenotype, and clinical outcome in infants with CNS caused by genetic mutations are scarce.

Methods: We analyzed the genetic background, clinical manifestations, treatment response, and prognosis of pediatric patients with CNS in Taiwan.

Acute kidney disease following COVID-19 vaccination: a single-center retrospective study.

Background: Rare cases of or relapsed kidney diseases associated with vaccination against coronavirus disease 2019 (COVID-19) have been increasingly reported. The aim of this study was to report the incidence, etiologies, and outcomes of acute kidney disease (AKD) following COVID-19 vaccination.

Methods: This retrospective study extracted cases from renal registry of a single medical center from 1 March 2021 to 30 April 2022, prior to the significant surge in cases of the Omicron variant of COVID-19 infection in Taiwan.

Machine Learning to Identify Genetic Salt-Losing Tubulopathies in Hypokalemic Patients.

Introduction: Clinically distinguishing patients with the inherited salt-losing tubulopathies (SLTs), Gitelman or Bartter syndrome (GS or BS) from other causes of hypokalemia (LK) patients is difficult, and genotyping is costly. We decided to identify clinical characteristics that differentiate SLTs from LK.

Methods: A total of 66 hypokalemic patients with possible SLTs were recruited to a prospective observational cohort study at the University College London Renal Tubular Clinic, London.

ER ribosomal-binding protein 1 regulates blood pressure and potassium homeostasis by modulating intracellular renin trafficking.

Background: Genome-wide association studies (GWASs) have linked RRBP1 (ribosomal-binding protein 1) genetic variants to atherosclerotic cardiovascular diseases and serum lipoprotein levels. However, how RRBP1 regulates blood pressure is unknown.

Methods: To identify genetic variants associated with blood pressure, we performed a genome-wide linkage analysis with regional fine mapping in the Stanford Asia-Pacific Program for Hypertension and Insulin Resistance (SAPPHIRe) cohort.