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Simple Summary: True personalization of internal/general medicine depends on the assessment and acknowledgment of sarcopenia and frailty characteristics of patients. The co-existence of sarcopenia, frailty, and hypothyroidism must be acknowledged by physicians, since these are common comorbidities bearing negative long-term clinical outcomes. Low ALT values could serve as a useful biomarker for screening of patients already diagnosed with hypothyroidism. Background: Hypothyroidism is very common worldwide. It is known to be associated with frailty which, in turn, is associated with increased morbidity and mortality in the elderly. Low ALT blood activity is an established marker for sarcopenia and frailty. The incidence and outcomes of the association between low ALT values and hypothyroidism, as manifested in elevated blood TSH levels, is unknown. The objective of this study was to assess if low ALT values could improve the prediction of clinical outcome in hypothyroid patients. Methods: This was a retrospective analysis of hospitalized patients in a large, tertiary hospital. Results: Over a period of 21 years, an overall population of 16,827 patients were identified as eligible to participate in this study. Within the study population, 726 (4.3%) were classified as suffering from hypothyroidism (TSH values > 6 MIU/L) and 2184 (13%) were classified as patients with sarcopenia (ALT < 12 IU/L). Within our patient population, hypothyroidism was associated with sarcopenia in a statistically significant manner (p = 0.011). Patients classified as suffering from both hypothyroidism and sarcopenia had significantly shorter survival: A multivariate analysis showed that the frail and hypothyroid group of patients had a statistically significant risk of mortality in the next 5 years (HR = 3.6; CI 2.75–4.71; p < 0.001). Conclusions: Sarcopenia and frailty are common comorbidities, bearing negative long-term clinical outcomes. Low ALT values could serve as a useful biomarker for screening of patients already diagnosed with hypothyroidism. [ABSTRACT FROM AUTHOR]

We hereby present two case reports of moderate coronavirus disease patients, suffering from profound hypoxaemia, further deteriorating later on. A schedule pre‐planned awake prone position manoeuvres were executed during their hospital stay. Following this, the patients' saturation improved, later to be weaned from oxygen support. Paucity of evidence and data regarding this topic led us to review the concept of awake prone position. [ABSTRACT FROM AUTHOR]

Background: Prolonged, inappropriate hospital stay after patients' eligibility for discharge from internal medicine departments is a world-wide health-care systems' problem. Nevertheless, the extent to which such surplus hospital stays are associated with infectious complications, their time frame of appearance and their long-term implications was not previously addressed. Methods: We conducted a retrospective cohort analysis of patients experiencing an In-hospital Waiting Period (IHWP) after discharge eligibility in a single, tertiary hospital. Results: We screened the records of 245 patients out of which 104 patients fulfilled our inclusion criteria. The mean length of IHWP was 15.7 ± 4.79 day during which 9(8.7 %) patients died. The study primary composite end-point, in-hospital mortality or hospital acquired infection (pneumonia, UTI or sepsis) occurred in 32(31 %) patients. The most hazardous time was during the first 3 IHWP days: 63.7 % of patients experienced a complication and 44 % of the total complications occurred during this period. The occurrence of any complication during IHWP was associated, with statistical significance, with increased risk of mortality during the first year after IHWP initiation (HR = 6.02, p = 0.014). Conclusion: Prolongation of hospital stay after patients are deemed to be discharged from internal medicine departments is associated with increased morbidity and mortality, mainly during the first surplus days of in-hospital stay. Efforts should be made to shorten such hospital stays as much as possible. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) patients are prone to infections leading to hospitalization. We used the Norton Scale score (NSS) as a prognostic tool for these patients. Method: Retrospective analysis of consecutive PD patients, all had NSS appreciation upon admission. Analyses were made to establish the association between NSS upon admission, short-term, and long-term clinical outcomes. Results: Five hundred twenty-eight PD patients' records were reviewed, of which 81 were eligible for analysis. Patients who died during hospitalization had a significantly lower NSS (10.0 vs. 13.1, p = .026). Among surviving patients, those who were discharged to more intensive care facilities relative to their original place of arrival also had a significantly lower NSS (10.38 vs. 13.63, p = .0002). Lower NSS was found to increase the risk for 1-year mortality (odds ratio = 1.3; 95% confidence interval = [1.09, 1.56], p = .003). Conclusion: Lower NSS upon admission of PD patients, suffering from infection is associated with worse clinical outcomes., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Bedside sonography by non-radiologists is rapidly expanding, presenting modern medicine with challenging professional, medico-legal, financial and logistic aspects. In the current article, we reviewed the relevant literature describing sonography application by internal medicine practitioners and the obstacles that may interfere with large-scale integration of point of care ultrasound imaging. In conclusion, we see a great potential for clinical benefit by internists who will use bedside sonography and we recommend establishing an official training program in the fiell of bedside ultrasonography by internists.