Impact of Immune Thrombocytopenia in Patients Admitted with Coronary Artery Disease: Results from National Inpatient Sample 2009-2011
BackgroundPatients with immune thrombocytopenia (ITP) may be at increased risk of thromboembolism related to different causes, including the use of thrombopoietin receptor agonists and splenectomy. Patients with ITP who develop coronary artery disease (CAD) can be a further challenge given their risk of both thromboembolism and bleeding, which may significantly increase the risk of mortality and length of stay (LOS) compared to patients who do not have ITP. We aimed to study the impact of ITP in hospital outcomes of patients with CAD.MethodsWe utilized the National Inpatient Sample database from years 2009 - 2011. We selected non-pregnant inpatients over the age of 18 with history of CAD. We selected patients with CAD and ITP based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). We used STATA version 13.0 (College Station, TX) for database analysis.ResultsA total of 4,777 cases of ITP with CAD were identified compared to 2,614,008 without ITP (Table 1). Logistic multivariable analyses found that patients with ITP had higher in-hospital mortality (95% CI: 1.21 to 1.55, p=0.0001) and LOS (95% CI: 1.32 to 1.72, p
This study retrospectively evaluated the added value of MRI over X-ray in guiding the extent of amputation in a cohort of patients with surgically treated, pathologically proven osteomyelitis.Materials and methodsA database search revealed 32 cases of pathology-proven diabetic forefoot osteomyelitis between 2006 and 2016, in which X-ray, MRI, and surgery occurred within 30 days. Data collection included extent of osteomyelitis reported on imaging and extent of subsequent amputation using a point system. Added value of MRI over X-ray in guiding surgical resection was stated if the X-ray was negative, MRI was positive,...
Most perinatal hospitals use a combination of maternal risk assessment and neonatal toxicology testing to identify infants at risk for substance withdrawal symptoms and to confirm the types of drugs that may have been used during pregnancy. Although meconium has been used for many years as the specimen of choice for toxicology testing, screening can also be performed on umbilical cord tissue. Due to the easy availability of umbilical cord tissue, this method is growing in popularity but there have been few studies that compare the equivalence of umbilical cord tissue with meconium.
In a recent article appearing in The Journal, Faustino et al reported the findings of a multicenter intensive care unit (ICU) study investigating the frequency of deep venous thrombosis (DVT) among critically ill adolescents (13-17 years of age).1 The authors indicate that DVT has been well studied in the adult population of critically ill patients, but such studies in the pediatric population are sparse. As such, the frequency of DVT among critically ill adolescents is not well known, and pediatric protocols to use pharmacologic prophylaxis to reduce risk of DVT vary widely from center to center.
TYPE 2 diabetes is a common condition in the UK which causes a person ’s blood sugar level to become too high. One of the best ways to prevent the condition is to eat the right foods. So when it comes to the first meal of the day breakfast, what should you eat?
CONCLUSIONS: In light of the increased risk of these serious complications, surgeons should have a lower threshold of suspicion for infection in patients with COPD after TSA so that adequate measures can be taken before developing severe infectious complications including pneumonia and septic shock. Surgeons may also consider administering tranexamic acid in patients with COPD undergoing TSA to reduce the amount of blood transfusions necessary. Future work through randomized control trials analyzing (1) the effectiveness of more aggressive infection prophylaxis in decreasing the risk of pneumonia/septic shock; and (2) the ...
CONCLUSIONS: Associations were found between antidepressants and many other types of drugs for both men and women; indicating comorbidity between depression and other conditions. Further, some of the associations between antidepressants and other drugs were found to be specific among women. Whether this indicates that men and women differ in comorbidity between depression and other conditions cannot be concluded based on this cross-sectional study. However, comorbidity impairs the possibility of recovery; in the somatic condition as well as the depression. Thus, physicians need to be aware that the association between anti...
Conclusion: Laparoscopic excision of anterior compartment endometriosis is effective in restoring fertility in patients with otherwise-unexplained infertility and in treating endometriosis-related symptoms. PMID: 30662252 [PubMed - in process]
Many thanks to Koestenberger and co-workers for their correspondence emphasizing the pediatric perspective on the tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure (TAPSE/PASP) ratio, an echocardiographic surrogate for right ventricular (RV)-pulmonary arterial (PA) coupling in patients with pulmonary arterial hypertension (PAH) . We agree that adult TAPSE/PASP values should not be adopted as reference values for the pediatric age group , as acquisition might be challenging and development-dependent.
With interest we read the article by Tello et al.  on the tricuspid annular plane systolic (TAPSE)/pulmonary artery systolic pressure (PASP) ratio used for echocardiographic estimation of pulmonary vascular resistance (PVR), pulmonary arterial capacitance, and functional capacity (WHO-FC) in adults with pulmonary arterial hypertension (PAH) . We further agree with Guazzi's editorial and previous work suggesting that the TAPSE/PASP ratio represents an indicator of right ventricular (RV) to pulmonary circulation (PC) coupling [2,3].
HIGH BLOOD pressure can be controlled by eating the right kind of diet, but what types of food should you ensure you eat? According to experts there are three key minerals to help control blood pressure.
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