Thromboembolic events in COVID-19 patients : A Tunisian case series study
Coronavirus disease 2019 (COVID-19) can lead to systemic coagulation activation and thrombotic complications(TC), which may lead to fatal outcomes if not diagnosed and managed appropriately.We aimed to report the incidence and characteristics of venous and arterial thrombotic complications(TC) in hospitalized patients with COVID-19 and to investigate the predictive factors of their occurrence.A retrospective study including 200 patients with COVID-19 confirmed by a reverse transcription polymerase chain reaction test, admitted between March 2020 and January 2021 in the pulmonary departement B at Abderrahman Mami Hospital was conducted. We compared the characteristics of 2 groups: patients with TC and patients without TC.The median age was 64,9±13,5 [22– 98] years and 65% were men. A total of 26(13%) patients required intensive care. The most comon comorbidities were hypertension(46%),diabetes(40%) and obesity(32%).The incidence of TC was 22%(44/200).Pulmonary embolism was confirmed in 21 patients, and deep venous thrombosis was confirmed in 9 patients. Acute limb ischemia, acute coronary syndrome and ischemic stroke were observed in 4.5%,1.5% and 1% respectively. Thrombotic events occured within 4,7±2,1 days of hospital admission. Besides ICU stay(p=0,02),other risk factors associated with TC in univariable regression analyses were higher neutrophil-to-lymphocyte ratio (p=0,04),and a higher D-dimer level (p=0,002).TC appeared to be associated with dea...
A healthy 21-year-old man presented with a right neck palpable mass and calcifications diagnosed during a Panorex odontologic study. Computed tomography angiography imaging of the neck demonstrated a right common and internal carotid artery (ICA) pseudoaneurysm with irregular thrombus and calcifications causing severe right ICA stenosis (A, B). An elongated styloid process was identified adjacent to the pseudoaneurysm associated with ossification of the stylohyoid ligaments (C/Cover). A diagnosis of stylocarotid artery syndrome, a subtype of Eagle's syndrome, was considered and operative treatment recommended, given the ps...
To perform a scoping review of how patients with COVID-19 are affected by acute limb ischaemia (ALI) and evaluate the recommendations of the 2020 ESVS ALI Guidelines for these patients.
Carotid stenosis is a major risk factor for stroke and surgical treatment is key in preventing recurrent ischaemic events. Previous randomised trials have demonstrated the net benefit of surgery for significant symptomatic carotid stenosis but, with present day medical treatment, there is limited evidence on the risk of late ipsilateral ischaemic stroke (IS) and its main risk factors.
Patients undergoing carotid endarterectomy (CEA) often experience intraoperative and postoperative blood pressure lability and postoperative headache. Postoperative headache and hypertension after CEA are thought to increase the risk of developing postoperative cerebral hyperperfusion syndrome (CHS). Although fortunately rare, CHS spans a wide spectrum of signs and symptoms, with patients usually presenting with an unrelenting ipsilateral headache. Temporary or permanent neurologic deficit, seizures, intracranial hemorrhage, and, sometimes, death can follow the initial headache 3 to 7 days after discharge.
ConclusionCTPA was the primary modality for confirming PE in all trimesters of pregnancy, although its proportional use was higher in later stages of pregnancy.Key Points•Computed tomography pulmonary angiography (CTPA) was the primary modality of diagnosis in all trimesters of pregnancy among patients with confirmed pulmonary embolism, even in the first trimester.•From the first trimester of pregnancy to postpartum period, there was a linear increase in the proportion of patients with pulmonary embolism who were diagnosed based on CTPA.•In the postpartum period, use of CTPA as the modality to confirm pulmon...
Cervical artery dissection is a common cause of stroke in young adults and can lead to significant disability. Clinicians should be able to recognize the clinical presentation and diagnose this condition to prevent cerebral ischemia and its complications. Consider cervical artery dissection in a young adult with new-onset, unilateral head pain with or without neck pain with antecedent neck trauma, with or without neurologic deficits or risk factors for dissection. Early diagnosis can lead to better outcomes but the overall prognosis is good for young adults with cervical artery dissection.
This article analyzes the burden of COVID-19 on patients with opioid addiction and discusses the beneficial policy changes that improve access to substance abuse care.
This article reviews some of the physiologic theories for the difference in recommendations and discusses potential complications with race-based treatment algorithms.
Dr Santina Wheat discusses the role and responsibility that family physicians have in preventing/managing hypertension in pregnant patients as well as those of reproductive age who may become pregnant.Medscape Family Medicine