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Procedure utilization, latency and mortality: Weekend versus Weekday admission for Myocardial Infarction

Published on: 19th May, 2017

OCLC Number/Unique Identifier: 7286355059

Background: Due to variations in hospital protocols and personnel availability, individuals with myocardial infarction admitted on the weekend may be less likely to receive invasive procedures, or may receive them with a greater latency than those admitted during the week. Whether or not this occurs, and translates into a difference in outcomes is not established. Method: Using the Nationwide Inpatient Sample (2008-2011) database, we identified all patients admitted with a principle diagnosis of acute myocardial infarction. They were stratified by weekend or weekday admission. Baseline clinical characteristics, procedure utilization and latency to procedure were compared, and logistic regression models were constructed to assess the relationship between these variables and in-hospital mortality. Results: Patient demographics and provider-related characteristics (hospital type, geography) were similar between weekend and weekday admission for myocardial infarction. Adjusted for covariates, we found that the odds of mortality for a weekend admission are 5% greater than for a weekday admission (OR: 1.05; 95% CI: 1.01, 1.09, p=0.009). For the utilization of an invasive procedure, we found that the odds of receiving a procedure for a weekend admission were 12% less than the odds for a weekday admission, adjusted for the other covariates (OR: 0.88; 95% CI: 0.86, 0.91, p<0.001). In addition, we found that the time to procedure was an average of 0.18 days (4.32 hours) longer for weekend admissions compared to weekday admissions (95% CI: 0.16, 0.20, p<0.001). However, we did not observe a significant difference in the overall length of stay for weekend and weekday admissions (0.004 days; 95% CI: -0.04, 0.05, p=0.87). Conclusion: In a large and diverse subset of patients admitted with myocardial infarction, weekend admission was associated with fewer procedures, increased latency to those procedures, and a non-significant trend towards greater in adjusted in-hospital mortality.
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A Perspective on Conservation Technologies for Endangered Marine Birds

Published on: 26th July, 2023

Seabirds are species in a collection of avian orders that live on and feed in saltwater and include penguins; albatrosses and petrels; gannets and cormorants; and gulls, terns, and auks. They are at risk from human activities with habitat loss, fisheries bycatch, food shortages, introduced predators and pollution impact. These effects are all exacerbated by human-induced climate change. Many researchers, non-governmental organizations, communities, and governments are working to conserve endangered seabird species by developing and implementing technologies and conservation management systems to assist seabird conservation. More recently moves are afoot to ensure organizations share data and outcomes.
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Incidence of symptom-driven Coronary Angiographic procedures post-drug-eluting Balloon treatment of Coronary Artery drug-eluting stent in-stent Restenosis-does it matter?

Published on: 29th June, 2017

OCLC Number/Unique Identifier: 7286426167

Objectives: The clinical impact of drug-eluting balloon (DEB) coronary intervention for drug-eluting in-stent restenosis (DES-ISR) is not fully known. To further evaluate this impact, we aimed to describe the incidence of symptom-driven coronary angiography (SDCA), an under-reported but potentially informative outcome metric in this cohort of patients. Methods: We retrospectively identified all patients (n=28) who had DEB-treated DES-ISR at University Hospital Limerick in between 2013-2015 and evaluated the incidence of subsequent SDCA as the primary endpoint. Data were expressed as mean ± SD and %. Results: Baseline demographics demonstrate a mean age 63±9 years with 61% of DEB-treated DES-ISR presenting with acute coronary syndrome. Mean number of ISR per patient and number of DEB per lesion was 1.2±0.6 lesions and 1.2±0.6 balloons, respectively. The incidence of SDCA was 54% after mean follow-up duration of 179±241 days. 67.8% of patients had follow-up data beyond 12 months. Within the first year of follow-up, the incidence of SDCA with and without target lesion revascularization (TLR) was 11% and 36% respectively. Among patients with SDCA without TLR, 30% had an acute coronary syndrome not requiring percutaneous coronary intervention. Conclusions: A high incidence of SDCA was observed, particularly within the first 12 months after DEB-treated DES-ISR. This under-reported metric may represent a cohort at higher cardiovascular risk but requires further confirmation in larger studies.
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Investigation of Retinal Microvascular Findings in patients with Coronary Artery Disease

Published on: 7th July, 2017

OCLC Number/Unique Identifier: 7286351578

Objectives: Retinal microvascular anomalies may be a marker for cardiovascular diseases. Our aim in this study was to investigate the utility of ocular fundoscopic examination as a noninvasive method in specifying the patients who carry a risk for coronary artery disease. Material and Method: Patients who were diagnosed with coronary artery disease by coronary angiography were included in our study. Bilateral fundoscopic examination was performed in these patients. Fundoscopic findings and risk factors for coronary artery disease were evaluated. Results: This study enrolled 100 patients (male: 72 (72%), mean age: 58.25±7.1) who were diagnosed with coronary artery disease by coronary angiography. Upon fundoscopic examination, 87% of the study population had atherosclerotic changes. Grade I atherosclerosis was found in 54% of the patients, grade II atherosclerosis was found in 32% of the patients and grade III atherosclerosis was found in 1% of the patients. Increased retinal tortuosity was present in 65% of the patients. Hollenhorst plaque was observed in 3 patients. Drusenoid bodies were observed with a statistically significantly higher rate in the patients who were not using clopidogrel compared to the patients who were using clopidogrel (p<0.001). Conclusions: Retinal findings are frequently found in patients with coronary artery disease. Therefore, fundoscopic examination is a noninvasive and feasible examination method which can be frequently used in the evaluation of cardiac functions.
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Review on epidemiology of bovine hemoparasites in Ethiopia

Published on: 29th April, 2022

A literature-based review was made to assess available information on bovine hemoparasites related to their epidemiology, distribution, and economic importance in Ethiopia. Babesiosis, anaplasmosis, cowdriosis, theileriosis, and trypanosomosis are the major hemo-parasitic disease of bovine in Ethiopia. Their adverse effects on the health of the animals can decrease production and productivity. Hemoparasites generally cause fever, anemia, jaundice, anorexia, weight loss, milk drop, malaise, swelling of lymph nodes, dyspnoea, diarrhea, nervous disorders, and death by affecting blood vessels and/or lymphatic system of the animal. Reports from different parts of the country displayed there is a high distribution of bovine hemoparastic disease throughout the country. Anaplasmosis, Babesiosis (redwater), Ehlichiosis (Heartwater), Theileriosis, and Trypanosomosis are the major hemoparasitic diseases with heavy economic losses. Their mode of transmission was by arthropod vectors ticks and flies. Applying effective vector control and using vaccines drugs are the two most important control methods for hemoparasites diseases. Also having knowledge of parasite life cycles, their biological vector, and the immune response of bovines to vectors and parasites were also used in the successful application of control strategies. Creating awareness of the mode of transmission, method of control, and prevention of hemoparastic disease of bovine to livestock owners were warranted to decrease the effect of the disease.
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A rare Congenital Coronary Artery Anomaly: Woven Right Coronary Artery associated with Myocardial Infarction

Published on: 7th July, 2017

OCLC Number/Unique Identifier: 7286355563

Woven coronary artery (WCA) is an extremely rare and still not a clearly defined coronary anomaly. It is characterized by the division of epicardial coronary artery into thin channels which then reanastomose with the distal part of the abnormal coronary artery [1]. Since the angiographic imaging of WCA looks like an intracoronary thrombus and dissection; the differential diagnosis between atherothrombotic coronary arteries with recanalization of organized thrombi in coronary arteries and WCA may be very difficult for invasive cardiologists, especially in patients with single or two coronary artery involvements [2].
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A pilot study on treatment of infantile cystinosis with mesenchymal stem cells

Published on: 9th December, 2019

OCLC Number/Unique Identifier: 9272394663

Infantile cystinosis is a lysosomal storage disease leading to end stage kidney disease at early ages. There is no effective treatment and patients require long term dialysis or kidney transplant for survival. We present our experience on three affected children who received HLA matched allogeneic stem cell transplant. The protocol used was novel and designed to promote engraftment. The primary endpoint was safety for treatment related mortality or morbidity; All three children survived without serious adverse effects during extended follow up for over 4 years. Although we could not prove engraftment, all three children met secondary end point of sustained target functions over a 6 month follow-up. Further studies are warranted to further evaluate safety and efficacy of MSC treatment for infantile cystinosis.
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Optimizing Milk Safety: Applying Nuclear Techniques in X-ray Fluorescence Spectroscopy for Heavy Metal Quantification in Powdered Milk Consumed in Senegal

Published on: 9th February, 2024

This study conducted an elemental analysis and assessed heavy metal concentrations in five powdered milk samples (V1, L1, H1, G1, and D1) from Senegal, utilizing X-ray Fluorescence (XRF). The analysis focused on aluminum (Al), calcium (Ca), potassium (K), phosphorus (P), and chlorine (Cl). Aluminum was either undetected or found at negligible levels in all samples. Calcium levels consistently surpassed the Acceptable Maximum Level (AML) in all samples, with H1 exceeding the AML by approximately 11.1 times (27,745.06 ± 310.16 ppm). Potassium concentrations varied, with G1 exhibiting the highest levels, significantly exceeding the AML (51,058.15 ± 456.13 ppm), while V1 remained within acceptable limits. Chlorine concentrations generally complied with the AML, except for G1, which slightly exceeded the limit (3631.04 ± 31.23 ppm). Phosphorus concentrations in H1 were notably higher than the AML (13,750.94 ± 275.35 ppm). The non-uniformity in heavy metal concentrations among samples emphasizes the need for ongoing research and regulatory scrutiny to address potential risks and ensure the safety of powdered milk.
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Non-hemodynamic factors associated to the risk of developing hypertensive cardiopathy

Published on: 20th September, 2017

OCLC Number/Unique Identifier: 7286431107

Introduction: Hypertensive cardiopathy is the target organ lesion caused by arterial hypertension (HTN) that exhibits the highest morbidity and mortality rates. Although the importance of hemodynamic overload exerted by HTN on the onset of cardiopathy is well established, several non-hemodynamic factors may contribute significantly to its development. Objective: To evaluate the influence of different non-hemodynamic risk factors in the development of hypertensive cardiopathy. Methods: A prospective cohort study was carried out in hypertensive patients assisted at the specialized arterial hypertension physicians’ office of the “Carlos Manuel de Céspedes” Specialty Policlinic attached to the General University Hospital, Bayamo Municipality, Granma Province, Cuba from January 5, 2006 to December 31, 2015. The study included 18-to-55-year-old hypertensive patients with a stage 1 arterial hypertension diagnosis for less than a year1. Results: The multivariate analysis showed a significant and independent relation among the majority of the factors studied and the risk of developing cardiopathy. The major factor was C-reactive protein (HR: 5.020; IC 95%: 3.383-7,448; p<0.005) followed by microalbuminuria (HR: 2.649; IC 95%: 1.932-3.631; p<0.005). The area under the model ROC curve was 0.887 (p<0,005). Conclusions: The results showed that it is possible to estimate the risk of developing hypertensive cardiopathy with the application of the regression model to major risk factors.
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When conservative treatment in trachea laserations?

Published on: 21st July, 2020

OCLC Number/Unique Identifier: 8639105303

Introduction: The tracheobronchial injuries are usually fatal and some of the lucky people can reach emergency services without dying in the place of trauma. They can cause severe symptoms which can be lifetreathing. This type of injuries must been taken carefully and need to decide fast what treatment you going to give. Case report: We present a 53 years old patient who has been stabbed during a fight and got his trachea ruptured. His complaints shortness of breath and neck swelling. He can be treated conservatively with bronchoscopic and clinical evaluation. Discussion: Tracheobronchial injuries are life-threatening and the airway must be secured first. They can be treated conservatively in some cases. CT can be useful but fiberoptic bronchoscopy is the key in diagnosis. Conclusion: Although early treatment of tracheal lacerations is urgent surgery, it is reported that these injuries can be treated with conservative methods under appropriate conditions.
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