The American journal of the medical sciences
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Psoriasis is a common chronic inflammatory skin disease associated with an increased risk for acute infections. Because chronic kidney disease is a risk factor for pneumonia, end-stage renal disease (ESRD) patients with psoriasis may have an increased risk for acquiring pneumonia. ⋯ When controlling for multiple factors, psoriasis does not increase the risk for pneumonia in ESRD patients. In this cohort, other factors, such as the CCI and tobacco use, were more strongly associated with increased risk for pneumonia than psoriasis.
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Review Case Reports
Acute myocardial infarction after a local anesthetic procedure in a middle-aged patient.
We report a case of acute myocardial infarction (AMI) occurring after a local injection of lidocaine. The patient presented with symptoms of myocardial ischemia, dynamic changes in the ST segment of the electrocardiogram, and significantly elevated levels of cardiac troponin; however, coronary angiography findings were normal. According to the clinical definition of AMI, these features indicated the presence of acute myocardial injury, reflected by abnormal cardiac biomarkers and supported by evidence of acute myocardial ischemia. ⋯ The potential mechanism in this case may be lidocaine-induced coronary artery spasm. The possible serious side effects of lidocaine require the attention and vigilance of clinicians. To our knowledge, this is the first report to describe coronary artery spasm possibly induced directly by lidocaine.
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Review Case Reports
A 49-year-old Man with Ischemic Cardiomyopathy and Persistent Hemoptysis for Eighteen Months.
Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of recurrent episodes of diffuse alveolar hemorrhage (DAH). IPH commonly manifests with hemoptysis, radiologic chest infiltrates and anemia. The etiology of IPH is unknown, but an immunologic mechanism is widely speculated. ⋯ Bronchoscopy revealed DAH. A surgical lung biopsy showed 'bland pulmonary hemorrhage.' A right heart catheterization ruled out cardiac causes of DAH. The patient was diagnosed with IPH and started on systemic corticosteroids with rapid improvement of hemoptysis.
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Coronavirus disease (COVID-19) continues to lead to worldwide morbidity and mortality. This study examined the association between blood type and clinical outcomes in patients with COVID-19 measured by a calculated morbidity score and mortality rates. The secondary aim was to investigate the relationship between patient characteristics and COVID-19 associated clinical outcomes and mortality. ⋯ There is strong evidence that blood type was not a significant predictor of clinical course or death in patients hospitalized with COVID-19. Older age and male gender led to worse clinical outcomes and higher rates of death; older age, male gender, and comorbidities predicted a worse clinical course and higher morbidity score. Race was not a significant predictor of death in our population and was associated with an increased, albeit not significant, morbidity score.