The American journal of the medical sciences
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Ankle brachial index (ABI) as a risk-enhancing factor in addition to the pooled cohort equation (PCE) in assessing cardiovascular risk for primary prevention of atherosclerotic cardiovascular disease (ASCVD) is uncertain. ⋯ Using the PCE, two-third of the participants with low ABI were classified as having a low, borderline or intermediate risk of ASCVD. Low ABI was associated with an increased all-cause mortality in the overall cohort and specifically among those with a borderline/intermediate or high risk of ASCVD but not in those with a low risk of ASCVD. Our study supports consideration of ABI as a risk enhancer for primary prevention among patients classified as borderline or intermediate risk of ASCVD.
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Randomized Controlled Trial
The impact of inspiratory pressure level on prevention of ventilator-associated pneumonia: A double-blind, randomized clinical trial.
Atelectasis and pneumonia are highly prevalent in patients under mechanical ventilation. Studies indicate that using ventilation with an open lung concept improves recovery, decreases ventilator-related pneumonia, decreases mortality and leads to faster weaning from the ventilator. Therefore, this study investigated the effect of higher airway pressure on ventilator-associated pneumonia. ⋯ High-pressure levels can decrease ventilator-associated pneumonia and organ failure. It is recommended that the study be repeated with a larger, more diverse population.
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Liver transplant (LT) is a lifesaving treatment for patients with end stage liver disease. Historically, institutions across the United States have deemed active marijuana use as an exclusion criterion for listing. This study aims to investigate LT outcomes in patients with history of marijuana use prior to LT. ⋯ Our data indicates that marijuana is not associated with increased risk of postoperative noncompliance, other organ complications, infections, or death. As a single factor, marijuana may not need to be a contraindication for LT.
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Th aim of this study was to analyze acute exacerbation of chronic obstructive pulmonary disease (AECOPD) readmission events and to determine whether neutrophil-to-lymphocyte ratio (NLR) and bilirubin levels were associated with readmission after discharge due to AECOPD. ⋯ For patients with AECOPD, longer hospital stay, and less use of systemic corticosteroids may be associated with a higher risk of readmission. NLR and bilirubin levels on admission may be related to the number of all-cause readmissions. Bilirubin can be regarded as a biomarker to predict readmission rates within 2 years after discharged throughout the course of the disease.
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Superior vena cava (SVC) syndrome resulting from obstruction of the blood flow to the superior vena cava is rarely reported to present with life-threatening hemoptysis. The pathogenesis and the underlying mechanism are still not well described in the literature. ⋯ Attempts for revascularization and stenting failed, and the patient had a prolonged and stormy course while admitted, including difficult alternative dialysis access that unfortunately resulted in death eventually. Here we are highlighting the importance of recognition of hemoptysis as a presentation of SVC syndrome by explaining the underlying pathogenesis and possible management options.