The American journal of the medical sciences
-
Review Case Reports
Hemophagocytic lymphohistiocytosis with a hemizygous PRF1 c.674G>A mutation.
Hemophagocytic lymphohistiocytosis(HLH) is a rare highly-fatal disease presenting with fever, hepatosplenomegaly, and pancytopenia and has a poor prognosis. Homozygous or semi-zygous or complex heterozygous variants can cause familial HLH and heterozygous carriers are frequently seen in secondary HLH. A 42-year-old male patient was admitted to the hospital for persistent fever, fatigue, and splenomegaly. ⋯ After a brief remission with dexamethasone and etoposide-based therapy, the disease relapsed quickly, and an allogeneic hematopoietic stem cell transplant was performed to achieve complete remission. To date, the patient's condition was in complete remission. Our study detected a rare missense mutation in the PRF1 gene in a patient with HLH disease and the c.674G>A mutation may be rated as a possible pathogenic variant.
-
Observational Study
Mortality of Patients Presented with Acute ST-Segment Elevation Myocardial Infarction According to the Status of Standard Modifiable Cardiovascular Risk Factors.
Standard modifiable cardiovascular risk factors (SMuRFs) remain well-established elements of assessing cardiovascular risk scores. However, there is growing evidence that patients presented without known SMuRFs at admission demonstrate worse post-myocardial outcomes. The aim of the study was to assess the influence of the SMuRF status on short- and long-term mortality rates in patients with first-time ST-segment elevation myocardial infarction (STEMI). ⋯ SMuRF-less individuals presented with STEMI are at an increased risk of all-cause mortality compared to those with at least one SMuRF. Consequently, further investigations regarding the recognition and treatment of risk factors, irrespective of SMuRF status, are indicated.
-
Influenza infection is rarely associated with cardiac conduction disorder. Cardiac arrhythmias due to such an infection have a full spectrum with ventricular arrythmias being the most common. ⋯ ACE 2 binder influenza viruses have more prone to be associated with cardiac conduction disorder. Oseltamivir for influenza infection is also associated with bradycardia and can shorten or lengthen QT segment. Influenza vaccination has found to be protective from cardiac arrhythmia.
-
Acute blood loss anemia is the most common form of anemia and often results from traumatic injuries or gastrointestinal bleeding. There are limited studies analyzing outcomes associated with acute blood loss anemia in hospitalized patients. ⋯ Acute blood loss anemia is associated with adverse outcomes in hospitalized patients.
-
Acute kidney injury (AKI) is common in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Early detection of AKI is likely to speed diagnosis and implementation of measures to preserve renal function. To evaluate if renal Doppler resistive index (RI) would predict AKI in patients with NSTEMI on presentation in the emergency department. ⋯ Renal Doppler RI may be a useful predictor of AKI in patients with NSTEMI in the emergency department.