Acute aortic dissection (AAD) is a cardiovascular emergency that requires emergent surgical, endovascular, or medical intervention depending on the portion of the aorta implicated, as dictated by the Stanford classification, and the extent of aortic involvement. Acute chest pain radiating to the back is typically seen in AAD and may be associated with radial pulse deficits. A high index of suspicion is required to diagnose and initiate management of this emergency as early as possible. This is a report of an atypical presentation of an extensive aortic dissection identified in a young man without most of the typical risk factors, but which was promptly diagnosed and treated.
Background and aims: The therapeutic strategy for the treatment of known sequelae of COVID-19 has shifted from reactive to preventative. In this study, we aim to evaluate the effects of acetylsalicylic acid (ASA), and anticoagulants on COVID-19 related morbidity and mortality. Methods: This record-based analytical cross-sectional study targeted 539 COVID-19 patients in a single United States medical center between March and December 2020. Through a random stratified sample, we recruited outpatient (n = 206) and inpatient (n = 333) cases from three management protocols, including standard care (SC) (n = 399), low-dose ASA only (ASA) (n = 112), and anticoagulation only (AC) (n = 28). Collected data included demographics, comorbidities, and clinical outcomes. The primary outcome measure was inpatient admission.Exploratory secondary outcome measures included length of stay, 30-day readmission rates, medical intensive care unit (MICU) admission, need for mechanical ventilation, the occurrence of acute respiratory distress syndrome (ARDS), bleeding events, clotting events, and mortality. The collected data were coded and analyzed using standard tests.Results: Age, mean number of comorbidities, and all individual comorbidities except for asthma, and malignancy were significantly lower in the SC compared to ASA and AC. After adjusting for age and comorbidity via binary logistic regression models, no statistical differences were found between groups for the studied outcomes. When compared to the SC group, ASA had lower 30-day readmission rates (odds ration
Background: How the incidence of infective endocarditis (IE) changed in various age, sex and racial/ethnic subgroups of the United States along with the worsening opioid epidemic over the last decade is unknown. Methods: We utilized data from the 2005-2018 State Inpatient Databases (SID)) of two large demographically diverse states (Florida and New York) to conduct a retrospective cohort study. Cases of incident IE identified using validated International Classification of Diseases codes were combined with census data to compute age, sex- and race-specific incidence. Joinpoint regression was used to quantify the annualized percentage change (APC) in incidence over time. Results: Of 98,221 incident IE admissions, 70.0% were Non-Hispanic White (NHW) and 60.6% were ? 65 years old (yo). The average annual age and sex-standardized incidence of IE in cases/100,000 population was 19.2 (95%CI 18.7-19.6) but this varied by age, sex and race. Incidence was ?20% higher in men (20.9 [95%CI 20.2-21.7]) compared to women (17.5 [95%CI 16.8-18.2]) and increased with age in both sexes. Incidence was higher in Non-Hispanic Blacks (NHB); 22.5(95%CI 21.0-23.9) compared to NHW: 20.0(95%CI 19.3 to 20.6), Hispanic: 13.2(95%CI 12.3-14.1) and Asian/Pacific Islander patients: 5.9(95%CI 4.7 to 7.1). The age and sex-standardized incidence did not change over time (APC 0.5%, p=0.646). However, incidence increased in women 18-44 (APC 11.0%, p<0.001), men 18-44 (APC 7.3, p<0.001) and 45-64 yo (APC 1.5%, p=0.002) but declined in women ? 65 yo (APC -2.8, p=0.049). Most of this increased incidence occurred in NHW women 18-44 (APC 16.6%, p<0.001), NHW men 18-44 (APC 10.6%, p<0.001), NHW men 45-64 (APC 2.8%, p<0.001) and Hispanic Men 18-44 yo (APC 5.6%, p<0.001). Incidence did not change over time in these age/sex groups of NHB and in other age/sex groups. Prevalence of opioid use disorder increased by >2-fold in all age/sex groups over time but the pace of increase was faster in NHW women and men 18-44 yo compared to other races of similar demography (p-for-time interaction <0.001). Conclusion: Over the last two decades, among residents of Florida and New York, incidence of IE increased in several demographic groups, but the most prominent rise was among young NHWs, particularly young NHW women.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.