Trial data available to date are unable to demonstrate a statistically significant reduction in mortality and cardiovascular risk associated with vitamin D. The quality of the available evidence is low to moderate at best.

Vitamin D combined with calcium reduces the risk of falls. The reduction in studies without calcium coadministration did not reach statistical significance. The majority of the evidence is derived from trials enrolling elderly women.

COVID-19 has become a pandemic in the United States and worldwide. COVID-19-induced coagulopathy (CIC) is commonly encountered at presentation manifested by considerable elevation of D-dimer and fibrin split products but with modest or no change in activated partial thromboplastin time and prothrombin time. CIC is a complex process that is distinctly different from conventional sepsis-induced coagulopathy. The cytokine storm induced by COVID-19 infection appears to be more severe in COVID-19, resulting in development of extensive micro- and macrovascular thrombosis and organ failure. Unlike conventional sepsis, anticoagulation plays a key role in the treatment of COVID-19, however without practice guidelines tailored to these patients. We propose a scoring system for COVID-19-coagulopathy (CIC Scoring) and stratification of patients for the purpose of anticoagulation therapy based on risk categories. The proposed scoring system and therapeutic guidelines are likely to undergo revisions in the future as new data become available in this evolving field.

Context Thirty day readmission rates have become a publicly reported quality performance measure for congestive heart failure (CHF), acute myocardial infarction (AMI), and percutaneous coronary intervention (PCI). However, little is known regarding the factors associated with 30-day readmission after PCI. Objective To assess the demographic, clinical, and procedural factors associated with 30-day readmission rates after PCI. Design, Setting, and Patients We identified 15,498 PCI hospitalizations (elective or for acute coronary syndromes) from January 1998 through June 2008 at Saint Marys Hospital, Rochester, MN. All were included in this analysis. Multivariable logistic regression models were employed to estimate the adjusted association between demographic, clinical, and procedural variables and 30-day readmission. The association between 30-day readmission and 1-year mortality was estimated using Cox proportional hazards models with readmission as a time dependent covariate and by using landmark analysis. Main Outcome Measure(s) All-cause 30-day readmission to any hospital following PCI and 1-year mortality. Results Overall, 9.4% of PCIs (n=1,459) were readmitted and 0.68% (n=106) of PCIs resulted in death within 30-days after discharge. After multivariable analysis, female sex, Medicare insurance, less than a high school education, unstable angina, cerebrovascular accident/transient ischemic attack (CVA/TIA), moderate/severe renal disease, chronic obstructive pulmonary disease (COPD), peptic ulcer disease, metastatic cancer, and a length of stay >3 days were associated with an increased risk of 30-day readmission after PCI. Thirty-day readmission after PCI was associated with a higher risk of 1-year mortality (adjusted HR=1.38; 95% CI: 1.08–1.75; p=0.009). Conclusions Nearly 1 in 10 patients undergoing PCI were readmitted within 30-days. Thirty-day readmission after PCI was associated with a higher risk of 1-year mortality.

Very low-quality evidence suggests that, compared with open repair or nonoperative management, endovascular repair of thoracic aortic transection is associated with better survival and decreased risk of spinal cord ischemia, renal injury, and graft and systemic infections. Nonoperative management is associated with the least favorable outcomes.