To compare short-term outcomes at index and subsequent pregnancies, as well as the long-term medical complications encountered later than 5 years after index pregnancy incomplete and partial HELLP syndromes. Pregnancies complicated by partial HELLP or complete HELLP during a period of 19 years were identified. Searches were limited to cases before 2012 to ensure an adequate follow-up period. Data on index or subsequent pregnancies occurring at our center were extracted from the hospital database, while data pertaining to subsequent obstetric outcomes when deliveries occurred elsewhere together with current medical conditions were acquired by patient self-reporting. Complete HELLP was defined as the presence of the 3 components of the syndrome whereas partial HELLP was defined by the presence of 1 or 2 components. 100 pregnancies were included. At index pregnancy, there was a higher rate of composite adverse maternal outcome in complete HELLP when compared to partial HELLP (45.8% vs 21.1%, p = 0.017). Outcomes at subsequent pregnancies showed no difference between the two variants of HELLP syndrome. When examined years later, a higher frequency of ''composite medical morbidity'' in the complete HELLP group was observed, though this difference did not reach statistical significance (77.7% vs 61.9%, p = 1.00). Although partial HELLP is relatively less harmful, it can nonetheless cause serious maternal complications including ruptured liver hematoma, intracranial hemorrhage and even mortality. These two clinical entities represent a continuum of the same pathology, which implies that the approach at management should be uniform. Furthermore, the prognosis and longterm outcomes were not different between these 2 variants.
COVID-19 pneumonia and community-acquired pneumonia (CAP) have been associated with morbidity and mortality. The aim of this study was to evaluate the outcome of hospitalized patients with COVID-19 pneumonia versus CAP in terms of mortality. This was a retrospective cohort study conducted between pre-COVID-19 era (May 2019–November 2019) and COVID-19 era (May 2020–November 2020). The study included all adult patients with COVID-19 pneumonia (Group 1) and adult patients with CAP but are COVID-19 negative (Group 2). A total of 106 patients were included in the study, of which 56 were in the COVID-19 pneumonia group and 50 in the CAP group. Patients who developed acute kidney injury (AKI) were 60.7% (n = 34) in Group 1 and 48% (n = 24) in Group 2. Mortality occurred in 37.5% (n = 21) patients in Group 1 and 12.0% (n = 6) in Group 2 (P = 0.003). A total of 52 patients required admission to intensive care unit (ICU), of which 44.6% (n = 25) were in Group 1 and 54.0% (n = 27) in Group 2. Of the 58 patients who developed AKI, 3 (8.8%) patients in Group 1 passed away compared to none in Group 2. Moreover, 58.8% patients (n = 20) in Group 1 and 70.8% patients (n = 17) in Group 2 required ICU admission. Mortality rate in the ICU was 80.0% (n = 16) and 35.3% (n = 6) in Groups 1 and 2, respectively (P = 0.006). The overall mortality rate was higher in case of COVID-19 patients than those with CAP. In case of patients with AKI, mortality rate in the ICU was significantly higher in COVID-19 pneumonia patients compared to CAP patients.
Bacteremia in dialysis patients is a major risk factor of mortality. The aim of this study was to assess the effectiveness of dialysis with high-flux versus low-flux dialyzer regarding risk of bacteremia in dialysis patients. This was a retrospective cohort study that included dialysis patients who underwent dialysis therapy at old dialysis center where old low-flux dialyzers were used and the new dialysis center where high-flux dialyzers were used. The rate of positive culture was more in high-flux group (37.0%) compared to low-flux group (24.5%), although the difference was not statistically significant (P = 0.13). The vascular access was mostly permanent catheter in high-flux group compared to low-flux group (48.9% vs. 28.6%, respectively; P = 0.06), while arteriovenous (AV) fistula was more prominent in low-flux group compared to high-flux group (65.3% vs. 47.8%, respectively; P = 0.06). This was reflected in the type of bacteria, which was mostly from Gram-positive family (Staphylococcus). The results showed higher risk of bacteremia in high-flux group as compared to low-flux group; however, permanent catheters were more prominent in high-flux group.
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