Introduction: Numerous case series have reported on the baseline characteristics and inhospital mortality of patients with COVID-19, however, these studies included patients localized in a specific geographic region. The purpose of our study was to identify differences in the clinical characteristics and the in-hospital mortality of patients with a laboratory-confirmed diagnosis of COVID-19 internationally. Methods: A comprehensive search of all published literature on adult patients with laboratory-confirmed diagnosis of COVID-19 that reported on the clinical characteristics and inhospital mortality was performed. Groups were compared using a Chi-square test with Yates correction of continuity. A two-tailed p value of less than 0.05 was considered as statistically significant. Results: After screening 516 studies across the globe, 43 studies from 12 countries were included in our final analysis. Patients with COVID-19 in America and Europe were older compared to their Asian counterparts. Europe had the highest percentage of male patients. American and European patients had a higher incidence of co-morbid conditions (p \ 0.05 for all variables). In-hospital mortality was significantly higher in America (22.23%) and Europe (22.9%) compared to Asia (12.65%) (p \ 0.0001), but no difference was seen when compared with each other (p = 0.49). Conclusions: There is a significant variation in the clinical characteristics in patients diagnosed with COVID-19 across the globe. In-hospital mortality is similar between America and Europe, but considerably higher than Asia.

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Transcatheter PFO closure has a high success rate, but a moderate residual shunt occurs in about 10% of cases. The observed incidence of residual shunting after PFO closure is significantly larger with the 30-mm Helex device. © 2014 Wiley Periodicals, Inc.

Background Similar to coronary angiography and interventions, patients undergoing percutaneous treatment of lower extremity peripheral arterial disease are also at risk of acute kidney injury (AKI). The incidence, risk factors associations, need for dialysis and inhospital mortality related to AKI in patients with critical limb ischemia (CLI) following endovascular therapy is poorly defined. Objectives The purpose of this study was to analyze data from the National Inpatient Sample (NIS) to determine the aforementioned outcomes in patients with CLI. Methods Using the full NIS admission dataset from 2003 through 2012, ICD‐9 codes relevant to comorbid conditions, procedure codes, composite codes for AKI, and inhospital mortality were analyzed using multivariate models. Results A total of 273,624 patients were included with a mean age of 70.0 ± 27.4 years, 46.0% were female, 57.2% had diabetes, 43.4% had coronary artery disease (CAD), and 29.2% had chronic kidney disease (CKD). The overall rate of AKI was 10.4%, and there was a temporal rise over the analysis period in AKI incidence (p < .001). Age, diabetes, CKD, and heart failure were all associated with AKI (p < .0001). The inhospital mortality rate in the patients with AKI declined over time but was higher than in patients without AKI (6.0% vs. 1.4%), p < .0001. The mortality rate was substantially higher in patients with AKI requiring dialysis as compared to AKI not requiring dialysis (13.4% vs. 5.6%), p < .0001. Conclusions AKI is associated with age, CKD, and heart failure. The incidence of AKI following endovascular therapy for CLI is rising and independently associated with inhospital mortality.

The hot springs in certain areas of Ramsar contain (226)Ra and (222)Rn. The effects of natural radiation on the inhabitants of these areas and the inhabitant's radiosensitivity or adaptive responses were studied. One group of volunteers from areas with high natural background radiation and another group from areas with normal background radiation were chosen as the case and control group respectively. The frequency of micronuclei, apoptosis, and DNA damage in peripheral blood mononuclear cells were measured following gamma irradiation (4 Gy). The incidence of micronuclei in the case group was significantly lower than that in the control group while their frequency of apoptosis was higher (P < 0.05). However, the rates of induced DNA damage and repair were significantly higher in the case group (P < 0.05). Smaller number of micronuclei and higher levels of apoptosis in the case group could be the result of higher resistance to radiation stress and a more rigorous checkpoint at cell division. However, regarding the alkaline labile sites, the individuals in the case group are more sensitive and susceptible to DNA damage. The results of micronuclei, apoptosis and repair studies suggest that an adaptive response might be induced in people residing in areas with high background radiation.