ObjectiveTo evaluate causes and impact of delay in the door-to-balloon (D2B) time for patients undergoing primary percutaneous coronary intervention (PPCI).Subjects and methodsFrom January 2009 to December 2012, 1268 patients (86% male, mean age of 58 ± 12 years) presented to our hospital for ST-elevation myocardial infarction (STEMI) and underwent PPCI. They were divided into two groups: Non-delay defined as D2B time ≤ 90 mins and delay group defined as D2B time > 90 mins. Data were collected retrospectively on baseline clinical characteristics, mode of presentation, angiographic findings, therapeutic modality and inhospital outcome.Results202 patients had delay in D2B time. There were more female patients in the delay group. They were older and tend to self-present to hospital. They were less likely to be smokers and have a higher prevalence of prior MI. The incidence of posterior MI was higher in the delay group. They also had a higher incidence of triple vessel disease.The 3 most common reasons for D2B delay was delay in the emergency department (39%), atypical clinical presentation (37.6%) and unstable medical condition requiring stabilisation/computed tomographic imaging (26.7%). The inhospital mortality was numerically higher in the delay group (7.4% versus 4.8%, p = 0.12).ConclusionsDelay in D2B occurred in 16% of our patients undergoing PPCI. Several key factors for delay were identified and warrant further intervention.
Aim This study was undertaken to determine the incidence and patterns of malignancies in rheumatoid arthritis (RA) patients in our cohort. Methods Between 2001 and 2013, we analyzed 1117 patients in the prospective Tan Tock Seng Hospital (TTSH) RA Registry. Patients who developed malignancies after the onset of RA were identified from this registry. Age‐ and sex‐adjusted standardized incidence ratios (SIRs) were calculated to compare observed to expected numbers of malignancies based on data from the Singapore Cancer Registry. Results Out of 19 839 person‐years of follow‐up, 132 incident malignancies were diagnosed during the observation period. There were 114 (86.4%) solid‐organ tumors and 18 (13.6%) hematological malignancies. The SIR (95% confidence interval) for all malignancies combined was 1.28 (0.88‐1.87) for males and 1.21 (1.00‐1.46) for females. Compared to the general population, we found a 4‐ to 5‐fold increase in lymphoma among our RA patients compared to the general population (SIR 5.05 [1.90‐13.46] for males and 3.75 [1.95‐7.20] for females). The SIR of lung malignancy in male RA patients is 2.36 (1.23‐4.53) and SIR of cervical malignancy in female RA patients is 3.72 (2.20‐6.23). Conclusion There is a trend toward an overall increased malignancy risk in our RA patients compared to the general population. Specifically, there is an increased risk of lymphomas in all RA patients, lung malignancy in male patients, and cervical malignancy in female patients, compared to the general population.
Objectives: This epidemiological research will be aimed to evaluate the longitudinal changes of Helicobacter pylori prevalence in Southwest China during recent period through a systematic review and analysis. Methods: The database PubMed and China National Knowledge Infrastructure will be searched. The cross-sectional studies or cohort studies on either massive or hospital-based health checkup population will be potentially eligible. The study population was originated from one of the southwestern major cities, Chengdu (Sichuan), Chongqing, Kunming (Yunnan), Guiyang (Guizhou), or Lhasa (Tibet). Two reviewers will independently select studies, extract data, and assess the quality of studies. The prevalence of H pylori infection will be estimated. In the individual city, the longitudinal comparisons will be conducted to evaluate the trends referring to the earliest cross-sectional baseline. The risk ratio and its 95% confidence interval will be estimated. Subgroup analyses will be performed in sex-specific and age-specific subsets. Trend analysis for proportions (p for trend) will be estimated in the longitudinal evaluation. If applicable, the longitudinal clearance rate (%) will be estimated. Ethics and Dissemination: The ethical approval is not required due to the nature of literature-based research. The results will be disseminated through meetings and a peer-reviewed journal. PROSPERO Registration Number: CRD42019120764
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