Corticosteroids Use and Incidence of Severe Infections in People Living with HIV Compared to a Matched Population.

Background: People living with HIV (PLWH) have been shown to have an increased risk of autoimmune diseases. Corticosteroids are the cornerstone of autoimmune diseases treatment, but their use is associated with an increased risk of infections. It is unclear how HIV status affects the risk of infection associated with corticosteroids use.

Prevalence and Risk Factors of QTc Prolongation in Prostate Cancer Patients Undergoing Brachytherapy.

QTc prolongation is linked to Torsade de Pointes, sudden cardiac death, and overall cardiovascular mortality. 754 prostate cancer patients undergoing brachytherapy were analyzed, prolonged QTc was defined as ≥450ms. A prolonged QTc was more frequent (10.

Renal Cell Carcinoma With Cardiac Metastases.

The median survival of metastatic renal cell carcinoma (mRCC) is 5 months with a 1-year survival rate of 29%. Cardiac metastasis from RCC is a rare finding and there is scarce data available on treatment options. Recently, the combination of nivolumab and ipilimumab has been approved as a first-line treatment for advanced RCC in patients with a poor prognosis.

Incidence of autoimmune diseases in people living with HIV compared to a matched population: a cohort study.

The objective of this paper is to estimate incidence and relative risk of autoimmune conditions in patients living with HIV compared to an HIV-negative matched population. We conducted a retrospective study in the medico-administrative database of the province of Québec, Canada. All HIV-positive patients treated with antiretrovirals were matched to up to 4 HIV-negative controls for age, sex, and period of follow-up.

HIV-Infected Patient Diagnosed With Osteomedullary and Hepatic Syphilis on Positron Emission Tomography: A Case Report.

A human immunodeficiency virus (HIV)-positive man presented with a recent history of weight loss and B symptoms. Positron emission tomography (PET) scan revealed multiple hypercaptation foci, including diffuse osteomedullary lesions and a dominant liver nodule. Syphilis screening was positive, with a rapid plasma reagin (RPR) titer of 1:1,024.

Use of modified intention-to-treat analysis in studies of direct oral anticoagulants and risk of selection bias: a systematic review.

Background: Following their evaluation in randomised controlled trials (RCTs), direct oral anticoagulants (DOACs) have replaced warfarin for stroke prevention in atrial fibrillation (AF), and treatment and prevention of venous thromboembolism (VTE). To avoid selection bias, it is recommended that RCTs use an intention-to-treat (ITT) analysis strategy.

Objective: The objective of this study was to systematically review and compare reported analytical strategies, the proportion of randomised patients included in analyses and the reasons for participant exclusions.

Impact of diabetes and metformin use on prostate cancer outcome of patients treated with radiation therapy: results from a large institutional database.

Introduction: Conflicting data exists on the influence of metformin on prostate cancer. We investigated the importance of metformin in patients treated with radiotherapy or brachytherapy.

Materials And Methods: All patients from a large institutionalized database, treated for primary localized prostate cancer with either brachytherapy or external-beam radiotherapy ± androgen deprivation therapy were identified.

Diagnostic precision of mentally estimated home blood pressure means.

Context: Paper home blood pressure (HBP) charts are commonly brought to physicians at office visits. The precision and accuracy of mental calculations of blood pressure (BP) means are not known.

Methods: A total of 109 hypertensive patients were instructed to measure and record their HBP for 1 week and to bring their paper charts to their office visit.

Preoperative antihypertensive medication intake and acute kidney injury after major vascular surgery.

Objective: Postoperative acute kidney injury (AKI) is frequent after major vascular surgery and is associated with significant morbidity and mortality. It remains unclear whether the administration of combined oral antihypertensive medications on the day of surgery can increase the risk of postoperative AKI.

Methods: We performed a retrospective cohort study of hypertensive patients undergoing elective major vascular surgery to determine the association between the number of antihypertensive medications continued on the morning of surgery and AKI at 48 hours postoperatively.

Comparison of Different Automated Office Blood Pressure Measurement Devices: Evidence of Nonequivalence and Clinical Implications.

Background: Automated office blood pressure (AOBP) measuring devices are increasingly recommended as preferred blood pressure (BP) diagnostic tools, but it is unclear how they compare and how clinical environments impact their performance.

Methods: This prospective randomized factorial parallel 4-group study compared BP estimates by BpTRU (VSM MedTech, Vancouver, BC, Canada) and Omron HEM 907 (Omron Healthcare, Kyoto, Japan) devices in closed vs open areas. Patients diagnosed with hypertension were recruited during office visits.

The Gap Between Manual and Automated Office Blood Pressure Measurements Results at a Hypertension Clinic.

Background: Blood pressure (BP) readings taken in clinics are often higher than BP readings taken in a research setting. Recent guidelines and clinical trials have highlighted the necessity of using automated office blood pressure (AOBP) devices and standardizing measurement procedures. The goal of the present study was to compare AOBP vs manual BP measurement in both research and clinical environments in which operators and devices were the same and measurement procedures were standardized and optimal.

Ketoacidosis in a Non-Diabetic Adult With Chronic EtOH Consumption.

Although much more rare than its diabetic counterpart, ketoacidosis secondary to alcohol withdrawal in the context of fasting has its own complex pathophysiology and can easily mimic the acute insulin deficiency presentation. We present here a rare case of a non-diabetic alcoholic patient who presented in ketoacidosis after a period of reduced intake.

Quantification of the External Validity of Randomized Controlled Trials Supporting Clinical Care Guidelines: The Case of Thromboprophylaxis.

Background: Clinical guidelines are based on the results of several randomized controlled trials. However, due to the stringent exclusion criteria of these trials, their external validity may be low. We aimed to evaluate the external validity of the randomized controlled trials cited in the American College of Chest Physicians guidelines for the use of pharmacological thromboprophylaxis in hospitalized medical patients.

Unreliability of home blood pressure measurement and the effect of a patient-oriented intervention.

Background: Home blood pressure (BP) measurement (HBPM) is recommended for the diagnosis and follow-up of high BP. It is unclear how this aspect of BP monitoring has evolved over the years and whether interventions could influence patient adherence to HBPM guidelines.

Methods: After a questionnaire-based cross-sectional study performed in 2010, a passive, multimodal intervention, focused on improving adherence to HBPM guidelines, was implemented.

Recurrent arterial and venous thromboemboli as initial presentation of acute promyelocytic leukemia.

We report a case of a 52-year-old Caucasian woman diagnosed with a synchronic arterial and venous thrombosis as an initial presentation of an acute promyelocytic leukemia (APL). After the diagnosis, the patient was treated with all trans-retinoic acid and arsenic chemotherapy concomitant to systemic anticoagulation. This treatment regimen led to a complete remission and absence of relapse of the thrombosis or APL during the follow-up.

Extracorporeal membrane oxygenation in diffuse alveolar hemorrhage secondary to systemic lupus erythematosus.

Diffuse alveolar hemorrhage (DAH) is a rare and potentially deadly complication of systemic lupus erythematosus (SLE). We report two adult cases where extracorporeal membrane oxygenation (ECMO) was used as rescue therapy for severe respiratory failure in this setting. We discuss the risk related to coagulation disturbance and the need for the circuit anticoagulation in this particular setting.

Pure Red Cell Aplasia with Adult Onset Still's Disease.

Adult Onset Still's Disease (AOSD) is a rare inflammatory syndrome mostly seen in young adults. Known for its wide range of clinical manifestations, AOSD often presents with nonremitting systemic signs and symptoms. Many rare case associations have been described with AOSD, but only few with pure red cell aplasia (PRCA).

[Thrombolysis or primary PCI: the gold standard in the management of acute myocardial infarction in 2003?].

Several studies published recently show the superiority of a primary percutaneous coronary intervention (I degree PCI) on thrombolysis in the treatment of acute myocardial infarction. This holds true even if PCI is delayed by 2 or 3 hours due to the secondary transfer to a hospital disposing of a cath lab. The advantage consists in a significant decrease in the number of secondary ischemia, recurrent myocardial infarction, hemorrhagic stroke and mortality.