Differences in length of stay by teaching team status in an academic medical center in the Midwestern United States.

: Given the high cost of inpatient stays, hospital systems are investigating ways to decrease lengths of stay while ensuring high-quality care. The goal of this study was to determine if patients in teaching teams (hospitalist teams with residents and interns) had a higher length of stay after adjusting for relevant confounders compared to hospitalist-only teams (staffed only by attending physicians).: Using a retrospective design, we investigated differences in length of stay for 17,577 inpatient encounters over a 2-year period.

COVID-19 Experience in a Wisconsin Academic Medical Center.

Background: Several studies describing Coronavirus disease 2019 (COVID-19) have been reported; however, to our knowledge, no case series has been published from the Midwest.

Objective: To describe demographic characteristics and outcomes of patients admitted with COVID-19 to a Wisconsin academic medical center.

Methods: We performed a retrospective analysis of data obtained for COVID-19 patients admitted from March 14, 2020, through April 19, 2020.

Acute Myocardial Infarction During Pregnancy and the Puerperium in the United States.

Objective: To analyze trends in the incidence, in-hospital management, and outcomes of acute myocardial infarction (AMI) complicating pregnancy and the puerperium in the United States.

Patients And Methods: Women 18 years or older hospitalized during pregnancy and the puerperium were identified from the National Inpatient Sample database from January 1, 2002, to December 31, 2014. International Classification of Diseases, Ninth Revision diagnosis and procedure codes were used to identify AMI during pregnancy-related admissions.

Trends in cardiovascular risk factor and disease prevalence in patients undergoing non-cardiac surgery.

Objectives: Cardiovascular risk factors are prevalent in the population undergoing non-cardiac surgery. Changes in perioperative cardiovascular risk factor profiles over time are unknown. The objective of this study was to evaluate national trends in cardiovascular risk factors and atherosclerotic cardiovascular disease (ASCVD) among patients undergoing non-cardiac surgery.

Perioperative acute myocardial infarction associated with non-cardiac surgery.

Aims: Acute myocardial infarction (AMI) is a significant cardiovascular complication following non-cardiac surgery. We sought to evaluate national trends in perioperative AMI, its management, and outcomes.

Methods And Results: Patients who underwent non-cardiac surgery from 2005 to 2013 were identified using the United States National Inpatient Sample.

Trends in Perioperative Venous Thromboembolism Associated with Major Noncardiac Surgery.

Background: Venous thromboembolism (VTE) is a common vascular complication of non-cardiac surgery.

Methods: We evaluated national trends in perioperative in-hospital VTE incidence, management, and outcomes using a large database of hospital admissions from the United States. Patients aged ≥ 45 years undergoing major non-cardiac surgery from 2005 to 2013 were identified from the National Inpatient Sample.

Perioperative bleeding and thrombotic risks in patients with Von Willebrand disease.

Von Willebrand disease (VWD) is an inherited bleeding disorder that often manifests clinically with hemorrhage after invasive procedures. We investigated the association between a diagnosis of VWD and bleeding and thrombotic outcomes following major non-cardiac surgery in a large national database from the United States. Patients age ≥45 years requiring major non-cardiac surgery were identified from Healthcare Cost and Utilization Project's National Inpatient Sample data.

Perioperative Major Adverse Cardiovascular and Cerebrovascular Events Associated With Noncardiac Surgery.

Importance: Major adverse cardiovascular and cerebrovascular events (MACCE) are a significant source of perioperative morbidity and mortality following noncardiac surgery.

Objective: To evaluate national trends in perioperative cardiovascular outcomes and mortality after major noncardiac surgery and to identify surgical subtypes associated with cardiovascular events using a large administrative database of United States hospital admissions.

Design, Setting, Participants: Patients who underwent major noncardiac surgery from January 2004 to December 2013 were identified using the National Inpatient Sample.

Management and outcomes of acute myocardial infarction in patients with chronic kidney disease.

Background: Chronic kidney disease (CKD) is associated with cardiovascular disease and acute myocardial infarction (AMI). Contemporary management and outcomes of AMI in patients with CKD have not been reported.

Methods: We analyzed United States National Inpatient Sample data for patients admitted with AMI with or without CKD from 2007 to 2012.

Influence of Human Immunodeficiency Virus Seropositive Status on the In-Hospital Management and Outcomes of Patients Presenting With Acute Myocardial Infarction.

Objectives: Human immunodeficiency virus (HIV) seropositive individuals are predisposed to acute myocardial infarction (AMI). We sought to evaluate management strategies and outcomes of AMI in patients with HIV in the contemporary era.

Methods: We analyzed data from the National Inpatient Sample from 2002 to 2011 for patients admitted with AMI with or without HIV.

Rates of Invasive Management of Cardiogenic Shock in New York Before and After Exclusion From Public Reporting.

Importance: Reduced rates of cardiac catheterization, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) are an unintended consequence of public reporting of cardiogenic shock outcomes in New York.

Objectives: To evaluate whether the referral rates for cardiac catheterization, PCI, or CABG have improved in New York since cardiogenic shock was excluded from public reporting in 2008 and compare them with corresponding rates in Michigan, New Jersey, and California.

Design, Setting, And Participants: Patients with cardiogenic shock complicating acute myocardial infarction from 2002 to 2011 were identified using the National Inpatient Sample.

Ischemia modified albumin (IMA) and albumin adjusted-IMA (AAIMA) as biomarkers for diabetic retinopathy.

Introduction: Oxidative stress has important role in the pathophysiology of diabetic retinopathy (DR). Ischemia modified albumin (IMA) has been recently considered as a marker of oxidative damage in diabetes. However, there is scarcity of published information about both IMA and albumin adjusted-IMA (AAIMA) in DR patients.

SIGNIFICANCE OF ISCHEMIA-MODIFIED ALBUMIN AS A SIMPLE MEASURE OF OXIDATIVE STRESS AND ITS DISCRIMINATORY ABILITY IN DIABETIC RETINOPATHY: Literature Review and Meta-Analysis.

Purpose: Oxidative stress (OXS) plays critical role in the development of diabetic retinopathy (DRP). Increased concentrations of serum ischemia-modified albumin (IMA) have been demonstrated as a novel and inexpensive measure of oxidative stress. Although few pilot studies have reported increased IMA in DRP, the available literature is limited to comprehensively describe the potential significance of IMA in predicting DRP.

Acute Myocardial Infarction in Adult Congenital Patients with Bodily Isomerism.

Introduction: Children born with congenital malformations of the heart are increasingly surviving into adulthood. This population of patients possesses lesion-specific complication risks while still being at risk for common illnesses. Bodily isomerism or heterotaxy, is a unique clinical entity associated with congenital malformations of the heart which further increases the risk for future cardiovascular complications.

Comparison of Outcomes of Patients With Sepsis With Versus Without Acute Myocardial Infarction and Comparison of Invasive Versus Noninvasive Management of the Patients With Infarction.

Patients hospitalized with sepsis may be predisposed to acute myocardial infarction (AMI). The incidence, treatment, and outcomes of AMI in sepsis have not been studied. We analyzed data from the National Inpatient Sample from 2002 to 2011 for patients with a diagnosis of sepsis.

Arrhythmias in Adult Congenital Patients With Bodily Isomerism.

There are an increasing number of adults with congenital heart disease, some of whom have bodily isomerism. Bodily isomerism or heterotaxy is a unique clinical entity associated with congenital malformations of the heart which further increases the risk for future cardiovascular complications. We aimed to investigate the frequency of arrhythmias in adults with bodily isomerism.

Trend in percutaneous coronary intervention volume following the COURAGE and BARI-2D trials: insight from over 8.1 million percutaneous coronary interventions.

Background: COURAGE and BARI-2D have questioned the utility of routine revascularization for the prevention of cardiovascular events in patients with stable ischemic heart disease (SIHD). On the other end of the spectrum, a routine invasive strategy in patients with acute coronary syndrome (ACS) is superior to a conservative strategy. The impact of the above trials on the trend in percutaneous coronary intervention (PCI) volume for SIHD and ACS is not known.

Aortic Atherosclerosis: A Common Source of Cerebral Emboli, Often Overlooked!

Aortic atherosclerotic plaques are usually seen in males older than 55 years who are known to have risk factors of atherosclerosis. Recent large series of consecutive stroke patients reported that the prevalence of aortic atheromatous plaques in patients with stroke is about 21%-27%, which is in the same magnitude when compared with the prevalence of carotid disease (10%-13%) and atrial fibrillation (18%-30%). Atheromatous plaques are composed of a lipid pool, a fibrous cap, smooth muscle cells, and mononuclear cell infiltration with calcification.

Outcomes with invasive vs conservative management of cardiogenic shock complicating acute myocardial infarction.

Background: In the SHOCK trial, an invasive strategy of early revascularization was associated with a significant mortality benefit at 6 months when compared with initial stabilization in patients with cardiogenic shock complicating acute myocardial infarction. Our objectives were to evaluate the data on real-world practice and outcomes of invasive vs conservative management in patients with cardiogenic shock.

Methods: We analyzed data from the Nationwide Inpatient Sample from 2002 to 2011 with primary discharge diagnosis of acute myocardial infarction and secondary diagnosis of cardiogenic shock.

Trend in the use of drug eluting stents in the United States: insight from over 8.1 million coronary interventions.

Background: Drug eluting stents (DES) reduce the risk of restenosis but are associated with increase in the risk of very late stent thrombosis, especially when antiplatelet therapy is held. The trend in DES use across the US is not fully defined.

Methods: Data from the 2001-2011 Nationwide Inpatient Sample for patients undergoing PCI were used.

Characteristics and outcomes in patients undergoing percutaneous coronary intervention following cardiac arrest (from the NCDR).

Outcomes in patients with out-of-hospital cardiac arrest (CA) who undergo percutaneous coronary intervention (PCI) have been limited to small, mostly single-center studies. We compared patients who underwent PCI after CA included in the CathPCI Registry with those without CA. Patients with ST elevation were classified as ST-elevation myocardial infarction (STEMI); all other patients having PCI were classified as without STEMI.

Characteristics, management, and outcomes of cocaine-positive patients with acute coronary syndrome (from the National Cardiovascular Data Registry).

Although cocaine ingestion may cause or contribute to myocardial infarction (MI), few contemporary data are available describing cocaine-associated MI. We describe the characteristics, management, and outcomes of patients with MI and recent cocaine use from the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines (ACTION Registry-GWTG) program. The study population was 102,952 patients enrolled in the American College of Cardiology ACTION Registry-GWTG from July 2008 to March 31, 2010 from 460 sites across the United States.

Missed ulnar nerve injury and closed forearm fracture in a child.

Ulnar nerve injury in closed fracture of forearm in children is uncommon.Commonly, neurapraxia is the reason for this palsy but other severe injuries or nerve entrapment has been reported in some cases. The importance of diagnosis concerning the types of the nerve injury lies in the fact that they have totally different management.