Publications by authors named "Witting C"

Article Synopsis
  • Disparities in heart failure care quality contribute to varying patient outcomes based on sex, race, ethnicity, and insurance type among hospitalized patients.
  • A study analyzed data from 685,227 patients across 596 hospitals, finding that women generally received worse quality of care than men, but some differences disappeared after adjusting for individual patient factors.
  • Racial and ethnic minorities often performed as well or better than White and insured patients, but specific treatment measures showed significant gaps, particularly for certain groups like Asian, Hispanic, and Black patients, highlighting within-hospital variations and a need for improvement in care equity.
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Background: There are established sex-specific differences in heart failure with reduced ejection fraction (HFrEF) outcomes. Randomized clinical trials (RCTs) based on cardiovascular outcome benefits, typically either reduced cardiovascular mortality or hospitalization for heart failure (HHF), influence current guidelines for therapy.

Objectives: The authors evaluate the representation of women in HFrEF RCTs that observed reduced all-cause or cardiovascular mortality or HHF.

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Relative apical longitudinal sparing (RALS) on echocardiography has become an increasingly used tool to evaluate for cardiac amyloidosis (CA), but the predictive value of this finding remains unclear. This is a retrospective analysis at a single tertiary care center across 3 years. Patients were included if they had RALS, defined by strain ratio ≥2.

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Article Synopsis
  • * When prescribed, women are also less likely to receive high-intensity dosing of statins (41.4% for women vs. 49.8% for men), especially among younger patients and those with private insurance.
  • * The study utilized Natural Language Processing (NLP) to analyze clinical notes, revealing that women were less frequently documented as being discussed for statin prescriptions and more likely to have statin intolerance noted.
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Background Statins are guideline-recommended medications that reduce cardiovascular events in patients with diabetes. Yet, statin use is concerningly low in this high-risk population. Identifying reasons for statin nonuse, which are typically described in unstructured electronic health record data, can inform targeted system interventions to improve statin use.

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Background: There are sociodemographic disparities in outcomes of heart failure with reduced ejection fraction (HFrEF), but disparities in guideline-directed medical therapy (GDMT) remain poorly characterized.

Objectives: This study aimed to analyze GDMT treatment rates in eligible patients with recently diagnosed HFrEF, and to determine how rates vary by sociodemographic characteristics.

Methods: This retrospective cohort study included patients diagnosed with HFrEF at Veterans Affairs (VA) hospitals from 2013 to 2019.

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Background Guidelines recommend catheter ablation of atrial fibrillation (AFCA) as an option for rhythm control. Studies have shown that Black patients are less likely to undergo AFCA compared with White patients. We investigated whether differences in referral patterns play a role in this observed disparity.

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Objective: This study aimed to compare the performance of a pediatric decision support algorithm to detect severe sepsis between high-risk pediatric and adult patients in a pediatric emergency department (PED).

Methods: This is a retrospective cohort study of patients presenting from March 2017 to February 2018 to a tertiary care PED. Patients were identified as high risk for sepsis based on a priori defined criteria and were considered adult if 18 years or older.

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Although cardiovascular disease is the leading cause of death in women, cardiovascular risk factors remain underrecognized and undertreated. Hyperlipidemia is one of the leading modifiable risk factors for CVD. Statins are the mainstay of lipid lowering therapy (LLT), with additional agents such as ezetimibe and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors as additive or alternative therapies.

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Complement-opsonized HIV-1 triggers efficient antiviral type I interferon (IFN) responses in dendritic cells (DCs), which play an important role in protective responses at the earliest stages in retroviral infection. In contrast, HIV-1 suppresses or escapes sensing by STING- and MAVS-associated sensors. Here, we identified a complement receptor-mediated sensing pathway, where DCs are activated in CCR5/RLR (RIG-I/MDA5)/MAVS/TBK1-dependent fashion.

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Article Synopsis
  • - T cells are essential for managing viral infections in the respiratory system, and a reduction in CD4 and CD8 T cells is linked to more severe cases and higher mortality rates in COVID-19 patients.
  • - A study analyzed immune responses in COVID-19 patients with varying severity; findings revealed that mild cases had stronger CD8 T cell responses and IFNγ production compared to severe or critical cases, despite all groups having similar antibody neutralization abilities.
  • - Severe and critical COVID-19 patients showed high antibody levels and elevated anaphylatoxins, suggesting that strong T cell responses and low anaphylatoxin levels are associated with milder infections, while higher antibody titers correlate with more severe disease.
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Background: Excessive inflammation triggered by a hitherto undescribed mechanism is a hallmark of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and is associated with enhanced pathogenicity and mortality.

Objective: Complement hyperactivation promotes lung injury and was observed in patients suffering from Middle East respiratory syndrome-related coronavirus, SARS-CoV-1, and SARS-CoV-2 infections. Therefore, we investigated the very first interactions of primary human airway epithelial cells on exposure to SARS-CoV-2 in terms of complement component 3 (C3)-mediated effects.

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Tocilizumab, an interleukin-6 receptor antagonist, has been used to treat critically ill patients with coronavirus disease-2019. We present the case of a previously immunocompetent man with coronavirus disease-2019 who developed invasive pulmonary aspergillosis after treatment with tocilizumab, illustrating the importance of considering opportunistic infections when providing immune modulating therapy.

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Enteric hyperoxaluria is a distinct entity that can occur as a result of a diverse set of gastrointestinal disorders that promote fat malabsorption. This, in turn, leads to excess absorption of dietary oxalate and increased urinary oxalate excretion. Hyperoxaluria increases the risk of kidney stones and, in more severe cases, CKD and even kidney failure.

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Background: Risk factors for severe acute respiratory syndrome coronavirus 2 infection in pregnancy remain poorly understood. Identifying and understanding populations at a heightened risk of acquisition is essential to more effectively target outreach and prevention efforts.

Objective: This study aimed to compare sociodemographic and clinical characteristics of pregnant women with and without severe acute respiratory syndrome coronavirus 2 infection and, among those with severe acute respiratory syndrome coronavirus 2, to compare characteristics of those who reported coronavirus disease symptoms and those who were asymptomatic at diagnosis.

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Compelling evidence suggests that defective DNA damage response (DDR) plays a key role in the premature aging phenotypes in Hutchinson-Gilford progeria syndrome (HGPS). Studies document widespread alterations in histone modifications in HGPS cells, especially, the global loss of histone H3 trimethylated on lysine 9 (H3K9me3). In this study, we explore the potential connection(s) between H3K9me3 loss and the impaired DDR in HGPS.

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The rising numbers of tissue samples for securing a diagnosis has led to a multitude of tissue samples in pathology institutes. Criteria and measures for ensuring the quality of histological diagnosis have been developed. Corresponding rules for the organization of the tissue sampling up to their processing do not yet exist.

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Occupational formaldehyde exposure in pathology depends on the efficiency of the ventilation system in use and may reach concentrations considerably above the current threshold limit values. The reduction of formaldehyde exposure by stepwise improvement of the ventilation system at a pathologist's workplace is presented as an example in this paper. Assessment of formaldehyde concentration by personal air sampling at a workplace originally equipped with a hood ventilation system resulted in values of up to 4 ml/m3 in the pathologist's breathing zone.

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A 53-year-old woman with chronic renal failure had secondary hyperparathyroidism relapsing after undergoing a second parathyroidectomy and excision of an autologous parathyroid graft that had been implanted after her first parathyroidectomy. Double-phase scintigraphy with Tc-99m MIBI disclosed pathologic MIBI uptake in the right anterior thorax where the parathyroid transplant had been placed. Histopathologic examination of three nodules excised from this region yielded hyperplastic parathyroid tissue.

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In 58 unselected necropsies, zinc (Zn) in specimens of liver (mean +/- s = 280 +/- 178 micrograms/g d.w./4.

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The case of a 36-year-old patient who underwent extirpation of a Leydig cell tumor of the epididymis is presented. Five years later a retroperitoneal mass was removed, which was found to be a metastatic Leydig cell carcinoma. The literature conrains reports of only 32 cases of metastatic Leydig cell tumors, all of which had originated in the testis and not extragonadally.

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Two groups of male and female Sprague-Dawley rats (50 animals/group per sex) were treated with either 15.37 or 46.77 mumole of 1,1,2-TCE in DMSO/rat for 2 years.

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Rhinoliths of the paranasal sinuses have often been reported and are generally due to trauma and surgery of these cavities and to retained foreign bodies. In the present case, an unilateral chronic rhinosinusitis had been treated by antiinflammatory agents only, but never underwent surgery or trauma. Tomography revealed a high density concretion.

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