Background: Down syndrome is a genetic condition that contributes to a significantly shorter life expectancy compared with the general population. We investigated the most common comorbidities in a population of acute hospital patients with Down syndrome and further explored what the most common risk factors for mortality are within this population.
Method: From our database of one million patients admitted to National Health Service (NHS) Trusts in northern England, we identified 558 people who had Down syndrome. We compared this group with an age- and gender-matched control group of 5580 people.
Results: The most prevalent comorbid diseases within the Down's population were hypothyroidism (22.9%) and epilepsy (20.3%). However, the conditions that had the highest relative risks (RRs) in the Down's population were septal defects and dementia. Respiratory failure, dementia and pneumonia were the most significantly related comorbidities to mortality in the Down syndrome population. In the control population, respiratory failure, dementia and renal failure were the most significant disease contributors. When these contributors were analysed using multivariate analysis, heart failure, respiratory failure, pneumonia and epilepsy were the identified risk factors for in-hospital mortality in the Down syndrome population. Respiratory failure was the sole risk factor for mortality in the Down syndrome population [RR = 9.791 (1.6-59.9) P ≤ 0.05], when compared with the risk factors for mortality in the control population.
Conclusions: There is significant medical morbidity in Down syndrome. This morbidity contributes to the lower life expectancy. Respiratory failure is a risk factor for mortality in Down syndrome. We need to thoroughly investigate people with Down syndrome to ensure any treatable illnesses are well managed.
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http://dx.doi.org/10.1111/jir.12196 | DOI Listing |
BMC Nephrol
January 2025
Department of Nephrology, Japan Community Healthcare Organization Sendai Hospital, 981-3281, Sendai, Miyagi, Japan.
Background: Oliguric acute kidney injury (AKI) is one of the critical conditions which needs emergent treatment due to the lack of the capacity of excreting toxins and fluids, and plasma membrane bleb formation is considered as one of the characteristic morphologic alterations in ischemic AKI in both animal models and human. We present here an autopsy case with clear electron microscopy images capturing a definitive instance of blebbing in ischemic AKI.
Case Presentation: A 66-year-old man was admitted for oliguric AKI with nephrotic syndrome (NS).
J Gen Intern Med
January 2025
Northwell Health, New Hyde Park, NY, USA.
Background: Oropharyngeal dysphagia (dysphagia) is a common (up to 86%) and devastating syndrome in hospitalized older adults with dementia.
Objective: To describe the perspectives of dysphagia management in hospitalized patients with dementia among hospital medicine providers (i.e.
Int J Hematol
January 2025
Department of Hematology, Kobe City Medical Center General Hospital, 2-1-1, Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan.
Transplantation-associated thrombotic microangiopathy (TMA) is a severe complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with high mortality. As calcineurin inhibitors (CNIs) reportedly contribute to TMA via drug-induced endothelial injury, treatment of TMA often involves CNI discontinuation or dose reduction. However, renal-limited TMA, defined as biopsy-proven renal TMA without the classical triad (hemolytic anemia, thrombocytopenia, and organ damage), has rarely been reported after allo-HSCT, and its optimal management remains unknown.
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January 2025
Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany. Electronic address:
Background: There is limited knowledge about long-term mortality, care pathways and health-related quality of life (HrQoL) among intensive care unit (ICU) patients receiving prolonged mechanical ventilation (PMV).
Research Question: What are the long-term mortality, care pathways, and HrQoL of patients receiving invasive PMV, stratified by weaning success?
Study Design: and methods: We conducted a secondary analysis of patients from the cluster-randomised controlled Enhanced Recovery after Intensive Care trial who were treated in two ICU clusters and received invasive PMV (≥21 days via endotracheal tube/tracheostomy or ≥four days via tracheostomy). Data on weaning success, mortality, care place transitions, readmissions, and HrQoL were collected for six months after ICU discharge.
Ann Vasc Surg
January 2025
Vascular and Endovascular Surgery, University of Miami School of Medicine, Miami, Florida. Electronic address:
Background: Cerebral hyperperfusion syndrome (CHS) is a rare but serious complication after carotid artery revascularization. This study aims to determine the impact of carotid artery stenting (CAS) modality on the incidence, severity and overall outcomes of CHS after carotid revascularization.
Methods: Data from patients who underwent CAS with either distal embolic protection (CAS+DEP) or transcarotid artery revascularization (TCAR) were obtained from the Vascular Quality Initiative (VQI) database 2016-2023.
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