Background: Coronary artery disease (CAD) is rising in epidemic proportions with India not being an exception. CAD in Indian scenario has its onset at a younger age with multitude of risk factors.
Objective: This study was carried out to obtain complete information about demographic profile, risk factors, clinical scenario, therapeutic modalities, natural course, outcome and changing profile of acute ST-segment elevated myocardial infarction (STEMI) patients.
Methods: This cross-sectional study was conducted in 45,122 acute STEMI patients admitted 1st March 1990 to 1st March 2014. A predefined performa was completed in every patient with detailed clinical history, physical examination, laboratory and investigation parameters, therapeutic interventions and inhospital outcome.
Results: Our population cohort presented with STEMI at age of 56.34±11.88 years with 82.48% male. Urban residency (64.35%), lower level of education (61.03%), middle and low socioeconomic status (81.01%), unemployment (56.47%), lack of exercise (78.80%) and poor dietary pattern including low intake of fruits and vegetables (58.80%) were pivotal players. Smoking was prevalent in 48.80% cases, with overweight and obesity (51.11%), diabetes mellitus (27.34%), hypertension (38.85%), hyperlipidemia (28.15%), alcoholism (28.80%) and family history (16.66%). Our population had mildly elevated LDL (101.4±33.38 mg/dl), low HDL (36.6±10.7 mg.dl) and high TC/HDL ratio (4.05±1.36). Majority harbored (52.06%) two or more risk factors, while in 16.60% no conventional risk factors were identified. Anterior wall STEMI (56.78%) far exceeded the inferior wall (37.55%). Less than half (47.77%) presented within the window period of 12 hours while only 0.8% of patients availed the golden period of 1 hour. 50.27% presented in Killip Class II or beyond. Angiography revealed single vessel disease (46.76%) with LAD involvement being most common (58.85%). Thrombolytic therapy was provided in 38.95% and primary PCI in 2.1%. Complications in the form of CHF (34.7%), cardiogenic shock (8.65%), reinfarction (6.5%), arrhythmia (59.2%) and mortality (10.57%) were seen. Mortality decreased from 13.9% (from 1990-2000) to 8.8% (2000-2014).
Conclusions: With recent increased use of β-blocker, ACEI/ARB, aldosterone antagonist and reperfusion strategy, we have brought down the mortality to lower level.
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Blood Adv
January 2025
Mayo Clinic, Rochester, Minnesota, United States.
In this study, we first analyzed data from 147 patients with solitary plasmacytomas treated at the Mayo Clinic between 2005 and 2022 and then expanded our investigation through a systematic review and meta-analysis of 62 studies, encompassing 3,487 patients from the years 1960 to 2022. Our findings reveal that patients with up to 10% clonal plasma cells in their bone marrow (BM), denoted as plasmacytoma +, had a significantly reduced median disease-free survival (DFS) of 15.7 months vs.
View Article and Find Full Text PDFJ Med Internet Res
January 2025
Department of Gastroenterology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
Background: Gastrointestinal bleeding (GIB) is a severe and potentially life-threatening complication in patients with acute myocardial infarction (AMI), significantly affecting prognosis during hospitalization. Early identification of high-risk patients is essential to reduce complications, improve outcomes, and guide clinical decision-making.
Objective: This study aimed to develop and validate a machine learning (ML)-based model for predicting in-hospital GIB in patients with AMI, identify key risk factors, and evaluate the clinical applicability of the model for risk stratification and decision support.
JMIR Res Protoc
January 2025
Department of Medicine and Optometry, eHealth Institue, Linnaeus University, Kalmar, Sweden.
Background: Health worker migration from Nigeria poses significant challenges to the Nigerian health care sector and has far-reaching implications for health care systems globally. Understanding the factors driving migration, its effects on health care delivery, and potential policy interventions is critical for addressing this complex issue.
Objective: This study aims to comprehensively examine the factors encouraging the emigration of Nigerian health workers, map out the effects of health worker migration on the Nigerian health system, document the loss of investment in health training and education resulting from migration, identify relevant policy initiatives addressing migration, determine the effects of Nigerian health worker migration on destination countries, and identify the benefits and demerits to Nigeria of health worker migration.
JMIR Aging
January 2025
Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, No. 106, Zhongshan 2nd Road, Yuexiu District, Guangzhou, China, 0898-66571684.
Background: The utility of aging metrics that incorporate cognitive and physical function is not fully understood.
Objective: We aim to compare the predictive capacities of 3 distinct aging metrics-motoric cognitive risk syndrome (MCR), physio-cognitive decline syndrome (PCDS), and cognitive frailty (CF)-for incident dementia and all-cause mortality among community-dwelling older adults.
Methods: We used longitudinal data from waves 10-15 of the Health and Retirement Study.
Am J Public Health
January 2025
Teeraboon Lertwanichwattana and Ram Rangsin are with Phramongkutklao College of Medicine, Bangkok, Thailand. Supattra Srivanichakorn, Sairat Noknoy, and Sirinapa Siriporn Na Ratchaseema are with the Royal College of Family Physicians of Thailand, Bangkok. Nittaya Phanuphak is with the Institute of HIV Research and Innovation, Bangkok. Kitti Wongthavarawat is with the National Science and Technology Development Agency, Bangkok. Arunotai Siriussawakul, Varalak Srinonprasert, and Pattara Leelahavarong are with the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok. Parawee Chevaisrakul and Putthapoom Lumjiaktase are with the Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok. Aree Kumpitak is with the Thai Network of People Living With HIV, Bangkok. Nopphan Phromsri is with the Human Settlement Foundation, Bangkok. Yupadee Sirisinsuk is with the Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok. Pongtorn Kietdumrongwong is with the Bangkok Dusit Medical Services, Bangkok. Apinun Aramrattana is with the Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
To determine the overall mortality and risk factors of COVID-19 patients who were admitted to the Home Isolation (HI) program in Bangkok, Thailand, during the epidemic crisis in 2021. We conducted a retrospective cohort study using the data from a government telehealth application from July to December 2021. The vital status was verified from the government database on September 20, 2022.
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