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The Association of Race With Outcomes in Hospitalised Patients With Hepatorenal Syndrome: Nationwide Cohort Study.
Liver Int
January 2025
Division of Gastroenterology-Hepatology, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Introduction: Racial/ethnic disparities have been previously reported in renal and hepatic disease care; however, acute kidney injury (AKI) in the setting of cirrhosis (hepatorenal syndrome [HRS]-AKI) despite its complexity requiring a multidisciplinary approach, remains understudied.
Methods: To identify unique associations of clinical and sociodemographic factors with mortality and length of stay (LOS) among patients hospitalised with HRS-AKI, hierarchical regression analysis was conducted, along with a mediation analysis to estimate how race-related differences in in-hospital mortality were influenced by payer type, area household income, and clinical severity.
Results: Black patients demonstrated a significantly higher odds of in-hospital mortality, compared to their white counterparts, adjusting for (1) sex and age, (2) sex, age, payer type, and area household income and (3) sex, age, and clinical severity [OR 1.
Waldenström Macroglobulinemia-Induced Cardiac Amyloid Light Chain Amyloidosis.
Ochsner J
January 2024
Division of Cardiology, Baylor Scott & White Medical Center, Temple, TX.
Waldenström macroglobulinemia is a rare cancer of plasma cells characterized by the excessive production of immunoglobulin M (IgM). IgM-associated systemic amyloid light chain (AL) amyloidosis is a rare complication of Waldenström macroglobulinemia, characterized by the misfolding of lambda light chains that deposit in various organs, including the heart. We describe a case of progressive nonischemic cardiomyopathy secondary to Waldenström macroglobulinemia and IgM-associated AL amyloidosis that was refractory to medical therapy and highlight the challenges in diagnosis and management.
View Article and Find Full Text PDFTrident Sign: The Key Magnetic Resonance Imaging Finding Distinguishing Spinal Cord Sarcoidosis From Multiple Sclerosis and Seropositive Neuromyelitis Optica Spectrum Disorder.
Ochsner J
January 2024
The University of Queensland Medical School, Ochsner Clinical School, New Orleans, LA.
Spinal cord sarcoidosis, an uncommon manifestation of neurosarcoidosis, presents diagnostic and therapeutic challenges because the condition is rare and has diverse clinical manifestations that can mimic other conditions such as multiple sclerosis and neuromyelitis optica spectrum disorder. A middle-aged African American female with a history of idiopathic intracranial hypertension and hydrocephalus with ventriculoperitoneal shunt presented with progressive, predominantly left-sided gait instability, weakness, and paresthesia. Cerebrospinal fluid showed lymphocytosis, red blood cells, elevated oligoclonal bands, and elevated kappa free light chains, concerning for multiple sclerosis.
View Article and Find Full Text PDFStudent perspectives on interdisciplinary learning in public health education: insights from a mixed-methods study.
Front Public Health
December 2024
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
Interdisciplinary learning is essential for equipping future health professionals to tackle the complexities of contemporary public health. This mixed-methods study investigates the experiences and perspectives of undergraduate public health students in Singapore on interdisciplinary learning in higher education and employed a convergent parallel design by combining a cross-sectional survey with in-depth interviews. Quantitative data were used to assess the relationship between students' exposure to interdisciplinary learning and its perceived value, while qualitative analysis explored key themes related to facilitators and barriers.
View Article and Find Full Text PDFLimb Salvage Versus Amputation: A Review of Variables Influencing the Assessment and Decision-Making in Complex Limb Fracture Management.
Cureus
November 2024
Emergency Medicine, West Midlands Deanery, Birmingham, GBR.
Complex limb injuries are combination injuries that involve all components of a limb's tissue, such as skin, bone with its surrounding soft tissue cover, and neurovascular elements. Complex limb trauma often has a background of a significant mechanism of injuries such as high-velocity road traffic accidents, ballistic injuries, industrial accidents, and other major mechanisms of injuries which involve high amounts of energy transfer through these tissue layers. These injuries pose a major challenge to trauma and orthopaedic surgeons.
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