Gastrointestinal bleed mortality disparities in patients with atrial fibrillation: A cross-sectional analysis 1999-2020.

Introduction: Gastrointestinal bleeding (GIB) is often encountered among patients with atrial fibrillation (AF) due to the use of anticoagulation. This study assesses disparities in GIB-related mortality among decedents with AF in the United States.

Methods: GIB mortality data in patients with AF from 1999 to 2020 was queried from the CDC database.

Sex differences in atrial fibrillation in India: Insights from the Kerala-AF registry.

Background: Much data informing sex differences in atrial fibrillation (AF) comes from Western cohorts. In this analysis, we describe sex differences in Kerala, India, using the Kerala-AF registry-the largest AF registry from the Indian subcontinent.

Methods: Patients aged ≥18 years were recruited from 53 hospitals across Kerala.

Novel anticoagulation therapy using apple watch after catheter ablation for atrial fibrillation-Up to AF trial: Design and rationale.

Background: Continuous anticoagulation based on the CHA2DS2-VASc score is recommended to prevent embolism caused by atrial fibrillation (AF), but it does not consider AF episodes. The Apple Watch's continuous heart rhythm monitoring and fast-acting direct oral anticoagulants (DOACs) could enable precise, episode-tailored anticoagulation, reducing bleeding risks while preventing stroke. This study evaluates Apple Watch-guided personalized anticoagulation therapy, adjusting DOAC usage based on real-time AF detection.

Real-world clinical practice of current periprocedural anticoagulation management in catheter ablation of atrial fibrillation: Data from a large prospective ablation registry.

Background: The guidelines recommend anticoagulation management with uninterrupted warfarin or direct thrombin inhibitors (DTIs) during the atrial fibrillation (AF) ablation periprocedural period.

Objectives: To clarify the Japanese real-world latest periprocedural anticoagulation management during AF ablation.

Methods: This multicenter observational study included 6232 consecutive AF patients (68.

Microprolactinoma Growth During Pregnancy With Pituitary Tumor Apoplexy: Case Report and Review of the Literature.

Prolactinomas are the most prevalent subtype of pituitary adenomas and represent one of the leading etiological factors responsible for amenorrhea and infertility in women. The primary therapeutic approach entails the use of dopamine agonists, which effectively restore fertility. In cases of microprolactinomas, the likelihood of experiencing a symptomatic enlargement of the tumor during pregnancy is exceptionally low, estimated at a mere 2.

A Predictive Model for Secondary Posttonsillectomy Hemorrhage in Pediatric Patients: An 8-Year Retrospective Study.

Objectives: Posttonsillectomy hemorrhage (PTH) is a common and potentially life-threatening complication in pediatric tonsillectomy. Early identification and prediction of PTH are of great significance. Currently, there are very few tools available for clinicians to accurately assess the risk of PTH.

Pyrazinyl-Substituted Aminoazoles as Covalent Inhibitors of Thrombin: Synthesis, Structure, and Anticoagulant Properties.

This study presents a novel series of -acylated 1,2,4-triazol-5-amines and 1-pyrazol-5-amines, featuring a pyrazin-2-yl moiety, developed as covalent inhibitors of thrombin. These compounds demonstrated potent inhibitory activity, with derivatives and achieving IC values as low as 0.7 and 0.

Lumbar total disk replacement versus microsurgical lumbar discectomy in treatment of radicular and back pain in railway workers: a prospective randomized controlled trial.

Background: Currently, there remains a high percentage of complications after lumbar discectomy, while there is no uniform tactic to prevent their development. Purpose of the study was to compare the clinical efficacy and return to work rate (RWR) after total disk replacement (TDR) and microsurgical lumbar discectomy (MLD) in railway workers with lumbar disk herniation (LDH).

Methods: We randomly assigned 75 patients out of a total of 81 patients, between 25 and 35 years of age who had one level LDH to undergo single-level TDR surgery (group I, n=37) or MLD surgery (group II, n=38) in the L4-L5 or L5-S1 segments.

Pregnancy-Related Spontaneous Coronary Artery Dissection in a 25-Year-Old Woman: A Case Report.

Pregnancy-related spontaneous coronary artery dissection (P-SCAD) is a life-threatening condition that occurs during or after pregnancy, is rare and can be overlooked. It is one of the most important causes of pregnancy-related acute myocardial infarction. A 25-year-old female patient was admitted with a complaint of chest pain in her 37th week of pregnancy.

Prevalence and clinicopathological characteristics of de novo metastatic cancer at a major radiotherapy centre in West Africa: a cross-sectional study.

Background: Cancer is a major public health challenge in West Africa, with a significant proportion of cancer-related deaths attributed to distant metastasis. De novo metastatic cancer (DnMC), where metastasis is detected at diagnosis, presents considerable therapeutic challenges, particularly in limited-resource settings where novel treatments are often unavailable and/or unaffordable.

Aim: To determine the prevalence, incidence and clinicopathological characteristics of patients diagnosed with DnMC at a major radiotherapy center in West Africa.

Black Esophagus: A Life-Threatening Consequence of Hypoperfusion.

Acute esophageal necrosis (AEN) is an uncommon endoscopic finding characterized by a patchy or diffuse circumferential black pigmentation of the esophageal mucosa, corresponding to ischemic necrosis. It usually presents with upper gastrointestinal bleeding and is thought to be caused by a systemic low blood flow in patients with predisposing risk factors, like advanced age and cardiovascular comorbidities. After initial hemodynamic stabilization, diagnosis is established by esophagogastroduodenoscopy (EGD) with careful biopsies and histological evaluation.

The Importance of Clinical History in the Etiological Diagnosis of Diffuse Alveolar Hemorrhage Associated With Improper Adrenaline Use.

This case involves a 21-year-old male healthcare student with a medical history of HIV-1 infection for two years and anxiety disorder. He presented to the emergency department with hemoptysis and dyspnea of sudden onset. A thoracic CT scan revealed multiple bilateral nodular ground-glass opacities suggestive of diffuse alveolar hemorrhage (DAH).

Early Enteral Nutrition May Improve Survival in Patients With Cardiogenic Shock.

International guidelines recommend early enteral nutrition (EEN) for critically ill patients. However, evidence supporting the optimal timing of EN in patients diagnosed with cardiogenic shock (CS) is lacking. As such, this study aimed to compare the clinical outcomes and safety of EEN versus delayed EN in patients diagnosed with CS.

A Case of Atraumatic Splenic Rupture Due to T-Cell/Histiocyte-Rich Large B-Cell Lymphoma and a Potential Role for Massive Transfusion Protocol.

Splenic rupture leads to massive hemorrhage and requires immediate surgical intervention. Splenic rupture results from trauma or from underlying disease processes. Lymphoma is a rare cause of atraumatic splenic rupture (ASR) with high mortality rates.

Lower Bone Mineral Density in Female Elite Athletes With Menstrual Dysfunction From Mixed Sports.

Menstrual dysfunction (MD) in female athletes might be indicative of the syndrome of relative energy deficiency in sports (REDs), associated with, e.g., impaired bone health, an increased risk of injury, and decreased performance.

Probiotic-rich fermented milk from IIA-1A5: Effects on pregnancy health in the animal model.

Previous studies of IIA-1A5 have shown its potential as a probiotic in modulating gut microbiota and providing health benefits; however, its effects during pregnancy remain underexplored. The aim of this study was to assess the safety of fermented milk enriched with IIA-IA5 in pregnant mice. An experimental study was conducted at Universitas Andalas, Padang, Indonesia.

Predictors for 30-day mortality in hepatocellular carcinoma patients undergoing liver resection.

Hepatocellular carcinoma (HCC) ranks among the most prevalent and fatal liver cancers globally. Liver surgery, particularly resection, offers the potential for cure but poses challenges, especially in Indonesia, where patients often present in advanced stages. This study aimed to determine the intraoperative and perioperative factors associated with 30- day mortality of HCC patients undergoing liver resection at a tertiary referral hospital.

Cancer metastasis to the upper gastrointestinal tract-a case series.

Background: Metastasis of non-gastrointestinal (non-GI) cancers to the upper GI tract is a rare occurrence, with limited cases reported in the literature. Recognising this type of metastasis is crucial, as it presents unique diagnostic and therapeutic challenges. This case series adds to the literature by discussing seven rare cases of non-GI cancer metastasising to the upper GI tract, emphasising the complications and clinical manifestations.

Risk Factors for Hypothermia during Laparoscopic or Open Surgery of Colorectal Cancer under General Anesthesia.

Aim: Colorectal cancer (CRC) is one of the most prevalent malignancies, which is commonly treated with curative surgical resection, often leading to intraoperative hypothermia. Therefore, this study aimed to compare and analyze the risk factors for intraoperative hypothermia associated with laparoscopic and open CRC resections under general anesthesia.

Methods: This study included 120 CRC patients admitted between January 2023 and January 2024.

Safety of direct oral anticoagulants in hemodialysis patients with venous thromboembolism: an analysis using the Korean National Health Insurance Service database.

Background: Limited data exist regarding the safety of direct oral anticoagulants in hemodialysis patients with venous thromboembolic disease. This study aims to investigate the safety of direct oral anticoagulants in hemodialysis patients using national data.

Methods: The National Health Insurance Service database was retrospectively queried to identify chronic kidney disease patients who took direct oral anticoagulants for venous thromboembolism from 2008 to 2019.

Epidemiology of diagnostic errors in pediatric emergency departments using electronic triggers.

Objectives: We applied three electronic triggers to study frequency and contributory factors of missed opportunities for improving diagnosis (MOIDs) in pediatric emergency departments (EDs): return visits within 10 days resulting in admission (Trigger 1), care escalation within 24 h of ED presentation (Trigger 2), and death within 24 h of ED visit (Trigger 3).

Methods: We created an electronic query and reporting template for the triggers and applied them to electronic health record systems of five pediatric EDs for visits from 2019. Clinician reviewers manually screened identified charts and initially categorized them as "unlikely for MOIDs" or "unable to rule out MOIDs" without a detailed chart review.

New polymorphisms of Vkork1 gene related to anticoagulant resistance of rats and mice in Italy.

Background: Anticoagulant rodenticides (ARs) are a very effective tool to control rodent pest populations. Nevertheless, AR resistance has been documented worldwide. ARs block the cycle of vitamin K, leading to the death of the animal by internal bleeding: mutations in Vkorc1 gene can cause resistance.

[Immune thrombocytopenia in people under the age of twenty : a ten-year experience of a pediatric hematology and oncology department in Casablanca].

We conducted a retrospective study of 83 cases of immune thrombocytopenia (IT) in patients under 20 years of age. The aim was to provide an overview of IT in our young patients. The median age was 10 years, with a predominance of females (71 %).

PICC Lines in Pregnancy and Other Peripartum Vascular Access Considerations.

Importance: To decrease associated infectious and thrombotic morbidity, it is important to understand the indications and risks of peripherally inserted central catheters (PICCs) and other vascular access means in pregnancy.

Objectives: The objectives are 3-fold: (1) discuss indications and contraindications, approach to placement, and associated complications for PICC lines, arterial catheters, centrally inserted central catheters, and peripheral intravenous catheters; (2) review available data regarding complications associated with these catheters in pregnancy; and (3) propose an evidence-based approach to clinical decision making regarding vascular access in 2 clinical scenarios among pregnant patients.

Evidence Acquisition: A literature review identified relevant research, review articles, textbook chapters, databases, and societal guidelines, with a focus on obstetrical anesthesia and obstetric literature.

Military influences on the evolution of clinical trials throughout history.

Clinical trials of drugs, procedures, and other therapies play a crucial role in advancing medical science by evaluating the safety, efficacy, and optimal use of medical interventions. The design and implementation of these trials have evolved significantly over time, reflecting advancements in medicine, ethics, and methodology. Early historical examples, such as King Nebuchadnezzar II's and his captives' dietary experiment and Ambroise Paré's treatment of gunshot wounds, laid some foundational principles of trial design.