RESUMEN
There is a paucity of data about the sex differences in acute coronary syndrome (ACS) outcomes in patients with prior mediastinal radiation. The National Inpatient Sample database from years 2009 to 2020 were queried for ACS hospitalizations of patients with prior mediastinal radiation. The primary outcome was MACCE (major cardiovascular events), and secondary outcomes included other clinical outcomes. A total of 23,385 hospitalizations for ACS with prior mediastinal radiation exposure ([15,904 (68.01%) females, and 7481 (31.99%) males]) were included in analysis. Males were slightly younger than females (median, age (70 [62-78] vs 72 [64-80]). Female patients with ACS had a higher burden of hypertension (80.82% vs 73.55%), diabetes mellitus (33% vs 28.35%), hyperlipidemia (66.09% vs 62.2%), obesity (17.02% vs 8.6%) however, males had a higher burden of peripheral vascular disease (18.29% vs 12.51%), congestive heart failure (41.8% vs 39.35%) and smoking (70.33% vs 46.92%). After propensity matching, primary outcome MACCE was higher in males (20.85% vs 13.29%, aOR: 1.80 95% CI (1.65-1.96), P < 0.0001) along with cardiogenic shock (8.74% vs 2.42%, aOR: 1.77 95% CI (1.55-2.02), P < 0.0001) and mechanical circulatory support use (aOR: 1.48 95% CI [1.29 -1.71], P < 0.0001). We observed no differences in the length of hospital stay, however total hospitalization cost was higher in males. This nationwide analysis showed significant disparities in outcomes among male and female ACS patients with prior mediastinal radiation history, with increasing trend in hospitalization for ACS among males and females but decreasing mortality among females.
Asunto(s)
Síndrome Coronario Agudo , Humanos , Masculino , Femenino , Síndrome Coronario Agudo/epidemiología , Pacientes Internos , Caracteres Sexuales , Hospitalización , Tiempo de InternaciónRESUMEN
Feeding jejunostomy is one of the most widely used procedures for enteral nutrition. It is associated with several complications which can be grouped into mechanical, metabolic, nutritional, and infectious. Amongst mechanical complications, complete impulsive tube migration is rarely seen. We hereby report the case of a 60-year old woman, with advanced esophageal carcinoma, re-admitted in the ward with blocked and stuck Foley's catheter placed in the jejenum for feeding purpose. Within hours of admission, patient developed rapid peristalsis and catheter completely disappeared in the abdomen. Exploratory laparotomy was performed to retrieve the catheter, which revealed jejunal intussception and erosions. Migration of the feeding tube is infrequent complication; however, complete migration is even rarer and needs urgent intervention.
Asunto(s)
Catéteres de Permanencia/efectos adversos , Nutrición Enteral/efectos adversos , Nutrición Enteral/instrumentación , Migración de Cuerpo Extraño/etiología , Intususcepción/etiología , Enfermedades del Yeyuno/etiología , Yeyunostomía/efectos adversos , Yeyuno/cirugía , Nutrición Enteral/métodos , Neoplasias Esofágicas/terapia , Femenino , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/terapia , Humanos , Intususcepción/cirugía , Enfermedades del Yeyuno/cirugía , Laparotomía , Persona de Mediana Edad , Radiografía , Resultado del TratamientoRESUMEN
Laurence Moon Bardet Biedl Syndrome is a rare genetic disorder. Consanguineous marriage is usually the common cause. Principal features of Bardet Biedl Syndrome are red cone dystrophy, obesity, polydactyl, hypogonadism and renal anomalies. The diagnosis was overlooked in our patient until he came in our hospital. We here report an infrequent case of autosomal recessive disorder with Anaemia.