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  • Rush Allison posted an update 1 week ago

    Mortality among smokers was 29.4% compared to 17.0% among non-smokers. RR was 2.07 (95% CI 1.59, 2.69). Based on analysis of four studies (532 patients), there was no difference in mortality risk between current and former smokers (RR 1.03; 95% CI 0.75, 1.40). Conclusions Smoking, current or past, is associated with higher mortality in COVID-19 patients. Mortality among current smokers was about 50% greater than former smokers, but the difference was not statistically significant.Background and objective Parkinson’s disease (PD) is a common neurodegenerative disorder. There are various manifestations of PD. Among them, motor dysfunction has been studied in many research studies; however, few studies are available related to the dermatological manifestations of PD. This study was conducted with the aim to shed light on various skin conditions that occur in PD. Methods This cross-sectional study was conducted at a tertiary care hospital in Pakistan for a period of nine months; 107 patients with PD were included after obtaining informed consent. A self-administrated questionnaire was used to record demographic data and dermatological findings. Results Among the various dermatological manifestations, patients with PD most commonly presented with seborrheic dermatitis (46.7%) and rosacea (10.2%). Other manifestations included bullous pemphigoid (7.4%) and melanoma (4.6%). Conclusion The study revealed several dermatological manifestations of PD, which usually get overlooked by neurologists. Through this study, we want to emphasize that PD, apart from all the motor signs and symptoms, can also present as skin problems, and hence, a multi-disciplinary approach should be taken while managing PD.Objectives The aim of this study was to identify factors and quality improvement strategies to improve coronary computed tomography angiography (CCTA) studies referred for fractional flow reserve derived from CT angiography (FFRCT) analysis. BMS-794833 ic50 Methods Thirty randomly selected CCTAs were analyzed for quality control. A uniform CCTA protocol was implemented by an in-house steering committee, emphasizing the importance of adequate heart rate control and nitroglycerine usage. Sixty additional randomly selected CCTAs were evaluated for quality at multiple time points during intervention, and FFRCT acceptance rate was analyzed at the conclusion. Results Prior to the implementation of this quality improvement program, our overall institution-specific percent acceptance rate was 76.1% for FFRCT compared to the national average of >95%. Post-intervention, this was improved to an average acceptance rate of 90% for FFRCT analysis. Conclusions Establishment and strict adherence to CCTA imaging protocols with appropriate training and adequate buy-in of CT technologists and nurses is a viable way of improving the quality of imaging and subsequent patient care.Background and objective The predialysis education program (PDEP) is an integral part of the management of patients with end-stage renal disease (ESRD). Hence, the aim of this study was to assess the distribution of renal replacement therapy (RRT) among patients with ESRD who received PDEP counseling at a single tertiary care center in Khamis Mushait, Kingdom of Saudi Arabia (KSA). Methodology In this study, we included 177 patients with ESRD who received a series of structured PDEP counseling sessions between March 2018 and February 2019 at the Armed Forces Hospital, Southern Region, Khamis Mushait, KSA. All patients were offered available RRT options, which included hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD), or renal transplantation. Patients’ opted RRT modality was recorded and managed as per the international guidelines and institutional protocols. Results Out of 177 patients, 58.8% (104) were males, with a mean age of 59 ± 13.7 years. The most common comorbid condition as the primary diagnosis was diabetic nephropathy in 49.7% (88), followed by hypertension in 30.5% (54), bilateral small kidney in 15.3% (27), and renal stone in 5.1% (nine) of the patients. Among the available RRTs, 51.4% (91) chose HD, 5.1% (nine) decided on CAPD, four patients (2.3%) opted for renal transplantation, while the remaining 41.2% (73) had yet to choose one, out of which 83.6% (61/73) had stage-IV chronic kidney disease (CKD) while the remaining 16.4% (12/73) had stage-V CKD. Conclusions In conclusion, a series of structured PDEP sessions for the patients progressing to ESRD can facilitate their selection of RRT. In a resource-limited setting, such as ours, where the number of patients who seek treatment for ESRD is rising, PDEP can provide patients with adequate information and knowledge to equip them with the ability regarding the selection of a self-care RRT modality.Solitary fibrous tumor (SFT) is an uncommon fibroblastic neoplasm that is most commonly associated with the pleura but has also been reported in almost all anatomic sites. Although the majority of SFTs are benign, few cases follow a malignant clinical course and may recur and/or metastasize after several years of their original occurrence. Only 16 cases of pancreatic SFTs are reported so far, and only one has metastasized to lung and subcutis. Pancreatic SFT resembles more common neuroendocrine tumor and gastrointestinal stromal tumor (GIST) radiographically and is at times almost indistinguishable from GIST histologically. Diagnosis of SFTs particularly, if attempted on biopsied specimens, can be very challenging due to its rare occurrence and nondescript morphology. It is imperative to understand the pathological spectrum of this entity to avoid misdiagnosis. We report a case of pancreatic SFT in a 43-year-old male with some unusual morphologic and immunohistochemical features including pseudoangiomatous growth pattern, a hypercellular area demonstrating nuclear pleomorphism, and only focal positivity for cluster of differentiation (CD)34. These atypical features can pose even more diagnostic challenge by causing additional confusion with other malignancies like dedifferentiated liposarcoma and vascular tumors. The potential diagnostic pitfalls are discussed.

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