TCT-879 SIMPLIPHieDE (Single center IMPella LVAD supported Pci in High Risk group of patients – Detroit Medical Center Experience) Balloon Aortic Valvuloplasty – Technique and Clinical Outcomes

We recently cared for a young patient who we believe represents a serious example of egg-associated salmonellosis in a member of a high-risk group because of his young age. His case serves to remind pediatricians to discuss infant feeding practices with parents and to warn them of the potential hazards of eggs related to salmonellosis. This previously healthy 5-month-old white male was brought to the emergency department of a Mississippi regional medical center with a 1-day history of fever and irritability.

Download Full-text

Impact of infectious etiology on the outcome of Taiwanese patients hospitalized with community acquired pneumonia

The Journal of Infection in Developing Countries ◽

10.3855/jidc.2834 ◽

2013 ◽

Vol 7 (02) ◽

pp. 116-124 ◽

Cited By ~ 3

Author(s):

Yuan-Ti Lee ◽

Shiuan-Chih Chen ◽

Kuei-Chuan Chan ◽

Tzu-Chin Wu ◽

Shih-Ming Tsao ◽

...

Keyword(s):

High Risk ◽

Chlamydia Pneumoniae ◽

Risk Group ◽

Medical Center ◽

Pneumonia Severity Index ◽

Community Acquired Pneumonia ◽

High Risk Group ◽

Low Risk ◽

Empiric Treatment ◽

Infectious Etiology

Introduction: This study aimed to assess the relationships between infectious etiology, empiric treatment, and outcomes in Taiwanese patients with community acquired pneumonia (CAP). Methodology: A retrospective analysis of the data of 208 adult patients from a single medical center was performed with patients classified as having low or high disease severity based on the Pneumonia Severity Index (PSI). Patients with PSI ≤ 90 (n=120) were classified as low severity and patients with PSI > 90 (n=88) were classified as high severity. Results: The low-risk group had significantly higher rates of infection with Chlamydia pneumoniae (C. pneumoniae) and Mycoplasma pneumoniae (M. pneumoniae), whereas the high-risk group had significantly higher rates of infection with Klebsiella pneumoniae (K. pneumoniae) and Pseudomonas aeruginosa (P. aeruginosa) (p < 0.05). Empiric treatment in both groups was in accordance with the 2007 guidelines issued by the Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS). Twenty-nine of 208 patients (13.9%) died, one in the low-risk group and 28 in the high-risk group. The highest rates of mortality were in patients infected with P. aeruginosa or K. pneumoniae. Conclusions: In the present study, we demonstrated that the patients with different severity had different microbiologic etiology. In general, P. aeruginosa and K. pneumoniae were the most commonly isolated organisms in high-risk patients who died from CAP. We showed that use of the IIDSA/ATS guidelines for treatment of CAP in Taiwan resulted in a better outcome in the low PSI group.

Download Full-text

Validation of Updated Cytogenetic Risk Classification in Patients with Myelodysplastic Syndrome: Retrospective Study at Single Institution.

Blood ◽

10.1182/blood.v114.22.4837.4837 ◽

2009 ◽

Vol 114 (22) ◽

pp. 4837-4837

Author(s):

Jina Yun ◽

Jee Hyun Kong ◽

Jung A. Kim ◽

Dong Hwan Dennis Kim ◽

Jun Ho Jang ◽

...

Keyword(s):

High Risk ◽

Scoring System ◽

Conflicts Of Interest ◽

Risk Group ◽

Medical Center ◽

High Risk Group ◽

Risk Classification ◽

International Prognostic Scoring System ◽

Prognostic Impact ◽

Very High

Abstract Abstract 4837 Introduction The International Prognostic Scoring System (IPSS) or the WHO Classification-Based Prognostic Scoring System (WPSS) are considered as gold standard to evaluate the patients with MDS in terms of their clinical courses. Recently, a new prognostic cytogenetic risk classification, defined as favorable (5q-, 12p-, 20q-, +21, -Y, 11q-, t(11)(q23), normal, 2 abnormalities including 5q-), intermediate-1 (+1q, 3q21/q26-abnormalities, +8, t(7q), +19, -21, any other single, any other double), intermediate-2 (-X, -7/7q-, 2 abnormalities incl. -7/7q-, complex = 3 abnormalities) or unfavorable risk group (Complex >3 abnormalities), has been reported through 3 large, well-characterized international investigations (German-Austrian (GA), Spanish MDS-registry, IMRAW). This new cytogenetic classification system showed better discrimination of patients according to their prognosis with respect to overall survival and leukemic transformation. The current study attempted to evaluate the new prognostic cytogenetic risk classification in patients with MDS, retrospectively. Patients and methods Between 1996 and 2007, 180 patients with MDS, who were diagnosed and treated at the Samsung medical center, Seoul, Korea, were enrolled into the study. One hundred seventy one patients were analyzed, 115 patients receiving best supportive care were included in the present analysis. Clinical characteristics were as follows; age 59 years (median, range 16-83), male 72%; 3 patients (pts) has 5q-; 1 patient (pt), 12p-; 3 pts, 20q-; 5 pts, -Y; 1 pt, 11q-; 1 pt, t(11)(q23); 80 pts, normal; 2 pts, 2 abnormalities including 5q-; 1 pt, +1q; 1 pt, 3q21/q26-abnormalities; 18 pt, +8; 16 pts, any other single; 19 pts, any other double; 2 pts, -7/7q-; 6 pts, complex = 3 abnormalities; 12 pts, complex >3 abnormalities. Results According to IPSS, 10 patients (9%) were at low risk, 77 patients (67%) at intermediate-1 (Int-1) risk, 22 patients (19%) at intermediate-2 (Int-2) risk and 6 patients (5%) at high risk. According to WPSS, 10 patients (9%) were at very low, 25 patients (22%) at low, 36 patients (31%) at intermediate, 31 patients(27%) at high and 13 patients(11%) at very high risk group. According to new cytogenetic risk classification, 66 patients (57%) were at favorable, 34 patients (30%) at intermediate-1 (Int-1), 9 patients (8%) at intermediate-2 (Int-2) and 6 patients (5%) at unfavorable subgroup. The median OS in overall population was 23.2 months. According to the IPSS, median OS in the Low, Int-1, Int-2 and High subgroup was 37.8, 27.5, 14.8 and 11.6 months, respectively (p<0.001). According to the WPSS, median OS in the subgroup of Very low, Low, Intermediate, High and Very high risk was 54.6, 43.1, 27.5, 16.5 and 11.9 months, respectively (p<0.001). By the new cytogenetic risk classification, median OS in the Favorable, Int-1, Int-2 and Unfavorable subgroup was 23.8, 24.1, 13.0 and 9.1 months (p=0.035). Sixteen cases (13.9%) showed documented leukemic evolutions with median 9.2 months of onset. It was difficult to analyze of leukemic evolution risk due to small number of sample size. Discussion In the present study, the new cytogenetic risk classification does not seem to be validated retrospective series of patients, we couldn't validate that the new cytogenetic subgroups are powerful predictor of prognosis as good as IPSS or WPSS. To warrant availability of the new cytogenetic risk classification, large data sets should be necessary. Also, we should be consider review about the prognostic impact of the karyotype in MDS. Disclosures No relevant conflicts of interest to declare.

Download Full-text

Acromegaly and Obstructive Sleep Apnea: Identifying the High-Risk Group

10.1055/s-0039-1679596 ◽

2019 ◽

Author(s):

Xiaojun Zhan ◽

Chandala Chitguppi ◽

Ethan Berman ◽

Gurston Nyquist ◽

Tomas Garzon-Muvdi ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

High Risk ◽

Risk Group ◽

High Risk Group ◽

Obstructive Sleep

Download Full-text

Recommendations from male students help shape mental health support for this high-risk group

10.3310/alert_42077 ◽

2020 ◽

Keyword(s):

Mental Health ◽

High Risk ◽

Risk Group ◽

High Risk Group ◽

Male Students ◽

Mental Health Support ◽

Health Support

Download Full-text

Anamnestic factors that shape reproductive health of women with repeated unsuccessful popygamy in vitro fertilization

HEALTH OF WOMAN ◽

10.15574/hw.2016.114.140 ◽

2016 ◽

pp. 140-143

Author(s):

N.V. Cotsabin ◽

◽

O.M. Makarchuk ◽

Keyword(s):

High Risk ◽

Risk Group ◽

Polycystic Ovary ◽

High Risk Group ◽

Stress Factors ◽

Control Group ◽

Fertilization In Vitro ◽

Infertile Women ◽

Group I

The proportion of patients with multiple unsuccessful attempts of assisted reproductive technology (ART) is about 30% of all patients treated with the use of ART. Women with history of unsuccessful ART attempts - a special category of patients who require emergency attention and a thorough examination at the stage of preparation for superovulation stimulation,the selection of embryos and endometrium preparation for embryo transfer. The objective: to distinguish high-risk group of unsuccessful attempts based on a detailed analysis of anamnestic and clinical data of infertile women with repeated unsuccessful ART attempts that requires more in-depth study of hormonal features, ovarian reserve and condition of the endometrium. Materials and methods. For better understanding of the problem of repeated unsuccessful ART attempts and сreation of efficient infertility treatment algorithms for these couples we conducted a thorough analysis of anamnestic data of three groups of infertile women (105 patients), which were distributed by age: group I – younger than 35, the II group – from 35 to 40, the III group - over 40 years. These groups of patients were compared with each other and with the control group of healthy women (30 persons). Results. Leading stress factors in the percentage three times prevailed in the group of infertile women and had a direct connection with the fact of procedure «fertilization in vitro» and chronic stressors caused by prolonged infertility. Primary infertility was observed significantly more frequent in patients younger than 35 years (p <0.05), secondary infertility - mostly in the second and third experimental groups (p <0.05). Noteworthy significant percentage of wellknown causes of infertility and idiopathic factor in all groups, and the prevalence of tubal-peritoneal factor in the second and third experimental groups, and endocrine dysfunction in the I experimental group. The most common disorder among this category of woman was polycystic ovary syndrome. Frequency of usual miscarriage among patients of I ana II groups was two times higher than in the third group (p <0.05). Among the experimental groups the leading place belongs urinary tract infection, respiratory tract diseases, pathologies of the cardiovascular system. Data of the stratified analysis show an increase likelihood of repeated unsuccessful ART attempts under the influence of constant chronic stress (odds ratio OR=2.06; 95% CI: 0.95–3.17; p<0.05). Conclusions. Among infertile patients with repeated unsuccessful ART attempts must be separated a high risk group of failures. The identity depends on the duration of infertility, female age and leading combination of factors. Key words: repeated unsuccessful ART attempts, anamnesis, infertility, high risk.

Download Full-text