Increased risk of infective endocarditis after traumatic skin wound

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318632
Author(s):  
Hiroyuki Ohbe ◽  
Masao Iwagami ◽  
Yusuke Sasabuchi ◽  
Hideo Yasunaga
Keyword(s):  
Risk Factor ◽  
Infective Endocarditis ◽  
Case Series ◽  
Baseline Period ◽  
Skin Wound ◽  
Current Data ◽  
Infectious Endocarditis ◽  
Skin Wounds ◽  
Increased Risk ◽  
Rate Ratios

ObjectiveCurrent data suggest that a history of traumatic open skin wounds may be a risk factor for infectious endocarditis, with limited evidence. We tested the hypothesis that traumatic skin wound is a risk factor for infectious endocarditis.MethodsUsing the Japan Medical Data Center (JMDC) database (4 650 927 people aged 20–64 years, 2012–2018) and the Kumamoto database (493 414 people aged ≥65 years, 2012–2017), we conducted nested case–control and self-controlled case series (SCCS) analyses.ResultsIn the JMDC database, 544 cases hospitalised for infective endocarditis (IE) were matched with 2091 controls; 2.8% of cases and 0.5% of controls were exposed to traumatic skin wounds in the previous 1–4 weeks, with an adjusted OR of 4.31 (95% CI 1.74 to 10.7). In the Kumamoto database, 4.0% (27/670) of cases and 1.1% (29/2581) of controls were exposed to traumatic skin wounds in the previous 1–4 weeks, with an adjusted OR of 4.15 (95% CI 2.04 to 8.46). In the SCCS, the incidence rate ratios for IE were 2.61 (95% CI 1.67 to 4.09), 1.73 (95% CI 1.01 to 2.94), 1.19 (95% CI 0.63 to 2.27) and 1.52 (95% CI 0.82 to 2.74) for the Kumamoto database and 3.78 (95% CI 2.07 to 6.92), 1.58 (95% CI 0.64 to 3.89), 1.60 (95% CI 0.65 to 3.94) and 1.29 (95% CI 0.47 to 3.53) for the JMDC database at 1–4, 5–8, 9–12 and 13–16 weeks after traumatic skin wound, respectively, compared with the baseline period.ConclusionsThis study suggests that traumatic skin wound is a risk factor for IE 1–4 weeks after the wound.

scholarly journals Risks of suicide attempts after prescription of zolpidem in people with depression: a nationwide population study in South Korea

SLEEP ◽  
2019 ◽  
Vol 43 (3) ◽  
Author(s):  
Hyewon Kim ◽  
Yuwon Kim ◽  
Woojae Myung ◽  
Maurizio Fava ◽  
David Mischoulon ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Medical Records ◽  
Suicide Attempts ◽  
Case Series ◽  
Population Based ◽  
Additional Increase ◽  
Series Design ◽  
Increased Risk ◽  
Before And After ◽  
Rate Ratios

Abstract Objectives To investigate the association between zolpidem prescription and suicide attempts in people with depression Methods A nationwide, population-based electronic medical records database from the Health Insurance Review & Assessment Service of South was used to investigate the incidence rate ratios (IRRs) of suicide attempts and probable suicide attempts in people with depression before and after zolpidem prescription using self-controlled case series design. Results In a total of 445 people who attempted suicide and 23 141 people who attempted probable suicide attempt, the IRRs of suicidal behavior during the risk periods before and after zolpidem prescription increased compared with those at the baseline. The IRRs gradually increased and peaked immediately before the prescription of zolpidem. The IRR was 70.06 (95% CI: 25.58–191.90) on day 2 before zolpidem prescription and 63.35 (95% CI: 22.99–174.59) on day 1 after zolpidem prescription in the suicide attempt group. The IRR was 24.07 (95% CI: 20.50–28.26) on the day before zolpidem prescription and 14.96 (95% CI: 12.21–18.34) on the day after zolpidem prescription in the probable suicide attempt group. The ratios declined eventually after zolpidem was prescribed. Conclusions Although zolpidem prescription was associated with an increased risk of suicide attempts in people with depression, the risk increased and peaked immediately before zolpidem prescription. The risk declined gradually thereafter. This result indicates that the risk of suicide attempts increases at the time of zolpidem prescription. However, zolpidem prescription does not contribute to additional increase in the risk of suicide attempts.

Effect of herpes zoster vaccine and antiviral treatment on risk of ischemic stroke

Neurology ◽  
2020 ◽  
Vol 95 (6) ◽  
pp. e708-e717
Author(s):  
Quanhe Yang ◽  
Mary G. George ◽  
Anping Chang ◽  
Xin Tong ◽  
Robert Merritt ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Herpes Zoster ◽  
Antiviral Treatment ◽  
Case Series ◽  
Effect Modification ◽  
Fee For Service ◽  
Zoster Vaccine ◽  
Increased Risk ◽  
Group Sex ◽  
Rate Ratios

ObjectiveTo determine whether increased risk of acute ischemic stroke (AIS) following herpes zoster (HZ) might be modified by the status of zoster vaccine live (ZVL) vaccination and antiviral treatment following HZ.MethodsWe included 87,405 Medicare fee-for-service beneficiaries aged ≥66 years diagnosed with HZ and AIS from 2008 to 2017. We used a self-controlled case series design to examine the association between HZ and AIS, and estimated incidence rate ratios (IRRs) by comparing incidence of AIS in risk periods vs control periods. To examine effect modification by ZVL and antiviral treatment, beneficiaries were classified into 4 mutually exclusive groups: (1) no vaccination and no antiviral treatment; (2) vaccination only; (3) antiviral treatment only; and (4) both vaccination and antiviral treatment. We tested for interaction to examine changes in IRRs across 4 groups.ResultsAmong 87,405 beneficiaries with HZ and AIS, 22.0%, 2.0%, 70.1%, and 5.8% were in groups 1 to 4, respectively. IRRs in 0–14, 15–30, 31–90, and 91–180 days following HZ were 1.89 (95% confidence interval [CI], 1.77–2.02), 1.58 (95% CI, 1.47–1.69), 1.36 (95% CI, 1.31–1.42), and 1.19 (95% CI, 1.15–1.23), respectively. There was no evidence of effect modification by ZVL and antiviral treatment on AIS (p = 0.067 for interaction). The pattern of association between HZ and risk for AIS was largely consistent across age group, sex, and race.ConclusionsRisk of AIS increased significantly following HZ, and this increased risk was not modified by ZVL and antiviral treatment. Our findings suggest the importance of following recommended HZ vaccination in prevention of HZ and HZ-associated AIS.

Pathogenesis of atherosclerosis: lipid metabolism

2017 ◽  
Author(s):  
Olov Wiklund ◽  
Jan Borén
Keyword(s):  
Risk Factor ◽  
Current Data ◽  
Atherosclerotic Cardiovascular Disease ◽  
Causative Role ◽  
Receptor Ligands ◽  
Increased Risk ◽  
Low Hdl ◽  
Arterial Intima ◽  
Coa Reductase

Lipids are carried in plasma as microparticles, lipoproteins, composed of a core of hydrophobic lipids and a surface of amphipathic lipids. In addition, the particles carry proteins (i.e. apolipoproteins). The proteins have key functions in the metabolism as receptor ligands, enzymes or activators. Lipoproteins are classified based on density into: chylomicrons, VLDL, IDL, LDL, and HDL. Retention of apoB-containing lipoproteins (LDL, IDL, and VLDL) in the arterial intima is the initiating event in the development of atherosclerosis. Retention is mediated by binding of apoB to structural proteoglycans in the intima. Increased plasma concentration of apoB-containing lipoproteins is the main risk factor for atherosclerotic cardiovascular disease (CVD) and the causative role of LDL has been demonstrated in several studies. Lp(a) is a subclass of LDL and elevated Lp(a) is an independent risk-factor, primarily genetically mediated. Genetic data support that high Lp(a) causes atherosclerosis. Elevated triglycerides in plasma are associated with increased risk for CVD. Whether triglycerides directly induce atherogenesis is still unclear, but current data strongly support that remnant particles from triglyceride-rich lipoproteins are causal. HDL are lipoproteins that have been considered to be important for reversed cholesterol transport. Low HDL is a strong risk-factor for CVD. However, the causative role of HDL is debated and intervention studies to raise HDL have not been successful. Reduction of LDL is the main target for prevention and treatment, using drugs that inhibit the enzyme HMG-CoA reductase, i.e. statins. Other drugs for LDL reduction and to modify other lipoproteins may further reduce risk, and new therapeutic targets are explored.

scholarly journals Type II Odontoid Fractures Case Series: History of Seizures a Risk Factor for Failure of Non-operative Treatment of Type II Odontoid Fractures

2021 ◽  
Vol 11 (9) ◽  
Author(s):  
Matthew A. Prevost ◽  
John G. DeVine ◽  
Uzondu F. Agochukwu ◽  
Jacob C. Rumley
Keyword(s):  
Risk Factor ◽  
Case Series ◽  
Odontoid Fracture ◽  
Type Ii ◽  
Odontoid Fractures ◽  
Non Union ◽  
Fracture Displacement ◽  
Increased Risk ◽  
Cervical Orthosis ◽  
History Of

Introduction:Odontoid fractures are one of the most common injuries to the cervical spine. Type II odontoid fracture treatment varies depending on age, co-morbidities, and fracture morphology. Treatment ranges from cervical orthosis to surgical intervention. Currently fractures with high non-union rates are considered for operative management which includes displacement of >6 mm, increasing age (>40-60 years), fracture gap >1 mm, delay in treatment >4 days, posterior re-displacement >2 mm, increased angulation, and history of smoking. While re-displacement of >2 mm has been associated with increased risk of non-union;, to the best of our knowledge, no studies have looked at the risk factors for re-displacement. Case Report:We present two 26-year-old male patients who were found to have minimally displaced type II odontoid fractures initially treated in a cervical collar. These two patients were subsequently found to have displaced their odontoid fracture after having a documented seizure. Conclusion:We suggest that a history of seizures be considered a risk factor for re-displacement of non-displaced type II odontoid fractures. Keywords:Operative indications odontoid case report, Type II odontoid fracture, Displacement, Seizure, Odontoid fracture displacement, Nondisplaced type ? odontoid fracture.

scholarly journals Unilateral Levator Aponeurosis Excision for Marcus Gunn Syndrome and Risk Factors of Residual Jaw Winking

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Qingyao Ning ◽  
Jing Cao ◽  
Jiajun Xie ◽  
Qi Gao ◽  
Changjun Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Strong Association ◽  
Case Series ◽  
Increased Risk ◽  
Frontalis Suspension ◽  
Silicone Rod ◽  
Independent Risk Factors ◽  
Levator Aponeurosis

Purpose. To investigate the association of ptosis, levator, and jaw winking in Marcus Gunn jaw-winking synkinesis (MGJWS), and the risk factor of preservation and outcomes of the unilateral levator excision and frontalis suspension.Methods. Clinical features of MGJWS case series from 2011 to 2018 were retrospectively reviewed. Association between jaw winking and ptosis/levator function was statistically analyzed. The patients underwent unilateral levator excision and frontalis suspension using silicone rod or autogenous fascia lata. Clinical outcomes were evaluated in operated patients and the independent risk factors of residual jaw winking were investigated after a long follow-up.Results. There were 42 MGJWS patients in 2011 to 2018, accounting for 2.87% of all congenital blepharoptosis. 80% of mild jaw winking was accompanied with mild ptosis and fair levator function, and moderate-to-severe jaw winking was often accompanied with moderate-to-severe ptosis and poor levator function (P<0.05). Ptosis showed a strong association with excursion of jaw winking (R = 0.785,P<0.01). Jaw winking was resolved in all 34 operated patients with good correction of ptosis. Severity of jaw winking is an independent risk factor for the residual synkinesis after surgery. Severe preoperative jaw winking had an 18.05 times increased risk of postoperative residual synkinesis compared with moderate jaw winking (P<0.05).Conclusions. In MGJWS eyelid excursion of jaw winking has a direct correlation with ptosis and dysfunction of levator muscle. Unilateral levator aponeurosis excision and frontalis suspension is an efficient approach for MGJWS. Severe jaw winking is a risk factor of residual eyelid synkinesis after surgery.

Sclerotherapy in an undetected pregnancy - a catastrophe?

VASA ◽  
2012 ◽  
Vol 41 (4) ◽  
pp. 243-247 ◽  
Author(s):  
Reich-Schupke ◽  
Leiste ◽  
Moritz ◽  
Altmeyer ◽  
Stücker
Keyword(s):  
High Probability ◽  
Spontaneous Regression ◽  
Current Knowledge ◽  
Varicose Veins ◽  
Case Reports ◽  
Case Series ◽  
Current Data ◽  
Unborn Child ◽  
Retrospective Case ◽  
Increased Risk

According to the guidelines and the manufacturer‘s information, pregnancy is a contraindication for sclerotherapy with Polidocanol. However, in some cases sclerotherapy has been conducted in a period when the pregnancy is not known by the patient. When pregnancy is diagnosed, patients and gynecologists often ask the phlebologist if there is an indication for the interruption of pregnancy. Up to now, there is only rare information on sclerotherapy, polidocanol and pregnancy. Current knowledge is summed up in this article together with case reports. The existing case reports and mainly retrospective case series on intended or accidentally conducted sclerotherapy with common sclerosants and doses show no increased risk for the mother and the unborn child. However, in view of the limited literature data available and the high probability for spontaneous regression of varicose veins postpartum, sclerotherapy should be avoided in pregnancy, if possible. Conservative measures during pregnancy or an elimination of varicose veins before pregnancy should be preferred. In single cases e.g. painful genitoanal varices, the use of sclerotherapy can be helpful even during pregnancy. Thereby, a very thorough clarification of the mother with a final written consent and an implementation according to the guidelines are especially important. According to the current data, there is no reason for an interruption after a sclerotherapy that has been conducted during undetected pregnancy.

scholarly journals Prevalence of diabetes and impaired glucose tolerance in patients with schizophrenia

2004 ◽  
Vol 184 (S47) ◽  
pp. s67-s71 ◽  
Author(s):  
Chris Bushe ◽  
Richard Holt
Keyword(s):  
Diabetes Mellitus ◽  
Mental Illness ◽  
Risk Factor ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Independent Risk Factor ◽  
Current Data ◽  
Increased Risk ◽  
General Populations ◽  
Prevalence Of Diabetes Mellitus

BackgroundA number of studies have examined the prevalence of diabetes mellitus and impaired glucose tolerance in general populations and in those with schizophrenia and other forms of serious mental illness.AimsTo establish whether it is possible to describe accurately comparative rates of diabetes mellitus and impaired glucose tolerance in populations of people with schizophrenia and those without mental illness.MethodReview of current literature.ResultsResearch published in the pre-neuroleptic era suggested that people with severe mental illness were at increased risk of developing glycaemic abnormalities. Recent studies appear to confirm that the prevalence of diabetes and impaired glucose tolerance may be higher in people with schizophrenia than in the general population, and suggest that patients with schizophrenia have impaired glucose tolerance even before they begin treatment.ConclusionsSchizophrenia may be a significant and independent risk factor for both diabetes and impaired glucose tolerance. Current data preclude precise estimates of the prevalence of these conditions among people with schizophrenia.

scholarly journals Risk of acute kidney injury following community prescription of antibiotics: self-controlled case series

2018 ◽  
Vol 34 (11) ◽  
pp. 1910-1916 ◽  
Author(s):  
Trijntje J W Rennie ◽  
Nicosha De Souza ◽  
Peter T Donnan ◽  
Charis A Marwick ◽  
Peter Davey ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Case Series ◽  
Kidney Injury ◽  
Patient Characteristics ◽  
Antibiotic Use ◽  
Antibiotic Exposure ◽  
Combined Use ◽  
Increased Risk ◽  
Rate Ratios ◽  
Stage 1

Abstract Background Development of acute kidney injury (AKI) following the use of antibiotics such as sulphonamides, trimethoprim and aminoglycosides is a frequently described phenomenon. More recently, an association between fluoroquinolone use and AKI has been suggested. The aim of this study was to evaluate the risk of AKI as an unintended consequence of commonly prescribed antibiotics in a large community cohort using a method that fully adjusts for underlying patient characteristics, including potential unmeasured confounders. Methods A self-controlled case study was conducted and included all individuals aged 18 years and over in the Tayside region of Scotland who had a serum creatinine measured between 1 January 2004 and 31 December 2012. AKI episodes were defined using the Kidney Disease: Improving Global Outcomes definition. Data on oral community-prescribed antibiotics (penicillins, cephalosporins, fluoroquinolones, sulphonamides and trimethoprim, macrolides and nitrofurantoin) were collected for all individuals. Incidence rate ratios (IRRs) for AKI associated with antibiotic exposure versus time periods without antibiotic exposure were calculated. Results Combined use of sulphonamides, trimethoprim and nitrofurantoin rose by 47% and incidence of community-acquired AKI rose by 16% between 2008 and 2012. During the study period 12 777 individuals developed 14 900 episodes of AKI in the community, of which 68% was AKI Stage 1, 16% Stage 2 and 16% Stage 3. The IRR of AKI during any antibiotic use was 1.16 [95% confidence interval (CI) 1.10—1.23], and this was highest during sulphonamides or trimethoprim use; IRR 3.07 (95% CI 2.81–3.35). Fluoroquinolone and nitrofurantoin use was not associated with a significantly increased rate of AKI; IRR 1.13 (95% CI 0.94–1.35) and 1.16 (95% CI 0.91–1.50), respectively. Conclusions Incidence of AKI rose by 16% between 2008 and 2012. In the same period the use of sulphonamides, trimethoprim and nitrofurantoin increased by 47%. A significant increased risk of AKI was seen with the use of sulphonamides and trimethoprim, but not with fluoroquinolones or nitrofurantoin.

scholarly journals Lipoprotein(a) as a Risk Factor for Venous Thromboembolism: A Systematic Review and Meta-analysis of the Literature

2017 ◽  
Vol 43 (06) ◽  
pp. 614-620 ◽  
Author(s):  
Vera Gessi ◽  
Rossella Marcucci ◽  
Monica Gianni ◽  
Anna Grandi ◽  
Massimo Franchini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Venous Thromboembolism ◽  
Case Reports ◽  
Random Effect ◽  
Random Effect Model ◽  
Case Series ◽  
Lipoprotein A ◽  
Increased Risk ◽  
Venous Thromboembolic Events

AbstractElevated plasma levels of lipoprotein(a) (Lp(a)) are associated with increased cardiovascular risk in several clinical studies. However, there is a lack of data supporting a positive association between elevated Lp(a) levels and venous thromboembolism (VTE). Thus, we conducted a systematic review of the literature to better clarify its role as a risk factor for VTE. Medline and the Embase (up to May 2015) electronic databases were used to identify potentially eligible studies. Studies measuring Lp(a) values in adult patients with deep vein thrombosis and/or pulmonary embolism and in a population of patients without a VTE were selected. Studies on patients with major venous thromboembolic events occurring at other unusual site, case reports, and case series were excluded. The odds ratios (ORs) of the association between high values of Lp(a) and VTE and the weighted mean difference (WMD) in Lp(a) levels in cases and in controls were calculated using a random-effect model. Results were presented with 95% confidence interval (CI). Fourteen studies for a total of more than 14,000 patients were finally included in our analysis. Lp(a) was slightly but significantly associated with an increased risk of VTE (OR: 1.56, 95% CI: 1.36, 1.79; 10 studies, 13,541 patients). VTE patients had significantly higher Lp(a) values compared with controls (WMD: 14.46 mg/L, 95% CI: 12.14, 16.78; 4 studies, 470 patients). Lp(a) appeared to be significantly associated with increased risk of VTE. However, Lp(a) levels were only slightly increased in VTE patients compared with controls.

scholarly journals Cerebrovascular Accident and SARS-CoV-19 (COVID-19): A Systematic Review

2021 ◽  
pp. 1-8
Author(s):  
Amira Athanasios ◽  
Ivy Daley ◽  
Anjali Patel ◽  
Olu Oyesanmi ◽  
Parth Desai ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cerebrovascular Accident ◽  
Case Series ◽  
Severity Of Illness ◽  
Epidemiologic Factors ◽  
Search Terms ◽  
Increased Risk ◽  
Comparable Control ◽  
Novel Coronavirus ◽  
Preexisting Conditions

<b><i>Background:</i></b> While the most common neurologic symptoms reported in patients affected by SARS-CoV-2 are headache, dizziness, myalgia, mental fog, and anosmia, there is a growing basis of published peer-reviewed cases reporting stroke in the setting of SARS-CoV-2 infection. The peer-reviewed literature suggests an increased risk of cerebrovascular accident (CVA) in the setting of COVID-19 infection. <b><i>Methods:</i></b> We searched 3 databases (PubMed, MEDLINE, and CINAHL) with search terms COVID-19, novel coronavirus, stroke, and cerebrovascular accident. Case series and case studies presenting patients positive for both COVID-19 and CVA published from January 1 through September 1, 2020, were included. Data collection and analysis was completed and risk of bias assessed. <b><i>Results:</i></b> The search identified 28 studies across 7 counties comprising 73 patients. Amongst patients hospitalized for COVID-19 infection and CVA, the average age was 60; the most common preexisting conditions were hypertension and diabetes mellitus, and those without preexisting conditions were significantly younger with an average age of 47. Amongst hospitalized patients with COVID-19 and CVA, there was a bimodal association with COVID-19 infection severity with majority of patients classified with mild or critical COVID-19 infection. <b><i>Discussion:</i></b> The data suggest SARS-CoV-2 is a risk factor for developing stroke, particularly in patients with hypertension and diabetes. Furthermore, the younger average age of stroke in patients with SARS-CoV-2, particularly those patients with zero identifiable preexisting conditions, creates high suspicion that SARS-CoV-2 is an independent risk factor for development of stroke; however, this cannot yet be proven without comparable control population. The data suggest the risk of developing CVA in the setting of COVID-19 infection is not dependent upon severity of illness. Continued studies must be done to understand the epidemiologic factors of COVID-19 infection and stroke and the pathophysiology of the COVID-associated hypercoagulable state.

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