scholarly journals A Narrative Review on Evaluation of Hypercoagulability State in Severe COVID-19 Patients with Background Risk Factors

2020 ◽  
Author(s):  
Minoosh Moghimi ◽  
Kasra Khodadadi ◽  
Yousef Mortazavi
Keyword(s):  
Risk Factors ◽  
Cause Of Death ◽  
Background Risk ◽  
Narrative Review ◽  
Fibrinolytic System ◽  
High Rate ◽  
Thromboembolic Events ◽  
Cytokine Storm ◽  
System A

COVID-19 induces coagulopathy at the base of SIC (sepsis-induced coagulopathy) and it is an important cause of death in the patients. Cytokine storm causes imbalance in coagulation and fibrinolytic system. A combination of hypercoagulability state, decrease or inhibition of fibrinolytic and endothelialopathy causes thromboembolic events. Underlined disease with a high rate of mortality in COVID-19 like diabetes, hypertension and some conditions like aging and obesity are the main disorders with hemostatic disturbance and increase of coagulopathy. Therefore, it seems that the combination of COVID-19 infection and these risk factors increase the risk of thromboembolic all together.

scholarly journals On the Safety of the COVID-19 Convalescent Plasma Treatment: Thrombotic and Thromboembolic Concerns

COVID ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 1-4
Author(s):  
Fatma Elrashdy ◽  
Elrashdy M. Redwan ◽  
Vladimir N. Uversky
Keyword(s):  
Risk Factors ◽  
Plasma Treatment ◽  
Cause Of Death ◽  
Population Studies ◽  
High Rate ◽  
Thromboembolic Events ◽  
Left Behind ◽  
Causes Of Mortality

Recently, it was reported that near-sourced COVID-19 convalescent plasma (CP) is more efficient than distantly sourced CP. What was left behind in this analysis is the investigation of the possible causes of mortality associated with the CP transfusion itself. Knowing this information is important for determining whether not receiving CP of near source is the main cause of high rate of death in the group of patients who received distantly sourced CP. We argue that the thrombotic and thromboembolic events may act as risk factors for adverse complications and death associated with CP transfusion. Therefore, they have to be considered and carefully accounted for in population studies as they can affect the CP safety profiles and change the interpretation of the cause of death in the studied groups.

scholarly journals Dom João VI's death: convulsions and coma

2007 ◽  
Vol 65 (4b) ◽  
pp. 1252-1255 ◽  
Author(s):  
Marleide da Mota Gomes ◽  
Rubens Reimão ◽  
Péricles Maranhão-Filho
Keyword(s):  
Risk Factors ◽  
Cause Of Death ◽  
Life Style ◽  
Gastrointestinal Symptoms ◽  
Narrative Review ◽  
Genetic Determination ◽  
Secondary Sources ◽  
Political Conditions ◽  
High Doses ◽  
The Way

Dom João VI's death occurred in adverse political conditions that led to the regicide hypothesis. The main aim of this paper is to mention life style and conditions of the death of the king by means of narrative review based on primary and secondary sources. Dom João VI died in the way of convulsions and gastrointestinal symptoms. This could be the result of the pathological chain of genetic determination, accentuated by the inappropriate life style, obesity and sedentary habits, and/or poisoning. The finding of arsenic in high doses in his viscera favors the last hypothesis as the basic cause of death, but one can not discard the atherosclerosis predisposing risk factors for a final stroke.

scholarly journals A Narrative Review on Evaluation of Hypercoagulability State in Severe Covid-19 Patients with Background Risk Factors

2020 ◽  
Vol 28 (131) ◽  
pp. 296-303
Author(s):  
Minoosh Moghimi ◽  
◽  
Kasra Khodadadi ◽  
Yousef Mortazavi ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Background Risk ◽  
Narrative Review

Staphylococcus aureus nasal colonization among Vietnamese adults: prevalence, risk factors and antibiotic susceptibility profile

MedPharmRes ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 21-31
Author(s):  
Nguyen Phan ◽  
Hien Pham ◽  
Thuc Nguyen ◽  
Hoai Nguyen
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Nasal Carriage ◽  
Resistance Rate ◽  
High Rate ◽  
Weight History ◽  
Potential Risk Factors ◽  
History Of ◽  
Vietnamese Community

Staphylococcus aureus (S. aureus) has long been recognized as an important human pathogen causing many severe diseases. It is also a part of human normal flora with its ecological niche in the human anterior nares. This study focused on screening S. aureus nasal carriage in community and its relationship to human physiological and pathological factors which have not been studied in Vietnam previously. Two hundred and five volunteers in Ho Chi Minh City from 18 to 35 and over 59 years old both male and female participated in the study. Result showed that the prevalence of S. aureus nasal carriage in southern Vietnamese community was relatively low, only 11.2% (23/205), much lower than that in other international reports on human S. aureus. In addition, nasal carriage of the older age group (> 59 years old, 13.7%) was higher than that of younger age (18-35 years old, 10.4%). Other potential risk factors such as gender, career, height, weight, history of antibiotic usage, daily nasal wash, use of nasal medication sprays, acne problems, smoking and nasal problems showed no significant impact on S. aureus carriage. The obtained S. aureus nasal isolates were all sensitive to vancomycin. Lincomycin and tetracycline had low resistance rate with 4.3 % and 17.4 %, respectively. However, the isolates showed particularly high rate of multidrug resistance (54.2%) In summary, our data provided researchers an overview on S. aureus nasal carriage and antibiotic susceptibility profile of the community- isolated S. aureus in Vietnam. This would serve as valuable information on assessing risk of community-acquired S. aureus infections.

scholarly journals In-hospital recurrence in a Chinese large cohort with acute ischemic stroke

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Fan Yu ◽  
Xiaolu Liu ◽  
Qiong Yang ◽  
Yu Fu ◽  
Dongsheng Fan
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Acute Ischemic Stroke ◽  
Recurrent Events ◽  
Early Stage ◽  
High Rate ◽  
Large Artery ◽  
Stroke Event

Abstract Acute ischemic stroke (AIS) has a high risk of recurrence, particularly in the early stage. The purpose of this study was to assess the frequency and risk factors of in-hospital recurrence in patients with AIS in China. A retrospective analysis was performed of all of the patients with new-onset AIS who were hospitalized in the past three years. Recurrence was defined as a new stroke event, with an interval between the primary and recurrent events greater than 24 hours; other potential causes of neurological deterioration were excluded. The risk factors for recurrence were analyzed using univariate and logistic regression analyses. A total of 1,021 patients were included in this study with a median length of stay of 14 days (interquartile range,11–18). In-hospital recurrence occurred in 58 cases (5.68%), primarily during the first five days of hospitalization. In-hospital recurrence significantly prolonged the hospital stay (P < 0.001), and the in-hospital mortality was also significantly increased (P = 0.006). The independent risk factors for in-hospital recurrence included large artery atherosclerosis, urinary or respiratory infection and abnormal blood glucose, whereas recurrence was less likely to occur in the patients with aphasia. Our study showed that the patients with AIS had a high rate of in-hospital recurrence, and the recurrence mainly occurred in the first five days of the hospital stay. In-hospital recurrence resulted in a prolonged hospital stay and a higher in-hospital mortality rate.

scholarly journals Thromboembolic Events in Patients with Testicular Germ Cell Tumours Are Predominantly Triggered by Advanced Disease and by Central Venous Access Systems

2020 ◽  
pp. 1-7
Author(s):  
Klaus-Peter Dieckmann ◽  
David Marghawal ◽  
Uwe Pichlmeier ◽  
Christian Wülfing
Keyword(s):  
Risk Factors ◽  
Central Venous Access ◽  
Multivariable Analysis ◽  
Venous Access ◽  
Germ Cell Tumours ◽  
Thromboembolic Events ◽  
Central Venous ◽  
Testicular Germ Cell ◽  
Testicular Germ Cell Tumours ◽  
Independent Risk Factors

<b><i>Background:</i></b> Thromboembolic events (TEEs) may significantly complicate the clinical management of patients with testicular germ cell tumours (GCTs). We analysed a cohort of GCT patients for the occurrence of TEEs and looked to possible pathogenetic factors. <b><i>Patients, Methods:</i></b> TEEs occurring within 6 months after diagnosis were retrospectively analysed in 317 consecutive patients with testicular GCT (median age 37 years, 198 seminoma, 119 nonseminoma). The following factors were analysed for association with TEE: histology, age, clinical stage (CS), chemotherapy, use of a central venous access device (CVA). Data analysis involved descriptive statistical methods with multivariable analysis to identify independent risk factors. <b><i>Results:</i></b> Twenty-three TEEs (7.3%) were observed, 18 deep vein thromboses, 4 pulmonary embolisms, and 1 myocardial infarction. Univariable risk calculation yielded the following odds ratios (ORs) : &#x3e;CS1 OR = 43.7 (95% confidence intervals [CIs] 9.9–191.6); chemotherapy OR = 7.8 (95% CI 2.3–26.6); CVA OR = 30.5 (95% CI 11.0–84.3). Multivariable analysis identified only CS &#x3e; 1 (OR = 16.9; 95% CI 3.5–82.4) and CVA (OR = 9.0; 95% CI 2.9–27.5) as independent risk factors. <b><i>Conclusions:</i></b> Patients with CSs &#x3e;CS1 are at significantly increased risk of TEEs even without chemotherapy. Particular high risk is associated with the use of CVA devices for chemotherapy. Caregivers of GCT patients must be aware of the particular risk of TEEs.

scholarly journals Mortality and Conversion Rate to Below Knee or Above Knee Amputation Following Transmetatarsal Amputation

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0011
Author(s):  
D. Anthony Barcel ◽  
Susan M. Odum ◽  
Taylor Rowe ◽  
Jefferson B. Sabatini ◽  
Samuel E. Ford ◽  
...  
Keyword(s):  
Risk Factors ◽  
Conversion Rate ◽  
Significant Risk ◽  
High Rate ◽  
Administrative Database ◽  
Categorical Variables ◽  
Diabetic Patients ◽  
Knee Amputation ◽  
History Of ◽  
Transmetatarsal Amputation

Category: Midfoot/Forefoot; Diabetes; Other Introduction/Purpose: Non-traumatic lower extremity amputations (LEA), especially those performed in dysvascular and diabetic patients, are known to have poor long-term prognosis. Perioperative mortality has been reported at between 4 and 10%, and the 1 and 5 year mortality rates range between 22-33% and 39-69%, respectively. While poor outcomes in these patients have been described, there is no consensus as to the predictors of mortality. The purpose of the study is to determine the percentage of patients who had a complication following transmetatarsal amputation (TMA) and identify associated risk factors for complications and mortality. Methods: We queried our institution’s administrative database to identify 247 TMA procedures performed in 229 patients between January, 2002 and December, 2016. Electronic health records were reviewed to document complications defined as reoperation, amputation and mortality. Mortality was also verified using the National Death Index. Additionally, we recorded risk factors including diabetes, A1c level, end stage renal disease (ESRD), cardiovascular disease (CVD), peripheral vascular disease (PVD), history of revascularization, contralateral amputation, and neuropathy. The majority of the study patients were males (157, 69%) and the average age was 57 years (range 24-91). The median BMI was 28 (range 16-58) and 29% of the study patients were obese with a BMI ≥ 30. Fishers Exact tests were used to compare categorical variables. Kruskal-Wallis and Independent T-tests were used to compare numeric data. All data were analyzed using SAS/STAT software version 9.4 (Carey, NC) and a 0.05 level of significance was defined apriori. Results: The conversion rate to below (BKA) or above knee amputation (AKA) was 26% (64 of 247). Males (p=.0274), diabetics (p=.0139), patients in ESRD (p=.019), and patients with a history of CVD (p=.0247) or perioperative revascularization (p=.022) were more likely to undergo further amputation following an index TMA. BMI was significantly higher in patients requiring BKA/AKA (p=.0305). There were no significant differences in age (p=.2723) or A1c levels (p=.4219). The overall mortality rate was 35% (84 of 229). Diabetes (p=.0272), ESRD (p=.0031), history of CVD (p<.0001) or PVD (p=.0179) were all significantly associated with mortality. Patients who died were significantly older (p=.0006) and had significantly higher A1c levels (p=.0373). BMI was not significantly associated with mortality. Twenty-two patients who had 23 further amputations subsequently died. Conclusion: In our series of patients undergoing TMA, 26% underwent further amputation and 35% of patients died. Conversion rate to BKA or AKA occurred at a high rate regardless of preoperative revascularization or the use of tendo-achilles or gastrocnemius lengthening procedures. Male sex, diabetes, ESRD, history of CVD or revascularization are significant risk factors for further amputation. ESRD, diabetes, history of CVD or PVD, older age and higher A1c levels are significant risk factors for mortality. These data provide useful insight into risk factors to be emphasized when counseling patients and their families to establish realistic postoperative expectations.

scholarly journals Risk factors for wound-related reoperations in patients with metastatic spine tumor

2018 ◽  
Vol 28 (6) ◽  
pp. 663-668 ◽  
Author(s):  
Hannah M. Carl ◽  
A. Karim Ahmed ◽  
Nancy Abu-Bonsrah ◽  
Rafael De la Garza Ramos ◽  
Eric W. Sankey ◽  
...  
Keyword(s):  
Risk Factors ◽  
Univariate Analysis ◽  
Tumor Resection ◽  
Multivariate Model ◽  
Wound Complications ◽  
Karnofsky Performance Scale ◽  
Thromboembolic Events ◽  
Spine Tumor ◽  
Wound Breakdown ◽  
Metastatic Spine Tumor

OBJECTIVEResection of metastatic spine tumors can improve patients’ quality of life by addressing pain or neurological compromise. However, resections are often complicated by wound dehiscence, infection, instrumentation failures, and the need for reoperation. Moreover, when reoperations are needed, the most common indication is surgical site infection and wound breakdown. In turn, wound reoperations increase morbidity as well as the length and cost of hospitalization. The aim of this study was to examine perioperative risk factors associated with increased rate of wound reoperations after metastatic spine tumor resection.METHODSA retrospective study of patients at a single institution who underwent metastatic spine tumor resection between 2003 and 2013 was conducted. Factors with a p value < 0.200 in a univariate analysis were included in the multivariate model.RESULTSA total of 159 patients were included in this study. Karnofsky Performance Scale score > 70, smoking status, hypertension, thromboembolic events, hyperlipidemia, increasing number of vertebral levels, and posterior approach were included in the multivariate analysis. Thromboembolic events (95% CI 1.19–48.5, p = 0.032) and number of levels involved were independently associated with increased wound reoperation rates in the multivariate model. For each additional spinal level involved, the risk for wound reoperations increased by 21% (95% CI 1.03–1.43, p = 0.018).CONCLUSIONSAlthough wound complications and subsequent reoperations are potential risks for all patients with metastatic spine tumor, due to adjuvant radiotherapy and other medical comorbidities, this study identified patients with thromboembolic events or those requiring a larger incision as being at the highest risk. Measures intended to decrease the occurrence of perioperative venous thromboembolism and to improve wound care, especially for long incisions, may decrease wound-related revision surgeries in this vulnerable group of patients.

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