The prevalence of diabetes mellitus (DM) in hospitalized heart failure (HF) patients is increasing over time. However, the effect of DM on short-term readmissions for HF is not well established. We ...investigated the effects of DM on readmissions of HF patients. All adult hospitalizations with a primary diagnosis of HF were identified in the National Readmission Database (NRD) for 2018 and were categorized into those with and without a secondary diagnosis of DM. The primary outcome was to assess risk difference in 30 and 90-day all-cause readmissions. Multivariate Cox survival analysis and multivariate Cox regression were performed to estimate the readmission risk difference in HF patients with and without DM. Of 925,637 HF hospitalizations that met the inclusion criteria, 441,295 (47.6%) had concomitant DM. Diabetics hospitalized for HF had higher prevalence of obesity (37.3% vs 19.5%), kidney disease (58.4% vs 29.2%) and coronary disease (61.1% vs 51.0%), compared to HF hospitalizations without DM. In adjusted analyses, DM was associated with higher hazards for all-cause hazards ratio (HR), 30 days: 1.04 (1.02-1.06); 90 days: 1.07 (1.05-1.09), HF HR, 30 days: 1.05 (1.02-1.07); 90 days: 1.08 (1.05-1.10) and myocardial infarction (MI) HR, 30 days: 1.26 (1.12-1.41); 90 days: 1.38 (1.25-1.52) readmissions. In conclusion, in patients with HF-related hospitalizations, the presence of DM was associated with a higher risk of 30 and 90-day all-cause, HF and MI readmissions.
The current study's objective was to find out the prevalence of malocclusion and the need for orthodontic treatment in 13- to 15-year-old school students in the Mehsana District of Gujarat using the ...IOTN.
A descriptive cross-sectional epidemiological survey was planned among 13- to 15-year-old school-going children of Mehsana district. The sample comprised of 1290 school children. DHC-IOTN was applied to evaluate normative need for orthodontic treatment. Perceived orthodontic treatment was described by the Aesthetic component of the IOTN index.
Results showed that 33.7 percent of participants required little/no treatment need, 43.9 percent of participants required moderate orthodontic treatment need, and 22.4 percent of participants required severe orthodontic treatment need in the district.
To prepare for public orthodontic and dental services, the current study provides baseline data on the need for orthodontic treatment among school-aged children.
The mid-aortic syndrome, also known as mid-aortic dysplastic syndrome or coarctation of aorta, is a rare clinical entity due to the narrowing of the distal thoracic and/or abdominal aorta and its ...branches. It has various causes including congenital or acquired although idiopathic is the most common cause. It is more common in children and adolescents. Here we present a unique case of a 52-year-old woman who presented with shortness of breath, chest pain, and hypertensive emergency and was found to have high-grade mid-aortic stenosis which was successfully managed with surgery with no post-operative complications and complete resolution of her symptoms.
<Learning objective: Mid-aortic syndrome (MAS) is a rare syndrome with various causes and presentations. It is associated with significant morbidity and mortality if left untreated. MAS can be managed symptomatically or surgically which requires taking multiple factors (age, severity, location and length of stenosis, severity of symptoms, previous response to medical therapy, end-organ damage, and visceral vessels involvement) into consideration including patient's own preferences.>
Keloids are an unorganized proliferation of fibrous tissue, usually arising from a site of injury due to an aberrant healing process. Clinically, it presents as ugly scar tissue on the skin and shows ...genetic predilection. They cause esthetic, physical, and psychological disturbances in the affected individuals. Such patients require special precautions during routine surgical procedures. Its treatment is associated with a high degree of resistance and recurrence. In this article, one such case is reported along with a literature review discussing the nature of the lesion, treatment options, and the recommended precautions.
We aimed to study the impact of acute myocardial infarction (AMI) in patients with celiac disease (CD).
We used the National Inpatient Sample 2011–2018 to identify patients aged 18 years and older ...with a history of CD who presented with AMI using International Classification of Disease Nineth and Tenth Revision codes. Primary outcome of interest was mortality differences in AMI patients with and without CD. Secondary outcomes were in-hospital length of stay, hospital costs, and coronary revascularization.
A total of 2,287,840 weighted patients were included in this study with a principal diagnosis of AMI. Among this population, 183,027 weighted patients had a history of CD (0.08%), and 2,286,010 weighted patients had AMI without a history of CD (99.92%). Most AMI patients with and without CD were older (69.57 ± 13.21 vs 67.08 ± 13.87 years, respectively) and white (92.55% vs 75.39%, respectively). Patients with AMI and CD were more likely to be female than patients without CD (53.76% vs 38.47%; P < .05). In our study, we found that the difference in hospital charges (adjusted mean difference $2644.7) was lower among AMI and CD; however, length of stay was higher among patients with CD (adjusted mean difference 0.36 day) although they were not statistically significant (P > .05). Both cohorts had higher number of Medicare recipients and lower number of patients who self-pay. Our study also found that smoking was more prevalent among patients with CD, 12.14%, vs patients without CD, 2.51%. Moreover, patients with CD who developed AMI had a lower adjusted odds of mortality than those without CD (adjusted odds ratio aOR 0.41; P < .05). Patients with CD and AMI also had lower odds of coronary revascularization (aOR 0.80; P < .05). In addition, we found that adults with CD had a lower odds of developing AMI (aOR 0.78; P < .05).
CD is a chronic disease leading to chronic inflammation and various nutrition-related problems which can lead to increased morbid conditions. However, we found lower odds of AMI among patients with CD, as well as lower mortality and comorbidities related to AMI, thus contradicting previous assumptions.
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