RocScholar (Rochester Regional Health)
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COPD: Best Practices and New Horizons
No full textCOPD: Best Practices and New Horizons. Dr. Talal Kaiser, Pulmonary Unit
Objectives: Recognize COPD as common pulmonary disease with significant morbidity and mortality Understand the pathophysiology of obstructive lung disease Review best practice guidelines for COPD management and understand the evidence behind the guidelines Discuss new medication options available for COPD management including biologic therap
Characterization of bleeding in thrombotic thrombocytopenic purpura in the precaplacizumab era: a retrospective nationwide analysis
No full textBackground: The addition of caplacizumab to immune thrombotic thrombocytopenia (iTTP) treatment options has led to a renewed interest in characterizing the epidemiology and risk factors for bleeding in iTTP. Limited data exist on the bleeding risk in iTTP due to systemic underreporting in earlier cohorts.
Objectives: To describe the incidence, patterns, and predictors of bleeding in hospitalized iTTP patients independent of caplacizumab use.
Methods: We retrospectively analyzed the National Inpatient Sample database (2012-2019) and identified adult patients with a diagnosis of iTTP. Predictors of bleeding were determined by multivariable logistic regression analysis.
Results: We identified 3103 iTTP hospitalizations; bleeding occurred in 594 (19.1%), and 157 (5.1%) were characterized by major bleeding. Mucocutaneous bleeding (7.6%) was the most frequent type of bleeding and included heavy menstrual bleeding (2.6%), gingival (2.3%), epistaxis (1.4%), and skin/procedure-related bleeding (1.3%). This was followed closely by gastrointestinal bleeding (5.6%). Patients with bleeding were more likely to be Hispanic, have a weekend admission, and have a higher prevalence of comorbidities. In the multivariable analysis, Hispanic race (odds ratio [OR], 1.48; 1.14-1.91), Asian/Pacific Islander/Native American race (OR, 2.04; 1.51-2.76), coronary artery disease (OR, 1.70; 1.38-2.11), heart failure (OR, 1.39; 1.13-1.72), autoimmune disease (OR, 2.61; 2.08-3.26), Charlson Comorbidity Index ≥ 3 (OR, 2.08; 1.66-2.61), weekend admission (OR, 1.45; 1.22-1.72), and delay ≥2 days in plasma exchange initiation (OR, 1.63; 1.38-1.92), were significantly associated with major bleeding.
Conclusions: Bleeding is a relatively common issue in acute iTTP that has not been adequately addressed in existing literature. Further studies are needed to elucidate this risk and associated factors, especially given the incorporation of caplacizumab in the treatment of iTTP
Outcomes of Intracoronary Imaging-Guided PCI With Optimal Versus Suboptimal Results: A Meta-Analysis
No full textChapter 99 - Presenting data
No full textPresenting data is one of the challenging steps in writing manuscripts. It is crucial to reflect an organized flow of ideas throughout the different sections of the paper to convey a clear message in a storytelling manner. Simplicity and clarity are essentials. Having a structure for presenting the data makes it easy to deliver the manuscript effectively. The IMRAD style is one of the most used by different publishers: Introduction (Question asked?), Methods (How was it studied?), Results (What was found?), Discussion (What do the findings mean?). The introduction section should summarize the knowledge gap that led to the research question. The method section should state the patient population, methods selection, and statistical analysis used in the study. The result section is the “number section,” where all relevant results should be reported objectively. A suggested flow of the discussion section is to summarize the major findings at the beginning, which will address the questions posed in the introduction. Then, comparing the results with the most recent trials should follow, whether the results supported or declined the current thinking. Next, the authors should explain the discrepant results followed by the study\u27s possible clinical and scientific implications. Finally, a suggestion for further work should conclude the section. Graphs give the researcher the advantage of visual emphasis of the data and a quicker grasp of the results while minimizing lengthy text descriptions
Health-related quality of life and treatment satisfaction in pediatric patients with hypogammaglobulinemia treated with subcutaneous versus intravenous immunoglobulin replacement therapy
No full textDiagnostic Accuracy of Coronary Computed Tomography Angiography in Pre-renal and Pre-hepatic Transplant Evaluation — A Meta-analysis
No full textAortic Valvular Papillary Fibroelastoma Presenting as Transient Ischemic Attacks
No full textWe present an aortic valve Papillary Fibroelastoma diagnosed on a transesophageal echo (TEE) in 2020 in a patient who had been presenting with recurrent CNS symptoms since 2013 without any known cause. She had clean imaging including transthoracic echo (TTE) and the Fibroelastoma was discovered only on a TEE in 2020. We hope to highlight the elusive nature of the lesion as an obscure cause of CNS symptomatology
