76
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Kittleson M, Patel J, Chang D, Patel N, Singer-Englar T, Sindha I, Truong M, Hage A, Ramzy D, Czer L, Kobashigawa J. Sex Disparities in Heart Transplant Waitlist Status After the Donor Heart Allocation Policy Change. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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77
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Kittleson M, Patel J, Chang D, Singer-Englar T, Patel N, Velleca A, Czer L, Kobashigawa J, Zabner R, Zakowski P. The Outcome of West Nile Virus Infection After Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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78
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Federico L, Courtwright A, Kamoun M, Molina M, Diamond J, Ahya V, Christie J, Clausen E, Hadjiliadis D, Patel N, Salgado J, Cevasco M, Cantu E, Crespo M, Bermudez C. Change in Panel Reactive Antibodies in Patients Bridged to Lung Transplantation with Extracorporeal Membrane Oxygenation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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79
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Patel N, Kittleson M, Patel J, Singer-Englar T, Chang D, Hage A, Azarbal B, Czer L, Esmailian F, Kobashigawa J. Is ATG Induction with Delayed Initiation of CNI Protective of Renal Function in Patients with Mild Renal Insufficiency? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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80
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Emerson D, Patel N, Singer-Englar T, Megna D, Catarino P, Ramzy D, Moriguchi J, Cole R, Chikwe J, Kobashigawa J, Esmailian F. Complexities of Explanting Durable LVADs (Done at Outside Facilities) at the Time of Heart Transplant Surgery. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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81
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Anjum F, Pishko A, Diamond J, Ahya V, Christie J, Clausen E, Hadjiliadis D, Patel N, Salgado J, Cevasco M, Cantu E, Crespo M, Bermudez C, Courtwright A. Antiphospholipid Antibodies and Outcomes Following Lung Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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82
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Kobashigawa J, Patel J, Kittleson M, Cole R, Patel N, Singer-Englar T, Runyan C, Geft D, Czer L, Esmailian F. Intra-Aortic Balloon Placement without Inotropes: A Shift in Practice for Higher Urgency Status for Patients Awaiting Heart Transplant? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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83
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Chang D, Kittleson M, Patel J, Kransdorf E, Singer-Englar T, Patel N, Truong M, Nikolova A, Trento A, Czer L, Kobashigawa J. Do Women Truly Have Less Than Optimal Outcome Post-Heart Transplantation Compared to Men. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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84
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Kim S, Chang D, Patel J, Kittleson M, Singer-Englar T, Patel N, Welton M, Megna D, Czer L, Kobashigawa J. ACEi Use in Select Patients Awaiting Heart Transplant May Be a Risk Factor for the Development of Primary Graft Dysfunction and Vasoplegia. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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85
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Patel J, Kittleson M, Kransdorf E, Singer-Englar T, Patel N, Yamamoto N, Kim S, Hamilton M, Emerson D, Czer L, Kobashigawa J. Sex Differences in Desensitization for Patients Awaiting Heart Transplantation: Is There a Difference? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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86
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Abratenko P, An R, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barnes C, Barr G, Basque V, Bathe-Peters L, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhat A, Bishai M, Blake A, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Castillo Fernandez R, Cavanna F, Cerati G, Chen Y, Cianci D, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Evans JJ, Fine R, Fiorentini Aguirre GA, Fitzpatrick RS, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hilgenberg C, Horton-Smith GA, Hourlier A, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Kaneshige N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, LaZur R, Lepetic I, Li K, Li Y, Lin K, Littlejohn BR, Louis WC, Luo X, Manivannan K, Mariani C, Marsden D, Marshall J, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Mettler T, Miller K, Mills J, Mistry K, Mogan A, Mohayai T, Moon J, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Murphy M, Murrells R, Naples D, Navrer-Agasson A, Nebot-Guinot M, Neely RK, Newmark DA, Nowak J, Nunes M, Palamara O, Paolone V, Papadopoulou A, Papavassiliou V, Pate SF, Patel N, Paudel A, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Prince S, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rice LCJ, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Sinclair J, Smith A, Snider EL, Soderberg M, Söldner-Rembold S, Spentzouris P, Spitz J, Stancari M, John JS, Strauss T, Sutton K, Sword-Fehlberg S, Szelc AM, Tang W, Terao K, Thorpe C, Totani D, Toups M, Tsai YT, Uchida MA, Usher T, Van De Pontseele W, Viren B, Weber M, Wei H, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yarbrough G, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. Search for Neutrino-Induced Neutral-Current Δ Radiative Decay in MicroBooNE and a First Test of the MiniBooNE Low Energy Excess under a Single-Photon Hypothesis. PHYSICAL REVIEW LETTERS 2022; 128:111801. [PMID: 35363017 DOI: 10.1103/physrevlett.128.111801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/10/2022] [Indexed: 06/14/2023]
Abstract
We report results from a search for neutrino-induced neutral current (NC) resonant Δ(1232) baryon production followed by Δ radiative decay, with a ⟨0.8⟩ GeV neutrino beam. Data corresponding to MicroBooNE's first three years of operations (6.80×10^{20} protons on target) are used to select single-photon events with one or zero protons and without charged leptons in the final state (1γ1p and 1γ0p, respectively). The background is constrained via an in situ high-purity measurement of NC π^{0} events, made possible via dedicated 2γ1p and 2γ0p selections. A total of 16 and 153 events are observed for the 1γ1p and 1γ0p selections, respectively, compared to a constrained background prediction of 20.5±3.65(syst) and 145.1±13.8(syst) events. The data lead to a bound on an anomalous enhancement of the normalization of NC Δ radiative decay of less than 2.3 times the predicted nominal rate for this process at the 90% confidence level (C.L.). The measurement disfavors a candidate photon interpretation of the MiniBooNE low-energy excess as a factor of 3.18 times the nominal NC Δ radiative decay rate at the 94.8% C.L., in favor of the nominal prediction, and represents a greater than 50-fold improvement over the world's best limit on single-photon production in NC interactions in the sub-GeV neutrino energy range.
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87
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Patel AK, Patel N, Jadeja RN, Patel SK, Patel RN, Kumar S, Kapavarapu R. Interaction of pseudohalides copper(II) complexes of hydrazide ligand with DNA: synthesis, spectral characterization, molecular docking simulations and superoxide dismutase activity. INORG NANO-MET CHEM 2022. [DOI: 10.1080/24701556.2022.2050755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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88
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Ramsay I, Patel N, Peat N, Jones G. The South-East London community head and neck cancer team audit of the altered airway service. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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89
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Patel RN, Patel SK, Patel AK, Patel N, Butcher RJ. A tetranuclear nickel(II) complex, [Ni4(L)4](ClO4)4·C2H3N·2H2O, with an asymmetric Ni4O4 open-cubane-like core. Acta Crystallogr E Crystallogr Commun 2022; 78:98-102. [PMID: 35145731 PMCID: PMC8819437 DOI: 10.1107/s2056989021012408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/22/2021] [Indexed: 11/17/2022]
Abstract
A tetranuclear complex with an open-cubane like structure was synthesized from 2-methoxy-6-(pyridin-2-yl-hydrazonomethyl)-phenol and characterized using micro-analytical and spectroscopic techniques, and single-crystal X-ray diffraction analysis. A tetranuclear complex with an open-cubane-like core structure was synthesized from 2-methoxy-6-(pyridin-2-yl-hydrazonomethyl)phenol (HL), namely, cyclo-tetrakis(μ-2-methoxy-6-{[2-(pyridin-2-yl)hydrazin-1-ylidene]methyl}phenolato)tetranickel(II) tetrakis(perchlorate) acetonitrile monosolvate dihydrate, [Ni4(C13H12N3O2)4](ClO4)4·C2H3N·2H2O, and characterized using micro-analytical and spectroscopic techniques. The crystal-structure determination reveals the formation of a distorted Ni4O4 cubane-like core architecture encapsulated by four hydrazone Schiff base (HL) molecules. A open-cube tetranuclear architecture is created in which nickel(II) ions of the NiN2O3 unit are connected by μ2-O anions of the phenolate moiety of HL. In this complex, each Ni centre has a slightly distorted square-pyramidal coordination environment. The supramolecular architectures are stabilized via the presence of various intermolecular hydrogen bonds and (aryl–aryl, aryl–chelate and chelate–chelate) stacking interactions.
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90
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Patel AK, Jadeja RN, Patel N, Patel RN, Patel SK, Butcher R, Kumar S, Kumar G. Copper(II) hydrazone complexes derived from (Z)-N′-{(2-hydroxynapthalen-1-yl}methylene)acetohydrazide: Synthesis, spectral characterization, electrochemical behaviour, density functional study, in vitro catalytic activity and molecular docking. RESULTS IN CHEMISTRY 2022. [DOI: 10.1016/j.rechem.2021.100244] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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91
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Patel SK, Patel RN, Patel AK, Patel N, Coloma I, Cortijo M, Herrero S, Choquesillo-Lazarte D. Synthesis, single crystal structures, DFT and in vitro anti oxidant superoxide dismutase studies of copper(II) complexes derived from the di-(2-picolyl)amine and co-ligands: Promising antioxidants. Polyhedron 2022. [DOI: 10.1016/j.poly.2021.115609] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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92
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Patel N, Patel R, Wyenandt CA, Kobayashi DY. First Report of Pseudomonas cichorii Causing Bacterial Leaf Spot on Romaine Lettuce ( Lactuca sativa var . longifolia) and Escarole ( Cichorium endivia) in New Jersey. PLANT DISEASE 2021; 105:4150. [PMID: 34236210 DOI: 10.1094/pdis-05-21-0929-pdn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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93
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Baktash V, Hosack T, Rule R, Patel N, Kho J, Sekhar R, Mandal AKJ, Missouris CG. Development, evaluation and validation of machine learning algorithms to detect atypical and asymptomatic presentations of Covid-19 in hospital practice. QJM 2021; 114:496-501. [PMID: 34156436 DOI: 10.1093/qjmed/hcab172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 06/12/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Diagnostic methods for Covid-19 have improved, both in speed and availability. Because of atypical and asymptomatic carriage of the virus and nosocomial spread within institutions, timely diagnosis remains a challenge. Machine learning models trained on blood test results have shown promise in identifying cases of Covid-19. AIMS To train and validate a machine learning model capable of differentiating Covid-19 positive from negative patients using routine blood tests and assess the model's accuracy against atypical and asymptomatic presentations. DESIGN AND METHODS We conducted a retrospective analysis of medical admissions to our institution during March and April 2020. Participants were categorized into Covid-19 positive or negative groups based on clinical, radiological features or nasopharyngeal swab. A machine learning model was trained on laboratory parameters and validated for accuracy, sensitivity and specificity and externally validated at an unconnected establishment. RESULTS An Ensemble Bagged Tree model was trained on data collected from 405 patients (212 Covid-19 positive) producing an accuracy of 81.79% (95% confidence interval (CI) 77.53-85.55%), the sensitivity of 85.85% (CI 80.42-90.24%) and specificity of 76.65% (CI 69.49-82.84%). Accuracy was preserved for atypical and asymptomatic subgroups. Using an external data set for 226 patients (141 Covid-19 positive) accuracy of 76.82% (CI 70.87-82.08%), sensitivity of 78.38% (CI 70.87-84.72%) and specificity of 74.12% (CI 63.48-83.01%) was achieved. CONCLUSION A machine learning model using routine laboratory parameters can detect atypical and asymptomatic presentations of Covid-19 and might be an adjunct to existing screening measures.
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Patel N, Khan D. M008 MANAGEMENT OF IOHEXOL-INDUCED ANAPHYLAXIS WITH ALTERNATIVE CONTRAST AGENTS. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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95
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Raissi G, Patel N, Casey R, Corcoran B, Sadeghi H. 152: Weekly patient-family-staff-volunteer during COVID-19. J Cyst Fibros 2021. [PMCID: PMC8518465 DOI: 10.1016/s1569-1993(21)01577-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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96
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Stenehjem K, Patel N, Bundy V. M194 IDENTIFICATION OF T-CELL LYMPHOPENIA VIA T-CELL RECEPTOR EXCISION CIRCLE ASSAY IN TURNER SYNDROME. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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97
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Yang K, Dinh M, Nam K, Madishetty S, Kilic S, Recinos V, Zahler S, Patel N, Elhalawani H, Scott J, Chao S, Murphy E, Suh J. Impact of Insurance Status on Radiation Treatment and Clinical Outcome in Adult Medulloblastoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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98
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Patel N, Amgai B, Chakraborty S, Hajra A, Ashish K, Patel Z, Aryal B, Aronow W, Singh A. Effect of thrombocytopenia in patients with infective endocarditis: an insight from the National Inpatient Sample database. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Infective endocarditis (IE) is one of the feared diseases in septic patients, and incidences are rising due to the intravenous drug abuse epidemic. Sepsis causes an escalation of the platelet destructions leading to thrombocytopenia (1). Few independent hospital-based studies have proposed increase mortality with thrombocytopenia in patients with IE (2–5). We aim to evaluate the significance of thrombocytopenia in IE subjects from the national inpatient sample (NIS) database.
Method
We analyzed the NIS database from Jan-2016 to Dec-2018 using Stata 16.0. NIS is the largest publicly available all-payer inpatient care database in the United States, containing data on more than seven million hospital stays per year. We identified patients with IE with or without thrombocytopenia using ICD-10 codes. The primary outcome of interest was in-hospital mortality comparison. We adjusted potential confounders (age, sex, diabetes, hypertension, etc.) with multivariate logistic regression analysis. Further analysis was done after balancing the population co-morbidity using a Greedy propensity match for accuracy.
Results
A total of 174,495 subjects were included in this study with a diagnosis of IE. Among these individuals, 33,285 patients had a concurrent diagnosis of thrombocytopenia. The mean ages were 53±19.5 years for the thrombocytopenia group and 55±19.8 years for others. Females were equally represented in both cohorts. There were 4,945 (14.86%) vs 2,835 (2.01%) mortalities reported in with and without thrombocytopenia group respectively. After propensity matching, there was a pronounced increase in mortality [Odds ratio (OR): 1.93 (1.72 – 2.15), p-value: <0.001] in the group with thrombocytopenia comparing to others. Complications such as Major bleeding requiring blood transfusion [OR: 1.45 (1.35–1.57)], acute myocardial infarction [OR: 1.56 (1.35–1.70)], complete heart block [OR: 1.44 (1.16–1.53)], cardiac arrest [OR: 1.44 (1.25–1.72)], acute respiratory failure [OR: 1.51 (1.39–1.73)] and pressor support requirement [(OR: 1.73 (1.57–2.01)] were notably higher in the cohort of thrombocytopenia with statistically significant p-value (<0.001). The difference in length of stay between both cohorts after propensity match wasn't statistically significant.
Conclusion
In conclusion, IE patients with thrombocytopenia have higher incidences of in-patient mortality and poor outcomes than cohort without thrombocytopenia. Some of the adverse consequences could be temporally explained by complications related to underlying thrombocytopenia. Further investigations are needed to delineate the outcome in this group of subjects.
Funding Acknowledgement
Type of funding sources: None.
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Patel N, Amgai B, Chakraborty S, Hajra A, Binit A, Patel Z, Ashish K, Reddy M, Aronow W, Khalid M. Impact of atrial fibrillation in patients with colorectal cancer: a national inpatient sample database analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting approximately 1–2% overall population (1). Its causal relationship with colorectal cancer (CRC) is much for debate. According to one hypothesis, the presence of autoantibodies directed against ionic channels or acetylcholine receptors can predispose to the development of atrial fibrillation (2–3). Thus, AF may be regarded as an inflammatory complication in patients with colon cancer. Our study objective was to determine if AF impacts the outcome of patients with CRC.
Method
We analyzed the National Inpatient Sample (NIS) database from Oct-2015 to Dec 2018 using Stata 16.0. The NIS databases are released under the Healthcare Cost and Utilization Project, which includes inpatient admissions from the United States' participating hospitals. Total population with CRC were identified using their respective ICD-10 diagnostic codes then divided based on AF. To determine atrial fibrillation association with mortality and complications, we used multivariate logistic regression analysis using weights to generate nationally representative results. Later, a propensity-matched population analysis was done for the accuracy of the results.
Result
We found 245,305 patients admitted with CRC between Oct 2015 to Dec-2018 in the USA, out of which 28,170 (11.5%) were having AF. The mean age for the patients with AF was 77±10 compare to 65±14 years in those without AF. Patients with AF were associated with higher comorbidities and had a high population percentage with Carlson category three or above. There were 1,456 (5.2%) mortalities in the AF group compared to 5,689 (2.6%) in the other. The higher odds of mortality in patients with AF was present in multivariate logistic regression analysis in both non-propensity matched [1.71 (1.45–2.02), P-value: <0.000] and propensity-matched [1.44 (1.18–1.75), P-value: <0.001] cohorts. Patients with AF were hospitalized longer (9.20±7.8 vs. 6.85±7.0 days), leading to a high admission costs (US$ 25,875±22,875 vs. 20,087±19,314). Odds of complications such as need for blood transfusions [1.61 (1.05–1.29), P-value: 0.005], hemorrhage requiring blood transfusion [1.17 (1.05–1.29), P-value: 0.003], lower-GI bleed [1.31 (1.21–1.43), P-value: <0.001], sepsis [1.45 (1.30–1.62), P-value: <0.001], respiratory failure [1.39 (1.15–1.67), P-value: 0.001] etc. were also higher in group of patients with CRC and AF.
Conclusion
In our retrospective, propensity-matched national inpatient sample analyses of patients admitted with colorectal cancer, atrial fibrillation is associated with higher morbidity and mortality. AF was associated with a high burden of complications with prolonged hospital stay leading to increased health care expenditures.
Funding Acknowledgement
Type of funding sources: None.
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Lee C, Patel N, Panepinto L, Byers M, Ambrosino M, Adusumalli S, Denduluri S, Cohen J, Scherrer-Crosbie M. The role of premorbid transthoracic echocardiogram in identifying adverse clinical outcomes in patients admitted with COVID-19. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
The novel coronavirus disease (COVID-19) inpatient mortality rate is approximately 20% in the United States. Reports have described a wide pattern of abnormalities in echocardiograms performed in patients admitted with COVID-19. The role of premorbid transthoracic echocardiogram (TTE) in the prediction of COVID-19 severity and mortality is yet to be fully assessed.
Purpose
To assess whether a pre-COVID TTE can identify patients at high risk of adverse outcomes who are admitted with COVID-19.
Methods
All patients who underwent a TTE from one year to one month prior to an index inpatient admission for COVID-19 were retrospectively enrolled across five clinical sites. Demographic information, medical history, and laboratory data were included for analysis. Echocardiograms were analyzed by an observer blinded to clinical data. Linear and logistic regressions were performed to detect the association of variables with death, invasive mechanical ventilation, initiation of dialysis, and a composite of these endpoints during the COVID-19 admission. Outcomes were then adjusted for a risk score using inverse propensity weighting incorporating age, sex, diabetes, hypertension, obstructive sleep apnea, history of atherosclerotic cardiovascular disease, atrial fibrillation, diuretic use, and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use.
Results
There were 104 patients (68±15 years old, 49% male, BMI 31.4±9.1kg/m2) who met inclusion criteria (baseline characteristics in Table 1). Mean time from TTE to positive SARS-CoV-2 PCR test was 139±91 days. Twenty-nine (28%) participants died during the index COVID-19 admission. There was no association of pre-COVID echocardiographic measures of systolic ventricular function with any endpoint. Diastolic function, as assessed by LV e', was associated with mortality (Table 2). There were 25 patients (24%) with a normal lateral e' (≥10cm/s); none died. There were 35 (34%) patients with LV e' lateral velocity <8 cm/s, of whom 15 (43%) died. LV e' lateral velocity <8 cm/s was associated with an unadjusted odds ratio of 7.69 (95% confidence interval [CI] 2.26–26.19) for death and 3.25 (95% CI 1.11–9.54) for the composite outcome. The odds ratio for death was 4.76 (95% CI 1.10–20.61) and 3.78 (95% CI 0.98–14.6) for the composite outcome after adjustment for clinical risk factors (Table 2).
Conclusion
In patients with an echocardiogram prior to COVID-19, impaired diastolic function as represented by an abnormal LV e' lateral velocity was associated with both inpatient COVID-19 mortality and a composite outcome of death, mechanical ventilation, and initiation of dialysis, even after adjustment for multiple co-morbidities and medication use. Knowledge of the pre-COVID TTE results may help clinicians identify patients at higher risk of adverse outcomes during an admission for COVID-19.
Funding Acknowledgement
Type of funding sources: None.
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