Internal and emergency medicine
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An association with aortic aneurysm has been reported among patients with atrial fibrillation (AF). The aims of this study were to investigate the prevalence of thoracic aorta aneurysm (TAA) among patients with AF and to assess whether the co-presence of TAA is associated with a higher risk of adverse clinical outcomes. ⋯ Using TriNetX, a global federated health research network of anonymised electronic medical records, all adult patients with AF, were categorised into two groups based on the presence of AF and TAA or AF alone. Between 1 January 2017 and 1 January 2019, 874,212 people aged ≥ 18 years with AF were identified. Of these 17,806 (2.04%) had a TAA. After propensity score matching (PSM), 17,805 patients were included in each of the two cohorts. During the 3 years of follow-up, 3079 (17.3%) AF patients with TAA and 2772 (15.6%) patients with AF alone, developed an ischemic stroke or transient ischemic attack (TIA). The risk of ischemic stroke/TIA was significantly higher in patients with AF and TAA (HR 1.09, 95% CI 1.04-1.15; log-rank p value < 0.001) The risk of major bleeding was higher in patients with AF and TAA (OR 1.07, 95% CI 1.01-1.14), but not significant in time-dependent analysis (HR 1.04, 95% CI 0.98-1.10; log-rank p value = 0.187), CONCLUSION: This retrospective analysis reports a clinical concomitance of the two medical conditions, and shows in a PSM analysis an increased risk of ischemic events in patients affected by TAA and AF compared to AF alone.
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The first COVID-19 lockdown resulted in enforced quarantine of heavily affected areas with social isolation and related measures by several governments to slow the spread of the disease. The general population experienced several mental and lifestyle changes. Herein, we aimed to evaluate the metabolic and psychological effects induced by lifestyle changes during COVID-19 self-isolation among an Apulian overweight/obese cohort with metabolic disturbances. ⋯ Psychological aspects were significantly higher in females than in males. Finally, work activities and familial status strongly affected the metabolic and psychological profile. In conclusion, COVID-19 self-isolation induced changes in lifestyle and dietary habits with psychological distress and detrimental effects on metabolic patterns, which were more pronounced in female gender.
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The cardiovascular risk (CVD) in patients with rheumatoid arthritis (RA) is 1.5-2 times higher than that in individuals of the same age and sex. ⋯ Angiopoietin 2 and pentraxin 3 could be considered surrogate biomarkers of endothelial activation and vascular disease, as they could play an essential role in the regulation of endothelial integrity and inflammation.
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This study aims to determine the frequency and impact of concomitant cerebral infarction and acute myocardial infarction (AMI) and association with in-hospital outcomes. We analyzed the nationally representative data from National Inpatient Sample between 2016 and 2019. We used multiple logistic regressions to determine the impact of sustaining a cerebral infarction or AMI on in-hospital mortality and linear regression to evaluate length of stay and hospitalization costs. ⋯ The median total healthcare cost for cerebral infarction, AMI and when both occurred was US$10,647, $15,735 and $23,290, respectively (p < 0.001). After adjustments for potential confounders, in-hospital mortality [adjusted odds ratio (aOR) 4.07, 95% CI 3.93-4.21], length of stay (aOR 3.95 95% CI 3.85-4.04), and hospitalization cost (regression coefficient 15,480 95% CI 15,135-15,825) were greater for patients with AMI and cerebral infarction compared to admission for cerebral infarction only. Cerebral infarction and AMI during the same hospitalization occurs in 5% of admissions with cerebral infarction and 3% of admission with AMI and is associated with significant increase in mortality, length of stay and cost compared to admissions with either condition alone.