The American journal of the medical sciences
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Hypertension can cause significant morbidity and reduced life expectancy. Most patients with hypertension have primary hypertension; however, 10 to 15% of patients have secondary hypertension. Endocrine disorders explain approximately 10% of hypertension in all patients, and thyroid disorders account for approximately 1% of cases with hypertension. ⋯ Treatment of hyperthyroidism can cure hypertension in some patients. Consequently, identification of patients with secondary hypertension potentially has important benefits, and understanding secondary hypertension provides a framework for investigating the pathophysiology of hypertension. Clinicians should consider the possibility of hyperthyroidism in patients with hypertension, even in those of more advanced age.
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Patients with differentiated thyroid cancer who undergo radioiodine treatment often present oral complications with a significant impact on their oral cavity function. Any potential sources of systemic infections like periodontal disease, unfitted dentures, orthodontic appliances, deficient/rough fillings, or traumatic dentition must be treated by the dental practitioner, because they represent the main source of spread and dissemination. Any systemic complication of a dental foci may result from improper dental preparation of the patient before radioiodine therapy and inadequate post-radioiodine therapy oral care. Therefore, all patients proceeding into radioiodine treatment should be addressed by the oncological team to undergo thorough dental check-up and receive appropriate treatment in due time.
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This study aimed to assess inpatient prevalence, characteristics, outcomes, and resource utilization of hospitalization for methanol intoxication in the United States. ⋯ The overall inpatient prevalence of methanol intoxication among hospitalized patients was 6.4 cases per 1,000,000 admissions in the United States. The mean age was 38±18 (range 0-86) years. 44% used methanol for suicidal attempts. 20% of admissions required mechanical ventilation, and 40% required renal replacement therapy. The three most common complications were metabolic acidosis (44%), hypokalemia (18%), and visual impairment or optic neuritis (8%). The three most common end-organ failures were renal failure (22%), respiratory failure (21%), and neurological failure (17%). 6.5% died in the hospital. Factors associated with increased in-hospital mortality included alcohol drinking, hypernatremia, renal failure, respiratory failure, circulatory failure, and neurological failure. The mean length of hospital stay was 4.0 days. The mean hospitalization cost per patient was $43,222 CONCLUSION: The inpatient prevalence of methanol intoxication in the United States was 6.4 cases per 1,000,000 admissions. The risk of in-hospital mortality mainly depended on the number of end-organ failures.
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Individuals with cystic fibrosis (CF) have difficulty maintaining optimal vitamin D status due to pancreatic insufficiency-induced malabsorption, inadequate sunlight exposure, and poor intake of vitamin D containing foods. Vitamin D deficiency may increase the risk of pulmonary exacerbations of CF. The objective of this study was to assess factors impacting vitamin D status in patients with CF recently hospitalized for a pulmonary exacerbation of CF. ⋯ Sunlight exposure was the most predictive determinant of vitamin D status in patients with CF prior to pulmonary exacerbation. Subjects reported vitamin D intake below the recommended amounts. The role and mode of optimizing vitamin D status prior to a pulmonary exacerbation needs further investigation.
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Patients suffering an acute myocardial infarction complicated by cardiogenic shock (AMICS) may experience clinical deterioration with concomitant atrial fibrillation (AF). Recent data suggest that percutaneous ventricular assist devices (pVADs) provide superior hemodynamic support over intra-aortic balloon pump (IABP) in AMICS. In patients with AF+AMICS, however, outcomes data comparing these two devices remain limited. ⋯ All-cause inpatient mortality was similar in AMICS+AF patients undergoing PCI who were treated with either pVAD or IABP. The pVAD group, however, experienced more complications while consuming greater healthcare resources.