Journal of investigative medicine : the official publication of the American Federation for Clinical Research
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This study aimed to explore the clinical adverse effects of anthracyclines on patients undergoing chemotherapy after breast cancer surgery. A total of 118 patients who received anthracycline chemotherapy after breast cancer surgery were selected as the research object, and the changes of echocardiogram, ECG, myocardial enzymes and blood biochemical indices before, during and after chemotherapy were studied. SPSS V.20 was used to conduct statistical analysis. ⋯ Heart rate and triglycerides increased significantly in the early stage of chemotherapy; ST-segment abnormality increased during the entire chemotherapy period; creatine kinase and lactate dehydrogenase increased significantly in the late stage of chemotherapy; hemoglobin and albumin decreased in the early stage of chemotherapy. The magnitude is large; high-density lipoprotein decreases throughout the chemotherapy period. In anthracycline chemotherapy regimens, bone marrow suppression and dyslipidemia occur in the early stage of chemotherapy, and the risk of cardiotoxicity is higher in the late stage of chemotherapy.
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Arrhythmias are a major cardiac complication reported among patients with multiple myeloma (MM), but these have not been further characterized in this population. We explored the prevalence of arrhythmias and examined the predictors of mortality among patients with MM with arrhythmias. The National Inpatient Sample data collected between 2016 and 2018 were used to conduct retrospective analyses. ⋯ Other predictors of inpatient mortality were elective admission (AOR: 0.67; 95% CI: 0.52 to 0.85) and Charlson comorbidity indices between 5-7 (AOR: 1.23; 95% CI: 1.07 to 1.41) and ≥8 (AOR: 1.45; 95% CI: 1.21 to 1.73) compared with comorbidity indices between 0 and 4. Our study adds to the body of knowledge on the need for proper diagnosis and management of cardiac arrhythmias in patients with MM. Research is needed to further assess the time of arrhythmia diagnosis and its impact on health outcomes among patients with MM.
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Prognostic utility of biomarker levels and clinical severity scoring in sepsis: a comparative study.
Procalcitonin (PCT) is one of the best validated biomarkers in the management of sepsis. However, its prognostic utility remains poorly studied. The present study sought to assess the prognostic utility of serial PCT assessments in patients with sepsis, and to compare the prognostic predictive capability of serial measurements of PCT with conventional markers of inflammation and validated intensive care unit (ICU) severity scoring systems. ⋯ PCT clearance on days 3 and 5 of admission was measured and demonstrated predictive accuracy comparable to day-matched APACHE IV scores. While serial levels of serum PCT in patients with sepsis are accurate in the prediction of adverse patient outcome, they do not offer any additional clinical benefit over existing severity of illness scores and may be cost prohibitive in resource-limited settings. While serial levels of serum PCT in patients with sepsis are accurate in the prediction of adverse patient outcome, they do not offer any additional clinical benefit over existing severity of illness scores and may be cost prohibitive in resource-limited settings.
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Review Meta Analysis
Meta-analysis and systematic review of the association between adverse childhood events and irritable bowel syndrome.
Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction characterized by abdominal pain, bowel habits alterations, constipation, and/or diarrhea. Adverse childhood experiences (ACEs) are events such as abuse and mental illness causing childhood trauma. Studies report higher prevalence of ACEs in patients with IBS with varied effect consistency and association strength. ⋯ This meta-analysis explores the current literature to understand the biopsychosocial perspective of IBS and ACEs' role as risk factors. However, the risk of publication and design/study quality biases substantiates the need for further research. If an association is confirmed, further mechanistic research and development of targeted psychological therapies may be warranted.
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As no vaccines are 100% effective at preventing illness, COVID-19 vaccine breakthrough cases are expected. We here aim to review the most recent literature on COVID-19 vaccine breakthrough infections. SARS-CoV-2 breakthrough infections are, in general, rare. Age may still be a factor in SARS-CoV-2 infections in immunized individuals.