Clinical medicine (London, England)
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Although common, the long-term significance of -developing atrial fibrillation (AF) during a period of critical illness is unclear. We undertook a retrospective cohort analysis to -assess the rate of thromboembolism (TE) in patients -developing atrial fibrillation de novo during admission to our intensive care unit. ⋯ The unadjusted hazard ratio for TE in patients developing new AF compared with those not developing AF was 8.09 (95% CI 3.08-17.19, p<0.001). In patients admitted to critical care, the development of AF appears to be associated with a significantly increased risk of subsequent thromboembolism.
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Vitamin D is a fat-soluble vitamin essential for calcium homeostasis and bone health. Vitamin D toxicity or hypervitaminosis D is extremely rare. ⋯ This case, alongside other global case reports, highlights the potential dangers of unlicensed vitamin D replacement. We discuss the evidence for vitamin D replacement and remind readers of the current guidance on daily intake and supplementation.
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Public Health England (PHE) issued a guidance report on the management of Mycobacterium chimaera endocarditis following cardiac valve surgery. M chimaera is a non-tuberculous mycobacteria (NTM) belonging to mycobacterium avium complex (MAC). ⋯ Prosthetic valve endocarditis (PVE) presents as the frequent and severe form of infective endocarditis (IE). The objective of this review is to discuss the role of clinicians in assessment, treatment and reassurance of all the patients who are recalled for clinical consultation following their risk of suspected M chimaera infection after open-heart surgery.
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Haemostatic abnormalities are common in the critically ill or bleeding patient, including haemorrhage-related coagulopathies, disseminated intravascular coagulation and thrombocytopenia, among other pathologies. In this article we aim to outline some of the causes of these clotting abnormalities, highlighting recent advancements in knowledge and new insights into their clinical management, with the aim of optimising diagnostic and therapeutic strategies.