Atrial fibrillation: an independent risk factor for nonaccidental falls in older patients

Background: Nonaccidental falls are often the result of a combination of factors including cardiovascular disorders such as orthostatic hypotension and unspecified cardiac arrhythmias. The objective of this study was to determine if there is an association between atrial fibrillation (AF) and nonaccidental falls. Methods: We reviewed the records of 442 consecutive patients >65 years old who presented to the Emergency Department at the University of Utah Medical Center with a complaint of fall. Results: Two-hundred eleven patients presented with nonaccidental fall, 231 patients with accidental fall. Patients with nonaccidental fall were more likely to be older, have a history of hypertension and neurological disorders, and taking five or more medications when compared to patients with accidental fall. Despite a similar prevalence of sinus rhythm at presentation, the prevalence of a history of AF was significantly higher in patients with nonaccidental fall compared to patients with accidental fall (26% vs 15%; P = 0.003). After adjusting for clinically and statistically significant predictors with a multivariate logistic regression analysis, AF, neurological disorders, and age ≤81 years were independent predictors of nonaccidental fall. In patients ≤81 years old (median age), the risk of nonaccidental falls was 2.5 times greater in patients with a history of AF when compared to those without a history of AF (odds ratio = 2.53 [confidence interval 95% 1.3-5], P = 0.007). Conclusion: AF is an independent risk factor for nonaccidental falls. Our results emphasize the need to screen for AF in patients presenting with nonaccidental fall. (PACE 2012; 35:973-979).     

Risk factors associated with hospitalization owing to COVID-19: a cross-sectional study in Palestine

ObjectivesWe aimed to identify the risk factors for coronavirus disease 2019 (COVID-19)-associated hospitalization to provide evidence for improved clinical care of patients with COVID-19 infection.MethodsWe conducted a cross-sectional study among 300 participants. The collected data comprised sociodemographic data, lifestyle habits, physical activity, medical history, anthropometric measurements, COVID-19-related symptoms, dietary habits prior to and after COVID-19 infection, and psychological status.ResultsFifty-nine participants were hospitalized. Fever, dry cough, joint pain, chills, diarrhea, and shortness of breath were significantly associated with hospitalization owing to COVID-19. Adults with obesity, diabetes mellitus, hypertension, respiratory diseases, and cardiovascular diseases had higher rates of hospitalization. The findings also showed that residential area and age were related to COVID-19 hospitalization. Furthermore, our analysis revealed that certain dietary habits were associated with hospitalization rates.ConclusionOur study confirmed that older age, urban residence, illiteracy, obesity, hypertension, diabetes mellitus, respiratory diseases, cardiovascular diseases, and symptoms of loss of smell and sneezing elevated the risk of hospitalization among patients with COVID-19 infection. Patients with a higher risk of hospitalization may benefit from targeted therapeutic and preventive interventions.     

Laryngeal findings and acoustic changes in hubble-bubble smokers

The purpose of our investigation was to evaluate the laryngeal findings and acoustic changes in hubble-bubble smokers. A total of 42 subjects with history of hubble-bubble smoking were recruited for this study. A corresponding group with a history of cigarette smoking and controls were matched. All subjects underwent laryngeal video-endostroboscopic evaluation and acoustic analysis. In the hubble-bubble smoking group, 61.9% were males. The average age was 30.02 ± 9.48 years and the average number of years of smoking was 8.09 ± 6.45 years. Three subjects had dysphonia at the time of examination. The incidence of benign lesions of the vocal folds in the hubble-bubble group was 21.5%, with edema being the most common at 16.7% followed by cyst at 4.8%. The incidence of laryngeal findings was significantly higher in the hubble-bubble group compared to controls. In the cigarette-smoking group, the most common finding was vocal fold cyst in 14.8% followed by polyps in 7.4%, and edema, sulcus vocalis and granuloma. These findings were not significantly different from the hubble-bubble group except for the thick mucus, which was significantly higher in the latter. There were no significant changes in any of the acoustic parameters between hubble-bubble smokers and controls except for the VTI and MPT, which were significantly lower in the hubble-bubble group. In comparison with the cigarette-smoking group, hubble-bubble smokers had significantly higher Fundamental frequency and habitual pitch (p value 0.042 and 0.008, respectively). The laryngeal findings in hubble-bubble smokers are comparable to cigarette smokers. These laryngeal findings are not translated acoustically, as all the acoustic parameters are within normal range compared to controls.     

Abdominal pregnancy. An autochtonous case with full-term living normal infant]

Abdominal pregnancy is a serious obstetrical dilemma for mother and baby. Exceptional in the western world, it's often unsuspected or lately diagnosed. We report an autochtonous case, discovered at operation, with an alive, normal and full-term baby, and dramatic hemorrhagic consequences, threatening the mother's life.     

用电化学检测器的高效液相色谱法测定血清及尿中速尿的含量

本文报告了用电化学检测器的高效液相色谱法测定血清及尿中速尿含量的方法。样品予处理方法:血清用乙腈除蛋白,尿用蒸馏水稀释50倍。采用作者合成的FD-Val-OH作为内标物。色谱条件为:反相柱,以含35%乙醇的5mmol/L四丁基铵水溶液为流动相(pH7.50),流速1.0ml/min;用电化学检测器,检测电压0.90V:速尿及内标物的保留时间分别为10和15min。通过计算速尿对内标物的峰高比求得速尿含量。血清及尿中的最低检测浓度分别为16和9ng/ml。标准曲线在0.25～5ng/μl(血清)、0.5～10ng/μl(尿)的浓度范围内呈线性关系。血清及尿中回收率分别为100.5%和100.6%。变异系数在4.6%以下。     

Status of the remaining parotid duct and gland following superficial parotidectomy

The changes in Stensen’s duct and remaining parotid tissue following superficial parotidectomy have not been studied previously. The aim of this clinical case control study is to describe these changes using sialography and CT-sialography techniques. Fourteen superficial parotidectomy cases underwent parotid sialography bilaterally. CT sialography was also done. Stensen’s duct was patent in 11 cases (79%), and non-patent in three cases (21%). Its angle in relation to our reference line was 20° in operated cases versus 37° for the non-operated cases. Following superficial parotidectomy, the remaining parotid tissues usually remain functional and retain drainage through Stensen’s duct. Furthermore, superficial parotidectomy changes the direction of this duct. Parotid sialography and CT sialography can still be used to study the status of remaining parotid tissue following superficial parotidectomy. The post-surgical changes should be reviewed with care before interpreting these studies.     

Regional right ventricular function and timing of contraction in healthy volunteers evaluated by strain‐encoded MRI

Purpose

To prospectively determine the feasibility and accuracy of strain‐encoded (SENC) magnetic resonance imaging (MRI) for the characterization of the right ventricular free wall (RVFW) strain and timing of contraction at 3.0 Tesla (3T) MRI.

Materials and Methods

In 12 healthy volunteers the RVFW was divided into three segments (anterior, lateral, and inferior) in each of three short‐axis (SA) slices (apical, mid, and basal) and into three segments (apical, mid, and basal) in a four‐chamber view. The study was repeated on a different day and interobserver and interstudy agreements were evaluated.

Results

Maximal systolic longitudinal strain values were highest at the apex and base, with a pronounced decrease in the medial segments (apex: –19.1% ± 1.4; mid: –17.4% ± 2; base: –19.4% ± 2.4, P < 0.001), and maximal systolic circumferential strain showed the highest values at the apex (apex: –18.1% ± 1.7; mid: –17.6% ± 1.2; base: –16.6% ± 0.9, P < 0.001). Peak systolic longitudinal and circumferential shortening occurred earliest at the apex compared to the mid‐ventricle and base. Excellent interobserver and interstudy correlation and agreement were observed.

Conclusion

The use of SENC MRI for the assessment of normal RV contraction pattern is feasible and accurate in 3T MRI. J. Magn. Reson. Imaging 2008;28:1379–1385. © 2008 Wiley‐Liss, Inc.