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  • Ovid Technologies (Wolters Kluwer Health)  (8)
  • 1
    Online Resource
    Online Resource
    Alveolar Hydatid : Radiologic-Histologic Correlation
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Infectious Diseases in Clinical Practice Vol. 27, No. 4 ( 2019-7), p. 219-225
    Details
    In: Infectious Diseases in Clinical Practice, Ovid Technologies (Wolters Kluwer Health), Vol. 27, No. 4 ( 2019-7), p. 219-225
    Abstract: The aim of the present study was to study the different imaging appearances on proven cases of hepatic alveolar hydatid, which is often misdiagnosed as a tumor. Materials and Methods We studied ultrasonography, computed tomography, and magnetic resonance imaging findings in 21 histopathologically proven cases of hepatic alveolar hydatid disease over a period of 1½ year. The ultrasonography findings were heterogeneous hyperechoic mass in 14 cases, multilocular cystic mass in 3 cases, and hyperechoic mass with calcification giving dense acoustics in 4 cases. Computed tomography findings were a sheet-like hypodense, infiltrative, nonenhancing mass without biliary or portal encasement or infiltration in 16 cases, biliary infiltration in 4 cases, and portal encasement in 3 cases. The magnetic resonance imaging findings showed that all 21 patients had a characteristic microvesicular appearance of the parasitic mass on T2-weighted images corresponding to the microvesicles demonstrated on histopathology. The portal encasement and biliary infiltration were also demonstrated on magnetic resonance (MR) images. Conclusions T2-weighted MR images correlate with the histologic characteristic of the hepatic alveolar hydatid disease. Ultrasonography and computed tomography may help in initial assessment of the extent of the disease, but MR helps in exact diagnosis.
    Type of Medium: Online Resource
    ISSN: 1536-9943 , 1056-9103
    URL: Article
    DOI: 10.1097/IPC.0000000000000746
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2062211-9
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  • 2
    Online Resource
    Online Resource
    Genetic Determinants of Major Blood Lipids in Pakistanis Compared With Europeans
    Ovid Technologies (Wolters Kluwer Health) ; 2010
    In:  Circulation: Cardiovascular Genetics Vol. 3, No. 4 ( 2010-08), p. 348-357
    Details
    In: Circulation: Cardiovascular Genetics, Ovid Technologies (Wolters Kluwer Health), Vol. 3, No. 4 ( 2010-08), p. 348-357
    Abstract: Evidence is sparse about the genetic determinants of major lipids in Pakistanis. Methods and Results— Variants (n=45 000) across 2000 genes were assessed in 3200 Pakistanis and compared with 2450 Germans using the same gene array and similar lipid assays. We also did a meta-analysis of selected lipid-related variants in Europeans. Pakistani genetic architecture was distinct from that of several ethnic groups represented in international reference samples. Forty-one variants at 14 loci were significantly associated with levels of HDL-C, triglyceride, or LDL-C. The most significant lipid-related variants identified among Pakistanis corresponded to genes previously shown to be relevant to Europeans, such as CETP associated with HDL-C levels (rs711752; P 〈 10 −13 ), APOA5/ZNF259 (rs651821; P 〈 10 −13 ) and GCKR (rs1260326; P 〈 10 −13 ) with triglyceride levels; and CELSR2 variants with LDL-C levels (rs646776; P 〈 10 −9 ). For Pakistanis, these 41 variants explained 6.2%, 7.1%, and 0.9% of the variation in HDL-C, triglyceride, and LDL-C, respectively. Compared with Europeans, the allele frequency of rs662799 in APOA5 among Pakistanis was higher and its impact on triglyceride concentration was greater ( P -value for difference 〈 10 −4 ). Conclusions— Several lipid-related genetic variants are common to Pakistanis and Europeans, though they explain only a modest proportion of population variation in lipid concentration. Allelic frequencies and effect sizes of lipid-related variants can differ between Pakistanis and Europeans.
    Type of Medium: Online Resource
    ISSN: 1942-325X , 1942-3268
    URL: Article
    DOI: 10.1161/CIRCGENETICS.109.906180
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2010
    detail.hit.zdb_id: 2927603-2
    detail.hit.zdb_id: 2457085-0
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  • 3
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    Abstract 13502: Prognostic Significance of Non-Infarct-Related Coronary Artery Chronic Total Occlusion in Patients Presenting With Acute Myocardial Infarction: A Systematic Review and Meta-Analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 146, No. Suppl_1 ( 2022-11-08)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Introduction: In patients with acute myocardial infraction (AMI), multivessel coronary artery disease (CAD) is associated with worse prognosis than single-vessel CAD. Several observational studies have reported worse clinical outcomes in AMI patients with non-infarct-related artery chronic total occlusion (n-IRA CTO). We performed a systematic review and meta-analysis to evaluate the prognostic significance of n-IRA CTO in patients with AMI. Methods: Systematic review was performed querying PubMed, Google Scholar, Cochrane and clinicaltrials.gov from Inception through May 2022. Studies comparing AMI patients with and without n-IRA CTO were included. Outcomes included in-hospital, 30-day and long-term mortality, cardiac mortality, major adverse cardiovascular events (MACE), and major bleeding. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using random effects models. Results: Five prospective, eight retrospective and 3 subgroup analyses of randomized control trials (RCTs) (n-IRA CTO n=2,521, no CTO n=18,397) were identified. Presence of n-IRA CTO was associated with higher in-hospital (RR 2.86, 95% CI 1.77-4.62, p 〈 0.0001, Figure A), 30-day (RR 2.54, 95% CI 1.66-3.89, p 〈 0.00001, B) and long-term mortality (RR 2.32, 95% CI 1.81-2.99, p 〈 0.00001, C), as well as increased risk for cardiac mortality (RR 2.24, 95% CI 1.79-2.81, p 〈 0.0001, D), MACE (RR 1.51, 95% CI 1.32-1.74, p 〈 0.0001, E), and major bleeding (RR 1.99, 1.16-3.41, p=0.01, F) when compared to AMI patients without n-IRA CTO. Conclusions: In AMI patients, the presence of n-IRA CTO is associated with increased mortality and morbidity. Future studies should evaluate whether intensive monitoring and specialized care can improve outcomes in these patients.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.146.suppl_1.13502
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 4
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    Online Resource
    1072 Rates and Predictors for Readmission in Decompensated Cirrhosis at a Large Rural Tertiary Care Hospital
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  American Journal of Gastroenterology Vol. 114, No. 1 ( 2019-10), p. S607-S607
    Details
    In: American Journal of Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 114, No. 1 ( 2019-10), p. S607-S607
    Abstract: Decompensated cirrhosis (DC) is an organ failure state associated with multiorgan involvement. Patients with cirrhosis are frequently readmitted, accounting for a significant portion of the billions of dollars spent annually in hospitalization for chronic liver disease. Various studies involving North American cohorts have reported a varied range of readmissions rates and predictors depending on the location and type of hospital. This study aimed to determine the rates of readmission and validate the predictors of 30 and 90-day readmission at a large rural tertiary care hospital with no liver transplant or hepatology service. METHODS: A retrospective chart review of patients with DC discharged from September 2016 to September 2018 was conducted. Patients with DC were identified through ICD- 10 codes listed as primary or secondary discharge diagnosis. Patient demographics, laboratory values, and disease-related risk factors were recorded. Primary outcomes were a 30- and 90-day inpatient readmission. We used multivariate logistic regression to determine predictors of readmission at 30 and 90-days. RESULTS: A total of 300 patient charts were selected randomly from a sample of 1500 identified through ICD codes. A total of 180 patients that met the inclusion and exclusion criteria were included for analysis. Mean age of the patients was 60.0 ± 11.8 years and 56.74 %were males. The most common etiology for cirrhosis was alcohol use (42.22%), and the mean MELD-Na score was 17 ± 11.8. Mean length of stay was 7 ± 6.6 days. The 30-day and 90- day readmission rate was 28% and 40% respectively. On multivariate analysis, GI bleed, (OR 8.5, 95% CI 2.7-27.2, P = 0.0003), infection, (OR 8.7, 95% CI 2.0-36.6, P = 0.0003) and electrolyte imbalance, (OR 6.6, 95% CI 1.8-24.6, P = 0.0005) were found to be independent predictors of readmission. CONCLUSION: Decompensated cirrhosis is associated with high rates of early and late readmissions at a large rural tertiary care hospital with no liver transplant or hepatology service. The predictors for readmission were also unique. Readmission rates and predictors should be reassessed locally so that structured interventions explicitly targeting the local hospital or region can be taken to prevent these readmissions.
    Type of Medium: Online Resource
    ISSN: 0002-9270 , 1572-0241
    URL: Article
    DOI: 10.14309/01.ajg.0000593820.57923.25
    RVK:
    XA 18920
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 5
    Online Resource
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    Association of the 9p21.3 Locus With Risk of First-Ever Myocardial Infarction in Pakistanis : Case-Control Study in South Asia and Updated Meta-Analysis of Europeans
    Ovid Technologies (Wolters Kluwer Health) ; 2010
    In:  Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 30, No. 7 ( 2010-07), p. 1467-1473
    Details
    In: Arteriosclerosis, Thrombosis, and Vascular Biology, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. 7 ( 2010-07), p. 1467-1473
    Abstract: Objective— To examine variants at the 9p21 locus in a case-control study of acute myocardial infarction (MI) in Pakistanis and to perform an updated meta-analysis of published studies in people of European ancestry. Methods and Results— A total of 1851 patients with first-ever confirmed MI and 1903 controls were genotyped for 89 tagging single-nucleotide polymorphisms at locus 9p21, including the lead variant ( rs1333049 ) identified by the Wellcome Trust Case Control Consortium. Minor allele frequencies and extent of linkage disequilibrium observed in Pakistanis were broadly similar to those seen in Europeans. In the Pakistani study, 6 variants were associated with MI ( P 〈 10 −2 ) in the initial sample set, and in an additional 741 cases and 674 controls in whom further genotyping was performed for these variants. For Pakistanis, the odds ratio for MI was 1.13 (95% CI, 1.05 to 1.22; P =2×10 −3 ) for each copy of the C allele at rs1333049 . In comparison, a meta-analysis of studies in Europeans yielded an odds ratio of 1.31 (95% CI, 1.26 to 1.37) for the same variant ( P =1×10 −3 for heterogeneity). Meta-analyses of 23 variants, in up to 38 250 cases and 84 820 controls generally yielded higher values in Europeans than in Pakistanis. Conclusion— To our knowledge, this study provides the first demonstration that variants at the 9p21 locus are significantly associated with MI risk in Pakistanis. However, association signals at this locus were weaker in Pakistanis than those in European studies.
    Type of Medium: Online Resource
    ISSN: 1079-5642 , 1524-4636
    URL: Article
    DOI: 10.1161/ATVBAHA.109.197210
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2010
    detail.hit.zdb_id: 1494427-3
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  • 6
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    RETRACTED: Cardiovascular outcomes of ethyl eicosapentaenoic acid in diabetes mellitus: A meta-analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Annals of Medicine & Surgery Vol. 84 ( 2022-12)
    Details
    In: Annals of Medicine & Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 84 ( 2022-12)
    Type of Medium: Online Resource
    ISSN: 2049-0801
    URL: Article
    DOI: 10.1016/j.amsu.2022.104846
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2745440-X
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  • 7
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    Online Resource
    1069 Overutilization of CT Scan of the Brain in the Diagnosis of Hepatic Encephalopathy: Choosing Wisely
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  American Journal of Gastroenterology Vol. 114, No. 1 ( 2019-10), p. S606-S607
    Details
    In: American Journal of Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 114, No. 1 ( 2019-10), p. S606-S607
    Abstract: Hepatic encephalopathy (HE) is a clinical diagnosis and rarely requires neuroimaging. Hepatic encephalopathy (HE) is the most common diagnosis for patients with cirrhotic patients presenting with altered mental status (AMS). It is a clinical diagnosis, and computed tomography (CT) of the brain does not contribute to the diagnostic or grading information. However, patients with cirrhosis are at increased risk of intracerebral hemorrhage, and therefore, CT scans are usually performed to rule out other etiologies of AMS, which may lead to overutilization of CT scans. There is limited data on the magnitude and yield of CT scan utility in the workup for HE. This study aims to assess the magnitude and yield of CT scan for the workup of HE in a large tertiary care hospital. METHODS: An electronic medical query for adult patients discharged from our center between September 2016 to June 2019 with ICD-10 codes for liver cirrhosis and its complications was made. A total of 300 patient charts were randomly selected for detailed review. Patients with an established diagnosis of advanced dementia, stroke, intracranial tumor, or bleed were excluded. We collected patient demographics, admission records, readmissions, laboratory values, and imaging records. RESULTS: A total of 214 patients met our search criteria. Out of these, 64 patients admitted with a complaint of AMS were included in the final analysis. The mean age of these patients was 61 ± 9 years, and 54% were males. A total of 152 HE-related hospitalizations were recorded for these 64 patients (an average of 2.3 admissions per patient). In the study duration, a total of 178 brain CT scans were performed for 152 hospitalizations. Out of the total 178 scans, only 2 CT (1.1%) scans revealed intracranial bleed leading to change in diagnosis or management. Notably, 12 (18.75%) patients had multiple CT scans during a single hospitalization. CONCLUSION: The yield of CT scan brain in patients with an established diagnosis of hepatic encephalopathy is low (1%) and usually does not influence the diagnosis or management. CT scans are likely overutilized, leading to unnecessary excessive radiation exposure to the patients and increases the total costs of hospitalization. Institutional efforts should be implied for the judicious use of CT scans in patients with HE. Further large multicenter studies are needed.
    Type of Medium: Online Resource
    ISSN: 0002-9270 , 1572-0241
    URL: Article
    DOI: 10.14309/01.ajg.0000593808.12182.c3
    RVK:
    XA 18920
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 8
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    Risk of Failure and Complications of ERCP: Comparison of Elderly and Young Pakistani Patients : 2367
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  American Journal of Gastroenterology Vol. 111 ( 2016-10), p. S1222-
    Details
    In: American Journal of Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 111 ( 2016-10), p. S1222-
    Type of Medium: Online Resource
    ISSN: 0002-9270
    URL: Article
    DOI: 10.14309/00000434-201610001-02367
    RVK:
    XA 18920
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
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