Risk factors for early mortality in patients with pulmonary tuberculosis admitted to the emergency room.

Abstract Background and objectives Mortality of patients with pulmonary tuberculosis (TB) admitted to emergency departments is high. This study was aimed at analysing the risk factors associated with early mortality and designing a risk score based on simple parameters. Methods This prospective case-control study enrolled patients admitted to the emergency department of a referral TB hospital. Clinical, radiological, biochemical and microbiological risk factors associated with death were compared among patients dying within one week from admission (cases) and those surviving (controls). Results Forty-nine of 250 patients (19.6%) experienced early mortality. Multiple logistic regression analysis showed that oxygen saturation (SaO2) ≤90%, severe malnutrition, tachypnoea, tachycardia, hypotension, advanced disease at chest radiography, severe anaemia, hyponatremia, hypoproteinemia and hypercapnia were independently and significantly associated with early mortality. A clinical scoring system was further designed to stratify the risk of death by selecting five simple parameters (SpO2 ≤ 90%, tachypnoea, hypotension, advanced disease at chest radiography and tachycardia). This model predicted early mortality with a positive predictive value of 94.88% and a negative predictive value of 19.90%. Conclusions The scoring system based on simple parameters may help to refer severely ill patients early to a higher level to reduce mortality, improve success rates, minimise the need for pulmonary rehabilitation and prevent post-treatment sequelae

Named-Entity Recognition for Hindi language using context pattern-based maximum entropy

This paper describes Named Entity Recognition (NER) system for Hindi language using two methodologies. An existing BaseLine Maximum Entropy-based Named Entity (BL-MENE) model and Context Pattern-based MENE (CP-MENE) framework the one proposed in this work. BL-MENE utilizes several features for the NER task but suffers from inaccurate Named Entity (NE) boundary detection, mis-classification errors, and partial recognition of NEs due to certain missing essentials. However, CP-MENE based NER task incorporates extensive features and patterns set to overcome these problems. In fact, the CP-MENE features include right-boundary, left-boundary, part-of-speech, synonyms, gazetteers and relative pronoun features. CP-MENE formulates a kind of recursive relationship to extract high ranked NE patterns that are generated through regular expressions via python@ code. Nowadays, since the Web contents in the Hindi language are rising, especially in the health-care applications, this work is conducted on the Hindi Health Data (HHD) corpus at Kaggle dataset. We conducted experiments on four NE categories- Person (PER), Disease (DIS), Consumable (CNS) and Symptom (SMP). Usually, researchers’ work upon PER NE within news articles while other NEs, especially related to the health-care domain such as DIS, CNS, and SMP NE types are left out which are incorporated in this research. CP-MENE improvised the classification performance of NEs and the F-measure achieved are 79.68% for PER, 72.50% for DIS, 68.78% for CNS, and 67.23% for SMP respectively which are comparable with respect to other NER approaches

Genetic Architecture of Acute Myocarditis and the Overlap with Inherited Cardiomyopathy

No abstract available

Genetic Architecture of Acute Myocarditis and the Overlap With Inherited Cardiomyopathy.

BACKGROUND: Acute myocarditis is an inflammatory condition that may herald the onset of dilated cardiomyopathy (DCM) or arrhythmogenic cardiomyopathy (ACM). We investigated the frequency and clinical consequences of DCM and ACM genetic variants in a population-based cohort of patients with acute myocarditis. METHODS: This was a population-based cohort of 336 consecutive patients with acute myocarditis enrolled in London and Maastricht. All participants underwent targeted DNA sequencing for well-characterized cardiomyopathy-associated genes with comparison to healthy controls (n=1053) sequenced on the same platform. Case ascertainment in England was assessed against national hospital admission data. The primary outcome was all-cause mortality. RESULTS: Variants that would be considered pathogenic if found in a patient with DCM or ACM were identified in 8% of myocarditis cases compared with <1% of healthy controls (P=0.0097). In the London cohort (n=230; median age, 33 years; 84% men), patients were representative of national myocarditis admissions (median age, 32 years; 71% men; 66% case ascertainment), and there was enrichment of rare truncating variants (tv) in ACM-associated genes (3.1% of cases versus 0.4% of controls; odds ratio, 8.2; P=0.001). This was driven predominantly by DSP-tv in patients with normal LV ejection fraction and ventricular arrhythmia. In Maastricht (n=106; median age, 54 years; 61% men), there was enrichment of rare truncating variants in DCM-associated genes, particularly TTN-tv, found in 7% (all with left ventricular ejection fraction <50%) compared with 1% in controls (odds ratio, 3.6; P=0.0116). Across both cohorts over a median of 5.0 years (interquartile range, 3.9-7.8 years), all-cause mortality was 5.4%. Two-thirds of deaths were cardiovascular, attributable to worsening heart failure (92%) or sudden cardiac death (8%). The 5-year mortality risk was 3.3% in genotype-negative patients versus 11.1% for genotype-positive patients (Padjusted=0.08). CONCLUSIONS: We identified DCM- or ACM-associated genetic variants in 8% of patients with acute myocarditis. This was dominated by the identification of DSP-tv in those with normal left ventricular ejection fraction and TTN-tv in those with reduced left ventricular ejection fraction. Despite differences between cohorts, these variants have clinical implications for treatment, risk stratification, and family screening. Genetic counseling and testing should be considered in patients with acute myocarditis to help reassure the majority while improving the management of those with an underlying genetic variant