Long-term prognosis of patients with heart failure: Follow-up results of journey HF-TR study population

Background: Despite advances in therapeutic management of patients with heart failure, there is still an increasing morbidity and mortality all over the world. In this study, we aimed to present the 3-year follow-up outcomes of patients included in the Journey HF-TR study in 2016 that has evaluated the clinical characteristics and management of patients with acute heart failure admitted to the hospital and present a national registry data. Methods: The study was designed retrospectively between November 2016 and December 2019. Patient data included in the previously published Journey HF-TR study were used. Among 1606 patients, 1484 patients were included due to dropout of 122 patients due to inhospital death and due to exclusion of 173 due to incomplete data. The study included 1311 patients. Age, gender, concomitant chronic conditions, precipitating factors, New York Heart Association, and left ventricular ejection fraction factors were adjusted in the Cox regression analysis. Results: During the 3-year follow-up period, the ratio of hospitalization and mortality was 70.5% and 52.1%, respectively. Common causes of mortality were acute decompensation of heart failure and acute coronary syndrome. Angiotensin receptor blockers, beta-blockers, statin, and sacubitril/valsartan were found to reduce mortality. Hospitalization due to acute decompensated heart failure, acute coronary syndrome, lung diseases, oncological diseases, and cerebrovascular diseases was associated with the increased risk of mortality. Implantation of cardiac devices also reduced the mortality. Conclusions: Despite advances in therapeutic management of patients with heart failure, our study demonstrated that the long-term mortality still is high. Much more efforts are needed to improve the inhospital and long-term survival of patients with chronic heart failure

Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

Prognostic value of the neutrophil-lymphocyte ratio in patients with ST-elevated acute myocardial infarction

© The Author(s) 2012The predictive value of leukocyte counts has been reported in patients with acute myocardial infarction (AMI). We aimed to evaluate the predictive value of the total leukocyte count and neutrophil-lymphocyte (N/L) ratio for mortality due to AMI. A total of 522 patients with acute ST-elevated MI were included in the study. The study population was divided into tertiles based on admission N/L ratio values. High (n = 174) and low N/L (n = 348) ratio groups were defined as patients having values in the third tertile (>5.77) and lower 2 tertiles (≤5.77), respectively. The high N/L ratio group had a significantly higher incidence of in-hospital cardiovascular mortality (13.8% vs 4.6%, P 5.77 was found to be an independent predictor of in-hospital cardiovascular mortality (hazard ratio: 3.78, 95% confidence interval: 1.71-8.30, P = .001). A high N/L ratio is a strong and independent predictor of in-hospital cardiovascular mortality of AMI with ST elevation

Assessment of Respiratory Viral Co-infections Among SARS-CoV-2-Infected Patients

Introduction: Emerging evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients are at an increased risk for co-infections. The aim of this study was to assess the prevalence of respiratory viral co-infections among SARS-CoV-2 patients via molecular testing. Materials and Methods: Nasopharyngeal swabs of 68 SARS-CoV-2 positive cases detected between December 1, 2020 and December 20, 2021 were subjected to nucleic acid isolation and screening using molecular techniques. Real-time-qPCR analysis was performed using the FTD Respiratory Pathogens 21 Panel Kit. Positive results were further confirmed by QIAstat-Dx™ Respiratory Panel. Results: Co-infections were detected in 7.4% (n= 5/68) of SARS-CoV-2-infected patients. Commonly observed co-infecting pathogens were rhinovirus, parainfluenza virus 4, influenza A H3N2, bocavirus, respiratory syncytial virus, and adenovirus. Overall, co-infections were observed in the ≤35 age group. Patients with co-infections did not require hospitalization. Conclusion: Simultaneous identification of respiratory co-infections in SARS-CoV-2 positive patients offers the possibility of implementing optimized treatment regimens preventing morbidity and mortality

Propafenone-induced cardiac arrest: full recovery with insulin, is it possible?

Propafenone may cause mental depression, mania, convulsion, metabolic acidosis, hypotension, prolonged QRS, atrioventricular block, and cardiac arrest if it is taken at a dose greater than recommended. There is no standard specific treatment or antidote for a propafenone overdose, and life-supporting treatments are applied in these cases. In this case report, we report a case of a 15-year-old female patient who experienced cardiac arrest after an oral propafenone overdose. She was successfully treated using cardiopulmonary resuscitation, which took approximately 1.5 hours. Dopamine infusion, sodium bicarbonate, and insulin treatment were also administered to the patient. High-dose insulin treatment may be an effective treatment of propafenone poisoning