Risk of Gastrointestinal Bleeding with Rivaroxaban: A Comparative Study with Warfarin

Introduction. The risk of gastrointestinal (GI) bleeding with rivaroxaban has not been studied extensively. The aim of our study was to assess this risk in comparison to warfarin. Methods. We examined the medical records for patients who were started on rivaroxaban or warfarin from April 2011 to April 2013. Results. We identified 300 patients (147 on rivaroxaban versus 153 on warfarin). GI bleeding occurred in 4.8% patients with rivaroxaban when compared to 9.8% patients in warfarin group (p=0.094). GI bleeding occurred in 8% with therapeutic doses of rivaroxaban (>10 mg/d) compared to 9.8% with warfarin (p=0.65). Multivariate analysis showed that patients who were on rivaroxaban for ≤40 days had a higher incidence of GI bleeding than those who were on it for >40 days (OR = 2.8, p=0.023). Concomitant use of dual antiplatelet agents was associated with increased risk of GI bleeding in the rivaroxaban group (OR = 7.4, p=0.0378). Prior GI bleeding was also a risk factor for GI bleeding in rivaroxaban group (OR = 15.5). Conclusion. The incidence of GI bleeding was similar between rivaroxaban and warfarin. The risk factors for GI bleeding with rivaroxaban were the first 40 days of taking the drug, concomitant dual antiplatelet agents, and prior GI bleeding

Risk of Gastrointestinal Bleeding with Rivaroxaban: A Comparative Study with Warfarin

Introduction. The risk of gastrointestinal (GI) bleeding with rivaroxaban has not been studied extensively. The aim of our study was to assess this risk in comparison to warfarin. Methods. We examined the medical records for patients who were started on rivaroxaban or warfarin from April 2011 to April 2013. Results. We identified 300 patients (147 on rivaroxaban versus 153 on warfarin). GI bleeding occurred in 4.8% patients with rivaroxaban when compared to 9.8% patients in warfarin group ( = 0.094). GI bleeding occurred in 8% with therapeutic doses of rivaroxaban (>10 mg/d) compared to 9.8% with warfarin ( = 0.65). Multivariate analysis showed that patients who were on rivaroxaban for ≤40 days had a higher incidence of GI bleeding than those who were on it for >40 days (OR = 2.8, = 0.023). Concomitant use of dual antiplatelet agents was associated with increased risk of GI bleeding in the rivaroxaban group (OR = 7.4, = 0.0378). Prior GI bleeding was also a risk factor for GI bleeding in rivaroxaban group (OR = 15.5). Conclusion. The incidence of GI bleeding was similar between rivaroxaban and warfarin. The risk factors for GI bleeding with rivaroxaban were the first 40 days of taking the drug, concomitant dual antiplatelet agents, and prior GI bleeding

Simple design of optical fiber displacement sensor using a multimode fiber coupler

A simple design sensor is demonstrated using a fabricated multimode plastic fiber coupler in con-junction with reflective intensity modulation technique. The performances of this sensor are investigated for different light sources. This sensor uses only one fiber for sending and receiving the light and therefore only the back slope exists. The sensor shows the highest performance with the use of yellow light source, which has the highest intensity and the smallest beam divergence. The sensitivity, linear range, resolution and dynamic range of the sensor are obtained at 0.0001 mV/μm, 1500 μm, 70 μm, and 5.0 mm, respectively. The simplicity of the design, high degree of sensitivity, dynamic range and the low cost of the fabrication make it suitable for real field applications

Seasonal variation in the incidence of in-hospital cardiac arrest

Background: Seasonal variation in cardiovascular outcomes, including out-of-hospital cardiac arrest, has been described. Objectives: This study aimed to investigate seasonal differences in the incidence of in-hospital cardiac arrest (IHCA) and associated mortality. Methods: Using National Inpatient Sample data from 2005 to 2019, we determined the incidence of IHCA in 4 seasons. The primary objective was to evaluate overall seasonal trends in the incidence of IHCA and trends stratified by sex, age, and region. The secondary aim was to determine common causes of admission that led to IHCA, differences in those with shockable vs nonshockable IHCA, independent predictors of IHCA, and seasonal variation in IHCA-related in-hospital mortality and length of stay. Results: A consistent winter peak was observed in the incidence of IHCA in both male and female patients over the years in all age groups except young ( Conclusions: Improving insights into factors that influence the higher IHCA event rate during winter may help with proper resource allocation, development of strategies for early recognition of patients vulnerable to IHCA, and closer monitoring and optimization of care to prevent IHCA and improve outcomes

Bundled plastic optical fiber based sensor for ECG signal detection

This study demonstrates the development of a novel low-cost bundled plastic optical fiber (POF) displacement sensor for the measurement of amplitude and frequency of heart rate signal. A compact optical setup is developed in the laboratory for use in the testing. It consists of a fiber optic transmitter, fiber optic bundled probe and photodiode detector, and an electrocardiogram (ECG) simulator as a heart rate signal. The sensitivity of the sensor is found to be 4.6 mV/mm, and thus it is capable of measuring heart rate from 30 bpm to 300 bpm (for the amplitude of ECG at 0.5, 1.0 and 2.0 mV) with linearity of more than 99 %.The results demonstrate that the proposed fiber optic based heart rate sensor is not only easy-to-make, cost-effective and robust but also offers sensitive, stable and high precision heart beat measurements. © 2019 Elsevier Gmb

Effect of tilting angles on the performance of reflective and transmitting types of fiber optic-based displacement sensors

The performances of the fiber optic-based displacement sensor with reflective and transmitting techniques were investigated. The effects of axial displacement on the detected voltage were investigated for different tilting angles of the reflective and receiving fibers. Three types of light sources were used, yellow and red He-Ne including a green pointer laser at peak wavelengths of 594, 633, and 533 nm correspondingly. The highest sensitivity and resolution were obtained at 0.0017 mV/mu m and 4 mu m, respectively with the employment of a 594 nm laser as the light source. These were attributed to the output power and beam quality of the laser which was the highest. The tilting angles didn't change the sensitivity and resolution of the sensors in both setups. The widest linear range was obtained at 2410 mu m with the transmitting technique. The simplicity of the design, high degree of sensitivity, linear range, non-contact measurement and low cost fabrication make it suitable for industrially-orientated applications that include control and micro-displacement in the hazardous region

Burden of arrhythmia and electrophysiologic procedures in alcoholic cardiomyopathy hospitalizations

BACKGROUND: Limited national US data are available regarding the prevalence of and trends in different arrhythmias and the use of electrophysiological procedures in patients with alcoholic cardiomyopathy. METHODS: This was a cross-sectional study that used the Nationwide Inpatient Sample database (2007-2014). Hospitalizations of adults with alcoholic CMP were identified with the ICD-9 code (425.5). CAD and other causes of cardiomyopathy were excluded. Chi-square test, t-test, mixed-effect logistic regression and quantile regression were used. RESULTS: Among 75,430 hospitalizations, 48% had arrhythmias. Individuals with a co-diagnosis of arrhythmia tended to be older (56.9 vs 53.2-year-old) and male (89.5% vs 81.9%). The most prevalent arrhythmias were atrial fibrillation/flutter (31.5%), followed by ventricular tachycardia (7.9%). The prevalence of arrhythmias increased from 44% to 50% (2007-2014) (p \u3c 0.001) and this increase was mainly secondary to the increasing prevalence AFib/AFL. Excluding cardiac arrest, arrhythmias were not associated with increased in-hospital mortality. The median length of stay and total charges for arrhythmia vs no-arrhythmia hospitalizations were 5 vs 4 days (p \u3c 0.001) and $31,127 vs$24,199 respectively (p \u3c 0.001). EP procedures were performed in 5.6% of all hospitalizations and it increased from 5.2% to 6% (2007-2014) (p = 0.2). The most common procedures were cardioversion (2.7%), ICD placement (2.2%) and PPM placement (1.1%). CONCLUSION: Arrhythmias were reported in 48% of hospitalizations. There was an increasing burden of arrhythmias secondary to increasing atrial fibrillation. Excluding cardiac arrest, arrhythmias were not associated with increased in-hospital mortality but were associated with longer hospital stays and higher total charges