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Mahabir S, Okumus N, Samra G, Mohammed A, Gupta M, Naser A, Puttur A, Bihler E, DuMont T, Nauer K, Khalif A, Ivanova V. Common Cardiovascular Diseases in Women. Crit Care Nurs Q 2023; 46:362-376. [PMID: 37684732 DOI: 10.1097/cnq.0000000000000473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Cardiovascular disease is a leading cause of death for women in the United States. This article encompasses the epidemiology/etiology, clinical presentation, diagnostic assessment, management, and prognosis of some common cardiovascular disorders seen in women with a special focus on pregnancy.
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Affiliation(s)
- Sunita Mahabir
- Division of Cardiology, Allegheny General Hospital, Pittsburgh, Pennsylvania (Ms Mahabir and Drs Okumus, Samra, Mohammed, and Gupta); Division of Medicine (Drs Naser and Puttur), Division of Pulmonary and Critical Care Medicine (Drs Bihler and DuMont and Mr Nauer), Division of Cardiovascular Disease and Critical Care (Dr Khalif), and Division of Cardiovascular Medicine (Dr Ivanova), Allegheny Health Network Medicine Institute, Pittsburgh, Pennsylvania; and Drexel University College of Medicine, Philadelphia, Pennsylvania (Dr Ivanova)
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Steer KE, Johnson ML, Adjerid K, Bond LE, Howe SP, Khalif A, Nkachukwu KC, Edmonds CE, German RZ, Mayerl CJ. The Function of the Mammal Extrinsic Tongue Musculature in the Transition from Suckling to Drinking. Integr Comp Biol 2023; 63:641-652. [PMID: 37160353 PMCID: PMC10503468 DOI: 10.1093/icb/icad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/25/2023] [Accepted: 05/02/2023] [Indexed: 05/11/2023] Open
Abstract
The transition from suckling to drinking is a developmental pathway that all mammals take. In both behaviors, the tongue is the primary structure involved in acquiring, transporting, and swallowing the liquid. However, the two processes are fundamentally different: during suckling, the tongue must function as a pump to generate suction to move milk, whereas during drinking, the tongue moves backwards and forwards through the mouth to acquire and move water. Despite these fundamental differences, we have little understanding of how tongues role varies between these behaviors. We used an infant pig model to investigate the relationships between anatomy, physiology, and function of the tongue to examine how lingual function is modulated in the transition from infancy to adulthood. We found that while some muscles were proportionally largest at birth, others were proportionally larger at the time of weaning. Furthermore, we found variation in tongue movements between suckling and drinking along both the mediolateral and anteroposterior axes, resulting in differences in tongue deformation between the two behaviors. The extrinsic tongue muscles also changed in function differently between drinking and suckling. Genioglossus increased its activity and turned on and off earlier in the cycle during drinking, whereas hyoglossus fired at lower amplitudes during drinking, and turned on and off later in the cycle. Together, the data highlight the significant need for high neuroplasticity in the control of the tongue at a young age in mammals and suggest that the ability to do so is key in the ontogeny and evolution of feeding in these animals.
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Affiliation(s)
- K E Steer
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown OH 44272, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - M L Johnson
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown OH 44272, USA
| | - K Adjerid
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown OH 44272, USA
- Department of Biomedical Engineering, Tulane University, New Orleans, Lousiana, 70118, USA
| | - L E Bond
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown OH 44272, USA
| | - S P Howe
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown OH 44272, USA
| | - A Khalif
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown OH 44272, USA
| | - K C Nkachukwu
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown OH 44272, USA
| | - C E Edmonds
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown OH 44272, USA
- School of Biomedical Sciences, Kent State University, Kent, OH 44242, USA
| | - R Z German
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown OH 44272, USA
| | - C J Mayerl
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
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Kanwar MK, Blumer V, Zhang Y, Sinha SS, Garan AR, Hernandez-Montfort J, Khalif A, Hickey GW, Abraham J, Mahr C, Li B, Sangal P, Walec KD, Zazzali P, Kataria R, Pahuja M, Ton VANK, Harwani NM, Wencker D, Nathan S, Vorovich E, Hall S, Khalife W, Li S, Schwartzman A, Kim JU, Vishnevsky OA, Trinquart L, Burkhoff D, Kapur NK. Pulmonary Artery Catheter Use and Risk of In-hospital Death in Heart Failure Cardiogenic Shock. J Card Fail 2023; 29:1234-1244. [PMID: 37187230 DOI: 10.1016/j.cardfail.2023.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/29/2023] [Accepted: 05/02/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Pulmonary artery catheters (PACs) are increasingly used to guide management decisions in cardiogenic shock (CS). The goal of this study was to determine if PAC use was associated with a lower risk of in-hospital mortality in CS owing to acute heart failure (HF-CS). METHODS AND RESULTS This multicenter, retrospective, observational study included patients with CS hospitalized between 2019 and 2021 at 15 US hospitals participating in the Cardiogenic Shock Working Group registry. The primary end point was in-hospital mortality. Inverse probability of treatment-weighted logistic regression models were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CI), accounting for multiple variables at admission. The association between the timing of PAC placement and in-hospital death was also analyzed. A total of 1055 patients with HF-CS were included, of whom 834 (79%) received a PAC during their hospitalization. In-hospital mortality risk for the cohort was 24.7% (n = 261). PAC use was associated with lower adjusted in-hospital mortality risk (22.2% vs 29.8%, OR 0.68, 95% CI 0.50-0.94). Similar associations were found across SCAI stages of shock, both at admission and at maximum SCAI stage during hospitalization. Early PAC use (≤6 hours of admission) was observed in 220 PAC recipients (26%) and associated with a lower adjusted risk of in-hospital mortality compared with delayed (≥48 hours) or no PAC use (17.3% vs 27.7%, OR 0.54, 95% CI 0.37-0.81). CONCLUSIONS This observational study supports PAC use, because it was associated with decreased in-hospital mortality in HF-CS, especially if performed within 6 hours of hospital admission. CONDENSED ABSTRACT An observational study from the Cardiogenic Shock Working Group registry of 1055 patients with HF-CS showed that pulmonary artery catheter (PAC) use was associated with a lower adjusted in-hospital mortality risk (22.2% vs 29.8%, odds ratio 0.68, 95% confidence interval 0.50-0.94) compared with outcomes in patients managed without PAC. Early PAC use (≤6 hours of admission) was associated with a lower adjusted risk of in-hospital mortality compared with delayed (≥48 hours) or no PAC use (17.3% vs 27.7%, odds ratio 0.54, 95% confidence interval 0.37-0.81).
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Affiliation(s)
- Manreet K Kanwar
- Cardiovascular Institute at Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Vanessa Blumer
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, Ohio
| | - Yijing Zhang
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
| | - Shashank S Sinha
- Inova Heart and Vascular Institute, Inova Fairfax Campus, Falls Church, Virginia
| | - Arthur R Garan
- Beth Israel Deaconess Medical Center, Boston, Massachusetts'
| | | | - Adnan Khalif
- Cardiovascular Institute at Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Gavin W Hickey
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jacob Abraham
- Center for Cardiovascular Analytics, Research and Data Science, Providence Heart Institute, Portland, OR
| | - Claudius Mahr
- University of Washington Medical Center, Seattle, Washington
| | - Borui Li
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
| | - Paavni Sangal
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
| | - Karol D Walec
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
| | - Peter Zazzali
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
| | - Rachna Kataria
- Lifespan Cardiovascular Institute, Brown University, Providence, Rhode Island
| | - Mohit Pahuja
- University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - VAN-Khue Ton
- Massachusetts General Hospital, Boston, Massachusetts
| | - Neil M Harwani
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
| | - Detlef Wencker
- Baylor Scott & White Advanced Heart Failure Clinic, Dallas, Texas
| | | | | | - Shelley Hall
- Baylor Scott & White Advanced Heart Failure Clinic, Dallas, Texas
| | | | - Song Li
- University of Washington Medical Center, Seattle, Washington
| | | | - J U Kim
- Houston Methodist Research Institute, Houston, Texas
| | | | - Ludovic Trinquart
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston and Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA
| | | | - Navin K Kapur
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts.
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Khalif A, Kanwar MK. ECMO as a bridge to advanced heart failure therapies: Moving beyond 'crash and burn'. J Heart Lung Transplant 2023; 42:1072-1073. [PMID: 37098373 DOI: 10.1016/j.healun.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/08/2023] [Accepted: 04/10/2023] [Indexed: 04/27/2023] Open
Affiliation(s)
- Adnan Khalif
- Cardiovascular Institute at Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Manreet K Kanwar
- Cardiovascular Institute at Allegheny Health Network, Pittsburgh, Pennsylvania.
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Mahabir S, Samra G, Madgula A, Link C, Khalif A, Ranganathan K, Kanwar M. The Utility of Mechanical Circulatory Support in the Management of Massive Pulmonary Embolism with Right Ventricular Failure. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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jabbour F, Tsukashita M, Okumus N, Hegde S, Radhakrishnan S, Khalif A. IMPELLA 5.5 VIA A MINI STERNOTOMY AS A BRIDGE TO DURABLE LEFT VENTRICULAR ASSIST DEVICE IN THE SETTING OF LYMPHOCYTIC MYOCARDITIS COMPLICATED BY SCAI STAGE E CARDIOGENIC SHOCK. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)04007-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Noory AJ, Hegde S, Nestasie M, Yasin M, Khalif A, Chakravarthy M, Lasorda DM. 'AIRED OUT’ RIGHT VENTRICLE: AN UNEXPECTED EMBOLUS DURING VA-ECMO SUPPORTED PERCUTANEOUS MECHANICAL THROMBECTOMY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)04432-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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Samra GS, Mahabir S, Khalif A, Ranganathan K. HEARTBREAK AT THE PIRATES GAME: PERCUTANEOUS EXTRACORPOREAL LIFE SUPPORT AS A RESCUE THERAPY IN ACUTE MYOCARDIAL INFARCTION COMPLICATED BY OUT-OF-HOSPITAL CARDIAC ARREST. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)03178-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Khurana A, Khalif A, Al-Adwan SA, Khalil R. THE SUICIDE LEFT VENTRICLE: A DREADED COMPLICATION OF POST AORTIC VALVE REPLACEMENT. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)03355-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Khurana A, Khalif A, Popeck M, Oehler A, Chakravarthy M. PERCUTANEOUS DEBULKING OF AMITRAL VALVE VEGETATION: A NOVEL THERAPY FOR THE TREATMENT OF NONBACTERIAL THROMBOTIC ENDOCARDITIS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02924-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Cormican DS, Khalif A, McHugh S, Dalia AA, Drennen Z, Nuñez-Gil IJ, Ramakrishna H. Analysis of the Updated ACC/AHA Coronary Revascularization Guidelines With Implications for Cardiovascular Anesthesiologists and Intensivists. J Cardiothorac Vasc Anesth 2023; 37:135-148. [PMID: 36347728 DOI: 10.1053/j.jvca.2022.09.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Daniel S Cormican
- Divisions of Cardiothoracic Anesthesiology and Critical Care Medicine, Anesthesiology Institute, Allegheny Health Network, Pittsburgh, PA
| | - Adnan Khalif
- Cardiovascular Institute, Allegheny Health Network, Pittsburgh, PA
| | - Stephen McHugh
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Adam A Dalia
- Division of Cardiac Anesthesiology, Department of Critical Care, Anesthesia, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Zachary Drennen
- Anesthesiology Institute, Allegheny Health Network, Pittsburgh, PA
| | - Ivan J Nuñez-Gil
- Cardiovascular Institute, Hospital Clinico San Carlos, Madrid, Spain
| | - Harish Ramakrishna
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
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Elhamdani A, Alhuneafat L, Tobaa A, Din MTU, Bosah A, Vashistha K, Doyle M, Khalif A, Poornima IG. DOES INPATIENT PREOPERATIVE CARDIAC WORKUP IMPROVE PATIENT OUTCOMES? J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01981-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hegde S, Bucklew E, Radhakrishnan S, Okumus N, Khalif A, Noory AJ, Chakravarthy M. MECHANICAL THROMBECTOMY IN A PATIENT WITH CONCURRENT PULMONARY EMBOLUS AND PATENT FORAMEN OVALE: THE UTILITY OF ECHOCARDIOGRAM WITH BUBBLE STUDY. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)03894-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Fu S, Mian T, Radhakrishnan S, Joseph NR, Khalif A, Hughes-Doichev R, Lasorda D, Chakravarthy M, Radhakrishnan AU, Raina A. CHARACTERISTICS AND OUTCOMES OF PATIENTS UNDERGOING ENDOVASCULAR REMOVAL OF TRICUSPID VALVE VEGETATIONS VS. CATHETER-RELATED MASSES USING THE ANGIOVAC SYSTEM. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01586-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kashyap K, Tobaa A, Khalif A, Doyle M, Shah M. Invasive Coronary Angiography Yield When Applying A Computed Tomography-derived Fractional Flow Reserve (ct-ffrct) Strategy: A Real-world Experience. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Vashistha K, Fu S, Joseph N, Khalif A, Farah V. GULP! TRAUMATIC HEMOPERICARDIUM SUGGESTED BY BARIUM SWALLOW. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)04028-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mirza S, Khalif A, Khodjaev S, Alpert C, Raina A, Kanwar M, Murali S, Benza R, Hadi A. Echocardiographic Estimation of Pulmonary Artery Pulsatility Index in Pulmonary Hypertension. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Khalif A, Rahman R, Fu S, Waqar F. AN UNUSUAL CASE OF LEFT VENTRICULAR ANEURYSM DUE TO MYOCARDIAL BRIDGING. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)33152-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Fu S, Khalif A, Farah V. RIGHT HEART FAILURE FROM A MISSED ANOMALOUS PULMONARY VEIN CONNECTION: BACK FOR MORE. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)33558-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Khalif A, Pati P. The Forgotten Ventricle: Right Ventricular Failure After Induction and Intubation in a Patient With Severe Pulmonary Hypertension. Chest 2017. [DOI: 10.1016/j.chest.2017.08.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Pati P, Khalif A, Shanmugam B, Perimbeti S, Ward J. Trends in Infective Endocarditis Complicated by Congestive Heart Failure: Data From the National Inpatient Sample From 1999-2014. Chest 2017. [DOI: 10.1016/j.chest.2017.08.095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Khalif A, Shanmugam B, Pati P, Perimbeti S, Yassin M, Ward J. Trends in Overall Mortality and Age Specific Prevalence in Infective Endocarditis: Data From the National Inpatient Sample From 1999-2014. Chest 2017. [DOI: 10.1016/j.chest.2017.08.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Khalif A, Pati P, Shanmugam B, Perimbeti S, Ward J. Respiratory Failure in Acute Infective Endocarditis, Trends and Outcomes: Data From the National Inpatient Sample From 1999-2014. Chest 2017. [DOI: 10.1016/j.chest.2017.08.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Pati P, Khalif A, Shanmugam B. Abstract 504: Regional Variations of Ischemic Stroke in The United States. Arterioscler Thromb Vasc Biol 2017. [DOI: 10.1161/atvb.37.suppl_1.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Geographic Distribution of Acute Ischemic Stroke admissions in the United States
Background:
The geographic distribution of acute ischemic stroke in the United States has not been evaluated, unlike the association shown with acute MI by Patel et al., (International Journal of Cardiology, 2014, 172.3). Our study looked at the geographic distribution and seasonal variation of acute ischemic stroke using the National Inpatient Sample (NIS) from 2011 - 2013.
Methods:
Adult admissions with a primary diagnosis of acute ischemic stroke were extracted from the NIS database using the ICD 9 code 434.91 from 2011 - 2013. Admission information included hospital region (West, South, Mid-Atlantic and Northwest) and seasonal admission rates (Winter=December-February, Spring=March-May, Summer=June-August, Fall=September-November). A Chi square analysis was used to analyze differences in categorical variables (we assumed a normal distribution of 25% per region).
Results:
A total of 120714 admissions were identified (weighted = 603361). There were more cases of acute ischemic stroke in the South (41.52 percent of admissions) compared to the mid Atlantic (21.4), Northwest (17.98) or West (19.08) with a p value < 0.0001. Each year between 2011 to 2013 showed a higher rate of admissions for acute ischemic stroke in the South. Taking the years into summation showed no statistically significant difference in seasonal variation in any of the regions.
Conclusion:
Our study shows a higher number of admissions for acute ischemic stroke in the South, but failed to show any seasonal differences. However, there are several studies that suggest a preponderance of admissions for acute myocardial infarction during the winter season, Spencer et al., (Journal of the American College of Cardiology, 1998, 31.2.) Further studies are needed to identify why there is a significant regional difference in the admission rates for acute ischemic stroke.
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Khalif A, Saha D, Butcher B, Robertson DB. A Rare Case of Pericardial Tamponade as the Initial Presentation of Metastatic Non-small Cell Lung Cancer. Chest 2016. [DOI: 10.1016/j.chest.2016.08.856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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