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INTRODUCTION: Heart failure is a pressing public health concern, affecting millions in the United States and projected to rise significantly by 2030. Iron deficiency, prevalent in nearly half of ambulatory heart failure patients, contributes to anemia and diminishes patient outcomes. In this study, we aim to evaluate the impact of iron deficiency anemia on acute heart failure hospitalizations outcomes. METHODS: Utilizing the 2019 National Inpatient Sample (NIS) database, a retrospective observational study assessed 112,864 adult patients hospitalized with heart failure and 7,865 cases also had a concomitant diagnosis of iron deficiency anemia (IDA). RESULTS: Among 112,864 heart failure hospitalizations in 2019, approximately 7% had concomitant iron deficiency anemia (IDA). Heart failure patients with IDA exhibited distinct demographic characteristics, with females comprising 51.1% (p < 0.01) and higher rates of complicated hypertension (p < 0.01), complicated diabetes (p < 0.01), and peripheral vascular disease (p < 0.01). Adjusted mean LOS for patients with IDA was significantly longer at 1.31 days (95% CI 0.71-1.47; p < 0.01), persisting in both HFpEF and HFrEF subgroups. While total hospital charges were comparable in HFpEF, HFrEF patients with IDA incurred significantly higher charges ($13427.32, 95% CI: 1463.35-$25391.29, p = 0.03) than those without IDA. Complications such as atrial fibrillation and acute kidney injury were notably more prevalent in HFpEF and HFrEF patients with IDA. CONCLUSION: The study highlighted that iron deficiency in heart failure patients leads to extended hospital stays, increased costs, and heightened risks of specific complications, particularly in HFrEF. Our study emphasized the implications of IDA in patients with heart failure ranging from prolonged hospitalizations and increased costs. Addressing iron deficiency is crucial, given its substantial impact on heart failure hospitalizations and outcomes, emphasizing the need for proactive diagnosis and management.
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Background: congenital pouch colon (CPC) is an extremely rare Congenital gastrointestinal pathology, in which the normal colon is either partially or completely replaced by a pouch-like dilatation communicating with the urogenital tract through a fistula. That's divided into 2 types: Complete CPC and Incomplete CPC. Worldwide and middle east Arabian ethnicity except for Indians, show high scarcity regarding the incidence. Herein, we report a case of incomplete congenital pouch colon syndrome with glandular hypospadias and cardiac anomalies that are considered to be the 2nd documented case in the middle east and the first in Westbank. Case presentation: A 1-day-old newborn boy with prenatal history of abdominal cyst in 2nd trimester US, presented hours after birth with abdominal distention (Fig- 1), in addition to the imperforate anus. The abdominal x-ray showed many dilated bowel loops and gasless soft tissue density with calcifications on the right side (Fig- 2). Exploratory laparotomy was done and showed a pouch-like colon that later on was treated via 2 stages of operation. Clinical discussion: early identification of CPC and differentiation from colon dilatation due to anorectal malformation is essential for the patient's welfare. CPC is more common in males, usually noticed in the neonatal period with abdominal distention, absence of anus, and intestinal obstruction. CPC is managed surgically depending on its type. Conclusion: congenital pouch colon is a rare but important differential diagnosis of abdominal distention, which should always be at the back of the surgeon's mind especially when anorectal malformation is present.
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BACKGROUND: gastric wall abscess is a rare pathology that is often hard to diagnose and is often associated with poor prognosis. Herein, we report a case of Gastric wall abscess that we managed to treat by endoscopy without the need for surgery which is the usual treatment of choice. CLINICAL DATA: a 50 years old female presented with Epigastric pain. Complete blood count revealed Leukocytosis, neutrophilia and an elevated C-reactive protein. Abdominal CT scan showed a small hypodense area with rim wall enhancement in the pyloric canal. Gastroscopy and endoscopic ultrasound guided drainage was performed and the abscess was drained, content sent for pathology evaluation. Patient was discharged home on antibiotics. CONCLUSION: Gastric wall abscess is a rare but important differential diagnosis of Epigastric pain. Endoscopic Ultrasound is the modality of choice to diagnose it. Endoscopic drainage is associated with reduced mortality and morbidity (Soga et al., 2014) [2].