ABSTRACT
OBJECTIVES: The angiosome concept has significantly impacted diabetic foot ulcer management by highlighting the vascular anatomy's role in wound healing. However, its clinical applicability and validity remain debated due to complexities in foot blood supply and ulcer location determination. METHODS: A cross-sectional study was conducted on 84 individuals with diabetic foot ulcers undergoing lower limb angiography. Demographics, ulcer characteristics, and angiographic data were collected and analyzed using descriptive statistics and relevant tests. RESULTS: Digital subtraction angiography assessed 89 limbs with diabetic foot ulcers; males comprised 54.8%, primarily type 2 diabetes (96.4%), averaging 64.36 ± 10.09 years. Of 129 angiosomes, angiosome 2 (40.3%) had the highest ulcer incidence. Posterior tibial artery (PTA) involvement was predominant (72.9%), while external iliac artery (EIA) and profunda femoris artery (PFA) were least affected (2.4% each). Posterior tibial artery showed 46.5% complete occlusion. Angiosome 2 correlated notably with anterior tibial artery (ATA), peroneal artery (CPA), and PTA, but categorizing angiosomes by supply patterns showed no significant artery correlation (p > .05). CONCLUSIONS: The research indicates inconsistent support for below-the-knee artery involvement correlating with foot ulcer locations in angiosomes. While aiding vascular comprehension, the angiosome concept may not fully elucidate lower limb vascular complexities and ulcer genesis. Factors like collateral circulation should be noticed to understanding ulcer localization and severity, extending beyond angiosomal arterial supply.
ABSTRACT
BACKGROUND: This study aimed to determine the characteristics, vaccination status, and outcomes of confidence interval (COVID-19) patients, admitted to a tertiary hospital in Iran during the predominant severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) Delta variant period. METHODS: This retrospective study assessed the medical records of all hospitalized COVID-19 patients, who were admitted to a tertiary hospital from July 10 to September 15, 2021. Adjusted binary logistic regression analyses were conducted to determine factors associated with poor outcomes. RESULTS: More than 25% of hospitalized patients received at least one vaccine dose of SARS-CoV-2. The Sinopharm BIBP vaccine (China) was the most commonly received vaccine (73.3%). After adjusting for age and comorbidities, the adjusted odds ratio (AOR) for poor outcomes was significantly lower in hospitalized patients who received Remdesivir compared to those not receiving Remdesivir (AOR: 0.35; 95% confidence interval [CI]: 0.15, 0.78; p < .010). Besides, age ≥50 years (AOR: 2.51; 95% CI: 1.38, 4.59; p < .003), low educational level (AOR: 3.99; 95% CI: 1.17, 13.53; p < .027), work outside in the past year (AOR: 1.75; 95% CI: 1.02, 3.00; p < .041), and diabetes mellitus (AOR: 1.95; 95% CI: 1.66, 3.26; p = .011) were associated with more poor outcomes. CONCLUSION: Based on the present results, the risk of mortality and the risk of poor outcomes were lower in patients who received Remdesivir compared to those not receiving Remdesivir. The number of vaccinated patients was smaller than the unvaccinated among hospitalized patients. It is important to emphasize that vaccination reduced the need for hospitalization and that only vaccinated patients with comorbidities required hospitalization.
Subject(s)
COVID-19 , Humans , Middle Aged , SARS-CoV-2 , Iran , Tertiary Care Centers , Retrospective Studies , Hospitalization , VaccinationABSTRACT
Embolic material forms in many parts of the body and can affect anywhere in the body. Pulmonary embolism and embolic stroke are the most common presentations of embolic disorders in the body. Embolic events have different causes, and the heart is one of the most important places where emboli originate. One of the uncommon causes of embolic events is non-bacterial thrombotic endocarditis (NBTE), which can occur in patients with advanced cancer. NBTE can lead to embolism. Embolisation may occur in some organs including the central nervous system, kidneys, spleen, limb extremities, and coronary arteries. The authors aim to describe a rare case with concurrent pulmonary embolism (PE) and embolic stroke caused by non-bacterial thrombotic endocarditis (NBTE) in a woman with breast cancer.
ABSTRACT
Objectives: To avoid worsening from mild, moderate, and severe diseases and to reduce mortality, it is necessary to identify the subpopulation that is more vulnerable to the development of COVID-19 unfavorable consequences. This study aims to investigate the demographic information, prevalence rates of common comorbidities among negative and positive real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) patients, and the association between SARS-CoV-2 cycle threshold (Ct) at hospital admission, demographic data, and outcomes of the patients in a large population in Northern Iran. Methods: This large retrospective cross-sectional study was performed from 7 March to 20 December 2020. Demographic data, including gender, age, underlying diseases, clinical outcomes, and Ct values, were obtained from 8,318 cases suspected of COVID-19, who were admitted to four teaching hospitals affiliated to Babol University of Medical Sciences (MUBABOL), in the north of Iran. Results: Since 7 March 2020, the data were collected from 8,318 cases suspected of COVID-19 (48.5% female and 51.5% male) with a mean age of 53 ± 25.3 years. Among 8,318 suspected COVID-19 patients, 3,250 (39.1%) had a positive rRT-PCR result; 1,632 (50.2%) patients were male and 335 (10.3%) patients died during their hospital stay. The distribution of positive rRT-PCR revealed that most patients (464 (75.7%)) had a Ct between 21 and 30 (Group B). Conclusion: Elderly patients, lower Ct, patients having at least one comorbidity, and male cases were significantly associated with increased risk for COVID-19-related mortality. Moreover, mortality was significantly higher in patients with diabetes, kidney disease, and respiratory disease.
