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Although the number of women in the field of medicine continues to rise, the discrimination against women and the gender inequity in both leadership roles and salary remains persistent. The gender divide is particularly prominent in male-dominated specialties, such as cardiology. Social media help foster global connections and disseminate information quickly and worldwide. The rise of social media has influenced how female physicians communicate and has shown its benefits particularly within the field of cardiology. Virtual platforms are important avenues where female physicians have united for greater representation of gender issues and advocacy efforts. Social media further amplify gender-equality activism by facilitating the conversations surrounding gender equity and proposing solutions to self-identified issues by the virtual community of female physicians and their allies. In this review, we discuss the role of social media as tools for advancing women in the field of cardiology and fostering gender equality and diversity.
Bien que le nombre de femmes dans le domaine de la médecine continue d'augmenter, la discrimination à l'égard des femmes et l'inégalité entre les sexes, tant au niveau des rôles de direction que des salaires, persistent. L'écart entre les sexes est particulièrement marqué dans les spécialités à prédominance masculine, comme la cardiologie. Les médias sociaux contribuent à favoriser les liens à l'échelle mondiale et permettent de diffuser des renseignements rapidement dans le monde entier. L'essor des médias sociaux a influencé la manière dont les femmes médecins communiquent, et ces médias ont démontré des bienfaits, notamment dans le domaine de la cardiologie. Les plateformes virtuelles sont des moyens importants utilisés par les femmes médecins pour s'unir afin de mieux mettre de l'avant les questions de genre et d'améliorer les efforts de sensibilisation. Les médias sociaux amplifient encore davantage le militantisme en faveur de l'égalité des sexes en facilitant les conversations autour de l'égalité des sexes et en proposant des solutions aux problèmes ciblés par la communauté virtuelle des femmes médecins et de leurs alliés. Dans cet examen, nous discutons du rôle des médias sociaux à titre d'outils permettant de faire progresser les femmes dans le domaine de la cardiologie et de favoriser l'égalité des sexes et la diversité.
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INTRODUCTION: Syncope is common among emergency department (ED) patients with acute pulmonary embolism (PE) and indicates a higher acuity and worse prognosis than in patients without syncope. Whether presyncope carries the same prognostic implications has not been established. We compared incidence of intensive care unit (ICU) admission in three groups of ED PE patients: those with presyncope; syncope; and neither. METHODS: This retrospective cohort study included all adults with acute, objectively confirmed PE in 21 community EDs from January 2013-April 2015. We combined electronic health record extraction with manual chart abstraction. We used chi-square test for univariate comparisons and performed multivariate analysis to evaluate associations between presyncope or syncope and ICU admission from the ED, reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI). RESULTS: Among 2996 PE patients, 82 (2.7%) had presyncope and 109 (3.6%) had syncope. ICU admission was similar between groups (presyncope 18.3% vs syncope 25.7%) and different than their non-syncope counterparts (either 22.5% vs neither 4.7%; p<0.0001). On multivariate analysis, both presyncope and syncope were independently associated with ICU admission, controlling for demographics, higher-risk PE Severity Index (PESI) class, ventilatory support, proximal clot location, and submassive and massive PE classification: presyncope, aOR 2.79 (95% CI, 1.40, 5.56); syncope, aOR 4.44 (95% CI 2.52, 7.80). These associations were only minimally affected when excluding massive PE from the model. There was no significant interaction between either syncope or presyncope and PESI, submassive or massive classification in predicting ICU admission. CONCLUSION: Presyncope appears to carry similar strength of association with ICU admission as syncope in ED patients with acute PE. If this is confirmed, clinicians evaluating patients with acute PE may benefit from including presyncope in their calculus of risk assessment and site-of-care decision-making.
Asunto(s)
Embolia Pulmonar/complicaciones , Medición de Riesgo/métodos , Síncope , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Selección de Paciente , Pronóstico , Embolia Pulmonar/terapia , Estudios Retrospectivos , Síncope/diagnóstico , Síncope/etiologíaRESUMEN
PURPOSE OF REVIEW: Delayed graft function (DGF) has several long-term graft implications in the field of kidney transplantation and remains a challenge. The incidence of DGF is on the rise because of an increasing use of marginal kidneys in an era of organ shortage. Risk factors for DGF are numerous and stem from multiple sources in the transplant chain starting from the donor to its final allocation in the recipient. There is no FDA-approved therapy for DGF, and several therapies are being studied to mitigate ischemic injury and prolong graft survival. RECENT FINDINGS: Published data from studies suggest that ischemia-reperfusion injury (IRI) and immune responses to transplants are the leading cause of DGF, which in turn is associated with an increased incidence in acute renal rejection. Several novel methods are being developed and are undergoing further clinical validation to prove as an effective therapy against DGF. SUMMARY: Recent studies have proposed several different mechanisms to mitigate ischemic injury to prevent acute renal injury, both of which are representative of DGF. New therapies must be effectively reviewed to ensure advancement of DGF prevention. A number of immunotherapies targeted towards inhibition of complement activation in addition to other novel therapies might prove promising towards mitigating DGF.