RESUMEN
BACKGROUND: The association of vitamin D deficiency with coronary artery disease (CAD) is controversial. This study seeks the association between vitamin D deficiency and acute myocardial infarction (MI) in Iraq. PATIENTS AND METHODS: A total of 104 patients with acute MI and 104 healthy controls were studied throughout 2015. Their demographic, cardiovascular risk factors, and clinical characteristics were recorded. Serum vitamin D measurement was carried out for all patients. RESULTS: Vitamin D was more deficient in cases than controls; the number of cases was 60 (57.7%) and 53 (51%), respectively. However, a statistically significant difference (P=0.6) was not obtained. In the patient group, type 2 diabetes mellitus showed a strong association with vitamin D deficiency; there were 31 (81.6%) diabetic patients and 29 (43.9%) nondiabetic patients (P<0.001). CONCLUSION: No statistical association between vitamin D deficiency and acute MI was found. Nevertheless, a strong association between vitamin D deficiency and acute MI with type 2 diabetes mellitus was seen.
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BACKGROUND: Central nervous system complications (CNSC) can be the cause of morbidity and mortality in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). We aimed to determine the incidence of CNSC and its impact on survival. PATIENTS AND METHODS: This retrospective cohort study included patients with hematologic disorders who received allo-HSCT between 2002 and 2011 at the University of Nebraska Medical Center. RESULTS: Of the 351 patients identified, 45 developed CNSC (12.8%). The 100-day cumulative incidence of CNSC was 8% (95% confidence interval, 8-15). The most common CNSC included posterior reversible encephalopathy syndrome (40%), stroke or transient ischemic attack (24%), seizures (20%), and infection (9%). The 5-year overall survival was significantly lower among patients with versus without CNSC (14% vs. 44%, P = .0004). In multivariate analysis, the risk of mortality for patients with versus without CNSC was significantly higher (hazard ratio, 1.56; 95% confidence interval, 1.03-2.36; P = .04). CONCLUSION: The occurrence of CNSC after allo-HSCT was associated with reduced survival. Identifying patients at risk, monitoring, early detection, and management of CNSC after allo-HSCT are needed to improve outcomes.
Asunto(s)
Trasplante de Células Madre Hematopoyéticas/efectos adversos , Leucemia Mieloide Aguda/terapia , Síndrome de Leucoencefalopatía Posterior/etiología , Convulsiones/etiología , Accidente Cerebrovascular/etiología , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Lactante , Leucemia Mieloide Aguda/mortalidad , Masculino , Persona de Mediana Edad , Análisis Multivariante , Síndrome de Leucoencefalopatía Posterior/mortalidad , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de Riesgo , Convulsiones/mortalidad , Accidente Cerebrovascular/mortalidad , Trasplante Homólogo , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Acute flaccid paralysis surveillance (AFP) is an essential strategy of the WHO's Polio Eradication Initiative. This is the first study conducted to estimate the incidence, etiology, distribution, and surveillance performance of AFP in Iraq. METHODS: Surveillance data about the AFP cases under the age of 15 years reported from Iraq during January 1997 to December 2011 were depended in the current study. RESULTS: A total of 4974 cases of AFP were reported from Iraq during the study period, with an annual incidence of 2.5/100,000 population. Guillain-Barré syndrome represented more than half of the reported cases (N = 2611, 52.5%), followed by traumatic neuritis (N = 715, 14.4%), and other CNS infections (N = 292, 5.9%). Poliomyelitis accounted for 166 (3.3%) of cases, the last reported case being in January 2000. Surveillance performance showed that all, but two, indicators were below the required WHO recommended levels. CONCLUSIONS: AFP surveillance remains the gold standard method for poliomyelitis detection. It witnessed dramatic changes over the last two decades. This has raised people's and clinicians' awareness to the importance of promptness in notifying suspected cases and timely transportation of stool specimens to the National Poliovirus Laboratory in Baghdad, or alternatively having more than one laboratory for poliovirus detection in the country, all of which are very useful measures to increase the surveillance performance in the country.