Mcdowellforeman4605

0001), history of major bleeding (OR 2.85; 95% CI, 1.96-4.14; P  less then  .0001), time since AF diagnosis (OR 1.04; 95% CI, 1.01-1.06; P  less then  .0001), concomitant vascular disease (OR 1.43; 95% CI, 1.10-1.87; P = .0008) and diabetes mellitus (OR 1.3; 95% CI, 1.02-1.65, P = .03). Patients with minor bleeding, compared with the remaining subjects scored higher on the JAKQ (median, 62.5% vs 56.2%, respectively, P  less then  .0001). The former group knew more about the purpose of anticoagulant therapy (71.8% vs 65.7%, P = .01) and bleeding as its key side effect (66.1% vs 52.7%, P  less then  .0001), and were better informed on the safest painkillers to use in combination with anticoagulation (48% vs 35%, P  less then  .0001). CONCLUSION This study suggests that AF patients who accept persistent minor bleeding have better knowledge on the disease and anticoagulation therapy compared with those free of these side effects. © 2020 John Wiley & Sons Ltd.BACKGROUND AND AIM Colonic perforation is a rare complication of colonoscopy and ranges from 0% to 1% in all patients undergoing colonoscopy. The aim of this study was to assess the time trends, risk factors, and mortality associated with colonoscopy-induced perforation (CIP) in hospitalized patients as the data are limited. KPT-330 CRM1 inhibitor METHODS Data are obtained from the Nationwide Inpatient Sample database to identify hospitalized patients between 2005 and 2014 that had CIP. Various factors like age and gender were assessed for association with CIP, followed by univariate and multivariate regression analyses. RESULTS A total of 2 651 109 patients underwent inpatient colonoscopy between 2005 and 2014, and 4567 (0.2%) of the patients had CIP. Overall, incidence of CIP has increased from 2005 to 2014 (0.1% to 0.3%) (P  65 years (OR [95% CI] of 1.35 [1.23, 1.47], 1.34 [1.17, 1.53], 1.28 [1.02, 1.62], and 1.21 [1.11, 1.33], respectively) (all P  less then  0.05). CIP group had 33% less obesity (OR [95% CI] 0.77 [0.65-0.9], P = 0.002) and 13-fold higher mortality (0.5% vs 8.1%) (P  less then  0.001) as compared to patients without CIP. The CIP-associated mortality ranged from 2% to 8% and remained stable throughout the study period. CONCLUSIONS Our study suggests that the risk of CIP was highest in elderly patients, Caucasians, those with inflammatory bowel disease, end-stage renal disease, and after polypectomy. Recognizing the factors associated with CIP may lead to informed discussion about risks and benefits of inpatient colonoscopy. © 2020 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.OBJECTIVES To assess the qualitative and quantitative characteristics of suspected cardiac masses by contrast-enhanced ultrasonography (CEUS) and to evaluate its usefulness. METHODS Twenty-eight adult patients with suspected cardiac masses were selected for this study. All of them were examined by conventional transthoracic echocardiography (TTE) and CEUS. The location, attachment point, basement, morphology, size, boundary, internal echo, shape change, range of motion, length, area, effect on hemodynamics, and peak enhancement of the masses (A1), and adjacent normal myocardium (A2) were measured. Then, the A1 to A2 ratio was calculated and the above parameters were analyzed. RESULTS The benign lesions showed regular morphology and clear-boundary uniform enhancement of the contrast agent. Malignant lesions showed an irregular shape, unclear boundary with surrounding tissue, and uneven enhancement of the contrast agent. The normal myocardial perfusion intensity was the same; there was no enhancement inside a simple thrombus, and the A1 of the benign lesion was lower than that of the normal myocardium (mean value [dB] ± SD, 0.63 ± 0.42); the A2 of the malignant lesion was higher than that of the normal myocardium (mean value [dB] ± SD, 1.49 ± 0.09). The difference in the ratio of A1 to A2 between groups was statistically significant (P  less then  .05). CONCLUSIONS Contrast-enhanced ultrasonography can assess the basic biological characteristics and properties of cardiac masses and has a high diagnostic accuracy for differentiation of a thrombus from a tumor or a benign tumor from a malignant tumor. © 2020 Wiley Periodicals, Inc.The average age of renal transplant recipients in the United States has increased over the past decade. The implications, however, have not been fully investigated. We explored predictors of success and demographic variables related to outcomes in elderly live donor transplantation. Retrospective analysis was performed using the UNOS database between 2001 and 2016. Donor characteristics and the graft failure rate of recipients above and below 70 years of age were compared across four eras 2001-2004, 2005-2008, 2009-2012, and 2013-2016. There was a steady increase in average donor age from the first era to the fourth era (40-44) which was more evident among the septuagenarian patients (43-50) (P 70 population. Live donation in the elderly is justified based on graft survival and patient survival. However, racial and gender differences exist in septuagenarian recipients and their donors. © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.BACKGROUND Exposure to black carbon indoors may be associated with blood pressure; however, evidence is limited to vulnerable subpopulations and highly exposed individuals. Our objective was to explore the relationship between indoor black carbon at various exposure windows on resting blood pressure in a general population sample. METHODS Black carbon was measured in the home of 76 individuals aged 10-71 in New Orleans, Louisiana. Exposure was measured every 1 minute for up to 120 hours using an AE51 microaethalometer. Systolic blood pressure and diastolic blood pressure were measured at the conclusion of exposure monitoring. RESULTS In adjusted models, at all exposure windows, increasing black carbon was associated with increased systolic blood pressure. The period 0-72 hours prior to blood pressure measurement showed the strongest effect; a 1 μg/m3 increase in black carbon was associated with a 7.55 mm Hg (P = .02) increase in systolic blood pressure. The relationship was stronger in participants reporting doctor-diagnosed hypertension (β = 6.