ABSTRACT
Takotsubo cardiomyopathy (TTC), also defined as "stress cardiomyopathy," is characterized by a systolic dysfunction localized in the apical and medial left ventricles. Takotsubo cardiomyopathy is more prevalent in females and it is usually related to an event triggered by physical or emotional stress. We systematically explored PubMed and Embase medical information source to identify case reports showing association between infection and TTC. For each kind of infection, we collected a set of data, including pathogen, site of infection, clinical outcome, patient age and sex, and author and year of publication. We found 26 articles dealing with 27 case reports (74% women). The mean age was 61.4 ± 13.7 years and bacterial infections were more frequent (n = 23, 85.2%). In 14 cases, there was a culture-based definition of the bacterial strain: gram+ in 8 cases (57.1%) and gram- in 6 cases (42.9%). Clinical outcome was always favorable.
Subject(s)
Bacterial Infections/microbiology , Bacterial Infections/virology , Takotsubo Cardiomyopathy/microbiology , Takotsubo Cardiomyopathy/virology , Virus Diseases/virology , Adult , Aged , Aged, 80 and over , Bacterial Infections/complications , Bacterial Infections/diagnosis , Bacterial Infections/therapy , Female , Humans , Male , Middle Aged , Risk Assessment , Risk Factors , Takotsubo Cardiomyopathy/diagnosis , Takotsubo Cardiomyopathy/therapy , Treatment Outcome , Virus Diseases/complications , Virus Diseases/diagnosis , Virus Diseases/therapyABSTRACT
Acute cerebrovascular events are not randomly distributed over time but show specific temporal patterns of occurrence. However, most studies focused stroke and little is known about transient ischemic attack. This study aimed to explore the existence of a temporal pattern of transient ischemic attack and the possible influence by the most common risk factors. The analysis included all hospital admissions with the ICD9-CM code for TIA, recorded in the database of the Emilia Romagna region of Italy (1998-2006; n = 43642, mean age 76.8 +/- 11.5 years, 45.5% males). Transient ischemic attack was most frequent in autumn and winter and less common in spring and summer (P < 0.0001), with the highest number of cases in October and the lowest in February, and also most frequent on Monday (P < 0.0001). This study shows a seasonal and weekly pattern in occurrence of transient ischemic attack, independent of sex and the presence of the most common risk factors.
Subject(s)
Ischemic Attack, Transient/epidemiology , Patient Admission/statistics & numerical data , Aged , Aged, 80 and over , Chronobiology Phenomena , Databases, Factual/statistics & numerical data , Female , Humans , International Classification of Diseases , Ischemic Attack, Transient/therapy , Italy/epidemiology , Male , Middle Aged , Patient Admission/trends , Retrospective Studies , Seasons , Time FactorsABSTRACT
OBJECTIVE: This retrospective study, based on the database of hospital admissions of the region Emilia-Romagna [RER], Italy, was aimed to confirm the existence of a seasonal or weekly pattern of hospital admission of acute myocardial infarction (AMI) and to verify possible differences between nonfatal or fatal cases. METHODS: The study included all cases of patients with AMI hospitalized between 1998 and 2006. Day of admission was categorized, respectively, into four 3-month intervals, into twelve 1-month intervals, and into seven 1-day intervals for statistical analysis, performed by chi(2) test goodness of fit and partial Fourier series on total cases, males, females, and nonfatal and fatal cases. RESULTS: The database included 64 191 cases of AMI (62.9% males, 12.3% fatal). Acute myocardial infarction was most frequent in winter and least in summer (P < .0001). The highest number of cases was recorded in January and the lowest in July (P < .0001). Chronobiologic analysis showed winter peaks for total cases (January, P = .035), females (December, P = .009), and fatal cases (January, P < .001). Acute myocardial infarction was most frequent on Monday and least on Sunday (P < .0001). Comparing observed vs expected events, there was a significantly higher frequency of cases on weekdays and reduced on weekends, for total (P < .0001), nonfatal (P < .0001), and fatal cases (P = .0001). CONCLUSIONS: This study confirms a significantly higher frequency of AMI admissions in winter and on a Monday. No difference in the frequency of nonfatal vs fatal events, depending of patients' admissions on weekdays or weekends, was found.
Subject(s)
Hospitalization/statistics & numerical data , Myocardial Infarction/mortality , Myocardial Infarction/therapy , Seasons , Aged , Aged, 80 and over , Cohort Studies , Databases, Factual , Emergency Service, Hospital , Female , Hospital Mortality , Humans , Italy , Male , Middle Aged , Myocardial Infarction/diagnosis , Retrospective Studies , Sex DistributionSubject(s)
Hypertension/drug therapy , Renal Dialysis/adverse effects , Aged , Antihypertensive Agents/administration & dosage , Antihypertensive Agents/pharmacology , Antihypertensive Agents/therapeutic use , Cardiac Output/physiology , Drug Therapy, Combination , Female , Humans , Hypertension/etiology , Hypertension/physiopathology , Minoxidil/administration & dosage , Minoxidil/pharmacology , Minoxidil/therapeutic useABSTRACT
Low back pain with sciatica is one of the most common complaints of patients presenting to the ED, and it is usually managed on an outpatient basis. However, acute lower back pain not always derives from a benign cause. We report here the case of a 63-year-old diabetic man who presented to the ED complaining of acute low back pain with sciatica and fever. The cause was a large paravertebral abscess by Streptococcus milleri, and this was the first presenting sign of an unknown underlying colonic cancer.
