Objective
Heart failure (HF) is a chronic disease with growing numbers of patients and a significant compromise in quality of life and high mortality. The main purpose of this study was to evaluate the current practices in managing patients with HF among patients admitted to the hospital and discharged with a primary diagnosis of HF and patients managed in the heart function clinic.
Results
This study is a retrospective chart review of patients admitted to the hospital and discharged with a primary diagnosis of HF. A total of 448 patient charts were reviewed, of which 173 patients were in the hospital group and 275 patients in the Clinic group. 278 (62.1%) were men, and 170 (37.9%) were women. The Clinic group of patients were significantly received guideline-directed medical therapy (Beta-blockers, Angiotensin-converting enzyme inhibitors, Angiotensin receptor blockers, Diuretics, Mineralocorticoid receptor antagonists—p < 0.001). The Clinic group of patients (17.1%) were significantly less re-hospitalized (p < 0.001) compared to the Hospital group (28%) at 180 days. Physician led multidisciplinary Heart function clinics have better adherence to guideline directed medical therapy and significantly lower rates of re-hospitalization thereby providing cost effective heart failure management with usual care.
Evaluating the use of media on perceptions and behaviour during the COVID-19 pandemic Examen de l'influence des médias sur les perceptions et les comportements pendant la pandémie de la COVID-19
CASE PRESENTATION: We report a rare case of Moraxella bovis bacteremia and polyarticular septic arthritis in a 37-year-old pregnant woman with HIV who injects drugs. Two sets of blood cultures obtained 5 hours apart were positive for gram-negative bacilli, and purulent fluid was present intra-operatively from both her left knee and her right third MCP joints. DIAGNOSIS: Organism identification using ligation sequencing confirmed both her blood culture and synovial tissue isolates as M. bovis. Her infection was initially treated with third-generation cephalosporins and later changed to moxifloxacin because of a drug reaction; although she defervesced clinically with improvement in her C-reactive protein levels, she died most likely as a result of a non-traumatic fat embolism after an elective Caesarean delivery. DISCUSSION: In contrast to Moraxella catarrhalis, other Moraxella species are rarely associated with disease in human hosts. M. bovis is classically associated with infectious bovine keratoconjunctivitis in cattle; interestingly, our patient denied significant animal exposure. To the authors’ knowledge, this is the first case describing infection secondary to M. bovis in an adult host.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.