Introduction:Although atherogenesis is clearly entwined with systemic infl ammation, the risk-predictive relationship between preclinical and overt cardiovascular disease (CVD) and systemic white blood cell (WBC) subtypes remains unclear. Implication of an association would greatly facilitate cardiac risk prediction, assessment and monitoring. Methods: 1383 asymptomatic individuals (795 men, 588 women) attending for executive health screening were examined clinically as well as with phlebotomy and exercise stress testing to determine their ten-year risk of developing overt cardiovascular disease (as estimated by both Framingham and SCORE calculations). The signifi cance of their association with overall WBC and subtypes were determined using both univariate and multiple regression modeling. Results: Of all WBC subtypes, monocyte count was found to have the strongest, independent relationship with overall CVD risk by backwards linear regression modeling (Framingham: β = 0.057; p = 0.03; SCORE: β = 0.128; p = Ͻ0.0005). Independent associations with BMI (β = 5.214; p = Ͻ0.0005), waist circumference (β = 21.866; p = Ͻ0.0005), systolic blood pressure (β = 10.738; p = 0.003), HDL cholesterol (β = −0.639; p = Ͻ0.0005) and triglyceride concentrations (β = 0.787; p = Ͻ0.0005) were also evident. Overall WBC along with neutrophils, lymphocytes and basophil subfractions were variably (but less strongly) associated with such dependents and outcome measures. Conclusions: In conclusion, monocyte count, a simple inexpensive test, may provide useful predictive cardiovascular risk information in asymptomatic individuals to inform and guide attempts at interrupting CVD development at a preclinical stage.
We noted a higher prevalence of MetS in the studied population when defined by IDF criteria. However, those identified by IDF and not by ATPIII definition did not have a higher cardiovascular risk score by either Framingham or European Score than those without MetS. Thus, application of the ATPIII definition of MetS, may be the more practical.
Within the reference range, increasing thyrotropin concentrations are associated with increasing cardiovascular risk parameters. Fasting glucose and triglycerides have been shown to be independently associated with thyrotropin concentration.
Objectives
: Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has caused enormous strain on health-care systems worldwide. Early recognition of prognostic markers and appropriate management of patients with coronavirus disease 2019 (Covid-19) remains a major global health concern, particularly when resources are limited. We undertook a study to see if basic tests can inform frontline clinicians of disease trajectory in individual patients with COVID-19.
Methods
: We retrospectively assessed characteristics of the first 50 consecutive patients admitted to district general hospital in the United Kingdom with positive SARS-Cov-2 RNA swabs.
Results
: Our patient cohort shared broad similarities with previously published data on comorbidities and presenting features. We have found that chest radiographic assessment differed between survivors and non-survivors. Air space shadowing in middle zones were more prevalent in non-survivors (73.3% vs. 35.5% [p = 0.027]). Chest radiograph severity score was also found to be higher in non-survivors compared to survivors (3 vs. 1.5 [p = 0.007]).
Conclusions
: In this small retrospective study, our results suggest features of chest radiographs at presentation may provide a helpful tool for prognostication. In environments with constrained computed tomography (CT) imaging with serial chest radiographs could be a cost-effective tool in the assessment of Covid-19 patients.
Deep venous thrombosis (DVT) is a commonly encountered diagnosis in clinical practice with a variety of well-established risk factors. Congenital absence of the inferior vena cava (IVC) is an extremely rare but established risk factor for DVT. Patients who develop DVTs are at high risk of long-term complications, including DVT recurrence and post-thrombotic syndrome. Here we report a rare case of a 27-year-old female who presented with an extensive DVT of the right lower extremity secondary to complete absence of the infrarenal portion of the IVC, confirmed on computed tomography. There is little consensus regarding the appropriate management of this patient population, and a brief review of the current evidence follows.
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