About seller
dentifying potential sampling bias. Prior studies have demonstrated that anticoagulation underutilisation for atrial fibrillation (AF) and elevated stroke risk is common. However, there is little data on factors associated with appropriate anticoagulation, particularly in Indigenous Australians who face a disproportionate burden of AF and stroke. We thus sought to determine factors associated with anticoagulation use in Australians with AF. Administrative, clinical, prescriptive and laboratory data were linked and aggregated over a 12-year period. Single tertiary teaching hospital. 19,305 (98%) and 308 (2%) consecutive non-Indigenous and Indigenous Australians with AF identified from administrative databases. Associations of anticoagulation use according to ethnicity. Significant independent predictors of anticoagulation use included hypertension (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.17-1.34; p<0.001), diabetes (OR 1.14, 95% CI 1.05-1.24; p=0.002), heart failure (OR 1.54 95% CI 1.43-1.66; p<0.001) and prior strlians. Older age, female gender, and comorbid vascular disease were found to be negatively associated with anticoagulation. Importantly, hypertension may also be under-recognised as a stroke risk factor in Indigenous Australians. Future efforts to encourage anticoagulation use in accordance with guideline recommendations is likely to reduce the burden of AF-related stroke in both Indigenous and non-Indigenous populations. Aortic dilatation and bicuspid aortic valve (BAV) are frequent in Turner syndrome (TS). Due to short stature, aortic size index (ASI)-ascending aortic diameter (AD)/body surface area (BSA)-is used to identify aortic dilatation in TS patients. We sought to 1) describe echocardiographic findings in the largest cohort of Australian women with TS; 2) assess if ASI progresses differently with age in TS BAV compared to non-syndromic BAV; and 3) determine whether adjustment of AD for body composition may be superior to BSA indexation. Transthoracic echocardiography (TTE) data were retrospectively collected on 125 women with TS. Body composition was quantified by dual energy X-ray absorptiometry (DXA) in 60 women within 6 months of baseline TTE. Age-matched females with non-syndromic BAV (n=170) were used as controls for TS patients with BAV. Mean age of TS women was 28±16 years, and mean height and BSA were 141.6±21.7 cm and 1.4±0.4 m , respectively. Mean AD was 2.5±0.8 cm, and ASI 2.0±0.6 cm/m . Aortic dilamension with age when compared to matched women with non-syndromic BAV. Several DXA-derived body composition parameters correlate with aortic size in TS, however BSA appears to be the most robust method of indexation. Familial hypercholesterolaemia (FH) is an under recognised cause of coronary artery disease, despite the proven reductions in risk with early detection and treatment. Data from 180 consecutive patients presenting to a large regional hospital with acute coronary syndrome were collected. Potential FH was assessed using the Dutch Lipid Clinic Network Criteria (DLCNC), and if patients were on statins, pre-treatment cholesterol was estimated according to a validated algorithm. Ninety per cent (90%) of patients presented with non-ST elevation myocardial infarction (NSTEMI) or ST elevation myocardial infarction (STEMI). A total of 11 patients (6%) were classified as having phenotypic FH. The phenotypic FH cohort was younger (mean age 53.1 vs 62.0, p=0.011); and more likely to have documented ischaemic heart disease (63.6% vs 20.7%, p=0.001). Familial hypercholesterolaemia patients had a higher rate of ezetimibe use (18.2% vs 2.4%, p=0.005), but fibrate use was not significantly different. Phenotypic FH patients also had higher levels of total cholesterol, corrected LDL and triglycerides, but no statistically significant difference in HDL levels compared with non-FH counterparts. The prevalence of FH is relatively high among patients presenting with acute coronary syndromes. see more This has now been established in a regional Australian population, with similar prevalence to large European registries. This highlights the need for improved access to specialised services in regional and rural areas to reduce adverse cardiovascular (CV) outcomes.The prevalence of FH is relatively high among patients presenting with acute coronary syndromes. This has now been established in a regional Australian population, with similar prevalence to large European registries. This highlights the need for improved access to specialised services in regional and rural areas to reduce adverse cardiovascular (CV) outcomes. Tricuspid regurgitation (TR) is a known complication of cardiac implantable electronic devices (CIED). Abetter understanding of the patient population affected by this complication and their outcomes is needed. The aims of our study were to 1) describe the incidence of CIED-related tricuspid regurgitation; 2) identify patient characteristics conferring risk; 3) assess the long-term risk of hospitalisation for heart failure and mortality in patients with this complication. This was a retrospective cohort study of 2,265 patients that had a de novo device implantation at a tertiary referral centre between January 2010 and December 2017. Patients with echocardiograms prior to and at least 3 months after device implantation were included. Patients with moderate or severe TR at baseline were excluded. Following screening of medical records, 165 patients were analysed. Forty-four (44) (27%) patients developed new-onset moderate or severe device-related TR, without a significant difference between patients with heart failure.CIED-related TR is common and clinically significant with serious implications for long-term outcomes, especially congestive heart failure.As the US healthcare system restructured to deal with the COVID-19 pandemic, medical training was significantly disrupted. During the peak of the crisis, three surgical trainees in different stages of their residency shared their experiences and concerns on how this pandemic affected their training. The article is intended to generate discussion on the concerns of derailment and stagnation of surgical training and difficulties faced at all levels of surgical training to perform clinical duties and fulfill academic responsibilities during the early months of the COVID pandemic.