Monday, January 28, 2019

Non-traumatic hemorrhage, a cause of mortality in pancreatitis

·         A Salmonella outbreak impacting eight states in US has been linked to contact with pet hedgehogs. The outbreak has affected 11 people. Three cases have been reported in Missouri and two cases have been reported in Minnesota. Colorado, Maine, Mississippi, Nebraska, Texas and Wyoming each have one case as of Jan. 23. The CDC has previously warned that hedgehogs can carry Salmonella.

·         Fans of comedian Kevin Barnett were shocked earlier this week when news broke that the 32-year-old died suddenly while on vacation in Mexico. Now, the results of his autopsy are in, and it appears he died of “non-traumatic hemorrhage, caused by pancreatitis. Mortality in patients with acute pancreatitis is associated with the number of failing organs and the severity and reversibility of organ dysfunction. Persistent early systemic inflammatory response syndrome is associated with multiorgan dysfunction syndrome and death in patients with acute pancreatitis and is an early indicator of severity of acute pancreatitis. Alcohol as a cause of pancreatitis has been associated with an increased risk of pancreatic necrosis and need for intubation. A time interval between the onset of symptoms and hospital admission of less than 24 hours, as well as rebound tenderness and/or guarding were associated with increasing severity of pancreatitis.

·         President Trump’s health: His CT coronary calcium level is 133, and anything over 100 indicates heart disease, his LDL cholesterol level is 143, which is far above the ideal level (80) and his BMI is 29.9. That’s considered overweight and verging on obese. What does this mean?

Coronary artery calcium (CAC) scoring — In both men and women, CAC detected by CT is highly sensitive for the presence of ≥50 percent angiographic stenosis but only moderately specific, especially in individuals over 60 years of age. However, the absence of CAC is highly predictive of the absence of significant (greater than 50 percent) coronary artery stenosis. In three series, patients with no CAC had a probability of significant coronary stenosis of less than 1% (0 – No identifiable disease; 1 to 99 – Mild disease; 100 to 399 – Moderate disease;  ≥400 – Severe disease). For his coronary calcium score, he should have been losing weight and kept his LDL < 80. Celebrities should be role models for the society.

·         Feb. 1 is National Wear Red Day, when people are encouraged to wear red to raise awareness that heart disease is the number one killer of women.

·         Dengue patients should defer blood donation for up to 6-12 months post-infection(Correction) Dr NK Bhatia, Medical Director, Mission Jan Jagriti Blood Bank is a renowned name in blood banking with more than three decades of experience the field. According to Dr NK Bhatia, “Dengue patients are not allowed to donate blood for one year after treatment. If there is a history of blood/blood products transfusion, the same deferral period applies. This is also true for Chikungunya patients. Any person who has a ‘normal’ viral fever is not allowed to donate blood for 7 days after the active phase is over. Some extend this duration to one month.”     

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA

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