Introduction: Venous thromboembolism (VTE) is a major cause of non-cancer-related mortality in cancer patients. Understanding how demographic factors and cancer types influence VTE risk is critical for developing prevention strategies. This study investigates the incidence of VTE in a large cancer patient population, focusing on gender, race, and differences between solid and hematological malignancies. Methods: Data from the National Inpatient Sample (NIS) database were used to identify cancer patients diagnosed with acute VTE. The patients were divided into those with solid and hematological cancers. Key demographic and clinical characteristics were collected, and patients were matched 1:1 using propensity scoring. Statistical analyses, including logistic regression, assessed VTE incidence and its associations with demographic and cancer type variables. A p-value of <0.05 indicated statistical significance. Results: Out of 1,233,832 cancer patients, 63,505 (5.1%) were diagnosed with acute VTE. Females had a higher VTE rate than males (5.5% vs. 4.8%, p < 0.001). Racial disparities showed Black patients with the highest incidence (6.4%), followed by White patients (5%). Patients with solid malignancies exhibited a significantly higher incidence of VTE compared to those with hematological malignancies (5.4% vs. 4.1%; p < 0.001), with lung cancer and non-Hodgkin lymphoma mostly associated with VTE. Conclusions: This study identifies demographic and cancer-specific differences in VTE risk, emphasizing the need for personalized prevention. High-risk groups, including those with solid tumors, females, and Black patients, may benefit from targeted strategies to reduce the burden of VTE and improve cancer outcomes.
Shingles, also known as herpes zoster, is a reactivation of the chickenpox virus that causes a painful, blistering rash. After a chickenpox infection, the virus lies dormant in nerve cells. When reactivated, usually in older adults or those with weakened immune systems, it travels along nerves, typically affecting a single strip of skin called a dermatome. Shingles usually presents as a painful, one-sided rash that may involve nerves in the head, face, and body. While it typically resolves on its own, it can lead to complications, especially in older adults. Antiviral medications are effective in reducing the severity and duration of shingles and should be started as soon as the rash appears. This report describes an unusual case of an elderly patient who developed shingles on their face after a wound, notably without experiencing any pain.
Bacillus thuringiensis is a gram-positive bacterium used in agriculture, with rare human infections that typically occur in immunocompromised individuals through environmental exposure. This report discusses the case of a 30-year-old intravenous drug user and polysubstance abuser who developed bacteremia due to Bacillus thuringiensis. The patient originally presented with fever and leg ulcers from injection sites, and he was successfully treated with vancomycin. This case underscores the importance of recognizing atypical pathogens like Bacillus thuringiensis in intravenous drug users, particularly when contaminated drug paraphernalia is involved. Although generally low in virulence, this bacterium can cause systemic infections under certain conditions. Prompt identification and treatment are crucial to prevent complications, highlighting the need for increased clinical awareness and appropriate microbiological investigations in this vulnerable population.
Background/Objectives: Pulmonary hypertension (PH) is an increasingly recognized complication in patients with end-stage renal disease (ESRD) undergoing hemodialysis, particularly those utilizing arteriovenous fistulas (AVF) or grafts (AVG) for vascular access. The prevalence and clinical impact of PH in this population remain unclear due to methodological heterogeneity and variable diagnostic criteria. This systematic review and meta-analysis aimed to quantify the association between AVF/AVG use and PH prevalence in ESRD patients and to explore sources of heterogeneity. Methods: A systematic search of PubMed, Embase, Scopus, and Web of Science was conducted for studies published through 31 December 2024, without language or date restrictions. Eligible studies included adults (≥18 years) with ESRD on dialysis, comparing those with AVF/AVG access to non-AVF/AVG controls (e.g., tunneled dialysis catheters or peritoneal dialysis), and reporting PH prevalence or mean pulmonary artery pressures. Study quality was assessed using the Newcastle–Ottawa Scale, and risk of bias was evaluated. A random-effects meta-analysis calculated pooled odds ratios (OR) for PH prevalence, with heterogeneity assessed by I2 and Cochran’s Q. Sensitivity analyses and tests for publication bias (Egger’s and Begg’s) were performed. Secondary analysis compared pooled mean pulmonary artery pressures between groups. Results: Eleven observational studies (1299 dialysis patients) met the inclusion criteria; ten studies (1224 patients) contributed to the quantitative meta-analysis after exclusion of one study with a zero-event control arm. Most studies were small, predominantly cross-sectional, and of moderate methodological quality. The pooled analysis showed a statistically significant association between AVF/AVG use and PH (OR 2.06, 95% CI: 1.69–2.52), with low statistical heterogeneity (I2 = 0%). This estimate was sensitive to individual studies: in leave-one-out analysis the association lost statistical significance when the single most influential study was removed indicating that the pooled result is driven in part by a small number of studies rather than being uniformly robust. No statistical evidence of publication bias was detected. Five studies reported continuous pulmonary artery pressures, which were directionally higher in AVF/AVG patients but were not pooled because of extreme heterogeneity (I2 = 99.4%). Conclusions: In this synthesis of observational data, AVF/AVG use was associated with higher odds of pulmonary hypertension than non-AVF/AVG access. Because all included studies were observational and the pooled estimate is sensitive to individual influential studies, these findings indicate a possible association rather than a causal effect and should be interpreted with caution. They support the rationale for prospective hemodynamic studies and for evaluating—rather than presuming the benefit of—PH monitoring and individualized access strategies in higher-risk dialysis patients.