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Gastrointestinal angiodysplasia (GIAD) is the presence of aberrant blood vessels in the gastrointestinal (GI) tract that can lead to GI bleeding. There has been an increase in the incidence of GI angiodysplasia, partly due to the availability of better diagnostic techniques. The cecum is known as the most common site for GIAD; therefore, GIAD is considered a frequent cause of lower GI bleeding. Studies have shown an increasing incidence of GIAD in the upper GI tract and jejunum. No population-based studies exist on inpatient outcomes of GIAD-bleeding (GIADB) in recent years, and no prior studies have compared the inpatient outcomes of upper vs lower GIADB. We identified 321,559 weighted hospitalizations and found a 32% increase in GIADB-related hospitalizations from 2011 to 2020. There were more hospitalizations for upper (57.38%) than lower GIADB (42.62%), indicating GIADB is an important cause of upper GI bleeding as well. No statistically significant difference in mortality was found between upper and lower GIADB cohorts; however, lower GIADB was associated with a 0.2-day longer length of stay (95% confidence interval 0.09–0.30, P < 0.001) and $3857 higher mean inpatient cost (95% confidence interval $2422–$5291, P < 0.001). [ABSTRACT FROM AUTHOR]

Background: Tumor lysis syndrome (TLS) is a life‐threatening oncologic emergency associated with fatal complications including arrhythmia. The epidemiology and mortality outcomes of arrhythmia in TLS are scarcely studied in the literature. Methods: We used the National Inpatient Sample (NIS) to study the prevalence and outcome of arrhythmia in patients hospitalized with TLS (ICD‐9 code 277.88) from 2009 to 2014. Baseline characteristics, burden of arrhythmia, and pertinent outcomes were analyzed. Multivariable regression analysis was performed to identify the impact of underlying malignancy in predicting TLS‐related mortality. Results: A total of 9034 cases of arrhythmia among 37 861 TLS patients were identified. More than half of the arrhythmia cases (67%) were found among white old (>65) males admitted to large bed size and urban teaching hospitals. Arrhythmic cohort showed higher frequency of comorbidities such as fluid‐electrolyte disturbances, hypertension, congestive heart failure, renal failure, dyslipidemia, diabetes, pulmonary circulatory disorders, chronic pulmonary disease, coagulopathy, and deficiency anemia. The most common malignancies were leukemia, lymphoma, metastatic tumor, and solid tumor without metastasis. We found significantly higher odds of in‐hospital mortality among patients with TLS compared to general inpatient population on unadjusted (OR 9.69, 95% CI: 9.27‐10.13, P <.001) and adjusted (OR 4.62, 95% CI: 4.39‐4.85) multivariable analyses. Overall in‐hospital mortality (32% vs 21.3%), median length of stay (11 days vs 9 days), and hospital charges were higher among arrhythmic than nonarrhythmic patients. Conclusion: With the availability of more advanced cancer therapy in the US, nearly one in four inpatient encounters of TLS had arrhythmia. Arrhythmia in TLS patients was associated with higher odds of mortality and increased resource utilization. Therefore, strategies to improve the supportive care of TLS patients plus timely diagnosis and treatment of arrhythmia are of utmost importance in reducing mortality and health‐care cost. [ABSTRACT FROM AUTHOR]

Gastrointestinal angiodysplasia (GIAD) is the presence of aberrant blood vessels in the gastrointestinal (GI) tract that can lead to GI bleeding. There has been an increase in the incidence of GI angiodysplasia, partly due to the availability of better diagnostic techniques. The cecum is known as the most common site for GIAD; therefore, GIAD is considered a frequent cause of lower GI bleeding. Studies have shown an increasing incidence of GIAD in the upper GI tract and jejunum. No population-based studies exist on inpatient outcomes of GIAD-bleeding (GIADB) in recent years, and no prior studies have compared the inpatient outcomes of upper vs lower GIADB. We identified 321,559 weighted hospitalizations and found a 32% increase in GIADB-related hospitalizations from 2011 to 2020. There were more hospitalizations for upper (57.38%) than lower GIADB (42.62%), indicating GIADB is an important cause of upper GI bleeding as well. No statistically significant difference in mortality was found between upper and lower GIADB cohorts; however, lower GIADB was associated with a 0.2-day longer length of stay (95% confidence interval 0.09-0.30, P   <   0.001) and $3857 higher mean inpatient cost (95% confidence interval $2422-$5291, P   <   0.001)., Competing Interests: The authors report no funding or conflicts of interest., (Copyright © 2023 Baylor University Medical Center.)

Worsening hiatus hernia (HH) symptoms have been well recognized as a complication of gastric banding, however, it has not yet been explored whether gastric banding plays a role in the development of HH de novo in patients undergoing gastric banding. From the 696 studies identified, five studies met the eligibility criteria and were included. Data was extracted from PubMed, Embase, Medline, HMIC, and Web of Science databases. The pooled complication rate was evaluated along with 95% confidence intervals (95% CIs). The meta-analysis was performed using the Cochrane RevMan tool (Cochrane, London, UK). Heterogeneity was tested using the I 2 index for each outcome. All the included studies assessed HH incidence among followed-up patients who needed a re-operation for upper gastrointestinal symptoms. Between-study variability was high (I 2 = 94%, Chi 2 = 68.92, df = 4, < 0.00001, Tau2=1.91). Complication rate ranged between 0.24% to 5.55%; pooled complication rate was 2.17% CI 95% (0.90 - 3.44%) P = 0.0008. The included studies show a comparable rate of post-operative HH; the fact that HHs can become symptomatic following the adjustable gastric banding (AGB) procedure indicates that AGB plays a role in creating symptomatic hiatal hernias at the very least. Further research is needed to underpin the mechanism and confirm causation. However, this complication should potentially be discussed with patients opting for this kind of operation as it can be a reason for re-operation., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Majdoubeh et al.)

Coronavirus disease 2019 (COVID-19) has a myriad of different presentations and various complications. Aortitis is one of the less explored pathologies associated with COVID-19 infections. In this review, we searched PubMed/Medline, Web of Science, Google Scholar, and Scopus for case series and case reports involving adults patients who presented with aortitis and COVID-19. We found and reviewed four published case reports of aortitis in a setting of COVID-19 infection. The mean age of the four adult patients was 69 ± 1.732 years (range = 63-71 years), and all patients were males. Most of the patients (75%) did not have any preexisting comorbidities. All patients were treated conservatively and recovered with excellent outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Abu Hassan et al.)

Background Endoscopic retrograde cholangiopancreatography (ERCP) can be associated with complications, including precipitation of peri-procedural myocardial ischemia. However, data regarding the trends and impact of previous myocardial infarction (MI) and/or percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) on ERCP outcomes remains unknown. Methods Using the National Inpatient Sample (2007-2014) and relevant ICD-9-CM codes, we identified adults who underwent ERCP with (Group 1) and without (Group 2) prior history of MI/PCI/CABG, and compared their demographics, comorbidities, and inpatient outcomes. Primary endpoints were inpatient mortality and post-ERCP complications. The secondary endpoints were discharge disposition, the mean length of stay, and total hospital charges. Results Of 1,374,773 ERCP procedures performed, 120,418 (8.8%) were performed in adult patients with a prior history of MI/PCI/CABG with an increasing trend from 2007-2014 (7.5% to 9.5%, p trend =0.022). Group 1 consisted of older, white, males compared to Group 2. Group 1 demonstrated a higher prevalence of all-cause mortality (1.7% vs. 1.5%, p<0.001), other cardiovascular comorbidities, post-ERCP cardiopulmonary complications (5.6% vs. 3.8%, p<0.001), sepsis (10.2% vs. 8.2%, p<0.001) and hemorrhage (1.5% vs.1.2%, p<0.001) as compared to Group 2. However, post-ERCP pancreatitis (14.1% vs. 15.4%, p<0.001) was lower in Group 1 without any difference in frequency of cholecystitis (0.4% vs. 0.4%, p=0.180). The mean length of stay was marginally higher in Group 1, without any difference in the hospitalization charges between the groups. Conclusions This nationwide study revealed higher inpatient mortality, sepsis, and hemorrhage in adult patients who underwent ERCP with a prior history of MI/PCI/CABG., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Patel et al.)

Background: Tumor lysis syndrome (TLS) is a life-threatening oncologic emergency associated with fatal complications including arrhythmia. The epidemiology and mortality outcomes of arrhythmia in TLS are scarcely studied in the literature., Methods: We used the National Inpatient Sample (NIS) to study the prevalence and outcome of arrhythmia in patients hospitalized with TLS (ICD-9 code 277.88) from 2009 to 2014. Baseline characteristics, burden of arrhythmia, and pertinent outcomes were analyzed. Multivariable regression analysis was performed to identify the impact of underlying malignancy in predicting TLS-related mortality., Results: A total of 9034 cases of arrhythmia among 37 861 TLS patients were identified. More than half of the arrhythmia cases (67%) were found among white old (>65) males admitted to large bed size and urban teaching hospitals. Arrhythmic cohort showed higher frequency of comorbidities such as fluid-electrolyte disturbances, hypertension, congestive heart failure, renal failure, dyslipidemia, diabetes, pulmonary circulatory disorders, chronic pulmonary disease, coagulopathy, and deficiency anemia. The most common malignancies were leukemia, lymphoma, metastatic tumor, and solid tumor without metastasis. We found significantly higher odds of in-hospital mortality among patients with TLS compared to general inpatient population on unadjusted (OR 9.69, 95% CI: 9.27-10.13, P  < .001) and adjusted (OR 4.62, 95% CI: 4.39-4.85) multivariable analyses. Overall in-hospital mortality (32% vs 21.3%), median length of stay (11 days vs 9 days), and hospital charges were higher among arrhythmic than nonarrhythmic patients., Conclusion: With the availability of more advanced cancer therapy in the US, nearly one in four inpatient encounters of TLS had arrhythmia. Arrhythmia in TLS patients was associated with higher odds of mortality and increased resource utilization. Therefore, strategies to improve the supportive care of TLS patients plus timely diagnosis and treatment of arrhythmia are of utmost importance in reducing mortality and health-care cost., Competing Interests: The authors declare no conflict of interests for this article., (© 2020 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society.)