Borgess Medical Center

Current ESC/EACTS guidelines recommend standard-duration dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI). However, the subsequent transition to either extended DAPT or single antiplatelet therapy (SAPT) remains debated due to limited comparative outcome data. This Bayesian meta-analysis and meta-regression evaluate the clinical safety of DAPT versus SAPT, and the impact of potential confounders on all-cause mortality. Following PRISMA guidelines, a systematic search of PubMed, Embase, Cochrane Library, ScienceDirect, and Scopus was conducted till April 2025 to identify randomized clinical trials (RCTs) and cohort studies. Primary outcomes were all-cause mortality and bleeding events. Bayesian random-effects meta-analysis was performed using the brms package in R with Markov Chain Monte Carlo sampling and weakly informative priors. Bayesian meta-regression of log-transformed odds ratios (OR) assessed associations with relevant covariates. Fourteen studies (9 RCTs and 5 cohort studies) comprising 56,572 patients were included. Compared with SAPT, DAPT was associated with increased all-cause mortality (OR 1.25; 95% credible interval [CrI], 1.04-1.51; posterior probability of harm, Pr[OR > 1] = 84%). DAPT also increased the risk of net adverse clinical events [NACE] (OR, 1.29; 95% CrI, 1.08-1.53), minor bleeding (OR, 1.60; 95% CrI, 1.10-2.33), major bleeding (OR, 1.70; 95% CrI, 1.30-2.23), and BARC 2-5 bleeding (OR, 1.78; 95% CrI, 1.40-2.26) with Pr [OR > 1] >90% for all outcomes. No significant differences were observed in cardiac death, cardiovascular mortality, major adverse cardiac and cerebrovascular events (MACCE), myocardial infarction (MI), stent thrombosis, or stroke. Meta-regression revealed that higher baseline odds of dyslipidemia (-0.89), hypertension (-1.19), prior MI (-0.94), and previous revascularization (-0.30) were associated with greater mortality benefit from DAPT. However, in the DAPT cohort, increased odds of adverse events, including cardiac death (0.41), MACCE (0.55), stroke (0.60), MI (0.29), and NACE (0.98), were significantly associated with higher all-cause mortality. Extended DAPT is associated with a higher all-cause mortality, bleeding events, and NACE. While DAPT may benefit high-risk populations, the increased odds of adverse events are significantly associated with mortality, warranting that it be carefully considered and monitored in post-PCI patients.

Traditionally known as a nosocomial organism and preponderance to infect the immunocompromised patients or withpreexisting structural damage in lung parenchyma1, Burkholderia cepacia infection in an apparentlyimmunocompetent host in ICU settings is not very commonly heard of. On the other hand, acute colonicpseudo-obstruction (Ogilvie’s syndrome) is also a very rare surgical complication. Here we present a case of apostpartum lady who developed colonic perforation following caesarean section due to Ogilvie’s syndrome andBurkholderia cepacia sepsis and eventually expired.
 Bangladesh Crit Care J March 2023; 11 (1): 43-45

Abstract Synthetic turf has become an increasingly common playing surface in athletics. Synthetic turf maintenance and athlete health are related and are important considerations at all levels of play. As part of the development of testing practices for the National Football League (NFL) game‐day surfaces, a literature search of MEDLINE and PubMed between the years 1990 and 2018 was conducted. Additionally, a taskforce was convened, and expert opinion was solicited from members through systematic interviews regarding synthetic turf design and maintenance practices in the NFL. All game‐day synthetic turf manufacturers were routinely solicited for input during development and implementation of the mandatory practices. Appropriate maintenance practices can improve the consistency of a synthetic playing surface. Methods for evaluating surface hardness and other aspects of synthetic turf have been developed. The relationships between current hardness testing methods and injury outcomes have been studied but are not well established. Consensus methods for evaluating surface traction and cleat release at potentially injurious loading levels are currently unavailable and needed. Mandatory practices were developed and have been implemented by the NFL, which have resulted in more consistent playing surfaces over the course of a season. Despite the extant gaps in knowledge, a formalized set of testing practices and maintenance has proven effective for reducing surface variability across synthetic surfaces in the NFL. Characteristics such as surface hardness, traction, and shoe–surface interaction, and the effects of surface maintenance procedures should be the focus of future research.

A patient presenting with worsening dyspnea and left‐sided chest pain underwent heart catheterization, found to have a rare connection between the right and left coronary arteries draining into the left ventricle, consistent with dual coronary‐cameral fistula.

A 75-year-old man presenting with sudden onset angina was found to have inferior wall ST elevation myocardial infarction ([figure 1][1]). He was emergently scheduled for cardiac catheterisation. Coronary angiography revealed aneurysmal dilatation of distal right coronary artery (RCA) with 100%

Peach is a common elicitor of food allergic reactions. Peach-induced immediate reactions may occur as benign pollen-food syndromes, usually due to birch pollen-related PR-10 cross-reactivity in temperate climates, and as potentially severe primary food allergies, predominantly related to nsLTP Pru p 3 in Mediterranean regions. The newly described peach allergen Pru p 7 has gained recent attention as a potential peach allergy severity marker. Sensitization to Pru p 7 and its allergenic homologues of the gibberellin-regulated protein family occurs in areas with high Cupressaceae tree pollen exposure. We sought to investigate the distribution, clinical characteristics and molecular associations of Pru p 7 sensitization among subjects with suspected peach allergy in different regions of France. Subjects with suspected peach allergy (n=316) were included. Diagnostic work-up was performed according to current guidelines, including open food challenge when required. IgE antibody measurements and competition experiments were performed using the ImmunoCAP assay platform. Sensitization to Pru p 7 was present in 171 (54%) of all subjects in the study and in 123 of 198 (62%) diagnosed as peach allergic, more than half of whom were sensitized to no other peach allergen. Frequency and magnitude of Pru p 7 sensitization were associated with the presence of peach allergy, the clinical severity of peach-induced allergic reactions and the level of cypress pollen exposure. Cypress pollen extract completely outcompeted IgE binding to Pru p 7. Pru p 7 was extremely potent in basophil activation tests. A subtype of Cupressaceae pollinosis, characterized by Pru p 7 sensitization, can be an underlying cause of severe peach allergy.