Patients with either hereditary or acquired thrombophilia can present with arterial and venous thrombotic complications. However, it is unclear to whom the thrombophilia panel should be assessed, particularly in patients presenting with a common cardiovascular risk factor and acute coronary thrombus. Herein, we presented the management of an active smoker female patient who presented to our emergency room with inferior acute ST-segment elevation myocardial infarction, and hereditary thrombophilia has been diagnosed due to the presence of substantial left main coronary artery (...) thrombus. (shrink)

Objective: The objective of this study was to evaluate the clinical efficacy and appropriateness of colistin therapy in patients with hematological malignancies. -/- Methods: Age, gender, type of hematologic malignancy, and potential carbapenem-resistant microorganism risk factors were all noted in this retrospective study. In empirical and agent-specific treatment groups, differences in demographic features, risk factors, treatment responses, and side effects were compared. -/- Results: Sixty-three patients were included, 54% were male, and the median age was 49. In the last three (...) months, the hospitalization rate history was 68%, and four patients had a hospitalization history in the ICU. Carbapenem-resistant K. pneumoniae colonization was present in 22 patients (35%). Gram-negative microorganisms were isolated in 34 patients (54%). The carbapenem, quinolone, and colistin resistance rates were 82%, 76%, and 4% respectively. Clinical and microbiological response rates were 60% and 69%. 7 and 28-day mortality rates were 17% and 35%. There was no significant difference in demographic data and comorbidities in empirical (n=48) and agent-specific (n=15) treatment groups. The rate of carbapenem and glycopeptide treatments before colistin was higher in the empirical treatment group (p = 0.004; p = 0.001). The rate of starting combined antibiotics was higher in the empirical treatment group (p = 0.016). Two of the patients developed renal failure in the first week after treatment. -/- Conclusion: The use of empirical colistin may be unavoidable given the risk considerations. Shortly, colistin-resistant strains may also be a factor affecting treatment success negatively. (shrink)