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Aortic dissection albeit negative d-dimers and zero clinical probability - Another facet of medicine's deadly chameleon.

ABSTRACT: Aortic dissection, the rupture of the aorta's intimal and medial layers, leading to the formation of a false lumen, is a relatively common disease with high mortality. So far, while not addressing penetrating aortic ulcer or intramural hematoma, current guidelines take a negative value for d-dimers for a sufficient method to rule out aortic dissection in patients with a low clinical probability, as calculated by the ADD risk score. We present two cases of patients with acute aortic dissection, albeit presenting with a low clinical probability for acute aortic dissection and negative values for d-dimers. .

SUBMITTER: Ruf TF

PROVIDER: S-EPMC6283770 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Aortic dissection albeit negative d-dimers and zero clinical probability - Another facet of medicine's deadly chameleon.

Ruf Tobias Friedrich TF Pfluecke Christian C Mues Christoph C Strasser Ruth H RH

Journal of cardiology cases 20161116 2

Aortic dissection, the rupture of the aorta's intimal and medial layers, leading to the formation of a false lumen, is a relatively common disease with high mortality. So far, while not addressing penetrating aortic ulcer or intramural hematoma, current guidelines take a negative value for d-dimers for a sufficient method to rule out aortic dissection in patients with a low clinical probability, as calculated by the ADD risk score. We present two cases of patients with acute aortic dissection, a ...[more]

PMID: 30546696

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Project description:IntroductionIn December 2017, Lancet called for gender inequality investigations. Holding other factors constant, trends over time for significant author (i.e., first, second, last or any of these authors) publications were examined for the three highest-impact medical research journals (i.e., New England Journal of Medicine [NEJM], Journal of the American Medical Association [JAMA], and Lancet).Materials and methodsUsing randomly sampled 2002-2019 MEDLINE original publications (n = 1,080; 20/year/journal), significant author-based and publication-based characteristics were extracted. Gender assignment used internet-based biographies, pronouns, first names, and photographs. Adjusting for author-specific characteristics and multiple publications per author, generalized estimating equations tested for first, second, and last significant author gender disparities.ResultsCompared to 37.23% of 2002 - 2019 U.S. medical school full-time faculty that were women, women's first author publication rates (26.82% overall, 15.83% NEJM, 29.38% Lancet, and 35.39% JAMA; all p < 0.0001) were lower. No improvements over time occurred in women first authorship rates. Women first authors had lower Web of Science citation counts and co-authors/collaborating author counts, less frequently held M.D. or multiple doctoral-level degrees, less commonly published clinical trials or cardiovascular-related projects, but more commonly were North American-based and studied North American-based patients (all p < 0.05). Women second and last authors were similarly underrepresented. Compared to men, women first authors had lower multiple publication rates in these top journals (p < 0.001). Same gender first/last authors resulted in higher multiple publication rates within these top three journals (p < 0.001).DiscussionSince 2002, this authorship "gender disparity chasm" has been tolerated across all these top medical research journals. Despite Lancet's 2017 call to arms, furthermore, the author-based gender disparities have not changed for these top medical research journals - even in recent times. Co-author gender alignment may reduce future gender inequities, but this promising strategy requires further investigation.

Dataset Information

Aortic dissection albeit negative d-dimers and zero clinical probability - Another facet of medicine's deadly chameleon.

Publications

Aortic dissection albeit negative d-dimers and zero clinical probability - Another facet of medicine's deadly chameleon.

Similar Datasets

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