Pandemic news information uncertainty-News dynamics mirror differential response strategies to COVID-19.

National differences in uncertainty, inequality, and trust have been accentuated by COVID-19. There are indications that the pandemic has impacted societies characterized by high uncertainty, inequality, and low trust harder than societies characterized by low uncertainty, equality, and high trust. This study investigates differential response strategies to COVID-19 as reflected in news media of two otherwise similar low uncertainty societies: Denmark and Sweden.

Causal and Associational Language in Observational Health Research: A Systematic Evaluation.

We estimated the degree to which language used in the high-profile medical/public health/epidemiology literature implied causality using language linking exposures to outcomes and action recommendations; examined disconnects between language and recommendations; identified the most common linking phrases; and estimated how strongly linking phrases imply causality. We searched for and screened 1,170 articles from 18 high-profile journals (65 per journal) published from 2010-2019. Based on written framing and systematic guidance, 3 reviewers rated the degree of causality implied in abstracts and full text for exposure/outcome linking language and action recommendations.

Peer review: the case for neutral language.

Peer review is an integral part of scientific life, determining success in publishing, grant applications, and professional appointments. We argue for the importance of neutral language in peer review and provide examples of nonneutral linguistic and stylistic devices that emphasize a reviewer's personal response to the manuscript rather than their objective assessment.

Computational fluid dynamics simulation to evaluate aortic coarctation gradient with contrast-enhanced CT.

Coarctation of aorta (CoA) is a narrowing of the aorta leading to a pressure gradient (ΔP) across the coarctation, increased afterload and reduced peripheral perfusion pressures. Indication to invasive treatment is based on values of maximal (systolic) trans-coarctation ΔP. A computational fluid dynamic (CFD) approach is herein presented for the non-invasive haemodynamic assessment of ΔP across CoA.

Haemodynamic predictors of a penetrating atherosclerotic ulcer rupture using fluid-structure interaction analysis.

We present preliminary data on the flow-induced haemodynamic and structural loads exerted on a penetrating atherosclerotic aortic ulcer (PAU). Specifically, one-way fluid-structure interaction analysis was performed on the aortic model reconstructed from a 66-year-old male patient with a PAU that evolved into an intramural haematoma and rupture of the thoracic aorta. The results show that elevated blood pressure (117 mmHg) and low flow velocity at the aortic wall (0.

The new patent foramen ovale occluder FIGULLA in complex septal anatomy: a case series.

Background: The appropriate treatment strategy for secondary stroke prevention in patients with cryptogenic stroke and patent foramen ovale (PFO) remains challenging. The aim of this study was to describe a case series of patients with PFO and complex septal anatomy who underwent percutaneous correction using a FIGULLA (Occlutech) septal occluder (FSO).

Patients: Ten consecutive patients (6 females, 4 males, mean age 41.

Left main coronary in-stent intimal hyperplasia and hemodynamics as detected by contrast-enhanced transesophageal echocardiography.

Patients And Methods: In-stent hemodynamics were studied by transesophageal echocardiography (TEE) in a group of 54 patients after left main coronary artery stenting, during a 6-month follow-up. TEE was performed within 24 hours after stenting and at 1- and 3-month follow-up. Pulsed wave and color Doppler signals were enhanced by IV administration of Levovist.

Can learning to interpret pump messages help lead to an early diagnosis of HeartWare ventricular assist device thrombosis?

Left ventricular assist device thrombosis is a detrimental complication that, if not properly diagnosed and treated, can lead to low output syndrome and death. When ongoing thrombus formation is caused by inappropriate anticoagulation, timely identification is possible, and could perhaps be the key to successful treatment.

Atrial septostomy in patients with end-stage pulmonary hypertension. No more needles but wires, energy and close anatomical definition.

Objectives: To assess the usefulness of a new approach to atrial septal puncture and septostomy in patients with end-stage pulmonary hypertension.

Background: Atrial septostomy in end-stage pulmonary hypertension has high mortality and morbidity rates mainly due to trans-septal catheterization. New approaches to safety during this technical step are expected.

Use of bivalirudin for heparin-induced thrombocytopaenia after thrombolysis in massive pulmonary embolism: a case report.

A 68-year-old man was referred to the emergency department 6 h after onset of sudden acute dyspnoea. Immediate ECG showed sinus tachycardia with the typical S1-Q3-T3 pattern and incomplete right bundle branch block. The echocardiogram showed the presence of mobile thrombus in the right atrium, a distended right ventricle with free wall hypokinesia and displacement of the interventricular septum towards the left ventricle.

Reduction of a previous atrial septostomy in a patient with end-stage pulmonary hypertension by a manually fenestrated device.

A case of profound systemic oxygen desaturation after atrial septostomy in a patient with primitive pulmonary hypertension is reported. A new method to correct such severe complication of atrial septostomy is described, consisting in a graded reduction of the right to left atrial shunt by deployment of a manually perforated atrial septal closure device.

Six-month echocardiographic study in patients with submassive pulmonary embolism and right ventricle dysfunction: comparison of thrombolysis with heparin.

Introduction: The aim of this study was to assess the effect of thrombolysis versus heparin treatment on echocardiographic parameters and clinical outcome, during hospitalization and within the first 180 days after admission, in patients with first episode of submassive pulmonary embolism (SPE) and right ventricle dysfunction (RVD).

Methods: Consecutive patients (age, 18-75 years) with a first episode of SPE, symptoms onset since no more than 6 hours, normal blood pressure (>100 mm Hg), echocardiographic evidence of RVD and positive lung spiral computed tomography were double-blind randomized: 1 group received 100 mg of alteplase (10-mg bolus, followed by a 90-mg intravenous infusion over a period of 2 hours), while the other group received matching placebo. In addition to alteplase or placebo, both groups received an unfractionated heparin treatment.

Hybrid treatment of inferior vena cava obstruction after orthotopic heart transplantation.

Caval stenosis with subsequent thrombosis may occur after orthotopic heart transplantation (HT). Management of this complication may include a percutaneous approach or an open surgical one. Here, we report the case of an obstruction and severe thrombosis of the inferior vena cava, following orthotopic HT, that was managed in a hybrid fashion with surgical venous thrombectomy, inferior vena cava stenting, and atrio-caval patch-plasty.

In-stent thrombosis after 68 months of implantation inspite of continuous dual antiplatelet therapy: a case report.

Lately, there has been an increased incidence of late stent thrombosis; especially following Drug eluting stent (DES) implantation. Several factors are associated with an increased risk of stent thrombosis, including the procedure itself, patient and lesion characteristics, stent design, and premature cessation of anti-platelet drugs. We present a case of late stent thrombosis (LST) following DES implantation after a period of 68 months, making it the longest reported case of LST reported in the literature, despite the use of dual anti-platelet therapy.

Tamponade following breast augmentation.

Breast augmentation is one of most commonly performed cosmetic surgical procedures. Pneumothorax has been reported as a rare complication of breast augmentation but the incidence is not known. Our patient presented with dyspnea on exertion about 6 days following breast augmentation.

A planned hybrid culotte stenting procedure in the setting of an acute STEMI.

Introduction: Bifurcation lesions have traditionally presented a unique problem for interventional cardiologists because of their inherent anatomy and risk of closure of the side branch, after a percutaneous intervention for the primary lesion of the main branch.

Case Presentation: We report the case of a 57-year-old man who presented with acute ST-segment elevation myocardial infarction secondary to a 100% occlusion at the ostium of first diagonal (D1) branch. Patient also had a 70% stenosis of the mid-segment of the left anterior descending (LAD) coronary artery at the D1 branching point (1,1,1 Medina classification).

Endovascular treatment of a symptomatic carotid artery aneurysm with a stent graft.

Endovascular methods have become more widespread and offer an alternative to surgery, which is often difficult in case of a hostile neck resulting from radiotherapy. Carotid pseudoaneurysm after laryngectomy is a very uncommon complication. We report a case of symptomatic carotid artery pseudoaneurysm treated using a stent graft.

Spontaneous coronary hematoma during systemic thrombolysis for acute myocardial infarction: intracoronary ultrasound findings, percutaneous coronary intervention and complications.

A case of coronary dissection with large parietal hematoma, involving the proximal left anterior descending and the left main coronary arteries after systemic thrombolysis for acute anterior myocardial infarction is described. The peculiar intravascular ultrasound features, therapy options, complications after stenting and follow-up are described.

Left anterior descending coronary artery bridge: contraindication to cardiac transplantation?

We report two cases of cardiac transplantation of donor hearts with left anterior descending (LAD) myocardial bridging (MB). In the first case, the diagnosis was done only days after transplant. In the second case, a pre-operative angiography showed evidence of LAD myocardial bridging and the organ was used for a marginal recipient.

Culotte bifurcation stenting with paclitaxel drug-eluting stent.

The results of using the culotte bifurcation technique have not been promising with regard to bare metal stents; however, some possible advantages with regard to drug-eluting stents (DES) must be taken into account, such as the possibility to stent provisionally, to use lower French sizes, and to completely cover the coronary wall and the new carina with a single or double stent layer. The crush technique, which aims to reach a complete coverage of the coronary wall to allow antiproliferative drugs to homogeneously distribute into the coronary walls, has been introduced. The culotte technique seems to act more physiologically, allowing the creation of a new, homogeneously covered carina, without any crushed metal inside the coronary wall.

Simultaneous double-culprit in-stent thrombosis. Who is the guilty prisoner behind bars: drug-eluting stent, bare-metal stent, or indication for treatment?

Background: The intrinsic thrombogeneity of stents was the historic limitation to their usage during the early phases of stenting. The risk of stent thrombosis has been minimized by the widespread use of platelet antiaggregation. Nowadays, the risk of subacute stent thrombosis is around 1%.

Intracardiac echocardiography in monitoring atrial septal defect percutaneous closure: initial experience in an adult laboratory.

Two cases of percutaneous closure of atrial septal defect and patent foramen ovale with intracardiac echo monitoring are described. Intracardiac echocardiography was compared to contemporary TOE with full data concordance. The inherent implications and limitations of this new method are discussed.

Downstream administration of a high-dose tirofiban bolus in high-risk patients with unstable angina undergoing early percutaneous coronary intervention.

Background: The best treatment option for high-risk patients with unstable coronary syndrome is an early invasive strategy accompanied by intensive anti-platelet therapy. We tested the effect on clinical outcome of early coronary angioplasty using a high-dose bolus of tirofiban in patients with non-ST segment elevation acute coronary syndrome.

Methods: One hundred and forty consecutive patients with unstable coronary syndrome who underwent an immediate percutaneous coronary intervention with the administration of a high (25 microg/kg) dose bolus of tirofiban followed by an 18-h infusion of 0.