Comparison of Alcohol Septal Ablation With Mavacamten in Obstructive Hypertrophic Cardiomyopathy.

Obstructive hypertrophic cardiomyopathy (HCM) is associated with significant morbidity attributed to left ventricular outflow tract (LVOT) obstruction. Although alcohol septal ablation (ASA) is an established interventional treatment, mavacamten, a novel cardiac myosin inhibitor, has emerged as a noninvasive pharmacologic alternative. Understanding the comparative efficacy of these 2 treatments is important for optimizing patient care.

Barriers and facilitators to implementation of physical activity programs for individuals with dementia living in aged care homes: A systematic review.

Objectives: This systematic review aimed to identify barriers and facilitators to the implementation of physical activity programs for residents with dementia in aged care homes.

Methods: A search was conducted using the databases Medline, PubMed, PsycINFO, CINAHL, Embase, and ProQuest, and captured articles were assessed for inclusion in the review. Included studies were appraised using the Mixed Methods Appraisal Tool (MMAT).

Intravenous Iron Repletion for Patients With Heart Failure and Iron Deficiency: JACC State-of-the-Art Review.

Iron deficiency and heart failure frequently co-occur, sparking clinical research into the role of iron repletion in this condition over the last 20 years. Although early nonrandomized studies and subsequent moderate-sized randomized controlled trials showed an improvement in symptoms and functional metrics with the use of intravenous iron, 3 recent larger trials powered to detect a difference in hard cardiovascular outcomes failed to meet their primary endpoints. Additionally, there are potential concerns related to side effects from intravenous iron, both in the short and long term.

Analysis of guideline recommendations for treatment of asthma exacerbations in children: a Pediatric Emergency Research Networks (PERN) study.

Rationale: There is significant practice variation in acute paediatric asthma, particularly severe exacerbations. It is unknown whether this is due to differences in clinical guidelines.

Objectives: To describe and compare the content and quality of clinical guidelines for the management of acute exacerbations of asthma in children between geographic regions.

Use of traditional and complementary medicine by ethnic Indian women living with polycystic ovary syndrome: a global survey.

Background: Traditional, complementary, and integrative medicine (TCIM) is commonly used by those living with Polycystic Ovary Syndrome (PCOS) but little is known about the use of TCIM such as yoga and Ayurveda in ethnic Indian women with PCOS living worldwide. This survey aimed to explore the prevalence and types of TCIM used and in particular the pattern of use of yoga and Ayurveda including reasons for not using and future interest in using them among non-users.

Method: An online, international cross-sectional survey was conducted using a pre-designed survey tool.

Associations of Recreational and Nonrecreational Physical Activity and Body Weight Change on Cardiovascular Disease Mortality During the Obesogenic Transition in the United States: National Health and Nutrition Examination Survey Follow-up Study.

Background: To investigate cardiovascular disease mortality associated with longitudinal changes in body weight, and recreational and nonrecreational physical activity during the obesogenic transition in the United States since the 1970s.

Methods: Data were analyzed from 4921 individuals aged 25-74 years who participated in the National Health and Nutrition Examination Survey between 1971 and 1979 and follow-up studies to 1992. Mortality was confirmed by searching the National Death Index or proxy interview; clinical data were collected in person.

The effect of intradialytic exercise on dialysis patient survival: a randomized controlled trial.

Background: Patients with kidney failure have a high mortality rate. This study aimed to evaluate the effect of intradialytic exercise on survival in patients receiving hemodialysis (HD).

Methods: In this randomized controlled trial conducted in a HD center in Iran, adult patients receiving chronic HD were randomized to intradialytic exercise (60 min) in the second hour of thrice weekly dialysis for 6 months (intervention) or no intradialytic exercise (control).

A Scoping Review of Ayurveda Studies in Women with Polycystic Ovary Syndrome.

Polycystic Ovary Syndrome (PCOS) is a complex disorder with diverse clinical presentations. Women with PCOS use traditional, complementary, and integrative medicines, including Ayurveda (traditional Indian medicine) to manage their symptoms. Therefore, it is important to understand the current evidence base and the potential areas that require further research.

International perspective on research priorities and outcome measures of importance in the care of children with acute exacerbations of asthma: a qualitative interview study.

Background: Acute exacerbations of asthma are common in children, however, treatment decisions for severe exacerbations are challenging due to a lack of robust evidence. In order to create more robust research, a core set of outcome measures needs to be developed. In developing these outcomes, it is important to understand the views of clinicians who care for these children in particular, views that relate to outcome measures and research priorities.

Augmented Intelligence to Identify Patients With Advanced Heart Failure in an Integrated Health System.

Background: Timely referral for specialist evaluation in patients with advanced heart failure (HF) is a Class 1 recommendation. However, the transition from stage C HF to advanced or stage D HF often goes undetected in routine care, resulting in delayed referral and higher mortality rates.

Objectives: The authors sought to develop an augmented intelligence-enabled workflow using machine learning to identify patients with stage D HF and streamline referral.

A Global Survey of Ethnic Indian Women Living with Polycystic Ovary Syndrome: Co-Morbidities, Concerns, Diagnosis Experiences, Quality of Life, and Use of Treatment Methods.

Background: Polycystic ovary syndrome (PCOS) is a common endocrinopathy that is highly prevalent in women of Indian ethnicity. Clinical practice guidelines do not adequately consider ethnic-cultural differences in the diagnosing and care of women with PCOS. This study aimed to understand co-morbidities, key concerns, quality of life (QoL), and diagnosis experiences of ethnic Indian women living with PCOS.

Concomitant Gastric Malignancy and Hepatocellular Carcinoma.

Multiple primary malignant tumors (MPMTs) are two or more separate malignancies found at different sites concurrently. Prior studies have shown that the most common tumor associations in MPMTs are typically between two tumors in the digestive system. We present a case of a male patient in his 60s who initially presented with melena and was found to have a clean-based gastric ulcer on initial endoscopic evaluation.

A Rare Case of Gastrointestinal Amyloidosis Presenting as Dysphagia.

A 74-year-old male with an unintentional 20-pound weight loss over the past year presented with new-onset dysphagia to solid foods. Esophagogastroduodenoscopy showed a subtle stricture with ill-defined scar tissue-like findings in the distal esophagus and erosions in the antrum of the stomach without masses. Pathologic findings showed the presence of amyloidosis involving the proximal and distal esophagus, as well as gastric mucosa with chronic inflammation and reactive epithelial changes.

Esophageal Perforation after Using a Single-Use Disposable Duodenoscope.

The Food and Drug Administration (FDA) has recently released a safety communication recommending transition to duodenoscopes with innovative designs that facilitate or eliminate the need for reprocessing. Thus, there has been a significant amount of development into disposable duodenoscope components and single-use duodenoscopes, with variable tactile feedback. We describe a case of esophageal perforation after using a single-use disposable duodenoscope (EXALT Model D; Boston Scientific Corporation, Marlborough, MA, USA).

Supportive Care Interventions for People With Cancer Assisted by Digital Technology: Systematic Review.

Background: Although relatively new, digital health interventions are demonstrating rapid growth because of their ability to facilitate access and overcome issues of location, time, health status, and most recently, the impact of a major pandemic. With the increased uptake of digital technologies, digital health has the potential to improve the provision of supportive cancer care.

Objective: This systematic review aims to evaluate digital health interventions for supportive cancer care.

Patient-present teaching in the clinic: Effect on agency and professional behaviour.

Background/purpose: Although much has been written about the medical learning environment, the patient, who is the focus of care, is rarely the focus in this literature. The purpose of this study was to explore the role of the patient as an active participant with agency in the medical learning environment from the standpoint of the learner, the attending physician, and most importantly, the patient. We hoped to gain insights into the mechanisms that can reinforce professional values such as patient-centred and respectful behaviours in a patient-present learning environment.

Triage and resuscitation tools for low and middle income countries: how to catch the killer?

Under-5 mortality rates in low and middle-income countries (LMIC) remain high. One major contributing factor is the failure to recognise critically unwell children when they first present to hospital. This leads to delayed or inadequate resuscitation and an increased risk of death.

Strain echocardiography to describe left ventricular function pre- and postexercise in elite basketball athletes: A feasibility study.

Background: Elite athletes show structural cardiac changes as an adaptation to exercise. Studies examining strain in athletes have largely analyzed images at rest only. There is little data available regarding the change in strain with exercise.

Rates of Serious Surgical Errors in California and Plans to Prevent Recurrence.

Importance: Despite widespread recognition and known harms, serious surgical errors, known as surgical never events, endure. The California Department of Public Health (CDPH) has developed an oversight system to capture never events and a platform for process improvement that has not yet been critically appraised.

Objectives: To examine surgical never events occurring in hospitals in California and summarize recommendations to prevent future events.

How much time do doctors spend providing care to each child in the ED? A time and motion study.

Background: The total time per patient doctors spend providing care in emergency departments (EDs) has implications for the development of evidence-based ED staffing models. We sought to measure the total time taken by doctors to assess and manage individual paediatric patients presenting to two EDs in the Western Cape, South Africa and to compare these averages to the estimated benchmarks used regionally to calculate ED staffing allocations.

Methods: We conducted a cross-sectional, observational study applying time and motion methodology, using convenience sampling.