Publications by authors named "Gabriel Velez Oquendo"

Background: Cardiovascular implantable electronic device (CIED) infections without early diagnosis, treatment, and proper follow-up are associated with increased morbidity, mortality, and worse outcomes.  Objective: This study aims to identify patients presenting for hospital admission with bacteremia and the presence of CIED by implementing a best practice advisory (BPA) notification in the electronic medical record to facilitate early consultation with the cardiac electrophysiology (EP) team and treatment.

Methods: A BPA was implemented into the electronic medical record (EMR) EPIC in 2022 and was generated for any patient that presented to our health system with bacteremia and the presence of a CIED.

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  • Atrial flutter is a heart condition that can lead to serious health issues, typically treated with medications, while more persistent cases may require ablation, a procedure that can have risks including complete heart block.* -
  • A case involving a 73-year-old woman highlighted complications during ablation for atrial flutter when a heart block occurred due to catheter positioning too close to the His bundle—a critical area for heart electrical signals.* -
  • The patient recovered quickly after the block but later needed a pacemaker due to severe bradycardia, emphasizing the need for careful catheter placement during ablation to avoid such complications.*
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  • Bictegravir-emtricitabine-tenofovir alafenamide, or Biktarvy, is a medication approved for treating AIDS, combining an integrase strand inhibitor and nucleoside reverse transcriptase inhibitors (NRTIs) to help manage the disease.
  • A rare side effect of NRTIs is lactic acidosis, which occurs due to mitochondrial dysfunction, affecting DNA replication and increasing lactic acid production.
  • In a case study, a patient with septic shock experienced persistent lactic acidosis from a high dose of Biktarvy, highlighting the need for careful medication review and understanding of potential side effects when diagnosing lactic acidosis.
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Vanishing lung syndrome (VLS) also known as type I bullae disease or idiopathic bullous disease is characterized by giant emphysematous bullae that commonly develop in the upper lobes, occupying at least one-third of a hemithorax. It is a progressive and irreversible condition that involves pulmonary parenchymal destruction and alveolar dilation. It is commonly associated with middle-aged tobacco smokers, habitual marijuana users, and those with alpha-1-antitrypsin deficiency.

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A 55-year-old man presented with sustained monomorphic ventricular tachycardia with a left bundle QRS complex pattern in the setting of non-ST-segment elevation myocardial infarction. The electrocardiographic morphology of the ventricular tachycardia and echocardiographic findings of significant right ventricular dysfunction led to the diagnosis of arrhythmogenic right ventricular cardiomyopathy.

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BACKGROUND Pericardial effusions are considered to be present when accumulated fluid within the pericardial sac exceeds the small amount that is normally present, causing impairment in the diastolic filling of the right heart. This case demonstrates an uncommon presentation of a large pericardial effusion by showing its relationship to myxedema in a patient with untreated hypothyroidism. CASE REPORT A 42-year-old man with a past medical history of hypertension, diabetes mellitus, and opioid abuse presented to the emergency department due to altered mental status, for which he received Narcan without resolution of symptoms.

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BACKGROUND Vision loss secondary to optic neuritis is an uncommon adverse effect of nonsteroidal aromatase inhibitors. There have been few reports in the literature on visual disturbance in patients on long-term treatment with Anastrozole for breast cancer prevention; but none had symptoms worse than blurry vision and/or xerostomia. The present patient had acute onset of right-sided vision loss without other neurologic deficits while using the aromatase inhibitor Anastrozole for breast cancer treatment.

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