Tricuspid Endocarditis Leading to a Stroke: A Case Report of Paradoxical Embolism in a Young Intravenous Drug User.

Infective endocarditis (IE) involving the tricuspid valve is commonly associated with intravenous drug use, with right-sided IE typically leading to septic pulmonary emboli; however, systemic embolization via paradoxical embolism is a rare and severe complication. We present a case of a 33-year-old female with a history of intravenous drug use who was admitted with generalized pain after leaving another facility against medical advice following treatment for pneumonia and tricuspid valve endocarditis, including vegetation debulking. On readmission, she exhibited signs of infection, and imaging revealed bilateral septic pulmonary emboli with cavitary lesions, while echocardiography showed severe tricuspid regurgitation with large mobile vegetation and an aneurysmal interatrial septum, suggesting a probable patent foramen ovale.

Impact of an online multicomponent very-low-carbohydrate program in women with polycystic ovary syndrome: a pilot study.

Objective: To study the impact of a very-low-carbohydrate (VLC) diet for 16 weeks in overweight or obese women with polycystic ovary syndrome (PCOS).

Design: Single-arm prospective pilot study.

Setting: We recruited participants using medical records from an academic medical center.