Therapeutic plasma exchange as adjunct therapy for bullous pemphigoid.

Bullous pemphigoid (BP) is a rare autoimmune blistering disease caused by pathogenic antibodies which deposit into the dermo-epidermal junction. We present a case of bullous pemphigoid in a young female refractory to initial therapy with immunosuppressives and steroids who experienced significant improvement in blister burden after a course of adjunct therapeutic plasma exchange (TPE). This case report provides valuable insight into the benefit of utilizing TPE for BP and provides treatment specifics regarding use of TPE in a patient with BP.

Impact of prefilter dilution on IgG removal in membrane-based therapeutic plasma exchange.

Introduction: Previous studies have demonstrated that a "one plasma volume exchange" would result in an estimated 63% decline in pretreatment IgG levels. We evaluated the use of prefilter dilution with normal saline as a method to prevent filter failure without decreasing the efficiency of IgG removal.

Methods: Twenty-one treatment sessions were analyzed and all received prefilter dilution with normal saline.

Diabetic nephropathy in pregnancy: Report of two cases progressing to end-stage renal disease within one year postpartum.

Background: Diabetes mellitus is a leading cause of nephropathy and end-stage renal disease. However, diabetic nephropathy during pregnancy in patients with normal glomerular filtration rate and subsequent progression to end-stage renal disease has not been well studied.

Cases: This report presents two patients with poorly controlled type 1 diabetes mellitus who had diabetic nephropathy with preserved estimated glomerular filtration rate (Case 1: 117 mL/min/1.

Safety and Efficacy of Renin-Angiotensin-Aldosterone System Inhibitors in COVID-19 Population.

Introduction: The safety of renin-angiotensin-aldosterone system inhibitors (RAASi) among COVID-19 patients has been controversial since the onset of the pandemic.

Methods: Digital databases were queried to study the safety of RAASi in COVID-19. The primary outcome of interest was mortality.

Bioresorbable polymer and durable polymer metallic stents in coronary artery disease: a meta-analysis.

Background: Literature on bioresorbable-polymer-stents (BPS) and second-generation durable-polymer-stents (DPS) in percutaneous coronary intervention (PCI) for all comer CAD is conflicting.

Methods: Randomized controlled studies comparing PCI among BPS and second-generation DPS were identified up until May-2020 from online databases.  Primary outcomes included are all-cause myocardial infarction (MI), cardiac-death, target-vessel-revascularization (TVR), target-vessel MI (TVMI), and stent-thrombosis (ST).

Meta-Analysis of Direct Oral Anticoagulants Compared With Vitamin K Antagonist for Left Ventricle Thrombus.

Background: The use of direct oral anticoagulants (DOAC) in preference to vitamin K antagonists (VKA) as a treatment of left ventricle (LV) thrombus is controversial.

Methods: Literature search for full-text articles and conference abstracts was performed using PubMed, EMBASE databases search was performed to identify articles that compared use of DOAC vs. VKA in patients with LV thrombus.

Post-PCI outcomes in STEMI patients with coronary ectasia: meta-analysis.

Background: Coronary ectasia (CE) is defined as dilation of the coronary artery, 1.5 times that of the surrounding vessel. Outcomes of percutaneous intervention (PCI) in patients with CE presenting as ST-elevated myocardial infarction (STEMI) remain a topic of debate.

Does Pulmonary Embolism in Critically Ill COVID-19 Patients Worsen the In-Hospital Mortality: A Meta-Analysis.

Background: Mortality in critically ill COVID (coronavirus disease) patients secondary to pulmonary embolism (PE) has conflicting data. We aim to evaluate the mortality outcomes of critically ill patients with and without PE (WPE).

Methods: Three studies were identified after a digital database search on PE in ICU (intensive care unit) patients until September 2020.

COVID-19 Related Arterial Coagulopathy.

Coronavirus disease of 2019 (COVID-19) is a disease caused by the novel coronavirus SARS-CoV-2, which is characterized by a multitude of clinical abnormalities, including hypercoagulability. Although thrombosis is commonly observed in sepsis, the hypercoagulable state associated with COVID-19 is much more dramatic and may not be related to either the severity of the disease or the D-dimer levels. It may be due to a prothrombotic state induced by the disease itself.

Speckle Tracking Echocardiography of the Right Atrium: The Neglected Chamber.

The right atrium (RA) plays a pivotal role in electromechanical and endocrine regulation of the heart. Its peculiar anatomical features and phasic mechanical function make it distinct from ventricles. Various invasive and noninvasive techniques have been used to elucidate RA structure and function.