The Utility of Echocardiography in Estimating Fluid Responsiveness.

Assessing the volume status in critically ill patients is the key to maintain the stability of the hemodynamics; however, it can be challenging to view the complexity of cases and the diversity of shock etiology. Multiple noninvasive means have been used to study the effectiveness of volume resuscitation, but none of them have been used as gold standard. We aim to illustrate the most used techniques: left ventricular outflow tract velocity time integral versus inferior vena cava compressibility index, and highlight their limitations and strengths.

Heart failure - An unexplored risk factor for infective endocarditis after pacemaker implantation.

Background: With the widespread use of permanent pacemakers (PPM), and increased mortality associated with pacemaker endocarditis, it is essential to evaluate comorbidities that could potentially increase the risk of infective endocarditis (IE). Heart failure (HF), a common comorbidity, has not been well studied as an independent risk factor for development of IE in individuals with PPM.

Methods: The US National Inpatient Sample database was used to sample individuals with PPM.

Human Herpes Virus 6-Associated Meningitis in an Immunocompetent Adult With a History of Plaque Psoriasis: A Case Report.

Human herpes virus-6 (HHV-6) is a common cause of viral infection in humans, recognized for causing exanthema subitem during the first two years of life. Chronic inflammatory states in different autoimmune diseases can be associated with an immunosuppressed microenvironment. We report a case of HHV-6-associated meningitis in a patient with psoriasis.

Monitoring long-term vegetation condition dynamics in persistent semi-arid wetland communities using time series of Landsat data.

Wetlands in arid and semi-arid regions are characterized by dry- and wet-phase vegetation expression which responds to variable water resources. Monitoring condition trends in these wetlands is challenging because transitions may be rapid and short-lived, and identification of meaningful condition change requires longitudinal study. Remotely-sensed data provide cost effective, multi-decadal information with sufficient temporal and spatial scale to explore wetland condition.

A Rare Case of High-Grade Atrioventricular Block in Granulomatosis With Polyangiitis.

Granulomatosis with polyangiitis (GPA) is an autoimmune disease that affects small and medium-sized vessels. It is classically known to present with renal and respiratory tract symptoms. However, the disease can manifest in other organ systems, especially cardiovascular involvement.

Lactococcus endocarditis after Bentall procedure presenting with intracranial hemorrhage.

Background: Endocarditis is more common in patients with cardiac prostheses. A Bentall procedure entails surgical replacement of the aortic valve, aortic root, and ascending aorta with re-implantation of coronary arteries into the graft.

Case: 65-year-old male with history of atrial fibrillation on rivaroxaban, bicuspid aortic valve, and ascending aortic aneurysm with a history of a Bentall procedure two years prior, presented with headache and dysarthria for one day.

Severe Tricuspid Stenosis Secondary to Permanent Pacemaker Lead.

Tricuspid stenosis (TS) is a rare valvular abnormality and generally associated with mitral stenosis in cases of rheumatic heart disease. TS is now frequently being described in the setting of permanent pacemaker leads, either with or without the presence of infective endocarditis. We describe a case of a female with TS secondary to permanent pacemaker leads in the absence of infective endocarditis being managed during the pre-conception period.