IL-17 Producing T to Foxp3CD4 Regulatory T Cell Ratio as a Diagnostic and Prognostic Marker in Women With Recurrent Pregnancy Loss and Its Implications for Intravenous Immunoglobulin Therapy.

Problem: The imbalance in the Th17/Regulatory T (Treg) cell ratio is associated with recurrent pregnancy loss (RPL). This study aimed to determine a cut-off for the Th17/Treg cell ratio to predict pregnancy outcomes in RPL and evaluate the effectiveness of intravenous immunoglobulin (IVIG) based on this cut-off value.

Method Of Study: This retrospective cohort study included 49 idiopathic RPL and 75 controls.

Short term outcomes and resource utilization in versus acute on chronic heart failure related cardiogenic shock: a nationwide analysis.

Background: There has been growing recognition of non-ischemic etiologies of cardiogenic shock (CS). To further understand this population, we aimed to investigate differences in clinical course between acute on chronic heart failure related (CHF-CS) and de-novo CS (DN-CS).

Methods: Using the Nationwide Readmission Database, we examined 92,426 CS cases.

Neuronal AMPK regulates lipid transport to microglia.

In neurodegeneration, neurons release lipids that accumulate in glial lipid droplets (LDs). But what controls lipid transport and how does this affect glia? A recent study by Li et al. discovered that the loss of neuronal AMP-activated protein kinase (AMPK) activity promotes lipid efflux, which drives a proinflammatory state in microglia.

Early Clinical Outcomes of Patients With Stress-Induced Cardiomyopathy Receiving Acute Mechanical Support in the US.

Background: The role of acute mechanical circulatory support (aMCS) in patients with stress-induced cardiomyopathy (SIC) complicated by cardiogenic shock (CS) is not well studied. Here, we describe the incidence and outcomes of aMCS use in SIC-CS using a large national database.

Methods: Using the Nationwide Readmissions Database from January 2016 to November 2019, we identified patients hospitalized with SIC who received isolated intra-aortic balloon pump (IABP), microaxial flow pump (Impella, Abiomed), or extracorporeal membrane oxygenation (ECMO) during the index hospitalization.

Surgical Treatment of Enlarged Cervical Leiomyoma with Concomitant Uterine Prolapse: A Case Report.

This case report details the surgical treatment of a rare enlarged cervical leiomyoma with uterine prolapse in a 48-year-old woman. She presented to Konyang University Hospital with a palpable vaginal mass, lower abdominal pain, and urinary incontinence. Despite being nulliparous, she had severe chronic constipation due to schizophrenia medication and lived in a health care facility separated from her family.

Wide Spectrum of Flecainide Toxicity: A Case Report and Literature Review.

Flecainide toxicity is a rare but serious condition that can present with a wide range of clinical symptoms. We report the case of a 79-year-old female with paroxysmal atrial fibrillation on flecainide therapy who developed altered mental status, visual hallucinations, and bradycardia. Laboratory results revealed an acute kidney injury, which contributed to elevated flecainide levels.

Wireless pulmonary artery sensor implantation in a unilateral lung transplant recipient.

Unlabelled: Patients with lung transplantation can have concomitant left ventricular failure which can either precede the lung transplantation or develop after. Implantable wireless pulmonary artery (PA) pressure monitors to guide hemodynamic management in heart failure such as the CardioMEMS device (Abbott, Sylmar, CA, USA) have been shown to improve outcomes. However, in a lung transplant recipient there are unique physiological and practical considerations when contemplating to implant a PA pressure sensor such as safety of implanting the device, choice of site of implantation, accuracy of wedge tracings to calibrate, and exclusion of vascular stenoses post transplantation.

2-Deoxy-d-ribose induces ferroptosis in renal tubular epithelial cells via ubiquitin-proteasome system-mediated xCT protein degradation.

Ferroptosis is a novel form of cell death triggered by iron-dependent lipid peroxidation. Recent findings suggest that inhibiting system χc-induces ferroptosis by reducing intracellular cystine levels, and that ferroptosis in renal tubular epithelial cells (RTECs) contributes to acute kidney injury (AKI) and diabetic nephropathy. Moreover, 2-deoxy-d-ribose (dRib) has been shown to inhibit cystine uptake through xCT, the functional unit of system χc-, in β-cells.

Invasive Pulmonary Angiogram Performance and Interpretation in the Diagnosis of Pulmonary Thromboembolic Disease.

Invasive or selective pulmonary angiography has historically been used as the gold standard diagnostic test for the evaluation of a wide array of pulmonary arterial conditions, most commonly pulmonary thromboembolic diseases. With the emergence of various noninvasive imaging modalities, the role of invasive pulmonary angiography is shifting to the assistance of advanced pharmacomechanical therapies for such conditions. Components of invasive pulmonary angiography methodology include optimal patient positioning, vascular access, catheter selections, angiographic positioning, contrast settings, and recognition of angiographic patterns of common thromboembolic and nonthromboembolic conditions.

A call to consider an aortic stenosis screening program.

Aortic stenosis (AS) is the most common age-related valvular condition with a prevalence of 13.1% in patients older than 75 years of age. Based on the severity of AS and symptoms, current guidelines recommend interval monitoring with transthoracic echocardiogram (TTE).

Identification of osteopontin as a urinary biomarker for autosomal dominant polycystic kidney disease progression.

Background: Autosomal dominant polycystic kidney disease (ADPKD), one of the most common human monogenic diseases, is characterized by the presence of numerous fluid-filled renal cysts and is a leading cause of end-stage renal disease (ESRD). Urinary biomarkers may be useful for predicting the variable course of ADPKD progression from cyst growth to ESRD.

Methods: To identify candidate urinary biomarkers of ADPKD progression, we used CRISPR/Cas9 genome editing to generate porcine fibroblasts with mono- and biallelic ADPKD gene knockout (PKD2+/- and PKD2-/-, respectively).

Facial Diplegia Variant of Guillain-Barré Syndrome in Pregnancy Following COVID-19 Vaccination: A Case Report.

Serious neurologic complications from coronavirus disease 2019 (COVID-19) vaccination are rare, and only a few cases of Guillain-Barré syndrome (GBS) have been reported after COVID-19 vaccination. We present the first reported case of the facial diplegia variant of GBS after recent COVID-19 vaccination in a pregnant woman. The 30-year-old patient was 27 weeks pregnant at the time she was diagnosed with the facial diplegia variant of GBS.

Direct current cardioversion-triggered atypical Tako-tsubo cardiomyopathy: a case report and review of literature.

Background: Tako-tsubo stress cardiomyopathy is a clinical syndrome marked by transient reduction of left ventricular function in the setting of emotional or physical stress and in the absence of obstructive coronary artery disease. We describe a case of an atypical variant of Tako-tsubo in a male patient following an elective direct current cardioversion (DCCV).

Case Summary: A 78-year-old male whose atrial fibrillation persisted after earlier unsuccessful direct current DCCV and radiofrequency ablations presented to the emergency department for acutely worsening dyspnoea and orthopnoea 12 h following his most recent DCCV.

Haemophilus Parainfluenzae mural endocarditis with large atrial septal defect and peripheral embolization.

Mural endocarditis is a rare subclass of infective endocarditis (IE) associated with intra-cardiac tumors, prosthesis, valvular vegetation's, or structural abnormalities such as ventricular septal defects. Bacteria classified as HACEK ( species, , and ) are rare causes of IE found in only 1.3% to 10% of cases.

Identification of Phenotypes Among COVID-19 Patients in the United States Using Latent Class Analysis.

Background: Coronavirus disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) is a heterogeneous disorder with a complex pathogenesis. Recent studies from Spain and France have indicated that underlying phenotypes may exist among patients admitted to the hospital with COVID-19. Whether those same phenotypes exist in the United States (US) remains unclear.

Non-dissecting large thoracic aortic aneurysm leading to chronic aortic insufficiency presenting as acute heart failure.

Large, non-dissecting thoracic aortic aneurysms (TAA) up to 13 cm in size are typically found in elderly patients with non-specific respiratory symptoms yet must be detected quickly due to their mortality risk. We present a 31-year-old man with exertional dyspnea secondary to aortic insufficiency from a 9.4 cm TAA.

The Challenges of ST-Elevation Myocardial Infarction in COVID-19 Patients.

By July 2021, the United States had over 34.4 million confirmed COVID-19 cases. Various cardiovascular manifestations of COVID-19 have been reported including ST-elevation myocardial infarction (STEMI), and there is concern that SARS-CoV-2 may be associated with a higher thrombus burden.

Coombs-negative hemolytic anemia in a male with COVID-19.

This case illustrates the need to consider SARS-CoV-2 infection as a catalyst for Coombs-negative hemolytic anemia as well as the potential for IVIG to serve as an effective treatment for the condition.

Seronegative Goodpasture's syndrome associated with organising pneumonia.

Goodpasture's syndrome is a rare vasculitis associated with anti-glomerular basement membrane (anti-GBM) autoantibodies that target type IV collagen found in the basement membranes of glomeruli and alveoli. We present a case of a 79-year-old man with seronegative Goodpasture's syndrome with predominant respiratory symptoms and mild acute kidney injury that initially improved. Final diagnosis was made by immunofluorescent staining on open lung biopsy which also revealed concomitant organising pneumonia.

Diagnosis and treatment of transthyretin-related amyloidosis cardiomyopathy.

Transthyretin-related amyloidosis (ATTR) is a subgroup of amyloidosis that results from extracellular misassembled and toxic amyloid deposits affecting multiple organ systems, and cardiac tissues in particular. Because ATTR often presents as heart failure with preserved ejection fraction (HFpEF), it has been largely underdiagnosed. Once considered incurable with a grave prognosis, ATTR cardiomyopathy has seen the development of promising alternatives for diagnosis and treatment, with early diagnosis and treatment of ATTR cardiomyopathy highly beneficial due to its high mortality rate.

System χ overexpression prevents 2-deoxy-d-ribose-induced β-cell damage.

Pancreatic β-cells are vulnerable to oxidative stress, which promotes β-cell failure in type 2 diabetes. System χ is a sodium-independent, cystine/glutamate antiporter that mediates the exchange of extracellular l-cystine and intracellular l-glutamate. The import of l-cystine through this transporter is the rate-limiting step in the glutathione (GSH) biosynthesis pathway that plays a significant role in antioxidative defense.

Barley RNA viromes in six different geographical regions in Korea.

Barley is a kind of cereal grass belonging to the family Poaceae. To examine viruses infecting winter barley in Korea, we carried out a comprehensive study of barley RNA viromes using next-generation sequencing (NGS). A total of 110 barley leaf samples from 17 geographical locations were collected.