Crossroads of highly pathogenic H5N1: overlap between wild and domestic birds in the Black Sea-Mediterranean impacts global transmission.

Understanding transmission dynamics that link wild and domestic animals is a key element of predicting the emergence of infectious disease, an event that has highest likelihood of occurring wherever human livelihoods depend on agriculture and animal trade. Contact between poultry and wild birds is a key driver of the emergence of highly pathogenic avian influenza (HPAI), a process that allows for host switching and accelerated reassortment, diversification, and spread of virus between otherwise unconnected regions. This study addresses questions relevant to the spillover of HPAI at a transmission hotspot: what is the nature of the wild bird-poultry interface in Egypt and adjacent Black Sea-Mediterranean countries and how has this contributed to outbreaks occurring worldwide? Using a spatiotemporal model of infection risk informed by satellite tracking of waterfowl and viral phylogenetics, this study identified ecological conditions that contribute to spillover in this understudied region.

Kawasaki Related Coronary Artery Disease Refractory to Angioplasty: The Role of Intravascular Shockwave Lithotripsy.

Kawasaki disease is a systemic vasculitis with frequent coronary artery involvement, associated with coronary artery aneurysms (CAAs) even if appropriately treated. Patients with CAA have a high risk for cardiovascular complications and frequently undergo repeated coronary interventions. Coronary lesions associated with Kawasaki can be heavily calcified, presenting a therapeutic challenge.

Percutaneous thrombectomy of Impella-associated iliac artery thrombosis using the FlowTriever system.

Percutaneous thrombectomy using the FlowTriever system is a potentially safe and effective alternative to surgery in cases of Impella-associated peripheral arterial thrombosis.

A comparative analysis of the efficacy and safety of therapeutic interventions in phlegmasia cerulea dolens.

Objective: Present an institution's experience in management of phlegmasia cerulea dolens (PCD) with a review of the literature.

Methods: Beaumont Health's electronic record database was queried between July 2009 and November 2019 for inpatients with PCD. A comprehensive chart review was performed to verify the accuracy of the diagnosis and extract relevant parameters.

Delayed Yet Successful Mechanical Thrombectomy for Phlegmasia Cerulea Dolens in a Limb with Severe Arterial Disease and May-Thurner Syndrome.

Phlegmasia cerulea dolens (PCD) is a rare but life-threatening complication of acute deep venous thrombosis that lacks consensus regarding the approach to management. We present a case of PCD developing shortly after a spinal surgery and manifesting as acute swelling and discoloration in a leg with existing severe atherosclerotic arterial disease. The patient's critical limb ischemia was completely and rapidly reversed by percutaneous mechanical thrombectomy using the ClotTriever device despite a delay in treatment.

Results of iliac stenting and aortofemoral grafting for iliac artery occlusions.

Objective: To compare long-term results of percutaneous iliac artery stenting (PCIS) with aortobifemoral (ABF) grafting for patients with symptomatic iliac artery occlusions.

Methods: A retrospective review of 229 patients (January 2000 to December 2011) with symptomatic iliac artery occlusions was performed. In 100 patients, 103 PCIS procedures were performed, and 101 patients underwent ABF grafting.