Atrial Septal Defect Closure Device-Related Infective Endocarditis in a 20-Week Pregnant Woman.

With increasing atrial septal defect (ASD) repairs, more women of childbearing age will have ASD closure devices. Current ASD closure trials have excluded women planning pregnancy, making their management challenging. We present a pregnant woman, with a repaired ASD, who presented with device-related infective endocarditis.

Infection with New York Orthohantavirus and Associated Respiratory Failure and Multiple Cerebral Complications.

We report a case of infection with New York orthohantavirus in a woman who showed renal impairment and hemorrhage, complicated by hydrocephalus, in Long Island, New York, USA. Phylogenetic analysis showed that this virus was genetically similar to a New York orthohantavirus isolated in the same region during 1993.

Impact of Pulmonary Capillary Wedge Pressure on Long-Term Mortality in Patients With Pulmonary Arterial Hypertension Treated With Parenteral Trepostinil.

Background: The clinical impact of pulmonary capillary wedge pressure (PCWP) on long-term mortality among patients with pulmonary arterial hypertension (PAH) has been incompletely reported, particularly in relation to concomitant treprostinil administration. The goal of this study was to assess the impact of PCWP on long-term mortality in PAH patients treated with parenteral treprostinil.

Methods: We studied a cohort of 743 patients with PAH treated with parenteral treprostinil therapy.

In vitro delivery of aerosolized treprostinil via modern mechanical ventilation.

Background: The Tyvaso Inhalation System is a hand-held nebulizer system used to administer treprostinil, an approved therapy for pulmonary arterial hypertension. Our goal was to establish an in vitro method for delivering a standard dose of treprostinil through a ventilator circuit and artificial airway.

Methods: An AeroTech II jet nebulizer (continuous air flow at 10 L/min; Biodex Medical Systems) was placed in the ventilator circuit with a test lung.

Right ventricular strain rate predicts clinical outcomes in patients with acute pulmonary embolism.

Background: Echocardiographic quantification of global and regional right ventricular (RV) function is critical in patients with acute pulmonary embolism (PE), but remains a challenge particularly in acute RV dilatation.

Methods: Apical two-dimensional images of patients with acute PE were analyzed using both conventional and speckle tracking imaging compared with controls; patients with PE were divided into those who received thrombolysis and those who did not. The basal, mid and apical segments of the RV free wall and septum were analyzed.

Recurrent rhabdomyolysis associated with polydipsia-induced hyponatremia - a case report and review of the literature.

Rhabdomyolysis involves the breakdown of muscle due to an inciting insult. It has been reported to have many etiologies. Some of the more common causes are trauma and medications.

Mental status change, myoclonus, electrocardiographic changes, and acute respiratory distress syndrome induced by quetiapine overdose.

A 41-year-old man with bipolar disorder came to the emergency department with mental status changes, prolonged rate-corrected QT interval, and myoclonus after ingesting 4500 mg of quetiapine, an atypical antipsychotic drug. Within 24 hours, respiratory failure ensued, requiring intubation and mechanical ventilation. Chest radiograph demonstrated bilateral infiltrates consistent with acute respiratory distress syndrome (ARDS).