Fibrinogen Levels and Bleeding Risk in Patients Undergoing Ultrasound-Assisted Catheter-Directed Thrombolysis for Submassive Pulmonary Embolism.

Objectives: We sought to test the hypothesis that patients undergoing ultrasound-assisted catheter-directed thrombolysis (USAT) with standard alteplase and heparin dosing would not develop significant depletion of systemic fibrinogen, which may account for the lower risk of bleeding seen in contemporary trials. We also sought to compare the relative outcomes of individuals with submassive pulmonary embolism (PE) undergoing USAT and anticoagulation alone.

Methods: Utilizing a single-center prospective registry, we identified 102 consecutive adult patients with submassive PE who were considered for USAT based on a standardized treatment algorithm between November 2016 and May 2019.

Getting cardiogenic shock patients to the right place-How initial intensive care unit triage decisions impact processes of care and outcomes.

The objective of this study was to determine how initial intensive care unit triage decisions impact processes of care and outcomes for emergency department patients hospitalized with cardiogenic shock. Individuals with cardiogenic shock were stratified based upon whether they were initially admitted to a cardiac versus noncardiovascular intensive care setting. Those initially triaged to a noncardiovascular intensive care unit were less likely to receive potentially life-saving interventions, including percutaneous coronary intervention and temporary mechanical circulatory support, and were more likely to see significant delays in these interventions if ultimately used.

Age-Stratified National Trends in Pulmonary Embolism Admissions.

Background: Pulmonary embolism (PE) is one of the leading causes of death in hospitalized patients. Treatment patterns and patient demographics for PE are changing; therefore, we sought to evaluate national trends in admission rate, discharge disposition, and length of stay (LOS) in patients hospitalized with PE.

Methods: The National Inpatient Sample database was used to collect data for hospitalizations of patients ≥ 20 years old with primary diagnosis of PE between January 2000 and September 2015.

Epidemiology of Shock in Contemporary Cardiac Intensive Care Units.

Background Clinical investigations of shock in cardiac intensive care units (CICUs) have primarily focused on acute myocardial infarction (AMI) complicated by cardiogenic shock (AMICS). Few studies have evaluated the full spectrum of shock in contemporary CICUs. Methods and Results The Critical Care Cardiology Trials Network is a multicenter network of advanced CICUs in North America.

Related or not? Development of spontaneous Creutzfeldt-Jakob disease in a patient with chronic, well-controlled HIV: A case report and review of the literature.

Background: We report a novel case of a rare disease: spontaneous Creutzfeldt-Jakob disease in a patient with well-controlled HIV. We explore the relationship between spontaneous Creutzfeldt-Jakob disease and HIV.

Case Report: A 66-year-old man with long-standing, well-controlled HIV infection presented with 3 months of progressive, subacute neurocognitive decline.

Scalable, shape-specific, top-down fabrication methods for the synthesis of engineered colloidal particles.

The search for a method to fabricate nonspherical colloidal particles from a variety of materials is of growing interest. As the commercialization of nanotechnology continues to expand, the ability to translate particle-fabrication methods from a laboratory to an industrial scale is of increasing significance. In this feature article, we examine several of the most readily scalable top-down methods for the fabrication of such shape-specific particles and compare their capabilities with respect to particle composition, size, shape, and complexity as well as the scalability of the method.