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Evidence-Based Application of Natriuretic Peptides in the Evaluation of Chronic Heart Failure With Preserved Ejection Fraction in the Ambulatory Outpatient Setting.
Circulation
January 2025
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (Y.N.V.R., A.T., M.M.R., B.A.B.).
Background: Plasma NT-proBNP (N-terminal pro-B-type natriuretic peptide) is commonly used to diagnose heart failure with preserved ejection fraction (HFpEF), but its diagnostic performance in the ambulatory/outpatient setting is unknown because previous studies lacked objective reference standards.
Methods: Among patients with chronic dyspnea, diagnosis of HFpEF or noncardiac dyspnea was determined conclusively by exercise catheterization in a derivation cohort (n=414), multicenter validation cohort 1 (n=560), validation cohort 2 (n=207), and a nonobese Japanese validation cohort 3 (n=77). Optimal NT-proBNP cut points for HFpEF rule out (optimizing sensitivity) and rule in (optimizing specificity) were derived and tested, stratified by obesity and atrial fibrillation.
Dual disease co-expression analysis reveals potential roles of estrogen-related genes in postmenopausal osteoporosis and Parkinson's disease.
Front Genet
January 2025
First Clinical School, Liaoning University of Traditional Chinese Medicine, Shenyang, China.
Introduction: The deficiency of estrogen correlates with a range of diseases, notably Postmenopausal osteoporosis (PMO) and Parkinson's disease (PD). There is a possibility that PMO and PD may share underlying molecular mechanisms that are pivotal in their development and progression. The objective of this study was to identify critical genes and potential mechanisms associated with PMO by examining co-expressed genes linked to PD.
View Article and Find Full Text PDFDual Viral Infections and Para-Pneumonic Effusion in a Pediatric Patient: A Case of Respiratory Syncytial Virus and COVID-19 Complication.
Cureus
December 2024
Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, SAU.
Para-pneumonic effusion in children is often associated with bacterial infections; however, dual viral infections, including respiratory syncytial virus (RSV) and COVID-19, can also lead to severe respiratory complications, as demonstrated in this case. This case report presents the clinical course of a pediatric patient with both RSV and COVID-19 infections, leading to para-pneumonic effusion. A three-year-old girl with a history of asthma and prior febrile convulsions presented to the Emergency Department with fever, cough, vomiting, and fatigue.
View Article and Find Full Text PDFRuptured Ectopic Pregnancy in a Non-communicating Rudimentary Horn at 18 Weeks of Gestation.
Cureus
December 2024
Emergency, Ras Tanura General Hospital, Eastern Health Cluster, Ministry of Health, Ras Tanura, SAU.
This case highlights the critical role of early radiological screening by ultrasound in identifying uterine anomalies. In this report, we discuss a 39-year-old pregnant woman, gravida 4 para 3, and her fetus at gestational age 18 weeks. The patient was referred to the Obstetrics and Gynecology Emergency Department at Qatif Central Hospital, Saudi Arabia, from a private hospital due to an ultrasound study indicating a possible ectopic pregnancy with an abdominal fetal location.
View Article and Find Full Text PDFA Mysterious Cause of Coagulopathy With Bleeding Diathesis.
Cureus
December 2024
Department of Internal Medicine IV, Hospital Professor Doutor Fernando Fonseca, Amadora, PRT.
Vitamin K is essential to produce functional vitamin K-dependent coagulation factors (prothrombin, factors VII, IX, and X). Vitamin K antagonists inhibit the normal activation of these factors, leading to bleeding manifestations of variable severity. Long-acting vitamin K antagonists or superwarfarins were developed as rodenticides and have a significantly longer half-life and greater potency when compared to warfarin.
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