2,127 results match your criteria: "'Metropolitan Hospital'[Affiliation]"

Seizures When Exiting a Bath: A Rare Type of Reflex Epilepsy.

Neurology

November 2024

From the Department of Medical and Surgical Sciences (A.P., S.G., U.A., E.F.), Magna Graecia University of Catanzaro; Regional Epilepsy Centre (A.P., S.G., U.A., E.F.), Unit of Pediatrics (D.S., D.M.), Unit of Medical Genetics (C.M.), and Unit of Neurology (V.C., C.P.), "Bianchi-Melacrino-Morelli" Great Metropolitan Hospital, Reggio Calabria, Italy.

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The effect of lipid-lowering treatment on indices of MASLD in familial hypercholesterolemia patients.

Clin Nutr

December 2024

Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Medicine, Boston VA Healthcare System, Boston, MA, USA. Electronic address:

Background & Aims: The effect of lipid-lowering treatment (LLT) on metabolic dysfunction associated steatotic liver disease (MASLD) is unclear. This is relevant for patients with familial hypercholesterolemia (FH) who are on lifelong LLT. We aimed to evaluate the effect of LLT on MASLD indices in this population.

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Objective: To validate the ISGPS definition and grading system of PPAP after pancreatoduodenectomy (PD).

Summary Background Data: In 2022, the International Study Group for Pancreatic Surgery (ISGPS) defined post-pancreatectomy acute pancreatitis (PPAP) and recommended a prospective validation of its diagnostic criteria and grading system.

Methods: This was a prospective, international, multicenter study including patients undergoing PD at 17 referral pancreatic centers across Europe, Asia, Oceania, and the United States.

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Article Synopsis
  • Older patients with advanced hormone receptor-positive/HER2-negative breast cancer benefit from combining CDK4/6 inhibitors with standard endocrine therapy, according to recent studies.
  • There is a higher risk of side effects from these inhibitors in older patients, leading to a trend of starting them on lower doses, although this practice lacks strong evidence.
  • The IMPORTANT-trial aims
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Obesity and cardiovascular risk: a primer for the clinician.

Arch Cardiol Mex

October 2024

Emergency Department, Metropolitan Hospital Center, New York Medical College, New York City, EE.UU.

Obesity is a significant risk factor for the development of cardiovascular diseases. This review addresses the complex interaction between obesity and cardiovascular risk, highlighting dysfunctional adiposity as a crucial precursor in the metabolic renal cardiovascular continuum. The underlying pathophysiological mechanisms are reviewed, emphasizing the importance of risk identification and proper stratification, as well as the various available treatment strategies, including pharmacological and non-pharmacological interventions that have proven to reduce cardiovascular risk.

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Tenecteplase vs Alteplase in Acute Ischemic Stroke Within 4.5 Hours: A Systematic Review and Meta-Analysis of Randomized Trials.

Neurology

November 2024

From the Second Department of Neurology (L.P., A.T., A. Safouris, G. Tsivgoulis), "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece; Department of Medicine (Neurology) (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Ontario, Canada; Department of Neurology (Guillaume Turc), GHU Paris Psychiatrie et Neurosciences; Université Paris Cité (G. Turc); INSERM U1266 (G. Turc); FHU NeuroVasc (G. Turc), Paris, France; Department of Primary Education (A.-G.A., D.M.), University of Ioannina, Greece; Department of Neurology and Neurogeriatrics (P.D.S.), Johannes Wesling Klinikum Minden, Ruhr-University Bochum, Germany; Department of Neurology (R.L.), University Hospitals Leuven; Division of Experimental Neurology (R.L.), Department of Neurosciences, KU Leuven-University of Leuven, Belgium; Department of Biotechnological and Applied Clinical Sciences (S.S.), University of L'Aquila, Italy; Stroke Unit (A. Safouris), Metropolitan Hospital, Piraeus, Greece; Department of Neurology (M.K., U.F.), University Hospital Basel, University of Basel, Switzerland; Department of Neurology (A. Sarraj), Case Western Reserve University, University Hospitals Cleveland Medical Center, OH; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland.

Article Synopsis
  • The European Stroke Organisation recommends using tenecteplase (TNK) as an alternative to alteplase (TPA) for treating acute ischemic stroke within 4.5 hours, based on previous studies establishing its noninferiority.
  • An updated systematic review and meta-analysis assessed the efficacy and safety of TNK compared to TPA, using data from 11 randomized controlled trials involving nearly 7,600 patients.
  • Results showed that TNK was linked to better chances of achieving excellent functional outcomes and reduced disability at 3 months, while maintaining similar safety profiles for symptomatic intracranial hemorrhage when compared to TPA.
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  • This case report discusses the challenges and anesthesia strategies for managing severe pulmonary hypertension (PH) in an elderly patient undergoing emergency orthopedic surgery for a hip fracture.
  • The 86-year-old male had several health issues, requiring a collaborative approach for preoperative care that included blood transfusions and adjustments to his medication.
  • Anesthesia involved spinal anesthesia with an epidural catheter, low-dose hyperbaric bupivacaine, and close monitoring to ensure the patient's stability during and after the surgery, underscoring the importance of careful planning in such high-risk cases.
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Article Synopsis
  • * Takotsubo syndrome (TTS) is a temporary heart condition often triggered by stress, but its causes and effects are not well understood, affecting around 1-2% of acute coronary syndrome cases.
  • * A study analyzed hospital data from 2016 to 2020, finding significant racial and ethnic disparities in TTS outcomes; most patients were White, with minorities generally younger and from lower-income backgrounds.
  • * Key findings include higher rates of stroke and mortality in Black and Asian patients, respectively, emphasizing the urgent need for targeted interventions to address healthcare inequalities related to TTS.
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  • Tretinoin, a topical retinoid, is recognized as the leading anti-aging treatment, promoting skin growth and reducing collagen breakdown.
  • A systematic review analyzed 25 studies comparing tretinoin with other topical anti-aging products, focusing on outcomes like visible aging signs and skin histology.
  • While tretinoin is effective, it can cause irritation; many alternative treatments were found to be less irritating, though their efficacy compared to tretinoin varied widely.
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Article Synopsis
  • GLP-1 receptor agonists (liraglutide, semaglutide, tirzepatide) may lower cardiovascular risk in overweight/obese individuals without diabetes.
  • A systematic review of 16 trials involving over 28,000 participants showed these medications reduced major adverse cardiovascular events and all-cause mortality compared to placebo.
  • While they significantly lowered the risk of myocardial infarction, the relationship with stroke is less clear due to limited data.
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Article Synopsis
  • * In the study, 345 previously treated patients were given either sotorasib or docetaxel, with various validated questionnaires used to assess quality of life and symptom burden over time.
  • * Results indicated that patients on sotorasib experienced fewer and less severe side effects, maintained better quality of life, and reported that their symptoms caused less interference with daily activities compared to those on docetaxel.
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Objective: The objective of this systematic review was to describe novel regimens and treatment strategies in neoadjuvant therapy for colorectal cancer (CRC). The aim was to summarize the current advancements in neoadjuvant chemotherapy (NACT) for CRC, including the use of cytotoxic drugs, targeted treatments, and immunotherapy. The analysis aimed to provide insights into the potential benefits and drawbacks of these novel approaches and highlight the need for further research to optimize NACT use in CRC and improve patient outcomes.

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Background: Enhanced characterization of the atrial electrical substrate may lead to better comprehension of atrial fibrillation (AF) pathophysiology.

Objective: With the use of high-density substrate mapping, we sought to investigate the occurrence of functional electrophysiological phenomena in the left atrium and to assess potential association with arrhythmia recurrences after catheter ablation.

Methods: Sixty-three consecutive patients with AF referred for ablation were enrolled.

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The aim of this review is to provide an overview of the status of patient/public involvement (PPI) in oncology research, including definitions, regulatory aspects, ongoing clinical activities in different countries, achievements and difficulties. The 10-year activities of the Swiss Group for Clinical Cancer Research (SAKK) Patient Advisory Board are described, illustrating challenges faced and solutions in daily practice. Even though clinical data are still limited, it appears PPI has great potential for development in oncology.

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Heart failure (HF) is an important comorbidity for patients with ischemic stroke, present in 11 %-18 % of patients, and may also independently increase the risk of first-ever and recurrent ischemic stroke. HF is categorized based on ejection fraction (EF) into HF with reduced (HFrEF), mildly-reduced (HFmrEG) and preserved ejection fraction (HFpEF), with the efficacy of HF therapies differing between the three subcategories. Despite this classification, the incidence, recurrence rates and outcomes of ischemic stroke do not appear to differ significantly between the three subtypes, even when considering the concurrent presence of atrial fibrillation.

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Thrombolysis After Dabigatran Reversal for Acute Ischemic Stroke: A National Registry-Based Study and Meta-Analysis.

Neurology

October 2024

From the Second Department of Neurology (A.T., K.M., E.B., M.C., M.I.S., L.P., S.G., G.T.), "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens; Department of Neurology (A.K., P.P.), Korgialenio-Benakio Greek Red Cross General Hospital of Athens; Stroke Unit (K.P., A. Safouris, O.K.), Metropolitan Hospital, Piraeus; Department of Neurology (E.N.), School of Medicine, University of Ioannina, Greece; Department of Neurology (A. Sarraj), University Hospital Cleveland Medical Center, Case Western Reserve University, OH; Department of Neurology (D.J.S.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.

Article Synopsis
  • A study evaluated the safety and efficacy of IV thrombolysis (IVT) for acute ischemic stroke (AIS) in patients who received dabigatran reversal with idarucizumab, as limited data exist on this topic.
  • Thirteen cohorts and one case series involving 553 patients were analyzed, revealing low rates of symptomatic intracranial hemorrhage (4%), any intracranial hemorrhage (10%), and 3-month mortality (18%).
  • Functional outcomes were promising, with 56% achieving excellent outcomes and 70% good outcomes at 3 months, with no significant differences observed between patients treated with idarucizumab and those without.
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The recent rise of active shootings calls for adequate preparation. Currently, the "Run, Hide, Fight" concept is widely accepted and adopted by many hospitals nationwide. Unfortunately, the appropriateness of this concept in hospitals is uncertain due to lack of data.

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