Collaboration to transition members to preferred formulary dipeptidyl-peptidase-4 inhibitor.

Objective: To describe the outcomes of a partnership between a drug plan and pharmacists to switch patients from brand name dipeptidyl-peptidase-4 inhibitors to the generic alogliptin.

Study Design: Single-center, retrospective chart review.

Methods: Clinical pharmacists contacted patients with primary care providers within the health system affiliated with the drug plan to facilitate the switch.

Impact of order set implementation on appropriate treatment of community-acquired pneumonia (CAP).

Objective: This study aimed to evaluate appropriate antimicrobial prescribing after implementing a pneumonia order set within a community teaching hospital.

Design: Retrospective chart review study.

Setting: 450-bed community teaching hospital.

Prevalence and Outcomes of Sepsis in Patients With Colon Carcinoma: Organism-Specific Analysis.

Background Sepsis is a challenging condition, especially in patients with malignancy, that is associated with worse mortality and increased complications. This study aimed to analyze the prevalence of sepsis, its complications, healthcare outcomes, and associated organism-specific mortality in patients with colorectal carcinoma using the National Inpatient Sample database. Methodology We included patients aged >18 years with a primary diagnosis of colon cancer.

Inclisiran as a siRNA Inhibitor of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9); Past, Present, and Future.

Reducing low-density lipoprotein cholesterol (LDL-C) levels has been shown to reduce the risk of developing atherosclerotic cardiovascular disease (ASCVD). Statins are the foundation of LDL-C lowering therapy with other non-statin agents used in circumstances where goal LDL-C levels are not reached or owing to intolerance to adverse effects of statins. In 2003, the discovery of the role of the proprotein convertase subtilisin/kexin type 9 (PCSK9) system in promoting elevated LDL-C levels led to new avenues of drug development to achieve target LDL-C.

Insights into the Experiences of Persons with Substance Use Disorders During COVID-19 Lockdown in Lagos, Nigeria: A Qualitative Investigation.

Objective: This study investigated the impact of COVID-19 lockdown on the consumption of illicit drugs among Persons with Substance Use Disorders in Lagos, Nigeria.

Methods: Using convenience sampling, 25 participants, who use different substances consented to participate in the study. Data was collected using in-depth interview guide and thematically analysed using NVivo 12 Plus.

Iatrogenic Cardiac Arrest During Thyroid Storm.

Introduction: Thyroid storm is a life-threatening condition with often severe cardiac implications. Correct treatment choices can vary depending on underlying cardiac systolic function.

Case Description: We present a case of a 47-year-old male with untreated Grave's disease who presented with a thyroid storm.

Impella™-assisted left main coronary artery intervention via aortofemoral bypass graft limb: a case report.

Aortofemoral graft limbs are a rarely used and understudied option for large-bore access for mechanical support due to a risk of downstream vascular events. Here we present a case of left main coronary artery percutaneous intervention utilizing an aortofemoral bypass graft limb for large-bore access for mechanical support with successful hemostasis utilizing a widely available suture-based closure device.

Bridging With Low-Molecular-Weight Heparin Versus Antiplatelet Therapy in Patients Undergoing Noncardiac Surgery After Percutaneous Coronary Intervention: A Comprehensive Review.

Background: This review article discussed the use of bridging therapy with low-molecular-weight heparin (LMWH) in patients who undergo noncardiac surgery (NCS) after percutaneous coronary intervention (PCI).

Hypotheses: Patients who undergo PCI are at an increased risk of thrombotic events due to their underlying cardiovascular disease. However, many of these patients may require NCS at some point in their lives, which poses a significant challenge for clinicians as they balance the risk of thrombotic events against the risk of bleeding associated with antithrombotic therapy.

Rationale and Design of the Latin-American Registry of Peripheral Interventions: Insights From SOLACI Peripheral.

Background: Chronic limb-threatening ischemia (CLTI) represents the most advanced stage of lower extremity peripheral artery disease (PAD). The aim of this manuscript is to provide an overview of the demographic and clinical characteristics of patients with lower-limb peripheral artery disease, as well as the procedural and technical aspects of peripheral endovascular interventions in Latin-America.

Methods: The SOLACI peripheral registry is a prospective, multi-center, observational, and hospital-based registry of patients with lower-limb PAD, who are treated with endovascular interventions across Latin American countries.

Cardiac Manifestations in Inherited Metabolic Diseases.

Inherited metabolic diseases (IMDs) stem from genetic defects affecting enzyme function within specific metabolic pathways, collectively constituting rare conditions with an incidence of less than 1/100,000 births. While IMDs typically manifest with multisystemic symptoms, cardiac manifestations are common, notably hypertrophic cardiomyopathy. Additionally, they can lead to dilated or restrictive cardiomyopathy, as well as noncompacted left ventricular cardiomyopathy.

COVID-19 Infection in Ultramarathon Runners: Findings of the Ultrarunners Longitudinal TRAcking Study.

Objective: Ultramarathon runners are a unique patient population who have been shown to have a lower rate of severe chronic medical conditions. This study aimed to determine the effect that COVID-19 infection has had on this population and their running behavior.

Design: The Ultrarunners Longitudinal TRAcking (ULTRA) Study is a large longitudinal study of ultramarathon runners.

SOFIA Aspiration System as first-line Technique (SOFAST): a prospective, multicenter study to assess the efficacy and safety of the 6 French SOFIA Flow Plus aspiration catheter for endovascular stroke thrombectomy.

Background: Mechanical thrombectomy (MT) is the standard of care for acute ischemic stroke (AIS) patients with large vessel occlusion (LVO). The SOFAST study collected clinical evidence on the safety and efficacy of the 6 French SOFIA Flow Plus aspiration catheter (SOFIA 6F) when used as first-line treatment.

Methods: This was a prospective, multicenter investigation to assess the safety and efficacy of SOFIA 6F used for first-line aspiration.

Outcomes of Ultrafiltration in community-based hospitals.

Objective: We sought to examine outcomes of ultrafiltration in real world community-based hospital settings.

Background: Ultrafiltration (UF) is an accepted therapeutic option for advanced decompensated heart failure (ADHF). the feasibility of UF in a community hospital setting, by general cardiologists in a start-up program had not been objectively evaluated.

Spontaneous Coronary Artery Dissection in the Setting of Marijuana: A Case Report.

This case report presents a detailed examination of spontaneous coronary artery dissection (SCAD) in a 61-year-old Middle Eastern male with a history of marijuana use and essential hypertension. The patient's emergency presentation with loss of consciousness and subsequent diagnostics - including elevated troponins and distinctive electrocardiogram changes - led to the identification of extensive SCAD affecting multiple coronary arteries. The association between marijuana use and cardiovascular pathology is focal in this study, particularly considering the patient's positive test for tetrahydrocannabinol (THC) and significant smoking history.

Aspiration Thrombectomy Using Inari FlowTriever System for Inferior Vena Cava Tumor Thrombus: A Case Report.

Pharmacomechanical therapy and catheter-directed thrombolysis are potent treatments for venous thromboembolism. However, limited data exist regarding the management of thrombi in the inferior vena cava (IVC). IVC thrombus resulting from tumors is a particularly uncommon condition.

Kissing Balloon-Stent Technique for Simple Bifurcation Lesions.

Coronary bifurcation lesions are commonly encountered during coronary angiography. The management of bifurcation lesions remains challenging, with various bifurcation techniques being available and outcomes varying depending on the Medina classification and operator experience. We present a short case series and the outcomes of a new bifurcation technique for the management of simple Medina '0,0,1' and '0,0,1' bifurcation lesions using the kissing balloon-stent technique (kissing BS).

Elevated lipoprotein(a) levels: A crucial determinant of cardiovascular disease risk and target for emerging therapies.

Cardiovascular disease (CVD) remains a significant global health challenge despite advancements in prevention and treatment. Elevated Lipoprotein(a) [Lp(a)] levels have emerged as a crucial risk factor for CVD and aortic stenosis, affecting approximately 20 of the global population. Research over the last decade has established Lp(a) as an independent genetic contributor to CVD and aortic stenosis, beginning with Kare Berg's discovery in 1963.

Beyond the Surface: A Clinical Insight Into a 60-Year-Old Male With Pemphigus vulgaris.

Pemphigus vulgaris, a rare and life-threatening autoimmune disorder, presents with painful skin and mucosal lesions, leading to blistering sores attributed to acantholysis. This study delves into the clinical manifestations, risk factors, and diagnostic intricacies associated with pemphigus vulgaris, with a focus on a representative case highlighting the challenges in its recognition and management. We explore the case of a 60-year-old male with pemphigus vulgaris, whose initial presentation involved yellow-crusting lesions on the scalp progressing to non-pruritic lesions on the chest, neck, and inguinal areas.

Psychologic assessment in patients undergoing bariatric surgery.

Background: Psychological Clearance level (PCL) for patients undergoing metabolic and bariatric surgery (MBS) is a critical step for successful postoperative outcomes. This study aims to assess the relationship between the level of psychologic fitness and postoperative outcomes in patients undergoing MBS.

Methods: We retrospectively analyzed the data of patients who underwent MBS (laparoscopic sleeve gastrectomy [LSG] and laparoscopic Roux-en-Y Gastric Bypass [LRYGB]) and completed two years follow-up, between 2012 and 2019, in a single medical center.

WATCHMEN: a case report highlighting the closure of a bilobed left atrial appendage using two WATCHMAN-FLX devices.

Background: Left atrial appendage occlusion (LAAO) performed percutaneously has emerged as a widely accepted method for stroke prevention, offering a viable alternative to anticoagulation. Numerous studies have demonstrated the effectiveness and safety of this procedure. However, in certain cases, the use of a single LAAO device may not adequately achieve optimal closure due to variations in the anatomy of the left atrial appendage (LAA).

Feasibility and Safety Study of Concomitant Left Bundle Branch Area Pacing and Atrioventricular Node Ablation with Same-Day Hospital Dismissal.

Background: Left bundle branch area pacing (LBBAP) has rapidly emerged as a promising modality of physiologic pacing and has demonstrated excellent lead stability. In this retrospective study, we evaluate whether this pacing modality can allow concomitant atrioventricular node (AVN) ablation and same-day dismissal.

Methods: Twenty-four consecutive patients (female 63%, male 37%) with an average age of 78 ± 5 years were admitted for pacemaker (75%)/defibrillator (25%) implantations and concomitant AVN ablation.

Melanoma With Cardiac Metastasis.

Melanoma is considered a masquerader of many diseases owing to its potential to metastasize to many organs. Several malignancies can metastasize to the heart including malignant melanoma. Historically, antemortem diagnosis of cardiac involvement of melanoma is not common, but with significant improvement in imaging modalities, the diagnosis can now be made early and accurately, aiding in treatment and improved survival.

Real world single center experience with saphenous vein grafts interventions: should filters be filtered out?

Background: Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) can be challenging due to no reflow phenomenon from distal embolization of debris and microvascular vasoconstriction, resulting in myocardial injury post-procedure. Guidelines promote the use of distal embolic protection devices (EPD) to protect the distal arterial bed during SVG PCI. However, this approach has shown less-than-optimal results in many studies.