Efficacy and safety of creatine phosphate sodium in the treatment of viral myocarditis: A systematic review and meta-analysis.

Purpose: To systematically evaluate the efficacy and safety of creatine phosphate sodium in the treatment of viral myocarditis, and to provide guidance for its clinical treatment.

Methods: We conducted a search of The Cochrane Library, PubMed, EMbase, and Web of Science databases to retrieve randomized controlled trials (RCTs) on the use of creatine phosphate sodium (CPS) in the treatment of viral myocarditis. The search was conducted up to April 2024.

The impact of a commercial lower extremity exoskeleton on metabolic load, perceived exertion, and physiological response to a challenging military relevant task: A randomized cross-over design pilot study.

Purpose: To assess physiological metrics during the use of a commercially available bilateral active ankle exoskeleton during a challenging military-relevant task and if use of the exoskeleton during this task influences: metabolic load, physiological measures or rate of perceived exertion.

Methods: Nine healthy volunteers (5M, 4F) completed this randomized cross-over design trial, with a baseline visit and two randomized test sessions (with/without the exoskeleton). Variables included impact on time to exhaustion during walking on a treadmill at varying speeds and gradients (0-15%) at 26.

Iodinated Contrast Adsorption in Cartridges With Styrene-Divinylbenzene Sorbent.

Background: Contrast-associated acute kidney injury (CA-AKI) is frequent in patients with chronic kidney disease who are submitted to cardiac endovascular procedures using iodinated contrast. In hemoadsorption, cartridges containing styrene-divinylbenzene sorbent resin are applied to remove substances from the blood through an extracorporeal circuit. Importantly, iodinated contrast is also removed via adsorption.

Cognitive impairment and limited health literacy are associated with poor health outcomes among patients with heart failure residing in rural areas.

Background: Cognitive impairment and limited health literacy are prevalent among patients with heart failure, particularly those residing in rural areas, and are linked to poor health outcomes. Little is known about the intricate relationships among cognitive function, health literacy, and rehospitalization and death in rural patients with heart failure.

Objectives: To determine the relationships among cognitive function, health literacy, and cardiac event-free survival (ie, heart failure hospitalizations and cardiac mortality) in rural patients with heart failure.

The Evolving Features of Takotsubo Syndrome.

Purpose Of The Review: Takotsubo syndrome (TTS) is a transient form of left ventricular dysfunction, typically affecting post-menopausal females, often preceded by emotional or physical stressful events that act as triggers. Initially believed to be a rare and benign condition for its reversible nature, TTS has recently emerged as a complex multifaceted clinical entity, with heterogenous clinical presentations and a non-negligible risk of serious in-hospital complications, including acute heart failure, arrhythmias and death.

Recent Findings: Emerging pathophysiological hypotheses, ranging from microvascular dysfunction to systemic inflammation, offer new insights into the underlying mechanisms of TTS.

Acute effects of beetroot extract and resveratrol ingestion on cardiovascular and cardiac autonomic modulation recovery after moderate-intensity aerobic exercise in individuals with coronary artery disease: a triple-blinded, randomized, placebo-controlled trial.

Purpose: This study aimed to evaluate the acute effects of beetroot extract and resveratrol supplementation (isolated and combined) on cardiac autonomic modulation and cardiovascular parameters recovery after exercise in individuals with coronary artery disease (CAD).

Methods: 14 males with CAD were submitted to 4 protocols consisting of 30 min (min) of rest, 30 min of aerobic exercise on a treadmill (60% of the heart rate reserve HRR), followed by 30 min of recovery. Before each protocol, the subjects consumed 500 mg of starch (placebo protocol), 500 mg of beetroot (beetroot protocol), or 500 mg of resveratrol (resveratrol protocol), or 500 mg of beetroot and 500 mg of resveratrol (combined protocol).

Effects of epidural dexmedetomidine on patient-controlled epidural analgesia after total knee arthroplasty: a single-center, prospective, double-blind, randomized controlled study.

Objective: To evaluate the impact of adding epidural dexmedetomidine to low-concentration patient-controlled epidural analgesia (PCEA) on pain control and side effects in total knee arthroplasty (TKA).

Methods: In this double-blind study, American Society of Anesthesiologists I to II patients undergoing TKA were assigned to receive 0.125% bupivacaine + fentanyl 4 µg/mL (group R) or 0.

Clinical Characteristics and Outcomes in Heart Failure Patients with Implantable Pulmonary Artery Pressure Monitors: A Single Centre Irish Experience.

Hospitalisation for acute decompensated heart failure (HF) portends a poor prognosis. Fluid retention manifesting in dyspnoea and oedema are important clinical features of decompensated heart failure and drive hospital admissions. Intracardiac and pulmonary artery pressure (PAP) monitoring can help predict heart failure decompensation, as changes in these haemodynamics occur before clinical congestion manifests.

Adapting and Implementing a Blended Collaborative Care Intervention for Older Adults with Multimorbidity: Quantitative and Qualitative Results from the ESCAPE Pilot Study.

Multimorbidity poses significant challenges for patients and healthcare systems, often exacerbated by fragmented care and insufficient collaboration across providers. Blended Collaborative Care (BCC) is a promising strategy to address care complexity by partnering care managers (CMs) with primary care providers (PCPs) and specialists. This study aimed to adapt and pilot a BCC intervention for patients aged 65+ with heart failure and physical-mental multimorbidity.

Xenotransplantation: future frontiers and challenges.

Purpose Of Review: Recent advancements in genetic engineering have propelled the field of xenotransplantation from preclinical models to early compassionate use cases. As first-in-human clinical trials (FIHCTs) approach, we examine recent developments, ethical and regulatory challenges, immunological considerations, and the clinical infrastructure necessary for successful xenotransplantation trials.

Recent Findings: Expanded access transplants of pig hearts, kidneys, and livers have identified key challenges.

Comparative Evaluation of Regain of Consciousness in Dexmedetomidine-Propofol versus Ketamine-Propofol in the Pediatric Cardiac Catheterization Procedure under Sedation using BIS Monitoring: A Randomized Prospective Study.

Background: Congenital heart diseases (CHDs) are not rare and often require an intervention at some point of time. Pediatric cardiac catheterization, a minimally invasive procedure, is performed to diagnose and to correct many cardiac abnormalities. Deep sedation with spontaneously breathing patients is the preferred technique for pediatric catheterization in the pediatric population.

General practitioner-centered rural obesity management: Design, protocol and baseline data of the German HAPpEN pragmatic trial.

Objective: HAPpEN aims to implement and evaluate a holistic general practitioner-centered, interdisciplinary obesity management strategy in rural Germany, focusing on feasibility, health outcomes, and economic benefits.

Methods: HAPpEN is a 12-month, pragmatic single-arm, multicenter trial, informed by a formative survey, and initiated in April 2023 with 98 obese participants (body mass index, BMI ≥ 30 kg/m) in Kulmbach, Germany. The program integrates nutritional counseling, physical activity, and behavior change techniques, including smartphone-based self-monitoring.

Investigating the impact of couple counseling based on the CHARMS model on sexual quality of life and marital satisfaction of wives of men suffering from myocardial infarction: a randomized clinical trial study.

Introduction: Cardiovascular diseases can adversely affect the quality of sexual life and marital satisfaction for both patients and their spouses. The aim of the current study is to determine the effect of couple counseling based on the CHARMS model on sexual quality of life and marital satisfaction of wives of men suffering from myocardial infarction (MI).

Method: This two-group randomized clinical trial study with a parallel design was conducted in 2024 in Urmia, Iran.

Association between white blood cell count and coronary artery bypass graft failure: an individual patient data analysis of clinical trials.

Background: Baseline systemic inflammation is associated with worse long-term outcomes after coronary artery bypass grafting [CABG], but the mechanisms of this association are unclear. This study aims to explore the association between pre-operative white blood cell [WBC] count and CABG graft failure.

Methods: We pooled individual patient data from two randomized clinical trials with systematic CABG graft imaging.

Clinical benefits and risks of remote patient monitoring: an overview and assessment of methodological rigour of systematic reviews for selected patient groups.

Background: Remote patient monitoring implies continuous follow-up of health-related parameters of patients outside healthcare facilities. Patients share health-related data with their healthcare unit and obtain feedback (which may be automatically generated if data are within a predefined range). The goals of remote patient monitoring are improvements for patients and reduced healthcare costs.

Contraceptive use and pregnancy in cystic fibrosis: Survey findings from 10 cystic fibrosis centers.

Background: Reproductive life planning is key, now that people with cystic fibrosis (pwCF) may live into their 60s. This study explores contraceptive use, pregnancy trends, and whether concomitant cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy reduces contraceptive effectiveness.

Methods: Females with CF aged 18-45 years from 10 U.

Therapeutic novelties in acute heart failure and practical perspectives.

Acute Heart Failure (AHF) is a leading cause of death and represents the most frequent cause of unplanned hospital admission in patients older than 65 years. Since the past decade, several randomized clinical trials have highlighted the importance and pivotal role of certain therapeutics, including decongestion by the combination of loop diuretics, the need for rapid goal-directed medical therapies implementation before discharge, risk stratification, and early follow-up after discharge therapies. Cardiogenic shock, defined as sustained hypotension with tissue hypoperfusion due to low cardiac output and congestion, is the most severe form of AHF and mainly occurs after acute myocardial infarction, which can progress to multiple organ failure.

Protective effects of herbal compounds against cyclophosphamide-induced organ toxicity: a pathway-centered approach.

Cyclophosphamide is a key component of numerous chemotherapeutic protocols, demonstrating broad-spectrum efficacy against various malignancies and non-cancerous conditions. This review examines CPM's metabolic pathways, therapeutic applications, and its resulting organ-specific toxicities. Despite its clinical benefits in treating nephrotic syndrome, encephalomyelitis, breast cancer, ovarian cancer, and other diseases, CPM is associated with significant adverse effects on the kidneys, liver, heart, lungs, and intestines.

Health State Utility Values in Fabry Disease: Insights from the Pegunigalsidase Alfa Clinical Trials.

Introduction: Fabry disease (FD) is a rare lysosomal storage disorder that is associated with pain and progressive damage to the renal, cardiac, and cerebrovascular systems. Enzyme replacement therapy (ERT) is one of the treatment options for FD and the most recently approved ERT agent, pegunigalsidase alfa, has shown clinical efficacy in three phase 3 clinical trials of adults with FD: BALANCE, BRIDGE, and BRIGHT. Recent published guidelines support the mapping of health utility state data to the EuroQol-5 Dimension-3 Level (EQ-5D-3L) index to align with the preferred methodology used by the National Institute for Health and Care Excellence (NICE).

Comprehensive Assessment of the Risk of Symptomatic Embolism in Patients With Infective Endocarditis.

Background: Echocardiographic evaluation of vegetations is crucial in infective endocarditis (IE). Although several studies have noted a link between larger vegetations and an increased risk of embolization, a more comprehensive evaluation of vegetation characteristics in a contemporary cohort has not been conducted. Our study aimed to define the short-term risk of symptomatic embolization in patients with IE.

NEDD4-Mediated GSNOR Degradation Aggravates Cardiac Hypertrophy and Dysfunction.

Background: The decrease in S-nitrosoglutathione reductase (GSNOR) leads to an elevation of S-nitrosylation, thereby exacerbating the progression of cardiomyopathy in response to hemodynamic stress. However, the mechanisms under GSNOR decrease remain unclear. Here, we identify NEDD4 (neuronal precursor cell expressed developmentally downregulated 4) as a novel molecule that plays a crucial role in the pathogenesis of pressure overload-induced cardiac hypertrophy, by modulating GSNOR levels, thereby demonstrating significant therapeutic potential.

Nanocurcumin in myocardial infarction therapy: emerging trends and future directions.

Myocardial infarction (MI) is the leading cause of morbidity and mortality worldwide. Curcumin has been observed to significantly reduce pathological processes associated with MI. Its clinical application is limited due to its low bioavailability, rapid degradation, and poor solubility.

Levosimendan for sepsis-induced myocardial dysfunction: friend or foe?

Sepsis-induced myocardial dysfunction (SIMD) involves reversible myocardial dysfunction. The use of inotropes can restore adequate cardiac output and tissue perfusion, but conventional inotropes, such as dobutamine and adrenaline, have limited efficacy in such situations. Levosimendan is a novel inotrope that acts in a catecholamine-independent manner.