Prevalence of abnormal left ventricular global longitudinal strain by speckle tracking echocardiography and its prognostic value in patients with COVID-19.

Importance: Although cardiac injury is a known complication of COVID-19 infection, there is no established tool to predict cardiac involvement and in-hospital mortality in this patient population.

Objective: To assess if left ventricular global longitudinal strain (LV-GLS) can detect cardiac involvement and be used as a risk-stratifying parameter for hospitalised patients with COVID-19.

Main Outcomes And Measures: In-hospital mortality.

Characteristics and outcome of patients with COVID-19 complicated by Takotsubo cardiomyopathy: case series with literature review.

Background: Cardiac involvement with COVID-19 is increasingly being recognised. Clinical characteristics and outcomes of patients with COVID-19 complicated by secondary Takotsubo cardiomyopathy (TC) is poorly understood.

Methods: This retrospective case series was conducted between March and April 2020 at four hospitals of Steward Health Care Network of Massachusetts, USA.

Unexplained high fever in an elderly patient treated with clonidine, duloxetine, and atorvastatin.

Background: Drug-induced fever is a clinical diagnosis and should always be considered when the fever is constant and high without a clear source of infection. Although drug-induced fever has been reported with other centrally acting antihypertensive drugs such as methyldopa, published reports of this adverse effect with clonidine in humans were not identified in a search of the literature.

Case Summary: A 66-year-old institutionalized white female with a history of morbid obesity (body mass index, 40 kg/m2), Alzheimer's dementia, hypertension, and depression presented to a hospital in Boston, Massachusetts (Caritas Saint Elizabeth's Medical Center) with generalized weakness and shortness of breath and was found to have a non-ST segment elevation myocardial infarction.

Effect of sustained-release PDGF and TGF-beta on cyclophosphamide-induced impaired wound healing.

Background: Proper wound healing is pivotal to successful surgical outcomes. Previous studies have shown that growth factors can be used to enhance tissue repair under impaired healing conditions. However, because of limited delivery methods, the growth factors in these studies were delivered either topically or as a single local administration.

Evaluation of left atrial and posterior mediastinal anatomy by multidetector helical computed tomography imaging: relevance to ablation.

Introduction: Increasing use of catheter ablation in the left atrium (LA) requires understanding of substrate anatomy, especially with regard to potential damage to adjacent structures.

Methods And Results: We reviewed multidetector helical computed tomography (MDCT) imaging on 42 subjects, 26 imaged before planned LA ablation for atrial fibrillation (AF), and 16 without AF. LA volume and dimensions were larger in patients with AF (p < 0.

Angiogenic gene therapy as a potential therapeutic agent in chronic osteomyelitis.

Bacterial osteomyelitis is common, and outcomes are often poor. Standard therapies fail in 31% of cases, and lower extremity amputation and loss of independent functional status are common. Innovative therapies are desperately needed, particularly in diabetic patients with peripheral vascular disease at high risk for bad outcomes.

Sheathless implantation of permanent coronary sinus-LV pacing leads.

Background: Implantation of CS-LV pacing leads is usually accomplished through specialized sheaths with additional use of contrast venography and other steps. Direct implantation at a target pacing site could provide a simplified procedure with appropriate leads.

Methods: A progressive CS-LV lead implant protocol was used, with initial attempts made to place the lead directly using only fluoroscopy and lead stylet or wire manipulation.

Intraneuronal beta-amyloid expression downregulates the Akt survival pathway and blunts the stress response.

Early events in Alzheimer's disease (AD) pathogenesis implicate the accumulation of beta-amyloid (Abeta) peptide inside neurons in vulnerable brain regions. However, little is known about the consequences of intraneuronal Abeta on signaling mechanisms. Here, we demonstrate, using an inducible viral vector system to drive intracellular expression of Abeta42 peptide in primary neuronal cultures, that this accumulation results in the inhibition of the Akt survival signaling pathway.

Septic arthritis.

Septic arthritis has increased in incidence in the United States in the past two decades, and increasingly affects an older population with a greater burden of chronic illness and a higher risk for drug-resistant organisms. Successful management depends on a high diagnostic suspicion, empiric antibiotic treatment, and joint drainage. A bacteriologic diagnosis is more likely with inoculation into blood culture bottles than plating on solid media.

Tuberculosis, bronchiectasis, and infertility: what ailed George Orwell?

In the last and most productive years of his life, George Orwell struggled with pulmonary tuberculosis, dying at the dawn of the era of chemotherapy. His case history illustrates clinical aspects of tuberculosis with contemporary relevance: the role of poverty in its spread, the limited efficacy of monotherapy, the potential toxicity of treatment, and the prominence of cachexia as a terminal symptom. Orwell's ordeals with collapse therapy may have influenced the portrayal of the tortures of Winston Smith in the novel 1984.

Shakespeare's chancre: did the bard have syphilis?

Shakespeare's obsessive interest in syphilis, his clinically exact knowledge of its manifestations, the final poems of the sonnets, and contemporary gossip all suggest that he was infected with "the infinite malady." The psychological impact of venereal disease may explain the misogyny and revulsion from sex so prominent in the writings of Shakespeare's tragic period. This article examines the possibility that Shakespeare received successful treatment for syphilis and advances the following new hypothesis: Shakespeare's late-life decrease in artistic production, tremor, social withdrawal, and alopecia were due to mercury poisoning from syphilis treatment.

Sternoclavicular septic arthritis: review of 180 cases.

We review 170 previously reported cases of sternoclavicular septic arthritis, and report 10 new cases. The mean age of patients was 45 years; 73% were male. Patients presented with chest pain (78%) and shoulder pain (24%) after a median duration of symptoms of 14 days.

Short-term treatment of actinomycosis: two cases and a review.

Recommendations for prolonged penicillin treatment of actinomycosis date from the early antibiotic era, when patients often presented with neglected, advanced disease and received interrupted therapy at suboptimal dosages. This report describes cases of esophageal and of cervicofacial actinomycosis treated successfully with short-term antibiotic therapy and reviews the literature. Many patients are cured with <6 months of antibiotic therapy.

Left ventricular assist devices as destination therapy.

Although an estimated 16,500 Americans annually could benefit from a heart transplant, in 1999 only 2184 heart transplants were performed in the United States. These statistics emphasize the severity of the shortage of available hearts for transplantation. Circulatory support provided by an implantable Left Ventricular Assist Device (LVAD) that meets Food and Drug Administration approval as destination therapy is a promising alternative that impacts patient survival.

Septic arthritis of the pubic symphysis: review of 100 cases.

We report a novel case of septic arthritis of the symphysis pubis due to Streptococcus pneumoniae and review 99 previously reported cases of infection of this joint. Typical features of pubic symphysis infection included fever (74%), pubic pain (68%), painful or waddling gait (59%), pain with hip motion (45%), and groin pain (41%). Risk factors included female incontinence surgery (24%); sports, especially soccer (19%); pelvic malignancy (17%); and intravenous drug use (15%).