Impact of frailty index on cardiovascular outcomes and readmissions of patent foramen ovale closure procedure: a propensity matched national analysis.

Background: Transcatheter patent foramen ovale (PFO) occluder device is a procedure mostly performed to prevent secondary stroke as a result of paradoxical emboli traversing an intracardiac defect into the systemic circulation. The complications and outcomes following the procedure remain poorly studied. We aimed to investigate morbidity and mortality associated with occluder device procedures using hospital frailty index score stratification.

Gender-based disparities in outcomes of coronary bifurcation stenting in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis.

Introduction: Around 15-20% of lesions necessitating percutaneous coronary interventions (PCI) are attributed to coronary bifurcation lesions. We aim to study gender-based differences in PCI outcomes among bifurcation stents.

Methods: 3 studies were included after thorough systematic search using MEDLINE (EMBASE and PubMed).

An unusual site of ablation for a ventricular tachycardia.

Scar-related ventricular tachycardia (VT) ablation involves localizing the critical isthmuses by overdrive pacing maneuvers and three-dimensional activation mapping. Implantable prosthetic devices have been known to complicate this by covering sites of potential isthmuses. We herein present a sentinel report of scar-VT ablation with a protected isthmus localized over an endothelialized post-myocardial infarction ventricular septal defect occluder device.

A case of exaggerated exuberance: Iatrogenic atrioventricular block/intra-Hisian Wenckebach during conduction system pacing.

Isolated sinus node dysfunction with its pursuant long-term risk for atrioventricular (AV) conduction disease poses a unique dilemma for proponents of CSP due to paucity of imprimatur guidelines. In such scenarios, the risk and prognosis of iatrogenic AV block is not well elucidated but is a valid concern. We report a case where CSP was complicated by iatrogenic AV block and peculiarly the rare phenomenon of intra-Hisian Wenckebach.

Treatment of Acute Myocardial Infarction and Cardiogenic Shock: Outcomes of the RECOVER III Postapproval Study by Society of Cardiovascular Angiography and Interventions Shock Stage.

Background: The Society for Cardiovascular Angiography and Interventions proposed a staging system (A-E) to predict prognosis in cardiogenic shock. Herein, we report clinical outcomes of the RECOVER III study for the first time, according to Society for Cardiovascular Angiography and Interventions shock classification.

Methods And Results: The RECOVER III study is an observational, prospective, multicenter, single-arm, postapproval study of patients with acute myocardial infarction with cardiogenic shock undergoing percutaneous coronary intervention with Impella support.

Cardiovascular Disease and COVID-19 Vaccines: A Systematic Review and Analysis of Published Cases.

As vaccination against COVID-19 became more widespread, side-effects that were not initially detected during clinical trials became more prominent. The aim of this systematic review is to discuss reports of adverse cardiovascular events associated with COVID-19 vaccination. Databases were searched from inception up to August 2022 to identify case reports and case series reporting on patients with cardiovascular disease after COVID-19 vaccination.

Papillary thyroid neoplasm: An incidental malignant nodule.

Papillary thyroid cancer (PTC), a common neoplasm originating from thyroid follicular cells, represents 85% of thyroid malignancy. PTC is known to metastasize to adjacent structures. Studies report that 5-15% of detected thyroid nodules represent malignancy; here, we report a 51-year-old woman with incidental thyroid nodules identified on the cervical spine.

Case report: An unusual case of cecal mucosal bleeding.

Cecal mucosal bleeding is an undocumented and rare cause of lower gastrointestinal (GI) bleeding. We present a case of a 73-year-old woman with end-stage renal disease and paroxysmal atrial fibrillation on apixaban who presented with lower gastrointestinal bleed. She was found to have symptomatic, acute chronic anemia requiring multiple packed red blood cell transfusions.

Closed-incision negative pressure therapy at -125 mmHg significantly reduces surgical site complications following total hip and knee arthroplasties: A stratified meta-analysis of randomized controlled trials.

Background: Closed-incision negative pressure wound therapy (ciNPT) has shown promising effects for managing infected wounds. This meta-analysis explores the current state of knowledge on ciNPT in orthopedics and addresses whether ciNPT at -125 mmHg or -80 mmHg or conventional dressing reduces the incidence of surgical site complications in hip and knee arthroplasty.

Methods: This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines and Cochrane Handbook.

Fecal microbiota transplantation for recurrent , safety, and pitfalls.

infection (CDI) is one of the leading causes of hospital-acquired infection attributing to substantial morbidity, mortality, and healthcare cost. Recurrent CDI (rCDI) is common and occurs after effective treatment of first episode. Treatment of rCDI is based on accurate diagnoses, due to difficulty in distinguishing between colonization of spores or CDI; coronavirus disease 2019 (COVID-19) added to the complexity of diagnoses as both entities can co-occur.

Do septic patients with reduced left ventricular ejection fraction require a low-volume resuscitative strategy?

Background: Many clinicians are wary of administering 30 cc/kg of intravenous fluid (IVF) to septic patients with reduced left-ventricular ejection fraction (rLVEF), fearing volume overload. Prior studies have used history of heart failure, rather than LVEF measured at presentation, thereby potentially distorting the relationship between rLVEF, IVF, and adverse outcomes. Our goal was to assess the relationship between IVF volume and outcomes in patients with, versus without, rLVEF.

Serial use of existing clinical decisions aids can reduce computed tomography pulmonary angiography for pulmonary embolism.

Pulmonary embolism (PE) remains a diagnostic challenge in emergency medicine. Clinical decision aids (CDAs) like the Pulmonary Embolism Rule-Out Criteria (PERC) are sensitive but poorly specific; serial CDA use may improve specificity. The goal of this before-and-after study was to determine if serial use of existing CDAs in a novel diagnostic algorithm safely decreases the use of CT pulmonary angiograms (CTPA).

Xylophagia (paper eating): A rare form of pica.

Xylophagia is a form of pica where patients have the unusual craving for ingestion of paper. After treating the underlying cause of pica, in this case treating iron deficiency anemia with iron replacement therapy, these unusual cravings resolve.

Ambulatory care practice in the COVID-19 era: Redesigning clinical services and experiential learning.

The coronavirus disease (COVID-19) has created a variety of challenges for health care professionals, including ambulatory care clinical pharmacists. High-quality remote and minimal-contact care has become a necessity. Ambulatory care clinical pharmacists around the nation have adjusted their practice.

Epistaxis management on COVID-19-positive patients: Our early case experience and treatment.

Epistaxis management on COVID-19 patients is concerning for otolaryngologists due to the highly virulence and increased concentration within respiratory droplets and nasal secretions. Authors suggest initial management with oxymetazoline nasal drops and local pressure before considering nasal packing with absorbable material to prevent COVID-19 transmission to surrounding healthcare workers.

Resuscitation Guided by Volume Responsiveness Does Not Reduce Mortality in Sepsis: A Meta-Analysis.

Unlabelled: Resuscitation with IV fluids is a critical component in the management of sepsis. Although the optimal volume of IV fluid is unknown, there is evidence that excessive administration can be deleterious. Static measures of volume status have not proven to be meaningful resuscitative endpoints.

Paraneoplastic leukemoid reaction in a patient with metastatic adenocarcinoma of the lung.

Paraneoplastic syndromes in lung malignancies can lead to leukemoid reaction with an elevation of eosinophils, neutrophils, and monocytes. The elevation of these three lineages together due to paraneoplastic syndromes has not been described in literature yet.

Clinical Implications of the New York Heart Association Classification.

Background The New York Heart Association (NYHA) classification has served as a fundamental tool for risk stratification of heart failure (HF) and determines clinical trial eligibility and candidacy for drugs and devices. However, its ability to adequately stratify risk is unclear. Methods and Results To compare NYHA class with objective assessments and survival in patients with HF, we performed secondary analyses of 4 multicenter National Institutes of Health-funded HF clinical trials that included patients classified as NYHA class II or III: TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist), DIG (The Effect of Digoxin on Mortality and Morbidity in Patients With Heart Failure), HF-ACTION (Efficacy and Safety of Exercise Training in Patients With Chronic Heart Failure), and GUIDE-IT (Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure).

Closing the Gap on Sex Disparity in Acute Coronary Syndrome: Is It Time to Reconsider Our Definitions of "Typical"?

See Article Ferry et al.

Dependent Functional Status is a Risk Factor for Perioperative and Postoperative Complications After Total Hip Arthroplasty.

Background: As the population ages, the need for total hip arthroplasty (THA) will increase. However, this will be associated with an increase in comorbidities and a decrease in the ability to independently perform activities of daily living (ADLs). This study was designed to evaluate the impact preoperative functional status has on short-term outcomes after THA.

Use of direct oral anticoagulants in the treatment of left ventricular thrombi: A tertiary center experience and review of the literature.

Direct oral anticoagulants can potentially provide a more convenient oral alternative for the management of left ventricular thrombi than Warfarin. These medications do not require frequent monitoring and have less drug-drug interactions. Randomized controlled trials are needed to further demonstrate their efficacy and safety in this setting.

Pathophysiology, echocardiographic evaluation, biomarker findings, and prognostic implications of septic cardiomyopathy: a review of the literature.

Background: Sepsis is a common condition encountered by emergency and critical care physicians, with significant costs, both economic and human. Myocardial dysfunction in sepsis is a well-recognized but poorly understood phenomenon. There is an extensive body of literature on this subject, yet results are conflicting and no objective definition of septic cardiomyopathy exists, representing a critical knowledge gap.

Deep cerebral vein expansion with metabolic and neurocognitive recovery in Sturge-Weber syndrome.

We present longitudinal imaging data of a child with Sturge-Weber syndrome (SWS). At age 8 months, 3 weeks after initial seizures and prolonged motor deficit, MRI showed extensive right hemispheric SWS involvement with severe glucose hypometabolism on PET. She was treated with levetiracetam and aspirin.