How Canines Can Assist Our Patients with Diabetes: Diabetes Alert Dogs: What Are Their Capabilities?

Background: The canine olfactory system is used for tasks that greatly aid society, such as detecting explosives, finding lost persons, and detecting many diseases and abnormal blood sugar levels early. However, the reliability of detection of glycemic fluctuations is questionable.

Methods: We reviewed the literature on the capability of canines in detecting significant variations in blood sugar.

Undetected metastatic melanoma in the colon.

Colonic melanoma is a rarely detected aetiology of small bowel obstruction. This is a case of a male in his 80s with a history of treated stage IIIA melanoma on his trunk 7 years prior who presented with small bowel obstruction. He underwent urgent surgical intervention, where a partial colectomy was performed.

Impact of cardiac conduction disease in patients with cardiac amyloidosis: A national retrospective cohort study.

Background: There is a paucity of data regarding the impact of cardiac conduction disease (CD) on clinical outcomes in patients with cardiac amyloidosis (CA).

Methods: The National Inpatient Sample (NIS) was queried to identify all CA admissions and those with CD using ICD-10 codes from 2016 to 2019. We explored baseline characteristics and used multivariate logistic regression to assess the association between CD and several clinical outcomes during index admission; a p-value of <0.

A Rare Presentation of Myocardial Bridging With Heart Failure Symptoms.

Myocardial bridging is an under-recognized cause of angina. This congenital anomaly occurs when a segment of the epicardial coronary artery has a short intra-myocardial course. A significant intra-myocardial course may lead to ischemia, causing anginal symptoms.

Severe Symptomatic Aortic Stenosis in an Octogenarian with Congenitally Corrected Transposition of the Great Arteries.

• ccTGA accounts for 0.5%-1.4% of patients with congenital heart disease.

COVID-19 Unveiling Heart Failure in the Realm of Rheumatic Heart Disease.

The global coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in various clinical manifestations, including cardiovascular complications. This case report focuses on a unique instance where COVID-19 infection exacerbated heart failure and induced atrial fibrillation in a previously asymptomatic young male with undiagnosed rheumatic heart disease (RHD). RHD, a prevalent cause of valvular abnormalities in developing countries, poses an additional risk for severe outcomes when coexisting with COVID-19 infection, highlighting the need for prompt and tailored interventions.

T-cell Acute Lymphoblastic Leukemia in Crisis: Hyperleukocytosis, Tumor Lysis Syndrome, and Innovative Approaches.

T-cell acute lymphoblastic leukemia (T-ALL) is a rare hematologic malignancy with a unique set of clinical challenges when it occurs in adults. This case report presents the complex management of a 32-year-old male with T-ALL who developed symptomatic hyperleukocytosis and tumor lysis syndrome. Upon presentation, the patient exhibited a constellation of critical clinical and laboratory findings, including leukocytosis, anemia, thrombocytopenia, hyperkalemia, high-anion gap metabolic acidosis, and acute kidney injury.

Bilateral Middle Cerebral Artery Occlusion: A Successful Case of Bilateral Thrombectomy.

Single-vessel occlusions often cause an acute ischemic stroke (AIS) but can rarely be caused by multi-vessel occlusions. Although bilateral AIS is rare, these patients often undergo mechanical thrombectomy as long as they are within the 24-hour window since symptom presentation. We present a case of a female in her 70s who presented to an outside facility with right-sided weakness in her upper and lower extremities, drooping of the right lower face, and aphasia.

Paroxysmal atrial fibrillation ablation with a novel temperature-controlled CF-sensing catheter: Q-FFICIENCY clinical and healthcare utilization benefits.

Introduction: The prospective, nonrandomized, multicenter Q-FFICIENCY study demonstrated the safety and 12-month efficacy of paroxysmal atrial fibrillation (AF) ablation with the novel QDOT MICRO temperature-controlled, contact force-sensing, radiofrequency (RF) catheter. Participants underwent pulmonary vein isolation with very high-power short-duration (vHPSD) mode (90 W, ≤4 s) alone or combined with conventional-power temperature-controlled (CPTC) mode (25-50 W). This study aimed to assess quality-of-life (QOL) and healthcare utilization (HCU) benefits experienced by Q-FFICIENCY study participants.

The First Metatarsophalangeal Joint: Updates on Revision Arthrodesis and Malunions.

First metatarsophalangeal joint (MPJ) arthrodesis procedures are a mainstay of forefoot surgery and are associated with high rates of patient satisfaction for addressing a multitude of first ray pathologic conditions. This procedure is often also used as a fallback option for the revision of poor outcomes after other surgical procedures involving the first ray. Despite its successes, there remain instances of complications that can develop after primary first MPJ arthrodesis.

The Association of Mental Illness With Outcomes of Emergency Surgery for Bowel Obstruction.

Introduction: Bowel obstruction is one of the most common surgical emergencies. The management of SBO is variable and influenced by numerous confounding factors. Recent studies have identified mental health as a health disparity that affects surgical outcomes.

A Novel Case of Deep Temporal Artery (DTA) Embolization for Recurrent Subacute-Chronic Subdural Hematoma.

Subdural hemorrhage (SDH) is a common neurological disease. In past, SDHs were managed either conservatively (non-surgically) or with surgical evacuation (burr hole versus craniotomy) depending on the severity. Surgical evacuation has major challenges including high recurrence rate, stoppage and reversal of antiplatelet or anticoagulation agents, risk of general anesthesia and surgery in elderly patients with multiple comorbidities.

Internal Carotid Artery Agenesis: A Rare Entity.

Congenital absence of the internal carotid artery (ICA) is an extremely rare entity that occurs due to insult during the embryonic development of the ICA. Various intracranial collateral pathways develop to compensate for the ICA agenesis. Patients can present with aneurysmal subarachnoid hemorrhage, stroke-like symptoms, or other neurological symptoms due to compression of brain structures from enlarged collateral pathways/aneurysms.

Impact of Chronic Heart Failure on Acute Pulmonary Embolism in-Hospital Outcomes (From a Contemporary Study).

There is a paucity of evidence on the impact of chronic heart failure (HF) on acute pulmonary embolism (PE) hospitalization outcomes. The aim of this study was to evaluate the in-hospital outcomes of patients with chronic HF and acute PE. A total of 1,391,145 hospitalizations with acute PE from the National Inpatient Sample Database from 2011 to 2019 were included.

Drug Reaction With Eosinophilia and Systemic Symptoms: A Diagnostic Dilemma.

Drug reaction with eosinophilia and systemic symptoms (DRESS) is an adverse reaction to medications such as sulfonamide-containing antibiotics, anticonvulsants, vancomycin, and non-steroidal anti-inflammatory drugs (NSAIDs). It typically presents with a characteristic rash, eosinophilia, and visceral organ failure. Patients who do not present with characteristic features of DRESS are at risk for delayed diagnosis and treatment.

Functional Quadriplegia as an Initial Presentation of Severe Rheumatoid Arthritis.

Rheumatoid arthritis is a chronic inflammatory condition with many manifestations primarily presenting in older female patients with joint stiffness. Quadriplegia associated with rheumatoid arthritis is common and can occur secondary to spinal cord compression from atlantoaxial dislocation. In contrast, functional quadriplegia is rare and has not been previously reported as an initial manifestation of rheumatoid arthritis.

Neoadjuvant Radiation Therapy with Interdigitated High-Dose LRT for Voluminous High-Grade Soft-Tissue Sarcoma.

Purpose: To report a case of large extremity soft tissue sarcoma (2933 cc), safely treated with a novel approach of interdigitating high-dose LATTICE radiation therapy (LRT) with standard radiation therapy as a neoadjuvant treatment to surgery.

Patients And Methods: Four sessions of high-dose LRT were delivered in a weekly interval, interdigitated with standard radiation therapy. The LRT plan consisted of 15 high-dose vertices receiving a dose >12 Gy per session, with 2-3 Gy to the peripheral margin of the tumor.

Very High-Power Short-Duration, Temperature-Controlled Radiofrequency Ablation in Paroxysmal Atrial Fibrillation: The Prospective Multicenter Q-FFICIENCY Trial.

Background: QDOT MICRO (QDM) is a novel contact force-sensing catheter optimized for temperature-controlled radiofrequency (RF) ablation. The very high-power short-duration (vHPSD) algorithm modulates power, maintaining target temperature during 90 W ablations for ≤4 seconds.

Objectives: This study aims to evaluate safety and 12-month effectiveness of the QDM catheter in paroxysmal atrial fibrillation (AF) ablation using the vHPSD mode combined with conventional-power temperature-controlled (CPTC) mode.