Evaluation of physical function and quality of life before and after nonradical surgical therapy for stage IA1 and IA2-IB1 cervical cancer (GOG-0278).

Objective: To examine patient outcomes before and after cone biopsy (CB) or simple hysterectomy (SH) and pelvic lymph node dissection (PLND) for bladder, bowel, and sexual function, quality of life (QOL), cancer worry, reproductive concerns, and lymphedema.

Methods: We stratified women with stage IA1 (lymphovascular space invasion-positive) and IA2-IB1 (≤2 cm) cervical carcinoma by fertility preservation (CB) or none (SH) with PLND. All patients completed study questionnaires at baseline (preoperatively) and postoperatively at 4-6 weeks and 6-, 12-, 18-, and 24-months, consisting of: Functional Assessment Cancer Therapy - Cervical Cancer (FACT-Cx); Female Sexual Functioning Index (FSFI), and 2 Patient-Reported Outcomes Measurement Information System (PROMIS) items; Gynecologic Cancer Lymphedema Questionnaire (GCLQ); Impact of Events Scale (IES); and Reproductive Concerns Scale (RCS).

A randomized phase II/III study of paclitaxel/carboplatin/metformin versus paclitaxel/carboplatin/placebo as initial therapy for measurable stage III or IVA, stage IVB, or recurrent endometrial cancer: An NRG oncology/GOG study.

Introduction: We evaluated the efficacy of the addition of the anti-diabetic drug metformin to standard-of-care paclitaxel and carboplatin (PC) in patients with advanced and recurrent endometrial cancer (EC).

Methods: In this phase II/III trial, EC patients with chemotherapy-naïve stage III/IVA (with measurable disease) and stage IVB or recurrent (with or without measurable disease) disease were randomly assigned to PC/metformin (850 mg BID) versus PC/placebo. Metformin or placebo was continued as maintenance therapy after completion of PC until disease progression.

Evaluation of efficacy and fertility after nonradical surgical therapy (extra fascial hysterectomy or cone biopsy, with pelvic lymphadenectomy) for stage IA1, IA2, and IB1 cervical cancer (GOG-0278).

Objective: To estimate the efficacy and perioperative morbidity of nonradical surgery (simple hysterectomy [SH] or cone biopsy [CB] plus pelvic lymphadenectomy [PLND] and to report pregnancy outcomes after CB.

Methods: Prospective international study with 3-year follow-up of patients with stage IA1 (lymphovascular space invasion-positive) to IB1 (≤2 cm) cervical cancer stratified by fertility preservation (CB) or none (SH) (both with PLND). Criteria included ≤10 mm stromal invasion and negative margins on loop electrosurgical excision procedure or CB.

First Documented Case of a Third-Generation LVAD Rotor Dislodgement.

The third-generation left ventricular assist device (3G-LVAD) has significantly reduced adverse events and hospitalizations compared with previous generations. This case presents a rare 3G-LVAD rotor dislodgement malfunction, not previously documented, in a 77-year-old man. Further research behind the malfunction is warranted for early prevention and appropriate management.

Pembrolizumab plus chemotherapy in advanced or recurrent endometrial cancer: overall survival and exploratory analyses of the NRG GY018 phase 3 randomized trial.

Historically, the treatment of patients with advanced stage or recurrent endometrial cancer included paclitaxel plus carboplatin. Immunotherapy in combination with chemotherapy resulted in improved clinical outcomes in several solid tumors. In the phase 3 NRG GY018 study, pembrolizumab plus chemotherapy significantly improved investigator-assessed progression-free survival (PFS; primary endpoint) versus placebo plus chemotherapy in patients with advanced/metastatic/recurrent endometrial cancer regardless of mismatch repair status.

Early detection of amniotic fluid embolism leading to extracorporeal membrane oxygenation prior to cardiac arrest.

Amniotic fluid embolism is a life-threatening peripartum condition with high morbidity and mortality rates. It is defined as the passage of fetal material into the maternal circulation which elicits a multisystem reaction that can lead to disseminated intravascular coagulopathy and severe hemodynamic instability. Despite established diagnostic criteria for amniotic fluid embolism, its identification relies heavily on clinical judgment, and early diagnosis is key to patient survival.

Iatrogenic ventricular septal defect after transcatheter aortic valve implantation: a rare complication.

Iatrogenic ventricular septal defect (VSD) is a rare complication following transcatheter aortic valve implantation (TAVI). An 83-year-old male underwent TAVI for severe aortic stenosis (AS) and was diagnosed with a peri-membranous VSD on echocardiography, which was not evident on pre-procedural imaging. This case highlights the risk factors, symptoms, diagnosis, and management of iatrogenic VSD following TAVI.

Acute myocarditis secondary to human metapneumovirus: a case series and mini-review.

Among viral myocarditis, human metapneumovirus (hMPV) is a rare causative agent with associated cardiac complications. This report provides insight into the disease progression and sheds light on reported cases from the literature. We present the clinical courses of two patients, aged 68 and 58, who developed myocarditis secondary to hMPV infection.

Efficacy and safety of nerinetide in acute ischaemic stroke in patients undergoing endovascular thrombectomy without previous thrombolysis (ESCAPE-NEXT): a multicentre, double-blind, randomised controlled trial.

Background: In the ESCAPE-NA1 trial, treatment with nerinetide, an eicosapeptide that interferes with post-synaptic density protein 95, was associated with improved functional outcome among patients with acute ischaemic stroke due to large vessel occlusion undergoing endovascular thrombectomy without co-treatment with an intravenous thrombolytic agent. There was no benefit when intravenous thrombolytic agent co-treatment was used. We sought to confirm the clinical benefit of nerinetide in the absence of previous intravenous thrombolytic drug treatment.

Heartfelt struggles: When ablation brings the squeeze.

Pericarditis frequently occurs as a complication following pulmonary vein isolation (PVI) for atrial fibrillation (AF), yet it seldom progresses to constrictive pericarditis (CP). The diagnosis of constrictive pericarditis is often challenging owing to nonspecific signs and symptoms. Nevertheless, a high level of suspicion and prompt diagnosis offer an ultimate cure.

Metastatic Insulinoma Managed With Continuous Glucose Monitoring in a Young Female Patient.

Insulinomas are rare neuroendocrine neoplasms and causes of hypoglycemia. They present with neuroglycopenic symptoms, including confusion and seizures. Suspected diagnosis must be confirmed through bloodwork and imaging.

COVID-19-Associated Encephalopathy: A Case Series Demonstrating the Rapid Deterioration of Mental Status and a Review of the Literature.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is known for its severe inflammatory response, often leading to multi-organ dysfunction. Among the less-recognized complications is COVID-19-associated encephalopathy, particularly in the elderly, where it contributes significantly to morbidity and mortality. This report explores the rapid neurocognitive decline observed in six hospitalized patients with COVID-19, with or without pre-existing neurological conditions.

The DIMASHQ Procedure: AO Plug pseudoaneurys repair in cending aorta using uality intracardiac ecocardiography.

The transcatheter management of complex cardiovascular diseases has significantly evolved, offering less invasive alternatives to traditional surgical interventions. In this report we describe 2 cases of patients who developed ascending aortic pseudoaneurysms soon after coronary artery bypass grafting. With meticulous computed tomography angiography planning and with live intracardiac echography, these patients underwent successful transcatheter repair using a 6/4-mm Amplatzer Duct Occluder II (Abbott) vascular plug.

Embolic Stroke in a Patient With Left Atrial Myxoma.

We present a case of a patient with a left atrial myxoma who presented with an ischemic stroke. Her cardiac myxoma had an irregular contour and was highly mobile, both features that have been associated with a greater risk of thromboembolism. She was treated with prompt surgical resection.

Aspiration of Left Atrial Masses Using the Large-Bore Manual Aspiration System: The ASPIRATE LA Procedure.

Transcatheter mass extraction of left-sided cardiac masses has gained popularity in recent years, with scarce data on effectiveness, safety, and types of devices used. Mostly, left-sided aspirations use mechanical and continuous-flow-mediated devices (the AngioVac [AngioDynamics] and Penumbra systems [Penumbra]). To our knowledge, the use of manual aspiration devices has not been reported yet.

Comparing Patency of Pulmonary Stent Implantation and Balloon Angioplasty in Pulmonary Vein Stenosis: A Systematic Review and Meta-Analysis.

Pulmonary vein stenosis (PVS) is an insidious diagnosis associated with morbidity and mortality. Pharmacologic therapy may suffice initially, but advanced stages demand mechanical intervention. Pulmonary stent implantation (PSI) and pulmonary balloon angioplasty (PBA) are common strategies, both carrying restenosis risks.

Takotsubo Syndrome Following Catheter Ablation for Atrial Fibrillation: A Systematic Review and Metasummary of Case Reports/Series.

Atrial fibrillation (AF) catheter ablation is safe and effective, though rare cases of takotsubo syndrome (TTS) have been observed without proven causation. This review synthesizes TTS following AF ablation case reports and series. Until October 2024, PubMed/Medline, SCOPUS, and Google Scholar were searched for AF ablation and TTS case reports and series.

Left Bundle Branch Area Pacing Versus Right Ventricular Pacing in Patients With Atrioventricular Block: A Systematic Review and Meta-Analysis.

Background: Left bundle branch area pacing (LBBAP) is a new technique for patients with atrioventricular block (AVB) and preserved left ventricular ejection fraction (LVEF), potentially offering better cardiac function than right ventricular pacing (RVP).

Methods: We searched databases and registries for studies that compared LBBAP with RVP in patients with AVB and preserved LVEF. We extracted data on various outcomes and pooled the effect estimates using random-effects models.

Practice Advisory on the Implementation of Preoperative Anemia Management: The Society of Cardiovascular Anesthesiologists and the Society for the Advancement of Patient Blood Management.

Preoperative anemia is common and associated with worse outcomes in cardiac surgery including acute kidney injury, red blood cell transfusion, cardiovascular complications, stroke, infection, and death. Patient blood management programs, which include dedicated clinical programs to diagnose and treat anemia in advance of surgery (ie, preoperative anemia programs), have been highlighted as a means to optimize the blood health of each patient, thereby decreasing risk for allogeneic transfusion and improving clinical outcomes. However, there remain implementation challenges for preoperative anemia programs, including difficulties with education of patients and staff, short lead times to address anemia, infrastructure and staffing limitations, lack of clear leadership or ownership of preoperative anemia, the need to develop treatment algorithms and ensure appropriate infusion therapy support, lack of capital support, and insurance/reimbursement concerns, amongst others.

Self-Expandable Versus Balloon-Expandable Transcatheter Aortic Valve Replacement for Treatment of Patients With Small Aortic Annulus: An Updated Meta-Analysis of Reconstructed Individual Patient Data.

Transcatheter aortic valve replacement has emerged as an effective alternative to surgery in selected patients with aortic stenosis. It needs to be made clear which type of valve has better results in patients with small aortic annulus. We searched PubMed, Scopus, Embase, Cochrane Library, and Web of Science, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

Successful Transcatheter Mitral Valve Mass Extraction With Complete Resolution of the Severe Mitral Regurgitation.

Interest has arisen in exploring the off-label application of left-sided percutaneous mechanical aspiration, where conventional management strategies may not suffice. Percutaneous mechanical aspiration has been shown to be effective as a diagnostic and therapeutic intervention in select patients with infective endocarditis. This paper hereby reports the first case of a successful transeptal large bore manual aspiration device (AlphaVac; Angiodynamics) for nonbacterial thrombotic endocarditis with total resolution of associated severe mitral valve regurgitation.

Andexanet Alfa-Associated Heparin Resistance in Cardiac Surgery: Mechanism and In Vitro Perspectives.

Background: Andexanet alfa (andexanet) is the only Food and Drug Administration-approved antidote for direct FXa (factor Xa) inhibitors but has been reported to cause resistance to unfractionated heparin (UFH). This has delayed anticoagulation for procedures requiring cardiopulmonary bypass. The mechanism, andexanet and UFH dose dependence, and thrombotic risk of andexanet-associated heparin resistance are unknown.

Multimedia-Based Education Led to Improvement in Disease Knowledge Among Patients with Cirrhosis.

Background: Current evidence shows limited patient understanding of liver disease, coupled with no standard guidelines or methods to offer patient education in a busy clinical environment. We developed multimedia-based education (MBE) for those with cirrhosis & tested its effectiveness in improving patient knowledge from baseline to 1 month.

Methods: This prospective study enrolled cirrhotic patients who had a scheduled visit with a hepatologist at an ambulatory academic practice or were admitted to the liver inpatient service.

High-Sensitivity Cardiac Troponin [hs-cTn] as a Valuable Biomarker for Pulmonary Hypertension Risk Stratification: A Contemporary Review of the Literature.

Pulmonary hypertension (PH) can lead to cardiac failure, thereby significantly affecting life expectancy and quality of life. Due to inadequate disease surveillance and risk assessment, clinical challenges persist despite advances in diagnosis and treatment. We aimed to review the potential of high-sensitivity cardiac troponin (hs-cTn) as a biomarker for predicting outcomes in PH patients.