Pre-transplant amiodarone use does not affect long-term heart transplant survival.

Purpose: Effect of pre-transplant amiodarone use on post-heart transplant (HT) survival is not well established. We therefore sought to examine the effect of amiodarone use on post-HT survival.

Methods: We stratified adults who underwent HT between January 2000 and August 2018 in the Scientific Registry of Transplant Recipients according to pre-transplant amiodarone use and used recipient and donor characteristics to calculate propensity scores.

Atherothrombosis in Acute Coronary Syndromes-From Mechanistic Insights to Targeted Therapies.

The atherothrombotic substrates for acute coronary syndromes (ACS) consist of plaque ruptures, erosions and calcified nodules, while the non-atherothrombotic etiologies, such as spontaneous coronary artery dissection, coronary artery spasm and coronary embolism are the rarer causes of ACS. The purpose of this comprehensive review is to (1) summarize the histopathologic insights into the atherothrombotic plaque subtypes in acute ACS from postmortem studies; (2) provide a brief overview of atherogenesis, while mainly focusing on the events that lead to plaque destabilization and disruption; (3) summarize mechanistic data from clinical studies that have used intravascular imaging, including high-resolution optical coherence tomography, to assess culprit plaque morphology and its underlying pathobiology, especially the newly described role of innate and adaptive immunity in ACS secondary to plaque erosion; (4) discuss the utility of intravascular imaging for effective treatment of patients presenting with ACS by percutaneous coronary intervention; and (5) discuss the opportunities that these mechanistic and imaging insights may provide for more individualized treatment of patients with ACS.

Standardizing the Definition and Analysis Methodology for Complete Coronary Artery Revascularization.

Guideline-based medical therapy is the foundation of treatment for individuals with coronary artery disease. However, revascularization with either percutaneous coronary intervention or coronary artery bypass grafting may be beneficial in patients with acute coronary syndromes, refractory symptoms, or in other specific scenarios (eg, left main disease and heart failure). While the goal of percutaneous coronary intervention and coronary artery bypass grafting is to achieve complete revascularization, anatomical and ischemic definitions of complete revascularization and their methodology for assessment remain highly variable.

Latency Period after Preterm Premature Rupture of Membranes: Singletons versus Twins.

Objective: Several studies have evaluated the differences in duration of latency and clinical outcomes between singleton and twin pregnancies after preterm premature rupture of membranes (PPROM); however, these data are limited to single-institution analyses and based on small sample sizes. The aim of this study was to assess differences in latency and clinical outcomes in singletons versus twin gestations affected by PPROM in a large, diverse cohort of women.

Study Design: This is a secondary analysis of a multicenter trial of magnesium for neuroprotection in women at high risk of preterm birth.

Report of National Brain Tumor Society roundtable workshop on innovating brain tumor clinical trials: building on lessons learned from COVID-19 experience.

On July 24, 2020, a workshop sponsored by the National Brain Tumor Society was held on innovating brain tumor clinical trials based on lessons learned from the COVID-19 experience. Various stakeholders from the brain tumor community participated including the US Food and Drug Administration (FDA), academic and community clinicians, researchers, industry, clinical research organizations, patients and patient advocates, and representatives from the Society for Neuro-Oncology and the National Cancer Institute. This report summarizes the workshop and proposes ways to incorporate lessons learned from COVID-19 to brain tumor clinical trials including the increased use of telemedicine and decentralized trial models as opportunities for practical innovation with potential long-term impact on clinical trial design and implementation.

Post-acute COVID-19 syndrome.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has resulted in global healthcare crises and strained health resources. As the population of patients recovering from COVID-19 grows, it is paramount to establish an understanding of the healthcare issues surrounding them. COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations.

Assessing the readability of patient-targeted online information on musculoskeletal radiology procedures.

Objective: To assess the readability of patient-targeted online information on musculoskeletal radiology procedures.

Methods: Eleven common musculoskeletal radiology procedures were queried in three online search engines (Google, Yahoo!, Bing). All unique patient-targeted websites were identified (n = 384) from the first three pages of search results.

Pharmacotherapy for durable left ventricular assist devices.

Left ventricular assist devices (LVADs) have revolutionized the care of patients with advanced heart failure, yet still require concomitant medications in order to achieve the best possible clinical outcomes. Since the outset of routine placement of durable, continuous-flow LVADs, much of the medication management of these patients to date has been based on International Society of Heart and Lung Transplantation (ISHLT) guidance, most recently published in 2013. Since 2013, numerous multidisciplinary pharmacotherapy publications have increased the LVAD community's understanding of best practices with respect to medications.

Intravascular Ultrasound in Chronic Total Occlusion Percutaneous Coronary Intervention: Solving Ambiguity and Improving Durability.

Chronic total occlusions remain among the most technically challenging lesions to treat percutaneously. Limitations of 2-dimensional angiography may further hinder successful treatment of these lesions. Intrasvascular ultrasound has a key role in percutaneous recanalization for a chronic total occlusion by providing key lesion characteristics, facilitating guidewire crossing, elucidating the intraplaque or extralaque path of the guidewire, optimizing lesion preparation, guiding stenting and identifying suboptimal results.

Blood component utilization in COVID-19 patients in New York City: Transfusions do not follow the curve.

Background: Blood suppliers and transfusion services have worked diligently to maintain an adequate blood supply during the COVID-19 pandemic. Our experience has shown that some COVID-19 inpatients require transfusion support; understanding this need is critical to blood product inventory management.

Study Design And Methods: Hospital-wide and COVID-19 specific inpatient blood product utilization data were collected retrospectively for our network's two tertiary academic medical centers over a 9-week period (March 1, 2020-May 2, 2020), when most inpatients had COVID-19.

Identifying Factors Important to Patients for Resuming Elective Imaging During the COVID-19 Pandemic.

Purpose: To identify factors important to patients for their return to elective imaging during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: In all, 249 patients had elective MRIs postponed from March 23, 2020, to April 24, 2020, because of the COVID-19 pandemic. Of these patients, 99 completed a 22-question survey about living arrangement and health care follow-up, effect of imaging postponement, safety of imaging, and factors important for elective imaging.

Electroencephalogram Monitoring in Critical Care.

Seizures are common in critically ill patients. Electroencephalogram (EEG) is a tool that enables clinicians to provide continuous brain monitoring and to guide treatment decisions-brain telemetry. EEG monitoring has particular utility in the intensive care unit as most seizures in this setting are nonconvulsive.

Principles of Pharmacotherapy of Seizures and Status Epilepticus.

Status epilepticus is a neurological emergency with an outcome that is highly associated with the initial pharmacotherapy management that must be administered in a timely fashion. Beyond first-line therapy of status epilepticus, treatment is not guided by robust evidence. Optimal pharmacotherapy selection for individual patients is essential in the management of seizures and status epilepticus with careful evaluation of pharmacokinetic and pharmacodynamic factors.

MRI following medial patellofemoral ligament reconstruction: assessment of imaging features found with post-operative pain, arthritis, and graft failure.

Objective: To assess MR features following MPFL reconstruction and determine their influence on post-operative pain, progressive arthritis, or graft failure.

Materials And Methods: Retrospective study on 38 patients with MPFL reconstruction and a post-operative MRI between January 2010 and June 2019. Two radiologists assessed MPFL graft signal, graft thickness, femoral screw, femoral tunnel widening, and patellofemoral cartilage damage.

Single-Cell Genomics Reveals a Novel Cell State During Smooth Muscle Cell Phenotypic Switching and Potential Therapeutic Targets for Atherosclerosis in Mouse and Human.

Background: Smooth muscle cells (SMCs) play significant roles in atherosclerosis via phenotypic switching, a pathological process in which SMC dedifferentiation, migration, and transdifferentiation into other cell types. Yet how SMCs contribute to the pathophysiology of atherosclerosis remains elusive.

Methods: To reveal the trajectories of SMC transdifferentiation during atherosclerosis and to identify molecular targets for disease therapy, we combined SMC fate mapping and single-cell RNA sequencing of both mouse and human atherosclerotic plaques.

Mitral Regurgitation in 2020: The 2020 Focused Update of the 2017 American College of Cardiology Expert Consensus Decision Pathway on the Management of Mitral Regurgitation.

The recently published "2020 Focused Update of the 2017 ACC Expert Consensus Decision Pathway on the Management of Mitral Regurgitation" provides a framework for the clinical and echocardiographic assessment of mitral regurgitation and describes considerations for the medical, surgical, and transcatheter treatment of mitral regurgitation. The Update provides guidance for clinicians in light of the significant interim developments since the 2017 recommendations, particularly in the areas of secondary mitral regurgitation and transcatheter mitral valve repair. The present review focuses on the aspects of the Update that are most relevant to the cardiac anesthesiologist, with emphasis on the integrated assessment of mitral regurgitation with echocardiography and the indications and considerations for the surgical and transcatheter management of mitral regurgitation.

Expanding Pharmacy Services With an Intern Program at an Academic Medical Center.

Background: Organizations that implement pharmacy services to provide patient education have reduced hospital readmissions and improved the patient experience. The term "pharmacy extender" has been used to describe pharmacy technicians and pharmacy students who alleviate the workload of a pharmacist, enhance pharmacy visibility throughout an organization, and foster professional development for the individual.

Objective: The objective of this pharmacy intern-driven program is to increase pharmacy reach for medication teaching.

Treatment Strategies and Outcomes of Pediatric Esthesioneuroblastoma: A Systematic Review.

Esthesioneuroblastoma, also known as olfactory neuroblastoma, is a small round blue cell tumor of nasal neuroepithelium first described in 1924. Though this tumor is especially rare in the pediatric population with an incidence of <0.1 per 100,000, it is the most common pediatric nasal cavity neoplasm.