Smart wearable devices in cardiovascular care: where we are and how to move forward.

Technological innovations reach deeply into our daily lives and an emerging trend supports the use of commercial smart wearable devices to manage health. In the era of remote, decentralized and increasingly personalized patient care, catalysed by the COVID-19 pandemic, the cardiovascular community must familiarize itself with the wearable technologies on the market and their wide range of clinical applications. In this Review, we highlight the basic engineering principles of common wearable sensors and where they can be error-prone.

Staphylococcus Auricularis Endocarditis: A Rare Cause of Subacute Prosthetic Valve Endocarditis with Severe Aortic Stenosis.

Prosthetic valve endocarditis (PVE) represents 20% of all cases of endocarditis. Herein, we present a rare cause of PVE by Staphylococcus auricularis (S. auricularis) exhibiting features of subacute endocarditis causing severe aortic stenosis and acute myocardial infarction.

Bezold-Jarisch reflex-mediated asystole during dobutamine stress testing: a case report.

Background: The Bezold-Jarisch reflex (BJR) is a cardioinhibitory parasympathetic response to activation of ventricular mechanoreceptors, which can result in bradycardia, atrioventricular block, or asystole. This phenomenon has been triggered by acute myocardial ischaemia, intra-arterial nitroglycerine use, natriuretic peptides, and with exceptional rarity, in middle-aged women only, by dobutamine infusion during stress echocardiography.

Case Summary: We present the case of a 61-year-old woman who suffered a 5.

The Indirect Costs of the SARS-CoV-2 Pandemic: A Case of Severe Malaria in Brooklyn.

Severe malaria due to the infection of is a critical infection that may lead to multisystem abnormalities if not promptly and adequately treated. We present a case of severe malaria in a patient recently repatriated from Conakry, Guinea, West Africa, marooned during the recent coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While the direct costs of the SARS-CoV-2 pandemic and its indirect effect on neighboring industries have been analyzed, the indirect costs of other ailments in medicine have yet to be fully established.

Optimizing Kidney Replacement Therapy During the COVID-19 Pandemic Across a Complex Healthcare System.

The unprecedented surge of nephrology inpatients needing kidney replacement therapy placed hospital systems under extreme stress during the COVID-19 pandemic. In this article, we describe the formation of a cross campus "New-York Presbyterian COVID-19 Kidney Replacement Therapy Task Force" with intercampus physician, nursing, and supply chain representation. We describe several strategies including the development of novel dashboards to track supply/demand of resources, urgent start peritoneal dialysis, in-house preparation of kidney replacement fluid, the use of unconventional personnel resources to ensure the safe and continued provision of kidney replacement therapy in the face of the unanticipated surge.

Cancer patients and COVID-19: Mortality, serious complications, biomarkers, and ways forward.

The SARS-CoV-2 (COVID-19) pandemic has particularly serious consequences for cancer patients, as they are at high risk for severe complications and mortality due to the virus since cancer patients are immunocompromised. Preliminary evidence suggests that patients with hematological, and metastatic malignancies are particularly susceptible to developing severe COVID-19 illness, which leads to poor prognosis. Biomarkers including C-reactive protein and interleukin-6 may be predictors of outcome and, therefore, crucial in assessing COVID-19 illness severity in cancer patients.

Femur Fracture in a Premature Infant: An Unusual Association of Sickle Cell Disease with Osteogenesis Imperfecta.

BACKGROUND Bone health is influenced by multiple factors, including genetic disorders such as osteogenesis imperfecta (OI) and sickle cell disease (SCD). OI is a genetic disorder caused by mutations in genes that encode type 1 collagen. Type 1 collagen synthesizes bones, skin, and other connective tissues.

Oral Antiplatelet Therapy Administered Upstream to Patients With NSTEMI.

Objective: To describe from a noninterventional registry (Utilization of Ticagrelor in the Upstream Setting for Non-ST-Segment Elevation Acute Coronary Syndrome), the short-term ischemic and hemorrhagic outcomes in patients with non-ST elevation myocardial infarction (MI) are managed with a loading dose (LD) of a P2Y12 inhibitor (P2Y12i) given at least 4 hours before diagnostic angiography and delineation of coronary anatomy. Prior data on the effects of such "upstream loading" have been inconsistent.

Methods: In 53 US hospitals, we evaluated the in-hospital care and outcomes of patients with confirmed non-ST elevation MI managed with an interventional strategy and loaded upstream (at least 4 h before diagnostic angiography) with oral P2Y12i therapy.

Crisis clinical pathway for COVID-19.

The pandemic of COVID-19 has been particularly severe in the New York City area, which has had one of the highest concentrations of cases in the USA. In March 2020, the EDs of New York-Presbyterian Hospital, a 10-hospital health system in the region, began to experience a rapid surge in patients with COVID-19 symptoms. Emergency physicians were faced with a disease that they knew little about that quickly overwhelmed resources.

Scalp Staples Placed in a Pediatric Emergency Department: Feasibility and Benefits of Home Removal.

Objectives: Scalp lacerations are a common occurrence in the pediatric population. A preferred method of closure in a busy pediatric emergency department (PED) is skin staples, because of their ease of use and rapid application. However, using skin staples also demands that the child have a follow-up visit for their removal.

Multiple sclerosis in a young woman with sickle cell disease.

Background: Comorbidities can impose diagnostic and treatment challenges in patients with multiple sclerosis (MS). Sickle cell disease (SCD) and MS are both inflammatory diseases featuring immune system dysregulation, and the reciprocal interaction of these diseases deserves investigation.

Methods/results: We present the case of a 28-year-old woman with SCD who developed a sickle cell crisis and acute chest syndrome during corticosteroid treatment for a first MS attack.

Imaging of Clinically Unrecognized Myocardial Fibrosis in Patients With Suspected Coronary Artery Disease.

Background: Stress cardiac magnetic resonance (CMR) provides accurate assessment of both myocardial infarction (MI) and ischemia.

Objectives: This study aimed to evaluate the incremental prognostic value of unrecognized myocardial infarction (UMI), detected during assessment of coronary artery disease (CAD) by stress CMR, beyond cardiac function and ischemia.

Methods: In the multicenter SPINS (Stress CMR Perfusion Imaging in the United States) study, 2,349 consecutive patients (63 ± 11 years of age, 53% were male) with suspected CAD were assessed by stress CMR and followed over a median of 5.

Role of Immune Checkpoint Inhibitors in Gastrointestinal Malignancies.

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of several solid and hematological malignancies. ICIs are not only able to produce long and durable responses, but also very well tolerated by patients. There are several approved indications of use of ICIs in treatment of metastatic gastrointestinal malignancies including gastric, esophageal, colorectal and hepatocellular carcinoma.

Key articles and guidelines for the emergency medicine clinical pharmacist: 2011-2018 update.

Purpose: To summarize recently published research reports and practice guidelines on emergency medicine (EM)-related pharmacotherapy.

Summary: Our author group was composed of 14 EM pharmacists, who used a systematic process to determine main sections and topics for the update as well as pertinent literature for inclusion. Main sections and topics were determined using a modified Delphi method, author and peer reviewer groups were formed, and articles were selected based on a comprehensive literature review and several criteria for each author-reviewer pair.

Analyses of electronic health records utilization in a large community hospital.

Introduction: The Electronic Health Record (EHR) has become an integral component of healthcare delivery. Survey based studies have estimated that physicians spend 4-6 hours of their workday devoted to EHR. Our study was designed to use computer software to objectively obtain time spent on EHR.

Medial Plating of Pauwels Type III Femoral Neck Fractures Decreases Shear and Angular Displacement Compared with a Derotational Screw.

Objectives: The purpose of this mechanical study was to compare 2 methods of augmented stabilization of Pauwels type III femoral neck fractures.

Methods: Ten matched pairs of young cadaveric femurs were cut 22 cm distal to the lesser trochanter. All specimens received a 70-degree osteotomy, which was stabilized with a 135-degree sliding hip screw.

Multimodality adjuvant therapy and survival outcomes in stage I-IV uterine carcinosarcoma.

Objectives: Uterine carcinosarcoma is a rare, aggressive form of uterine cancer with a high recurrence rate and poor survival at all stages. We sought to evaluate the outcomes of patients treated with chemotherapy versus a combination of chemotherapy and radiation (chemoradiation) to determine survival.

Methods: A multicenter retrospective analysis of patients with stage I-IV carcinosarcoma was conducted from January 2000 to December 2017.

Radical Prostatectomy Without Pelvic Lymph Node Dissection Is Widely Practiced in High-Risk Patients Despite Poorer Survival.

Purpose: Radical prostatectomy with pelvic lymph node dissection (PLND) is the standard of care for unfavorable risk prostate cancer. We investigated dissection practice patterns and their impact on overall survival using a large national database.

Patients And Methods: Men with prostate adenocarcinoma diagnosed between 2004 and 2013 were identified from the National Cancer Data Base.