Pediatric Medial Condyle of Humerus Fracture Dislocation: A Case Report.

We present the case of a six-year-old male patient, status post fall with elbow dislocation, successfully reduced. At the time of injury, he had normal appearing x-rays, signs of a mildly discrete chip, and possible epicondyle ossification, but no definitive fracture. A medial condyle fracture with dislocation was missed at the original time of injury.

Short-Term Outcomes of Cardiac Arrhythmias Among COVID-19 Patients: A Propensity Matched National Study.

The risk of arrhythmia is high in patients with COVID-19. The current literature is limited in understanding the clinical impact of arrhythmias and the extent of healthcare utilization in COVID-19 patients. The Nationwide In-patient Sample Database (NIS) from 2019 to 2020 was queried to identify COVID-19 patients who developed arrhythmias vs those without.

Molecular neurobiology of loss: a role for basolateral amygdala extracellular matrix.

Psychological loss is a common experience that erodes well-being and negatively impacts quality of life. The molecular underpinnings of loss are poorly understood. Here, we investigate the mechanisms of loss using an environmental enrichment removal (ER) paradigm in male rats.

Mechanical thrombectomy beyond 24 hours from last known well in tandem lesions: A multicenter cohort study.

Background: While recent studies suggest a benefit of mechanical thrombectomy (MT) for the treatment of patients with isolated large vessel occlusions presenting after 24 hours from the last known well (LKW), the effect of MT for acute cervical tandem lesions (TLs) beyond 24 hours remains unknown. We aimed to evaluate the safety and effectiveness of MT beyond 24 hours of LKW in patients with TLs.

Methods: We conducted a subanalysis study of patients with anterior circulation TL enrolled in a large, multicenter registry between January 2015 and December 2020.

Watchful Eye Prevents Catastrophe in Case of Malignant Hyperthermia: A Case Report.

Case: A 49-year-old woman presented with a displaced left posterior wall acetabular fracture-dislocation and a left comminuted intra-articular distal radius fracture sustained in a motor vehicle accident. Fifteen minutes after anesthesia induction for operative fixation of the fractures, the patient experienced severe hypertension, increased end-tidal carbon dioxide, and fever. A diagnosis of malignant hyperthermia (MH) was made before incision.

Clinical and Safety Outcomes of Endovascular Therapy 6 to 24 Hours After Large Vessel Occlusion Ischemic Stroke With Tandem Lesions.

Background And Purpose: Effect of endovascular therapy (EVT) in acute large vessel occlusion (LVO) patients with tandem lesions (TLs) within 6-24 hours after last known well (LKW) remains unclear. We evaluated the clinical and safety outcomes among TL-LVO patients treated within 6-24 hours.

Methods: This multicenter cohort was divided into two groups, based on LKW to puncture time: early window (<6 hours), and late window (6-24 hours).

Safety Outcomes of Mechanical Thrombectomy Versus Combined Thrombectomy and Intravenous Thrombolysis in Tandem Lesions.

Background: We aimed to describe the safety and efficacy of mechanical thrombectomy (MT) with or without intravenous thrombolysis (IVT) for patients with tandem lesions and whether using intraprocedural antiplatelet therapy influences MT's safety with IVT treatment.

Methods: This is a subanalysis of a pooled, multicenter cohort of patients with acute anterior circulation tandem lesions treated with MT from 16 stroke centers between January 2015 and December 2020. Primary outcomes included symptomatic intracranial hemorrhage (sICH) and parenchymal hematoma type 2.

'Cath' It Before It's Too Late: A Case Report of ECG Abnormalities Indicative of Acute Pathology Requiring Immediate Catheterization.

Unlabelled: Current guidelines to detect for myocardial infarction (MI) are not sufficient to triage patients requiring immediate cardiac catheterization, with at least 25% of non-ST elevation myocardial infarction (NSTEMI) patients found to have acute coronary occlusion (ACO) only on delayed catheterization, and up to 35% of perceived ST-elevation myocardial infarction (STEMI) ACOs found as false positives at catheterization. There has been a call for an integration of a new paradigm: occlusion/non-occlusion MI (OMI/NOMI). Here we discuss a 51-year-old female who presented to the emergency department with subtle electrocardiogram (ECG) abnormalities not adherent to the current MI guidelines.

A Case Report of Subtle EKG Abnormalities in Acute Coronary Syndromes Indicative of Type One Myocardial Infarction.

Unlabelled: This case report discusses a patient who had subtle EKG abnormalities that were indicative of a pathological amount of coronary artery disease resulting in occlusion of the right coronary artery (RCA) even though ST-elevation criteria for STEMI were not initially present. In the proper clinical setting, focal repolarization abnormalities in conjunction with cardiac risk factors and cardiac symptoms may indicate a high probability of a pathological amount of coronary disease that warrants emergent intervention. We report a case of a 54-year-old male with cardiac risk factors and cardiac symptoms who presented to the emergency department (ED).

Community Versus Vertically Acquired Neonatal SARS-CoV-2 Infection: The EPICENTRE Cohort Study.

Neonatal Severe Acute Respiratory Syndrome-CoronaVirus-2 infections can be community-acquired or vertically-acquired. The analysis of neonatal patients requiring hospitalization reported in the EPICENTRE worldwide registry shows that community-acquired cases have clinical features (fever, respiratory signs, feeding difficulties, P < 0.0001) and received antibiotics (P = 0.

Contralateral Gluteal Compartment Syndrome After Prolonged Use of a Fracture Table in a Scissoring Position: A Case Report.

Case: A 62-year-old Caucasian man presented with a comminuted subtrochanteric fracture after a low-energy fall. Physical examination postoperatively revealed a firm hard gluteal compartment in the contralateral buttocks. The patient underwent a fasciotomy, using the Kocher-Langenbeck approach, to release the gluteus maximus and lateral thigh fascia.

Meta-Analysis of Efficacy and Safety of Intravenous Iron in Patients With Iron Deficiency and Heart Failure With Reduced Ejection Fraction.

Iron deficiency is an independent risk factor for heart failure (HF) exacerbation. We aim to study the safety and efficacy of intravenous (IV) iron therapy in patients with HF with reduced ejection fraction (HFrEF). A literature search was conducted on MEDLINE (Embase and PubMed) using a systematic search strategy by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) until October 2022.

Multicenter comparison of antiplatelet treatment strategies for urgent/emergent neuroendovascular stenting.

Background: Emergent neuroendovascular stenting presents challenges for the utilization of antiplatelet agents.

Methods: This was a multicenter, retrospective cohort of patients who underwent emergent neuroendovascular stenting. The primary endpoints were thrombotic and bleeding events in relation to the timing of antiplatelet administration, route of administration, and choice of intravenous (IV) agent and the study investigated practice variability in antiplatelet utilization.

Patient Blood Management as an Emerging Concept in Quality: The Role of Nurses.

Background: Transfusion of blood components has long been considered lifesaving therapy. While blood transfusion may be clinically indicated as a treatment option for some patients, the benefits of transfusion in asymptomatic, hemodynamically stable patients are questionable.

Problem: Blood component transfusion is routinely used as a default therapy when not clinically indicated, increasing the risk of poor patient outcomes, adverse events, pressures on blood supply and availability, and increased health care costs.

Adjunct fixation in upper extremity long bone fracture plating.

Purpose: A variety of adjunct fixation methods to supplement primary plate and screw constructs are available. There are no large clinical series of these techniques in the upper extremity. The purpose of this study was to review patients with upper extremity fractures that underwent primary plating with adjunct fixation.

A Retrospective Analysis of Sacubitril/Valsartan in Heart Failure and Chronic Kidney Disease.

Sacubitril/valsartan has demonstrated benefit for patients with heart failure (HF); however, patients with advanced stages of chronic kidney disease (CKD) as defined by the National Kidney Foundation have historically been underrepresented in landmark HF trials. The goal of this study is to examine the safety and efficacy of sacubitril/valsartan in patients with HF and concomitant CKD stages III to V. This multicenter, retrospective, observational study included adult patients with HF and CKD stages III to V prescribed sacubitril/valsartan during hospital admission or upon discharge from January 2017 through March 2022.

Multicenter Comparison of the Safety and Efficacy of Clopidogrel Versus Ticagrelor for Neuroendovascular Stents.

Background: Dual antiplatelet therapy (DAPT) is commonly employed for neuroendovascular stenting due to the significant risk of thromboembolism. Clopidogrel and aspirin are most often selected as initial DAPTs; however, there is limited literature available to support guidance of DAPT in this setting. The objective of this study was to evaluate safety and efficacy in patients whose final regimen included either DAPT with aspirin and clopidogrel (DAPT-C) or DAPT with aspirin and ticagrelor (DAPT-T).

Immunologic profiles in patients with chronic limb-threatening ischemia undergoing endovascular revascularization.

Background: Inflammation and immune dysregulation have been associated with adverse outcomes in cardiovascular disease. There is limited understanding of the association of different profiles of white blood cell (WBC) subsets and red cell distribution width (RDW) in patients with chronic limb-threatening ischemia (CLTI).

Methods: Patients with CLTI undergoing endovascular revascularization in our single-center, tertiary care hospital from 2017 to 2019, who had a preceding complete blood count (CBC) with WBC differentials ( =213), were included in the analysis.

Endovascular Transcatheter Aortic Valve Replacement Outcomes in Hypertrophic Cardiomyopathy: Insights from the National Inpatient Sample (2014-2018).

Background: Outcomes of patients with hypertrophic cardiomyopathy (HCM) following transcatheter aortic valve replacement (TAVR) remain largely unknown.

Objectives: This study sought to assess the clinical characteristics and outcomes of HCM patients following TAVR.

Methods: We queried the National Inpatient Sample from 2014 to 2018 for TAVR hospitalizations with and without HCM, creating a propensity-matched cohort to compare outcomes.

Outcomes of Ventricular Tachycardia Catheter Ablation in Patients Who Underwent Cardiac Defibrillator Implantation Nationwide Readmission Database Analysis.

The timing of when to perform ventricular tachycardia (VT) ablation while receiving an implantable cardioverter defibrillator (ICD) during the same hospitalization has not been explored. This study aimed to investigate the use and outcomes of VT catheter ablation in patients with sustained VT receiving ICD in the same hospital stay. The Nationwide Readmission Database 2016 to 2019 was queried for all hospitalizations with a primary diagnosis of VT with subsequent ICD during the same admission.

Marginal Ulcer Following Completion Pancreatectomy Complicated by Portal Vein Erosion.

Marginal ulcers, defined as ulcers at the duodenojejunostomy or gastrojejunostomy, are a known late-onset complication of pancreaticoduodenectomy (PD) and total pancreatectomy (TP) with mean incidence ranging from 5.4% to 36% per the literature. These ulcers carry a risk of complications including hemorrhage or perforation which can result in significant mortality.