Risk Factors for Reduced Long-Term Survival Following Isolated Surgical Aortic Valve Replacement in Different Age Groups.

Background: According to recent guidelines, the selection of transcatheter vs surgical aortic valve replacement (TAVR vs SAVR) in low-risk patients depends on age and life expectancy. Our objective was to understand independent risk factors for reduced life expectancy following isolated SAVR and the rate of redo aortic valve (AV) intervention in different age groups, to delineate optimal intervention depending on patient characteristics.

Methods: Between 2000 and 2015, 2026 patients underwent isolated SAVR with Carpentier-Edwards pericardial tissue valves (Edwards Lifesciences, Irvine, CA).

Healthcare utilization among COVID-19 mRNA vaccine-associated myocarditis cases: a matched retrospective cohort study.

Objectives: We evaluated all-cause healthcare utilization among those with vaccine-associated myocarditis, compared to vaccinees without postvaccination myocarditis.

Methods: We conducted a retrospective cohort study in individuals aged 12 and older who received COVID-19 mRNA vaccination in British Columbia. Exposure was defined as an ED visit or hospitalization for myocarditis within 21 days postvaccination.

Community-Based Pharmacists' Perspectives on Prescribing Authority for the Minor Ailments and Contraception Service in British Columbia.

Recent changes to legislation in British Columbia (BC) have expanded the scope of pharmacist-provided services to include pharmacist prescribing for minor ailments and contraception (PPMAC). The purpose of this study was to gather community-based pharmacists' perspectives on these changes to practice. This was a cross-sectional online survey study.

Acute appendicitis in a patient with sub-hepatic, sub-serosal, and retroperitoneal location. An intraoperative management challenge.

Introduction: Appendicitis in patients with a sub-hepatic and retroperitoneal position is rare, often leading to delayed diagnosis and management due to its atypical presentation. A high index of clinical suspicion and the use of imaging modalities can improve the outcomes of patients with sub-hepatic appendicitis.

Case Presentation: A 20-year-old male presented with 36 h duration of right-sided abdominal pain, accompanied by nausea, vomiting, anorexia, and fever.

Locally advanced cervical cancer: Neoadjuvant chemotherapy plus radical surgery an alternative approach to chemo-radiation in a low-income setting: A descriptive study.

Objective: To describe the treatment outcomes of locally advanced cervical cancer managed with neoadjuvant chemotherapy (NACT) plus radical surgery at a gynecology oncology center in Ethiopia.

Methods: This was a retrospective descriptive study of management of locally advanced cervical cancer (LACC) at St. Paul's Hospital Millennium Medical College (Ethiopia) over 5 years.

Granzyme B cleaves tenascin-C to release its C-terminal domain in rheumatoid arthritis.

Rheumatoid arthritis (RA) is a common autoimmune disorder characterized by exacerbated joint inflammation. Despite the well-documented accumulation of the serine protease granzyme B (GzmB) in RA patient biospecimens, little is understood pertaining to its role in pathobiology. In the present study, tenascin-C (TNC) - a large, pro-inflammatory extracellular matrix glycoprotein - was identified as a substrate for GzmB in RA.

Medications for community pharmacists to dose adjust or avoid to enhance prescribing safety in individuals with advanced chronic kidney disease: a scoping review and modified Delphi.

Background: Community pharmacists commonly see individuals with chronic kidney disease (CKD) and are in an ideal position to mitigate harm from inappropriate prescribing. We sought to develop a relevant medication list for community pharmacists to dose adjust or avoid in individuals with an estimated glomerular filtration rate (eGFR) below 30 mL/min informed through a scoping review and modified Delphi panel of nephrology, geriatric and primary care pharmacists.

Methods: A scoping review was undertaken to identify higher risk medications common to community pharmacy practice, which require a dose adaptation in individuals with advanced CKD.

Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis.

Background: For patients with asymptomatic severe aortic stenosis and preserved left ventricular ejection fraction, current guidelines recommend routine clinical surveillance every 6 to 12 months. Data from randomized trials examining whether early intervention with transcatheter aortic-valve replacement (TAVR) will improve outcomes in these patients are lacking.

Methods: At 75 centers in the United States and Canada, we randomly assigned, in a 1:1 ratio, patients with asymptomatic severe aortic stenosis to undergo early TAVR with transfemoral placement of a balloon-expandable valve or clinical surveillance.

Clinicians' Perspectives and an Ethical Analysis of Safer Supply Opioid Prescribing.

In British Columbia, Canada, many physicians providing care to individuals with high-risk opioid use disorder adopted safer supply (SS) opioid prescribing in the spring of 2020 with the goal of facilitating public health measures for COVID-19. This prescribing practice continued after measures were lifted. This study aimed to explore prescribers' perspectives following several years of local experience in prescribing SS opioids, primarily in the form of hydromorphone tablets, and to apply ethical concepts to explore current challenges and ongoing sources of provider distress.

Indications and Techniques for Surgical Lead Extraction and Device Reimplantation.

Cardiac implantable electronic devices (CIEDs) can be lifesaving but complications associated with CIEDs can lead to significant morbidity and mortality. Effective techniques to remove these devices are critical to reducing complications and improving quality of life. Percutaneous extraction techniques are effective for removing the majority of CIEDs but surgical lead extraction is still required in certain situations.

Consensus Considerations and Good Practice Points for Use of Continuous Glucose Monitoring Systems in Hospital Settings.

Continuous glucose monitoring (CGM) systems provide frequent glucose measurements in interstitial fluid and have been used widely in ambulatory settings for diabetes management. During the coronavirus disease 2019 (COVID-19) pandemic, regulators in the U.S.

A high prevalence of antibiotic use at two large teaching hospitals in Addis Ababa, Ethiopia: a point prevalence survey.

Objective: Antimicrobial resistance (AMR) renders many bacterial infections untreatable and results in substantial morbidity and mortality worldwide. Understanding antibiotic use in clinical settings including hospitals is critical to optimize antibiotic use and prevent resistance.

Design: Hospital antibiotic point prevalence survey (PPS).

Mexican Hispanics show significant improvement in lung function approximately 1 year after having severe COVID-19.

The long-term effects of COVID-19 on lung function are not understood, especially for periods extending beyond 1 year after infection. This observational, longitudinal study investigated lung function in Mexican Hispanics who experienced severe COVID-19, focusing on how the length of recovery affects lung function improvements. At a specialized COVID-19 follow-up clinic in Yucatan, Mexico, lung function and symptoms were assessed in patients who had recovered from severe COVID-19.

Impactful Cardiac CT and MRI Articles from 2023.

Cardiac imaging is important in diagnosing, treating, and predicting prognosis in patients with cardiovascular disease. Imaging protocols and analysis are consistently evolving, and the implementation of artificial intelligence-based applications is of increasing interest. This review presents recent advancements in noninvasive cardiac imaging, specifically focusing on cardiac CT and MRI, from notable publications across multidisciplinary journals in 2023 of interest to both radiologists and referring clinicians in the field.

Large nonpedunculated colorectal polyp management through the lens of an interventional endoscopist.

SummaryMinimally invasive endoscopic resection techniques are now the first-line management strategy for most large (> 20 mm) nonpedunculated colorectal polyps (LNPCPs). Appropriate technique selection depends on optical evaluation to predict lesion histopathology alongside the presence of and depth of malignant invasion. We review the indications and performance of endoscopic mucosal resection, cold snare resection, and endoscopic submucosal dissection.

Resuming work roles after injury in a low-income context: Multiple factors influencing the return to work outcomes.

Background: Return to work (RTW) is an important outcome indicator for the effectiveness of rehabilitation services, and the functional status and overall recovery among individuals who have experienced injury. Despite the rising incidence of traumatic injury among economically productive citizens in Ethiopia, there is a paucity of evidence about the RTW status of injury survivors. This study examined factors associated with RTW success and determinants of time to RTW after injury in Ethiopia.

Longitudinal wastewater-based surveillance of SARS-CoV-2 during 2023 in Ethiopia.

Introduction: Although wastewater-based epidemiology (WBE) successfully functioned as a tool for monitoring the coronavirus disease 2019 (COVID-19) pandemic globally, relatively little is known about its utility in low-income countries. This study aimed to quantify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in wastewater, estimate the number of infected individuals in the catchment areas, and correlate the results with the clinically reported COVID-19 cases in Addis Ababa, Ethiopia.

Methods: A total of 323 influent and 33 effluent wastewater samples were collected from three Wastewater Treatment Plants (WWTPs) using a 24-h composite Moore swab sampling method from February to November 2023.