Increasing Incidence of Coronary Artery Disease in Younger Men: Case Study of a 39-Year-Old.

Coronary artery disease (CAD) is the leading cause of death globally. While it is usually diagnosed after years of declining health or after a myocardial infarction (MI), we found that patients can be asymptomatic, posing a latent and life-threatening risk. We present the case of a man less than 40 years old, in whom heart disease was incidentally discovered during a CT scan performed for an unrelated condition.

Cornulin as a Key Diagnostic and Prognostic Biomarker in Cancers of the Squamous Epithelium.

The prevalence of squamous cell carcinoma is increasing, and efforts that aid in an early and accurate diagnosis are crucial to improve clinical outcomes for patients. Cornulin, a squamous epithelium-specific protein, has recently garnered attention due to its implications in the progression of squamous cell carcinoma developed in several tissues. As an epidermal differentiation marker, it is involved in skin anchoring, regulating cellular proliferation, and is a putative tumor suppressor.

Bullet Wound Blues: A Case Report on Brachial Artery Pseudoaneurysm.

Pseudoaneurysms are typically iatrogenic due to the increasing use of the artery for arterial interventions such as invasive vascular radiological procedures, invasive coronary artery procedures, arterial punctures for an arteriogram, or catheterization. Other reasons for pseudoaneurysm formation are intravenous drug use and penetrating trauma. They are more commonly observed in the lower limbs than in the upper limbs.

Post-Stroke Recrudescence: A Case Report and Literature Review.

Post-stroke recrudescence (PSR) is a clinical entity characterized by the acute transient recurrence of previously recovered focal stroke deficits. Various names have been used to describe PSR, which further complicates its diagnosis. Increased awareness of this condition is crucial for preventing inappropriate management and unnecessary testing.

Misdiagnosed Seizure-Like Activity in a Patient With Postural Orthostatic Tachycardia Syndrome: A Case Report.

Postural orthostatic tachycardia is a syndrome characterized by an elevated heart rate in response to standing. This syndrome typically presents in late adolescence and early adulthood, with a higher percentage occurring in females. This syndrome is often seen following a viral infection, pregnancy, surgery, or intense psychological stress.

Adverse Events in Placebo Arms of Cancer Trials.

Background/aim: Adverse events (AEs) in cancer trials may be caused by the investigational agents or the underlying disease. Determining the causality is challenging, especially in early cancer drug development when a control arm is lacking.

Materials And Methods: We carried out a systematic literature review of AE frequencies in placebo arms of randomized trials for malignant solid tumors and hematologic malignancies reported in PubMed from 2016 to January 2022.

Diarrhea in Placebo Arms of Cancer Studies.

Background/aim: Diarrhea is among the most common adverse events in early oncology clinical trials, and drug causality may be difficult to determine.

Materials And Methods: This is a systematic literature review of placebo arms of randomized cancer trials.

Results: Anemia was reported in 95 of 127 placebo monotherapy cohorts.

The Advanced Application of Intracardiac Echocardiography for Cardiac Electrophysiology Ablation Procedures.

Purpose Of Review: The advanced use of intracardiac echocardiography (ICE) is both a significant leap forward and an underutilized and unrealized innovation for electrophysiological (EP) procedures [1]. ICE can inform operators of complex anatomic heterogeneity as well as close anatomic relationships beyond fluoroscopy and even electroanatomic mapping. We will review the myriad advantages of advanced ICE application to EP ablation procedures.

Fatigue in Cancer Treatment Studies: Analysis of Placebo Arms.

Background/aim: Fatigue and asthenia are common in patients with cancer; and identifying the cause as drug toxicity versus cancer progression is difficult, particularly in clinical trials without control arms.

Materials And Methods: We carried out a systematic literature review of fatigue in placebo arms of randomized cancer trials reported in PubMed from 2000 to 2021.

Results: Fatigue/asthenia were reported in 100 out of 134 placebo cohorts, and the average of reported frequencies was 22.

Preoperative Music Listening in Pelvic Reconstructive Surgery: A Randomized Trial.

Objectives: We aimed to investigate the effect of music listening on preoperative anxiety compared with usual care in patients undergoing pelvic reconstructive surgery.

Methods: Patients scheduled for pelvic reconstructive surgery were enrolled on the day of surgery. Participants were randomized to either the usual care (control group) or to music listening on headphones (music group) before their surgery.

Headache Reporting in Oncology Trials Depends on the Demographics of the Study Population.

Background/aim: The frequency of adverse events (AEs) in clinical trials without control arms is difficult to interpret.

Materials And Methods: This is a systematic literature review of AEs reported from the placebo arms of randomized cancer trials in PubMed between 2008 and 2020.

Results: We found 80 placebo patient cohorts in 73 publications, describing 17,968 subjects who received placebo.

Liver disease and outcomes among COVID-19 hospitalized patients - A systematic review and meta-analysis.

Introduction And Objectives: The coronavirus disease 2019 (COVID-19) pandemic has been a challenge globally. In severe acute respiratory syndrome (SARS) epidemic 60% of patients had hepatic injury, due to phylogenetic similarities of the viruses it is assumed that COVID-19 is associated with acute liver injury. In this meta-analysis, we aim to study the occurrence and association of liver injury, comorbid liver disease and elevated liver enzymes in COVID-19 confirmed hospitalizations with outcomes.

Eclampsia.

Audience: Emergency medicine residents and medical students on emergency medicine rotations.

Introduction: Eclampsia is an uncommon but important life-threatening obstetrical emergency, complicating 1.5-10 deliveries per 10,000 pregnancies in resource-rich countries.

Pivotal Trial of the Neuroform Atlas Stent for Treatment of Anterior Circulation Aneurysms: One-Year Outcomes.

Background And Purpose: Stent-assisted coil embolization using the new generation Neuroform Atlas Stent System has shown promising safety and efficacy. The primary study results of the anterior circulation aneurysm cohort of the treatment of wide-neck, saccular, intracranial, aneurysms with the Neuroform Atlas Stent System (ATLAS trial [Safety and Effectiveness of the Treatment of Wide Neck, Saccular Intracranial Aneurysms With the Neuroform Atlas Stent System]) are presented.

Methods: ATLAS IDE trial (Investigational Device Exemption) is a prospective, multicenter, single-arm, open-label study of wide-neck (neck ≥4 mm or dome-to-neck ratio <2) intracranial aneurysms in the anterior circulation treated with the Neuroform Atlas Stent and approved coils.

Atypical Presentation of Novel Coronavirus Disease 2019 in a Peritoneal Dialysis Patient.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a rapidly spreading disease causing increased morbidity and mortality across the globe. There is limited available knowledge regarding the natural history of the SARS-CoV-2 infection. Other factors that are also making this infection spread like a pandemic include global travelers, lack of proven treatment, asymptomatic carriers, potential reinfection, underprepared global health care systems, and lack of public awareness and efforts to prevent further spread.

Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: adaptation based on an expert consensus meeting.

Introduction Recently, an expert consensus on optimal use of procalcitonin (PCT)-guided antibiotic stewardship was published focusing mainly on Europe and the United States. However, for Asia-Pacific countries, recommendations may need adaptation due to differences in types of infections, available resources and standard of clinical care. Methods Practical experience with PCT-guided antibiotic stewardship was discussed among experts from different countries, reflecting on the applicability of the proposed Berlin consensus algorithms for Asia-Pacific.

Revise Guidelines/Standards to Reflect Clinical Evidence and New Technology.

In recent years, professional medical societies and other organizations have developed clinical practice guidelines and standards to guide the work of wound care scientists, manufactures, researchers, and clinicians. Wound care stakeholders tend to follow the guidelines and standards developed by organizations to which they belong. This article emphasizes the need to monitor all published wound care guidelines and standards and to revise them when new clinical evidence is published, and/or new technology is released.

Fluoroless Catheter Ablation of Cardiac Arrhythmias.

Fluoroless catheter ablation of all endocardial cardiac arrhythmias is feasible using current, and often standard, electrophysiology laboratory equipment. This article lays out a road map for performing fluoroless ablations, safely and efficaciously. We outline optimizing intracardiac echocardiography, performing complex ablations with radiofrequency and cryoballoon technology.

Superior Clinical, Quality of Life, Functional, and Health Economic Outcomes with Pneumatic Compression Therapy for Lymphedema.

Background: Pneumatic compression therapy is one of several options for the management of lymphedema. The lack of clarity around clinical outcomes, quality of life, cost of care, and its proper application, as a function of lymphedema complexity, limit its use in clinical practice. This is compounded by difficulties associated with insurance approval and uncertainty about the role of this modality in the treatment algorithm.

Misperceptions about the 'Opioid Epidemic:' Exploring the Facts.

A plethora of statistics and claims exist concerning the rise in prescription opioid use and the increase in opioid-related deaths. Eleven misperceptions were identified that underlie some of the growing national concern and backlash against opioid use. Misperceptions include the number of opioid overdose deaths, the quality of government-sponsored data and guidelines, the impact of opioid dose escalation on overdose risk, postoperative opioid use associated with long-term use, and the link between prescription opioid use and heroin initiation.

An Atypical Presentation of Myasthenia Gravis: A Case Report.

Myasthenia gravis (MG) belongs to a spectrum of autoimmune diseases in which anti-acetylcholine receptor antibodies damage neuromuscular junctions. It is a relatively rare disease with a higher incidence among the female population. The classical presentation is fatigable fluctuating diplopia or ptosis and, uncommonly, dysphagia or dysphonia.

Clinical use of [TIMP-2]•[IGFBP7] biomarker testing to assess risk of acute kidney injury in critical care: guidance from an expert panel.

Background: The first FDA-approved test to assess risk for acute kidney injury (AKI), [TIMP-2]•[IGFBP7], is clinically available in many parts of the world, including the USA and Europe. We sought to understand how the test is currently being used clinically.

Methods: We invited a group of experts knowledgeable on the utility of this test for kidney injury to a panel discussion regarding the appropriate use of the test.

How to Control Subannular Hemorrhage during Aortic Root Enlarging Procedures.

We describe an effective suture technique to control the persistent subannular bleeding at the aortoventricular curtain in four patients with aortic stenosis and small annulus who underwent aortic root enlargement and patch reconstruction. This technique approximates the left atrial roof to the aortic root without the need for re-replacement of the aortic prosthesis or revision of the patch. Reintervention for aortic root, valve, or the residual aorta was not required.