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Comput Biol Med 2021 May 7;134:104457. Epub 2021 May 7.

School of Engineering, Ngee Ann Polytechnic, Singapore; Biomedical Engineering, School of Social Science and Technology, Singapore University of Social Sciences, Singapore; International Research Organization for Advanced Science and Technology (IROAST), Kumamoto University, Kumamoto, Japan; Department Bioinformatics and Medical Engineering, Asia University, Taiwan; School of Management and Enterprise, University of Southern Queensland, Australia. Electronic address:

Cardiovascular diseases (CVDs) are main causes of death globally with coronary artery disease (CAD) being the most important. Timely diagnosis and treatment of CAD is crucial to reduce the incidence of CAD complications like myocardial infarction (MI) and ischemia-induced congestive heart failure (CHF). Electrocardiogram (ECG) signals are most commonly employed as the diagnostic screening tool to detect CAD. Read More

Int J Colorectal Dis 2021 May 13. Epub 2021 May 13.

Department of Gastroenterology and Hepatology, MercyOne Des Moines Medical Center, Des Moines, IA, USA.

Background: Ischemic colitis (IC) occurs when the blood supply of the large intestine becomes compromised. Several cardiovascular conditions, such as coronary artery disease, congestive heart failure, and atrial fibrillation, are well-established risk factors for the development of IC. The effects of pulmonary conditions, namely chronic obstructive pulmonary disease (COPD), on IC have not been well studied. Read More

Am J Case Rep 2021 May 14;22:e931376. Epub 2021 May 14.

Department of Infectious Disease, Rockledge Regional Medical Center, Rockledge, FL, USA.

BACKGROUND Convexal subarachnoid hemorrhage (cSAH), a rare form of non-aneurysmal subarachnoid hemorrhage, is confined to cerebral convexities without extension into basal cisterns or ventricles. Typical presentation includes thunderclap/progressive headache or transient focal neurological symptoms; rare manifestations include seizures, intractable vomiting, or altered mental status. Here, we report the first case of convexal subarachnoid hemorrhage and multifocal ischemic lesions caused by infective endocarditis (IE) in a treatment-naïve advanced HIV patient. Read More

Heart Vessels 2021 May 13. Epub 2021 May 13.

Cardiology Department, Heraklion University Hospital, Stavrakia, P.O. Box 1352, Heraklion, Crete, Greece.

The mortality of patients with non-ischemic dilated cardiomyopathy (NIDCM) remains substantial. We evaluated gene expression levels of myocardin, an early cardiac gene, in the peripheral blood cells of NIDCM patients as a prognostic biomarker in their long-term outcome and mortality from congestive HF (CHF). We retrospectively analyzed 101 consecutives optimally treated NIDCM patients of Cretan origin who were enrolled from the HF clinic of our hospital from November 2005 to December 2008. Read More

J Card Surg 2021 May 12. Epub 2021 May 12.

Department of Cardiac Surgery, CIMS Hospital, Ahmedabad, Gujarat, India.

Introduction: Primary cardiac synovial sarcoma is an exceedingly rare soft tissue malignant tumor, involving either the pericardium or chambers, with a striking male predominance, prevalently seen in the fourth decade. These tumours most commonly present as breathlessness on exertion. These patients readily exhibit gastrointestinal and systemic symptoms but sometimes the presentation can be fallacious. Read More

Emerg Radiol 2021 May 12. Epub 2021 May 12.

Department of Emergency Medicine, Mount Sinai Medical Center, New York, NY, USA.

Objective: The objectives of this study are to determine the efficacy of a roster of clinical factors in identifying risk for renal insufficiency in emergency department (ED) patients requiring intravenous contrast-enhanced CT scan (IVCE-CT) and to help mitigate potential for developing contrast-induced nephropathy (CIN).

Methods: A review was conducted of consecutive ED patients who received IVCE-CT during a 4-month period in our urban ED. The values of ED serum creatinine (SCr) performed were tabulated. Read More

Can Fam Physician 2021 May;67(5):e121-e129

Locum family physician and hospitalist in Ontario and mentors international medical graduates for the Northern Ontario School of Medicine.

Objective: To characterize primary care physician and nurse practitioner ("GP") workload and availability, and any relationship with daytime, low-acuity emergency department (ED) and after-hours walk-in clinic (WIC) visit counts.

Design: Retrospective database review.

Setting: Timmins, Ont, with 5 family health team (FHT) office sites, 1 after-hours FHT WIC, and 1 ED. Read More

Cancer Med 2021 May 12. Epub 2021 May 12.

Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.

Introduction: Young cancer survivors may be at increased risk of early-onset chronic health conditions. The aim of this population-based study is to estimate cardiovascular disease (CVD) risk among younger versus older B-cell non-Hodgkin's lymphoma (B-NHL) survivors compared with their respective general population cohorts.

Methods: B-NHL survivors diagnosed from 1997 to 2015 in the Utah Cancer Registry were matched with up to five cancer-free individuals on birth year, sex, and birth state, using the statewide Utah Population Database. Read More

Turk Neurosurg 2020 Oct 19. Epub 2020 Oct 19.

Suleyman Demirel Universitesi.

An 11-year-old girl presented with bilateral traumatic caroticocavernous fistula (CCF) associated with corkscrew eyelid vessels, which were considered indicators of severe congestive disease in this case. Direct CCFs are commonly associated with a history of head trauma, high-flow, prominent eye findings, and requirement for an early treatment. Indirect CCFs on the other hand are usually spontaneous, and associated with low flow, subtle findings and a benign course. Read More

Lancet Healthy Longev 2021 May 6;2(5):e250-e262. Epub 2021 May 6.

resTORbio, Boston, MA, USA.

Background: The COVID-19 pandemic highlights the need for therapies that improve immune function in older adults, including interferon (IFN)-induced antiviral immunity that declines with age. In a previous phase 2a trial, RTB101 (previously known as BEZ235), an oral mechanistic target of rapamycin (mTOR) inhibitor, was observed to increase IFN-induced antiviral gene expression and decrease the incidence of respiratory tract infections (RTIs) in older adults. Therefore, we aimed to investigate whether oral RTB101 upregulated IFN-induced antiviral responses and decreased the incidence of viral RTIs when given once daily for 16 weeks during winter cold and flu season. Read More

Indian J Pharmacol 2021 Jan-Feb;53(1):60-62

Department of Cardiology, Faculty of Medicine, Lokman Hekim University, Ankara, Turkey.

Intravenous amiodarone treatment may cause hepatic toxicity. N-acetylcysteine (NAC) is a powerful antioxidant, reduces the level of free radicals by increasing glutathione levels, and is used in acetaminophen intoxication. An 83-year-old female Caucasian patient who had congestive heart failure and implantable cardioverter-defibrillator was admitted to the hospital with palpitations and confusion. Read More

BMJ Case Rep 2021 May 11;14(5). Epub 2021 May 11.

Internal Medicine, Albany Medical Center, Albany, New York, USA.

Hydralazine is a common arterial vasodilator used in the management of congestive heart failure and hypertension. It can be associated with drug-induced lupus and less commonly antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). Drug-induced AAV typically has a favourable long-term prognosis. Read More

Acta Cardiol 2021 May 11:1-2. Epub 2021 May 11.

Department of Imaging and Pathology, KU Leuven - University of Leuven, Leuven, Belgium.

Clin Infect Dis 2021 May 11. Epub 2021 May 11.

Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines Jr. Veterans Affairs Hospital, Hines, IL,USA.

Introduction: Carbapenem-resistant Enterobacterales (CRE) cause approximately 13,100 infections with 8% mortality in the United States annually. The subset of carbapenemase-producing CRE (CP-CRE) infections have much higher mortality rates (40% -50%). There has been little research on characteristics unique to CP-CRE. Read More

Cureus 2021 Apr 7;13(4):e14344. Epub 2021 Apr 7.

Medicine, Mercy Health St. Vincent Medical Center, Toledo, USA.

Introduction In recent decades, transcatheter aortic valve implantation (TAVI) has become a treatment of choice for aortic stenosis. The purpose of this study was to evaluate predictors of mortality in patients undergoing TAVI. Methods The National Inpatient Sample database from the year 2011 to 2018 was used to identify all patients undergoing TAVI during the study period. Read More

Otolaryngol Head Neck Surg 2021 May 11:1945998211010443. Epub 2021 May 11.

Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA.

Objectives: To evaluate the impact of preoperative frailty on short-term outcomes following complex head and neck surgeries (HNSs).

Study Design: Cross-sectional database analysis.

Setting: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Read More

Am J Hematol 2021 May 10. Epub 2021 May 10.

Division of Hematology, Mayo Clinic, Rochester, MN, USA.

The development of cardiovascular disease (CVD) in long-term survivors of lymphoma is of increasing importance. Here, we characterize the cumulative incidence and risk factors for CVD in lymphoma patients diagnosed in the current treatment era. From 2002-2015, newly diagnosed lymphoma patients (>18 years) were enrollment into a prospective cohort study that captured incident CVD, consisting of congestive heart failure (CHF), acute coronary syndrome (ACS), valvular heart disease (VHD), and arrhythmia. Read More

Surg Case Rep 2021 May 10;7(1):115. Epub 2021 May 10.

Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.

Background: The Fontan procedure (FP) is a palliative surgery for functional single ventricle. The Fontan circulation maintains pulmonary circulation by a high central venous pressure, leading to chronic congestive liver. The number of patients diagnosed with hepatocellular carcinoma (HCC) arising from liver fibrosis and cirrhosis after FP is increasing. Read More

Autops Case Rep 2021 Apr 15;11:e2021265. Epub 2021 Apr 15.

Post Graduate Institute of Medical Education & Research (PGIMER), Departments of Histopathology, Chandigarh, India.

Aortopulmonary window (APW) is a rare congenital heart defect with abnormal communication between the ascending aorta and the pulmonary trunk with two separate semilunar valves. We present an autopsy case report wherein a young primigravida woman presented with progressive breathlessness and central cyanosis at 21 weeks of gestation. Echocardiography performed in the emergency room revealed elevated right-sided cardiac pressures suggestive of severe pulmonary hypertension; however, no structural cardiac defect was discernible. Read More

Indian J Thorac Cardiovasc Surg 2021 May 8;37(3):295-298. Epub 2021 Jan 8.

Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, WA 6009 Australia.

Iatrogenic cardiac injury is a catastrophic event and its management should be emergent. Cardiac surgeons need to be aware of basics related to the catheter-based intervention techniques and their outcomes. This mini-review discusses cardiac perforations and role of surgical team during catheter-based interventions. Read More

Int J Cardiol 2021 May 6. Epub 2021 May 6.

Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America. Electronic address:

Background: Prolonged monitoring of cardiac rhythm has been used to screen for subclinical atrial fibrillation (AF); little is known about other arrhythmias in the general population, especially in the elderly, who are at higher risk of arrhythmias.

Methods: We evaluated the frequency of arrhythmias in the tri-ethnic (white, Black, Hispanic), community-based Subclinical Atrial Fibrillation and Risk of Ischemic Stroke (SAFARIS) study using a patch-based recorder for up to 14 days in 527 participants free of AF, congestive heart failure (CHF) or history of stroke. Differences according to gender, age, ethnicity and presence of hypertension, diabetes and pertinent ECG and echocardiographic variables were examined. Read More

BMC Pulm Med 2021 May 8;21(1):154. Epub 2021 May 8.

Olive View-UCLA Medical Center, Los Angeles, CA, USA.

Background: Lefamulin, a first-in-class pleuromutilin antibiotic approved for intravenous and oral use in adults with community-acquired bacterial pneumonia (CABP), was noninferior to moxifloxacin in the Lefamulin Evaluation Against Pneumonia (LEAP) 1 intravenous-to-oral switch study and the LEAP 2 oral-only study. Using pooled LEAP 1/2 data, we examined lefamulin efficacy/safety overall and within subgroups of patients presenting with comorbidities typical in CABP management.

Methods: In LEAP 1, adults with CABP were randomized to receive intravenous lefamulin (150 mg every 12 h) for 5‒7 days or moxifloxacin (400 mg every 24 h) for 7 days, with optional intravenous-to-oral switch if predefined improvement criteria were met. Read More

PLoS One 2021 7;16(5):e0250531. Epub 2021 May 7.

Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Background: Tuberculosis (TB) presents a global threat in the world and the lung is the frequent site of metastatic focus. A previous study demonstrated that TB might increase primary lung cancer risk by two-fold for more than 20 years after the TB diagnosis. However, no large-scale study has evaluated the risk of TB and secondary lung cancer. Read More

Sleep Breath 2021 May 7. Epub 2021 May 7.

Sleep Disorders Center, Division of Pulmonary and Critical Care, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Purpose: Central sleep apnea (CSA) syndrome commonly occurs with other medical conditions such as congestive heart failure, opiate use, and brainstem disorders. Various treatment modalities have been used with varied effectiveness in an attempt to improve ventilation and reduce the apnea-hypopnea index (AHI) in patients with CSA. This study evaluated whether or not a bilevel positive airway pressure mode of noninvasive ventilation, average volume-assured pressure support (AVAPS) is effective in treating CSA. Read More

Sleep Breath 2021 May 6. Epub 2021 May 6.

Department of Epidemiology and Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, 101 Longmian Road, Nanjing, 211166, China.

Objectives: To examine the associations between four sleep behaviors and the risk of healthspan termination.

Methods: This study included 323,373 participants, free of terminated healthspan at baseline, from the UK-Biobank (UKB). We applied multivariable-adjusted Cox regression models to estimate the risk of terminated healthspan based on four sleep behaviors (insomnia/sleeplessness, napping, daytime sleepiness, and difficulty getting up from bed), which were self-reported and measured on Likert scales from "usually" to "never/rarely" experiences. Read More

JBJS Rev 2021 05 6;9(5). Epub 2021 May 6.

Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Background: Orthopaedic surgical procedures are increasingly being performed in outpatient settings. The drive for cost reduction without compromising patient safety and outcomes has increased interest in outpatient total shoulder arthroplasty (TSA). The primary aim of this study was to perform a review of the evidence regarding the outcomes and cost-effectiveness of outpatient TSA. Read More

Case Rep Rheumatol 2021 13;2021:6629405. Epub 2021 Apr 13.

Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Diagnosing infantile Kawasaki disease with atypical symptoms is difficult, and it also has higher risk of coronary abnormalities which is one of the most common complications of KD. Other complications such as pericardial effusion, mitral insufficiency, congestive heart failure, myocardial systolic dysfunction, and systemic vasculitis were also reported. Peripheral gangrene and necrosis are among the rare complications of this systemic vasculitis. Read More

BMJ Open 2021 May 5;11(5):e042779. Epub 2021 May 5.

HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland

Objective: Ambulatory care sensitive (ACS) conditions are those for which intensified primary care management could potentially prevent emergency admissions. This study aimed to quantify geographical variation in emergency admissions with ACS conditions in older adults and explore factors influencing variation.

Design: Repeated cross-sectional study. Read More

Medicine (Baltimore) 2021 May;100(18):e25701

Department of Neurology, University of Missouri Health Care, Missouri.

Rationale: Myasthenia gravis (MG) patients are at increased risk of COVID-19 infection and its complications due to chronic immunosuppression. COVID-19 infection can also increase the risk of myasthenia exacerbation.

Patient Concerns: The patient presented with respiratory distress, fever and chills and was diagnosed with COVID-19 pneumonia. Read More

Eur Heart J Acute Cardiovasc Care 2021 May 5. Epub 2021 May 5.

Department of Cardiovascular Medicine, Kaufman Center for Heart Failure Treatment and Recovery, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195, USA.