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Rare case report of anorectal malformation and intestinal atresia.

Int J Surg Case Rep 2021 Apr 30;82:105945. Epub 2021 Apr 30.

Division of Pediatric Surgery, Department of Surgery, Loma Linda University Medical Center, United States of America. Electronic address:

Introduction: Intestinal malformations, such as intestinal atresia, malrotation, and anorectal malformation, are rare events, but concurrent intestinal atresia and anorectal malformation are rare in combination. These anomalies have similar in utero and perinatal symptoms, which can make the diagnosis of both defects prenatally challenging.

Presentation Of Case: We present a case of a male infant with a prenatal diagnosis of truncus arteriosus who on a 32-week routine prenatal ultrasound was suspected to have an intestinal malformation. Read More

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Hypoxic acclimation improves cardiac redox homeostasis and protects heart against ischemia-reperfusion injury through upregulation of O-GlcNAcylation.

Redox Biol 2021 Apr 30;43:101994. Epub 2021 Apr 30.

Laboratory of Mitochondria and Metabolism, Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, China; Laboratory of Anesthesia and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China. Electronic address:

Ischemia-reperfusion (I/R) injury is detrimental to cardiovascular system. Alteration in glucose metabolism has been recognized as an important adaptive response under hypoxic conditions. However, the biological benefits underlying this metabolic phenotype remain to be elucidated. Read More

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EMS blood collection from patients with acute chest pain reduces emergency department length of stay.

Am J Emerg Med 2021 Apr 26;47:248-252. Epub 2021 Apr 26.

Department of Emergency Medicine, Wake Forest School of Medicine, USA.

Background: Expediting the measurement of serum troponin by leveraging EMS blood collection could reduce the diagnostic time for patients with acute chest pain and help address Emergency Department (ED) overcrowding. However, this practice has not been examined among an ED chest pain patient population in the United States.

Methods: A prospective observational cohort study of adults with non-traumatic chest pain without ST-segment elevation myocardial infarction was conducted in three EMS agencies between 12/2016-4/2018. Read More

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One year survival worse for lung retransplants relative to primary lung transplants.

Ann Thorac Surg 2021 May 5. Epub 2021 May 5.

Division of Cardiothoracic Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.

Background: Outcomes after lung re-transplantation (LRT) remain inferior compared to primary lung transplantation (PLT). We examined the impact of center volume on one-year survival after LRT.

Methods: Using the UNOS database, we abstracted patients undergoing PLT and LRT between January 2006 and December 2017, excluding combined heart-lung transplants and multiple re-transplants. Read More

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Applicability of the PAINESD risk score for 30-day mortality prediction post ventricular tachycardia catheter ablation in Chagas disease.

J Interv Card Electrophysiol 2021 May 8. Epub 2021 May 8.

Instituto do Coração FMUSP, São Paulo, Brazil.

Purpose: The PAINESD risk score was developed in 2015 as a tool to stratify the risk of acute hemodynamic decompensation during ventricular tachycardia (VT) ablation in structural heart disease patients and further then used for post procedure 30-day mortality prediction. The original cohort however did not include Chagas disease (ChD) patients. We aim to evaluate the relevance of the score in a ChD population. Read More

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Impact of bioprosthetic valve type on peri-procedural myocardial injury and mortality after transcatheter aortic valve replacement.

Heart Vessels 2021 May 7. Epub 2021 May 7.

DICATOV-Cardiothoracic and Vascular Department, San Martino Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy.

Peri-procedural myocardial injury (PPMI) is a common complication after transcatheter valve replacement (TAVR), often remaining clinically silent. The role of valve type on PPMI and the association between PPMI and mortality are still unclear. We sought to evaluate predictors and outcome of PPMI after TAVR, and the impact of self-expandable valve (SEV) vs. Read More

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Lowering cholesterol, blood pressure, or both to prevent cardiovascular events: results of 8.7 years of follow-up of Heart Outcomes Evaluation Prevention (HOPE)-3 study participants.

Eur Heart J 2021 May 8. Epub 2021 May 8.

The Population Health Research Institute, Hamilton Health Sciences, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.

Aims: Rosuvastatin (10 mg per day) compared with placebo reduced major adverse cardiovascular (CV) events by 24% in 12 705 participants at intermediate CV risk after 5.6 years. There was no benefit of blood pressure (BP) lowering treatment in the overall group, but a reduction in events in the third of participants with elevated systolic BP. Read More

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Impact of emergency medical service delays on time to reperfusion and mortality in STEMI.

Open Heart 2021 May;8(1)

School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

Objectives: To explore the relationship between emergency medical service (EMS) delay time, overall time to reperfusion and clinical outcome in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI).

Methods: This was a retrospective observational study of 2976 patients with STEMI who presented to EMS and underwent PPCI between January 2014 and December 2017. We performed multivariable logistic models to assess the relationship between EMS delay time and 30-day mortality and to identify factors associated with system delay time. Read More

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Palliative Care Services in Patients Admitted With Cardiogenic Shock in the United States: Frequency and Predictors of 30-Day Readmission.

J Card Fail 2021 May;27(5):560-567

Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California; Division of Cardiology, VA Greater Los Angeles Healthcare System, Los Angeles, California. Electronic address:

Background: Patients admitted with cardiogenic shock (CS) have high mortality rates, readmission rates, and healthcare costs. Palliative care services (PCS) may be underused, and the association with 30-day readmission and other predictive factors is unknown. We studied the frequency, etiologies, and predictors of 30-day readmission in CS admissions with and without PCS in the United States. Read More

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Premedication with pioglitazone prevents doxorubicin-induced left ventricular dysfunction in mice.

BMC Pharmacol Toxicol 2021 May 7;22(1):27. Epub 2021 May 7.

Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.

Background: Doxorubicin (DOX) is widely used as an effective chemotherapeutic agent for cancers; however, DOX induces cardiac toxicity, called DOX-induced cardiomyopathy. Although DOX-induced cardiomyopathy is known to be associated with a high cumulative dose of DOX, the mechanisms of its long-term effects have not been completely elucidated. Pioglitazone (Pio) is presently contraindicated in patients with symptomatic heart failure owing to the side effects. Read More

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Prognostic value of CT pulmonary angiography parameters in acute pulmonary embolism.

Radiol Med 2021 May 7. Epub 2021 May 7.

Department of Radiology, Santo Stefano Hospital, Prato, Italy.

Objectives: Computed tomographic pulmonary angiography (CTPA) is the first-line test in acute pulmonary embolism (APE) diagnostic algorithm, but its correlation with short-term outcome remains not clear at all. The aim is to determine whether CTPA findings can predict 30-day mortality of patients with APE in Emergency Department.

Methods: This retrospective monocentric study involved 780 patients with APE diagnosed at the Emergency Department of our institution (period 2010-2019). Read More

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The Role of B Cells in Regulation of Th Cell Differentiation in Coxsackievirus B3-Induced Acute Myocarditis.

Inflammation 2021 May 7. Epub 2021 May 7.

Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, People's Republic of China.

Viral myocarditis (VMC) is the major cause of sudden death in adolescents. To date, no effective treatment has been identified for VMC. Studies have shown that T helper (Th) cells such as Th1, Th2, Th17, and Th22 cells are involved in the pathogenesis of VMC. Read More

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Familial pseudohyperkalemia induces significantly higher levels of extracellular potassium in early storage of red cell concentrates without affecting other standard measures of quality: a case control and allele frequency study.

Transfusion 2021 May 7. Epub 2021 May 7.

Component Development Laboratory, NHS Blood and Transplant, Long Road, Cambridge Biomedical Campus, Cambridge, UK.

Background: Familial pseudohyperkalemia (FP) is characterised by an increased rate of potassium leakage in refrigerated red cells and is associated with the minor allele of the single nucleotide polymorphism rs148211042 (R723Q) in the ABCB6 gene. The study aims were to obtain the minor allele frequencies of ABCB6 variants and to measure supernatant potassium accumulation, and other red cell storage parameters, in red cell concentrates (RCC) from carriers of variant rs148211042 under standard blood bank conditions.

Study Design: Whole blood units were collected from 6 FP individuals and 11 controls and processed into RCC in additive solution. Read More

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The effect of peri-operative dexmedetomidine on the incidence of postoperative delirium in cardiac and non-cardiac surgical patients: a randomised, double-blind placebo-controlled trial.

Anaesthesia 2021 May 7. Epub 2021 May 7.

Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.

Delirium occurs commonly following major non-cardiac and cardiac surgery and is associated with: postoperative mortality; postoperative neurocognitive dysfunction; increased length of hospital stay; and major postoperative complications and morbidity. The aim of this study was to investigate the effect of peri-operative administration of dexmedetomidine on the incidence of postoperative delirium in non-cardiac and cardiac surgical patients. In this randomised, double-blind placebo-controlled trial we included 63 patients aged ≥ 60 years undergoing major open abdominal surgery or coronary artery bypass graft surgery with cardiopulmonary bypass. Read More

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Comorbidity Burden and Adverse Outcomes After Transcatheter Aortic Valve Replacement.

J Am Heart Assoc 2021 May 7:e018978. Epub 2021 May 7.

Division of Cardiology Tufts Medical Center Boston MA.

Background Transcatheter aortic valve replacement (TAVR) has become the preferred treatment for symptomatic patients with aortic stenosis and elevated procedural risk. Many deaths following TAVR are because of noncardiac causes and comorbid disease burden may be a major determinant of postprocedure outcomes. The prevalence of comorbid conditions and associations with outcomes after TAVR has not been studied. Read More

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Association of right ventricular dysfunction and pulmonary hypertension with adverse 30-day outcomes in COVID-19 patients.

Pulm Circ 2021 Apr-Jun;11(2):20458940211007040. Epub 2021 Apr 19.

Department of Cardiology, Heart and Vascular Institute, Maimonides Medical Center, Brooklyn, NY, USA.

Background: Cardiac manifestations in COVID-19 are multifactorial and are associated with increased mortality. The clinical utility and prognostic value of echocardiography in COVID-19 inpatients is not clearly defined. We aim to identify echocardiographic parameters that are associated with 30-day clinical outcomes secondary to COVID-19 hospitalization. Read More

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Anti-Interleukin-16-Neutralizing Antibody Attenuates Cardiac Inflammation and Protects against Cardiac Injury in Doxorubicin-Treated Mice.

Mediators Inflamm 2021 17;2021:6611085. Epub 2021 Apr 17.

Department of Cardiology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.

Background: Interleukin-16 (IL-16) is an important inflammatory regulator and has been shown to have a powerful effect on the regulation of the inflammatory response. Cardiac inflammation has been reported to be closely related to doxorubicin- (DOX-) induced cardiac injury. In this study, the role of IL-16 in DOX-induced cardiac injury and the possible mechanisms were examined. Read More

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Impact of an electronic medical record-based appointment order on outpatient cardiology follow-up after hospital discharge.

NPJ Digit Med 2021 May 6;4(1):77. Epub 2021 May 6.

Heart, Vascular and Thoracic Institute Center for Healthcare Delivery Innovation, Cleveland Clinic, Cleveland, OH, USA.

Outpatient follow-up after hospital discharge improves continuity of care and reduces readmissions, but rates of follow-up remain low. It is not known whether electronic medical record (EMR)-based tools improve follow-up. The aim of this study was to determine if an EMR-based order to secure cardiology follow-up appointments at hospital discharge would improve follow-up rates and hospital readmission rates. Read More

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Simultaneous acute myocardial infarction, stroke and critical limb ischaemia: an unusual presentation requiring multidisciplinary approach.

BMJ Case Rep 2021 May 6;14(5). Epub 2021 May 6.

Foundation Programme, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK

We report the case of a 57-year-old man who presented overnight to a district general hospital as a primary percutaneous coronary intervention alert for an inferior ST elevation myocardial infarction. On presentation to cardiac catheterisation lab, he had ongoing chest pain but began to complain of left-sided limb weakness and pain in his right leg. He was found to have dense hemiparesis on examination with an National Institute of Health Stroke Scale of 8 and an absent right femoral pulse. Read More

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Validation of the 2019 Expert Consensus Algorithm for the Management of Conduction Disturbances After TAVR.

JACC Cardiovasc Interv 2021 May;14(9):981-991

Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. Electronic address:

Objectives: The aim of this study was to validate the 2019 consensus algorithm in a large cohort of contemporary transcatheter aortic valve replacement (TAVR) patients.

Background: The optimal management of patients with atrioventricular conduction disturbances after TAVR is unknown. Guidance was consolidated in an expert consensus algorithm in 2019. Read More

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Preventing Coronary Obstruction During Transcatheter Aortic Valve Replacement: Results From the Multicenter International BASILICA Registry.

JACC Cardiovasc Interv 2021 May 6;14(9):941-948. Epub 2021 Mar 6.

Structural Heart and Valve Center, Emory University Hospital, Atlanta, Georgia, USA.

Objectives: This study sought to determine the safety of the BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction) procedure.

Background: Transcatheter aortic valve replacement causes coronary artery obstruction in 0.7% of cases, with 40% to 50% mortality. Read More

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Individualized Nutritional Support for Hospitalized Patients With Chronic Heart Failure.

J Am Coll Cardiol 2021 May;77(18):2307-2319

Medical University Department, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland; Medical Faculty of the University of Basel, Basel, Switzerland. Electronic address:

Background: Deterioration of nutritional status during hospitalization in patients with chronic heart failure increases mortality. Whether nutritional support during hospitalization reduces these risks, or on the contrary, may be harmful due to an increase in salt and fluid intake, remains unclear.

Objectives: The purpose of this trial was to study the effect of nutritional support on mortality in patients hospitalized with chronic heart failure who are at nutritional risk. Read More

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Permanent Pacemaker Implantation Following Valve-in-Valve Transcatheter Aortic Valve Replacement: VIVID Registry.

J Am Coll Cardiol 2021 May;77(18):2263-2273

Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.

Background: Permanent pacemaker implantation (PPI) remains one of the main drawbacks of transcatheter aortic valve replacement (TAVR), but scarce data exist on PPI after valve-in-valve (ViV) TAVR, particularly with the use of newer-generation transcatheter heart valves (THVs).

Objectives: The goal of this study was to determine the incidence, factors associated with, and clinical impact of PPI in a large series of ViV-TAVR procedures.

Methods: Data were obtained from the multicenter VIVID Registry and included the main baseline and procedural characteristics, in-hospital and late (median follow-up: 13 months [interquartile range: 3 to 41 months]) outcomes analyzed according to the need of periprocedural PPI. Read More

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Angiotensin-(1-7) oral formulation improves physical performance in mountain bike athletes: a double-blinded crossover study.

BMC Sports Sci Med Rehabil 2021 May 6;13(1):47. Epub 2021 May 6.

Postgraduate Program in Health and Nutrition/PPGSN, Federal University of Ouro Preto, Ouro Preto, Brazil.

Background: The ECA2/Ang-(1-7)/Mas axis is shown to be involved in effects mediated by physical exercise, as it can induce the release of nitric oxide (ON) and bradykinin (BK), which are potent vasodilators. The vasodilating action the NO/BK can contribute to increased metabolic efficiency in muscle tissue and central nervous system. The formulation HPβ-CD-Ang-(1-7) through its mechanisms of action can be a promising supplement to aid in the maintenance and improvement of performance and may also favor recovery during competitions. Read More

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Risk stratification of ST-segment elevation myocardial infarction (STEMI) patients using machine learning based on lipid profiles.

Lipids Health Dis 2021 May 6;20(1):48. Epub 2021 May 6.

Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, NO.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.

Background: Numerous studies have revealed the relationship between lipid expression and increased cardiovascular risk in ST-segment elevation myocardial infarction (STEMI) patients. Nevertheless, few investigations have focused on the risk stratification of STEMI patients using machine learning algorithms.

Methods: A total of 1355 STEMI patients who underwent percutaneous coronary intervention were enrolled in this study during 2015-2018. Read More

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A correlation between anaesthesia-related cardiac arrest outcomes and country human development index: A narrative review.

J Clin Anesth 2021 May 3;72:110273. Epub 2021 May 3.

Anaesthesia Cardiac Arrest and Mortality Study Commission, Department of Surgical Specialties and Anaesthesiology, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, SP, Brazil.

Studies have demonstrated gaps between developed and developing countries in the quality of surgical and anaesthesia care. The aim of this review was to provide a critical overview of documented outcomes from the 2010s of anaesthesia-related cardiac arrest events in countries with largely differing Human Development Indexes (HDIs). The HDI ranges from 0 to 1, representing the lowest and highest levels of development, respectively. Read More

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Outpatient Total Shoulder Arthroplasty: A Systematic Review Evaluating Outcomes and Cost-Effectiveness.

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

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Autonomic cardiogastric neural interaction after pulmonary vein isolation in patients with atrial fibrillation.

J Interv Card Electrophysiol 2021 May 6. Epub 2021 May 6.

Department of Cardiovascular Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.

Purpose: Clinical significance of reduced vagal activity following pulmonary vein isolation (PVI) for atrial fibrillation (AF) remains unclear. Periesophageal vagal nerve injury following PVI may be a powerful contributing factor of decreased vagal tone.

Methods: Drug-refractory 51 AF patients (31 males, 64 ± 11 years), who underwent successful PVI, were enrolled. Read More

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Gender Differences and Mortality Trends After Transcatheter Aortic Valve Implantation: A 10-Year Analysis From a Single Tertiary Center.

J Invasive Cardiol 2021 May 6. Epub 2021 May 6.

Division of Interventional Cardiology of MedStar, Cardiovascular Research Network at MedStar Washington Hospital Center, 110 Irving Street, Suite 4B-1, Washington, D.C., 20010.

Aim: To evaluate gender differences and mortality trends in a population undergoing transcatheter aortic valve implantation (TAVI) and to analyze the correlates to all-cause mortality at follow-up.

Methods: The study comprises a prospective cohort of 592 TAVI patients (53.4% female) treated between 2008 and 2018. Read More

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Social Determinants of Adherence to COVID-19 Risk Mitigation Measures Among Adults with Cardiovascular Disease.

Circ Cardiovasc Qual Outcomes 2021 May 6. Epub 2021 May 6.

Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX; Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX; Department of Cardiology, DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX.

: Social determinants of health (SDOH) may limit the practice of COVID-19 risk mitigation guidelines with health implications for individuals with underlying cardiovascular disease (CVD). Population-based evidence of the association between SDOH and practicing such mitigation strategies in adults with CVD is lacking. We used the National Opinion Research Center's COVID-19 Household Impact Survey conducted between April and June 2020 to evaluate sociodemographic disparities in adherence to COVID-19 risk mitigation measures in a sample of respondents with underlying CVD representing 18 geographic areas of the United States (US). Read More

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