Bicuspid Aortic Valve Endocarditis and Q Fever.

Background: Patients with bicuspid aortic valves (BAVs) are at increased risk of infective endocarditis. Coxiella burnetii is a rare cause of culture-negative infective endocarditis.

Case Summary: A young male with BAV presented with 3 months of fevers and abdominal distension.

Cardiac Metastasis of Pulmonary Spindle Cell Carcinoma Mimicking Lateral ST-Segment Elevation Myocardial Infarction.

Background: Cardiac metastasis of malignant tumors is rare but can mimic myocardial infarction (MI). We review a case of myopericardial metastasis presenting as ST-segment elevation MI (STEMI) and the clinical characteristics of cardiac injury from malignant metastasis.

Case Summary: A 78-year-old woman with a history of breast cancer and recently diagnosed pulmonary spindle cell carcinoma presented with progressive tongue pain related to metastasis.

Acute Systemic Sclerosis-Associated Cardiomyopathy That Improved With Glucocorticoids and Cyclophosphamide.

Background: Systemic sclerosis (SSc) cardiomyopathy has a prevalence of 7 to 39% and is associated with increased mortality. Despite this, little evidence informs SSc cardiomyopathy treatment.

Case Summary: We present a patient with diffuse cutaneous SSc with acute heart failure.

Moving the Paradigm Forward for Prediction and Risk-Based Primary Prevention of Heart Failure in Special Populations.

Purpose Of Review: Heart failure (HF) treatment paradigms increasingly recognize the importance of primary prevention. This review explores factors that enhance HF risk, summarizes evidence supporting the pharmacologic primary prevention of HF, and notes barriers to the implementation of primary prevention of HF with a focus on female and sexual and gender minority patients.

Recent Findings: HF has pathophysiologic sex-specific distinctions, suggesting that sex-specific preventive strategies may be beneficial.

Characterization of Ciprofloxacin Resistance Levels: Implications for Ototopical Therapy.

Hypothesis: Ciprofloxacin-resistant pathogens are inhibited by high concentrations of ciprofloxacin found in commercially-available ototopical solutions.

Background: Ciprofloxacin-resistant pathogens in otitis media are currently treated with ototopical ciprofloxacin suspensions. This is done irrespective of laboratory-reported ciprofloxacin susceptibility, under the assumption that the high concentration of ciprofloxacin applied topically is sufficient to overcome antimicrobial resistance.

Prediction of Atypical Ductal Hyperplasia Upgrades Through a Machine Learning Approach to Reduce Unnecessary Surgical Excisions.

Purpose: Surgical excision is currently recommended for all occurrences of atypical ductal hyperplasia (ADH) found on core needle biopsies for malignancy diagnoses and treatment of lesions. The excision of all ADH lesions may lead to overtreatment, which results in invasive surgeries for benign lesions in many women. A machine learning method to predict ADH upgrade may help clinicians and patients decide whether combined active surveillance and hormonal therapy is a reasonable alternative to surgical excision.

Patient and Procedural Factors Associated With Increased Islet Cell Yield in Total Pancreatectomy With Islet Autotransplantation.

Objectives: Total pancreatectomy with islet autotransplantation (TPIAT) offers symptom relief to highly selected patients with recurrent acute and/or chronic pancreatitis. However, with variable clinical response, it is important to refine islet manipulation technique and patient selection criteria. This study explores the variables associated with high islet cell yield, a driver of success in TPIAT.

Cell cycle-dependent adaptor complex for ClpXP-mediated proteolysis directly integrates phosphorylation and second messenger signals.

The cell-division cycle of Caulobacter crescentus depends on periodic activation and deactivation of the essential response regulator CtrA. Although CtrA is critical for transcription during some parts of the cell cycle, its activity must be eliminated before chromosome replication because CtrA also blocks the initiation of DNA replication. CtrA activity is down-regulated both by dephosphorylation and by proteolysis, mediated by the ubiquitous ATP-dependent protease ClpXP.