Temporary circulatory support for cardiogenic shock.

Purpose Of Review: Temporary circulatory support (TCS) devices play a crucial role in stabilizing patients with refractory cardiogenic shock. They provide essential hemodynamic support and serve as a bridge to recovery, decision-making, heart transplantation, or long-term mechanical circulatory support. However, despite their increasing use, recent trials challenge their impact on survival.

Characteristics of SARS-CoV-2-associated severe episodes of monoclonal gammopathy-associated capillary leak syndrome (Clarkson disease).

Background: Monoclonal gammopathy-associated capillary leak syndrome (MG-CLS) is a rare condition characterized by recurrent episodes of hypovolemic shock caused by a sudden increase in capillary permeability. The COVID-19 pandemic has been associated with a rise in MG-CLS episodes and increased mortality. We aimed to explore the association between MG-CLS and SARS-CoV-2 infection.

Does Levosimendan hasten veno-arterial ECMO weaning? A propensity score matching analysis.

Background: Preliminary evidence from small, single-center studies suggests levosimendan may improve the likelihood of successful venoarterial extracorporeal membrane oxygenation (VA-ECMO) weaning in patients with cardiogenic shock. However, the literature is limited and presents conflicting results. We aimed to assess the benefits of levosimendan on VA-ECMO for time to successful ECMO weaning, using a pragmatic and rigorous definition of successful VA-ECMO weaning in patients with potential for cardiac function recovery.

Anti-RNApol3-Associated myocarditis: an emerging disease linking autoimmunity and infection.

Background: Fulminant myocarditis (FM) is a severe condition primarily triggered by viruses. Anti-RNA polymerase III autoantibodies (RNApol3) which are typically found in patients with severe systemic sclerosis, have been reported in patients with influenza-related FM. Our objective is to provide additional insight into RNApol3-associated FM.

Fever following extracorporeal membrane oxygenation decannulation: Infection, thrombosis or just physiology?

Purpose: Fever is frequent after extracorporeal membrane oxygenation (ECMO) decannulation. We aimed to evaluate the incidence of post-decannulation fever and describe its causes.

Methods: Adult ECMO patients who were successfully weaned from ECMO were retrospectively included.

Risk of flare in patients with SLE in remission after hydroxychloroquine or chloroquine withdrawal.

Objective: Previous studies have provided evidence that the discontinuation of hydroxychloroquine (HCQ), and chloroquine (CQ), in patients with systemic lupus erythematosus (SLE) is associated with an increased risk of disease flares, with limited information on the level of disease activity at the time of HCQ/CQ discontinuation. Here we aimed to describe the risk of SLE flare after withdrawal of HCQ or CQ in patients with SLE in remission.

Methods: Case-control study (1:2) comparing the evolution of patients with SLE after HCQ/CQ withdrawal for antimalarial retinopathy (cases) with patients with SLE matched for sex, antimalarial treatment duration and age at SLE diagnosis, whose antimalarial treatment was continued throughout the entire follow-up period (controls).

Antiphospholipid Patients Admitted in the Intensive Care Unit: What Must The Rheumatologist Know?

Purpose Of The Review: Antiphospholipid syndrome (APS) is a rare systemic autoimmune disorder that can escalate into a 'thrombotic storm' called the catastrophic antiphospholipid syndrome (CAPS), frequently requiring ICU admission for multiple organ failure. This review aims to offer insight and recent evidence on critically-ill APS patients.

Recent Findings: The CAPS classification criteria define this condition as the involvement of at least three organs/systems/tissues within less than a week, caused by small vessel thrombosis, in patients with elevated antiphospholipid antibodies levels.

Identification of new risk factors for hydroxychloroquine and chloroquine retinopathy in systemic lupus erythematosus patients.

Background: Long-term hydroxychloroquine (HCQ) or chloroquine (CQ) intake causes retinal toxicity in 0.3-8 % of patients with rheumatic diseases. Numerous risk factors have been described, eg, daily dose by weight, treatment duration, chronic kidney disease, concurrent tamoxifen therapy and pre-existing retinal or macular disease.

Phenotypes in antiphospholipid syndrome: A hierarchical cluster analysis based on two independent databases.

Background: Antiphospholipid syndrome (APS) is a rare autoimmune disease characterized by thromboses at various sites and obstetric events associated with the persistent presence of antiphospholipid antibodies. The identification of clinical phenotypes in APS patients is a clinical need. In this study, we aimed to determine the clinical phenotypes of APS patients through an unsupervised analysis of two well-characterized cohorts of APS patients.

Prognostic value of hypermetabolic bone sarcoidosis observed by 18F-fluorodeoxyglucose positron emission tomography.

Objectives: Sarcoidosis is a multisystemic granulomatosis diagnosed mainly in young adults. 18F-fluorodeoxyglucose (18F-FDG) PET/CT is useful in sarcoidosis cases to search for a biopsiable site or assess disease activity.18F-FDG PET/CT can reveal bone hypermetabolism in sarcoidosis patients, even in the absence of osteoarticular symptoms.

One-Year Mental and Physical Health Assessment in Survivors after Extracorporeal Membrane Oxygenation for COVID-19-related Acute Respiratory Distress Syndrome.

Long-term outcomes of patients with coronavirus disease (COVID-19)-related acute respiratory distress syndrome treated with extracorporeal membrane oxygenation (ECMO) are unknown. To assess physical examination, pulmonary function tests, anxiety, depression, post-traumatic stress disorder and quality of life at 6 and 12 months after ECMO onset. Multicenter, prospective study in patients who received ECMO for COVID-19 acute respiratory distress syndrome from March to June 2020 and survived hospital discharge.

Lower disease activity but higher risk of severe COVID-19 and herpes zoster in patients with systemic lupus erythematosus with pre-existing autoantibodies neutralising IFN-α.

Objectives: Type-I interferons (IFNs-I) have potent antiviral effects. IFNs-I are also overproduced in patients with systemic lupus erythematosus (SLE). Autoantibodies (AAbs) neutralising IFN-α, IFN-β and/or IFN-ω subtypes are strong determinants of hypoxemic COVID-19 pneumonia, but their impact on inflammation remains unknown.