Safety, Efficacy, and Effectiveness of Coronary Sinus Reducer Implantation in Refractory Angina: A Meta-Analysis.

Background: Previous coronary sinus reducer (CSR) meta-analyses in refractory angina (RA) focused on single-arm studies, capturing observed effectiveness-comprising the physical effect of CSR, contextual effects (eg, placebo), and non-treatment-related phenomena (eg, confounding). Efficacy evaluation requires comparative estimates from randomized controlled trials (RCTs), ideally double blind and placebo controlled, to isolate the physical effect.

Objectives: The aims of this study were to evaluate the safety and efficacy of CSR in RA and to compare its efficacy with observed effectiveness.

Cardiometabolic Dysregulation and Heart Failure.

Heart failure (HF) is a complex clinical syndrome resulting from impaired myocardial function or structure, affecting approximately 56 million patients worldwide. Cardiometabolic risk factors, including hypertension, insulin resistance, obesity, and dyslipidemia play a pivotal role in both the pathogenesis and progression of HF. These risk factors frequently coexist as part of cardiometabolic syndrome and contribute to widespread organ and vascular dysfunction, leading to conditions such as coronary artery disease, chronic kidney disease, type 2 diabetes mellitus, non-alcoholic fatty liver disease, and stroke.

Contemporary Considerations in the Evolution of Wearable Technology for Arrhythmia Detection.

Arrhythmias are an increasingly common cause of hospital admissions worldwide. Late detection of arrhythmias is associated with a significantly increased risk of cardiovascular complications. Early identification and management of life-threatening arrhythmias is paramount to reduce mortality.

Percutaneous approach for reducing outflow tract obstruction in hypertrophic obstructive cardiomyopathy.

Hypertrophic obstructive cardiomyopathy (HOCM) affects approximately 1 in 500 people globally. The condition results in hypertrophy of the interventricular septum and thickening of the left ventricular wall. Surgical management to resect the thickened myocardium or septal alcohol ablation are currently considered the mainstay treatment option for HOCM refractory to pharmacological therapy.

Gene Mutations in Cushing's Syndrome.

Background: Prolonged exposure to glucocorticoids can result in the development of Cushing's syndrome. Excess serum cortisol can occur due to several factors including exogenous steroids, pituitary and adrenal adenoma, and ectopic ACTH secretion.

Summary: The last 2 decades have seen significant progress in identifying new genetic and molecular mechanisms underlying hypercortisolemia.

Temporal trend analysis of rheumatic heart disease burden in high-income countries between 1990 and 2019.

Aims: To assesses trends in rheumatic heart disease (RHD) burden in high-income, European Union 15+ (EU15+) countries between 1990 and 2019.

Methods And Results: Cross-sectional analysis of the incidence and mortality of RHD was conducted using data from the Global Burden of Disease (GBD) Study database. Age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs) were extracted for EU15+ countries per sex for each of the years from 1990 to 2019, inclusive, and mortality-to-incidence indices (MII) were computed.

Trends in the incidence and mortality of infective endocarditis in high-income countries between 1990 and 2019.

Background: Infective endocarditis (IE) remains a life-threatening disease with high morbidity and mortality.

Objectives: To describe temporal trends in IE incidence, mortality and survival over the last 30 years.

Methods: Nineteen high-income countries (the 'EU 15+') were included.

Recent Updates and Technological Developments in Evaluating Cardiac Syncope in the Emergency Department.

Syncope is a commonly encountered problem in the emergency department (ED), accounting for approximately 3% of presenting complaints. Clinical assessment of syncope can be challenging due to the diverse range of conditions that can precipitate the symptom. Annual mortality for patients presenting with syncope ranges from 0-12%, and if the syncope is secondary to a cardiac cause, then this figure rises to 18-33%.

Catastrophic case of suppurative, embolic and fistulating infective endocarditis causing complete heart block.

Complete heart block, aortic root abscess and aortic valve regurgitation are well-recognized complications of infective endocarditis of the aortic valve. Splenic abscess and aorto-cavitary fistula are rarer phenomena and are indicative of calamitous infection. The authors present the case of an otherwise healthy 61-year-old man presenting with a 2-month history of non-specific symptoms, who developed suppurative endocarditis with a fistulating aortic root abscess, combined with severe sepsis, splenic embolization and complete heart block.

Current and Emerging Classes of Pharmacological Agents for the Management of Hypertension.

Cardiovascular disease accounts for more than 17 million deaths globally every year, of which complications of hypertension account for 9.4 million deaths worldwide. Early detection and management of hypertension can prevent costly interventions, including dialysis and cardiac surgery.

Diabetes, Heart Failure and Beyond: Elucidating the Cardioprotective Mechanisms of Sodium Glucose Cotransporter 2 (SGLT2) Inhibitors.

Approximately 5 million individuals in the US are living with congestive heart failure (CHF), with 650,000 new cases being diagnosed every year. CHF has a multifactorial etiology, ranging from coronary artery disease, hypertension, valvular abnormalities and diabetes mellitus. Currently, guidelines by the American College of Cardiology advocate the use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, β-blockers, diuretics, aldosterone antagonists, and inotropes for the medical management of heart failure.

Vasospasm induced myocardial ischaemia secondary to sumatriptan use.

Certain medications have been implicated in causing acute myocardial infarctions (AMI). Sumatriptan, a medication usually prescribed for acute migraine and cluster headaches has been documented as potentially causing coronary vasospasm, thereby leading to MI. This is usually seen in patients with strong risk factors for coronary artery disease (CAD) or in those with established CAD.

Training in Interventional Radiology: A Simulation-Based Approach.

Innovations in medical technology have revolutionised both medical and surgical practice. Indeed, with such innovations, training for specific specialties has become more advanced and streamlined. However, despite these novel approaches to train students and specialist trainees, training for interventional radiology (IR) is lagging.

Genes regulating the hypothalamic-pituitary- -gonadal axis and its impact on pubertal onset in mammals.

Puberty in mammals is defined as the development of fertility, which involves the maturation of secondary sex characteristics and reproductive organs. This phenomenon is controlled by the Hypothalamic-Pituitary-Gonadal (HPG) axis. However, the timing of puberty differs greatly among individuals, and it is thought that a combination of genetic and environmental factors governs its onset.

Role of AYUSH Therapies in Modern Medicine: A Qualitative Study to Explore the Awareness and Attitudes of Doctors Towards the Utilization of Alternate System of Medicine for Diabetes Mellitus.

Objective: To understand doctors' attitude to and awareness of AYUSH therapies for the treatment of diabetes mellitus (DM).

Methods: This qualitative study, using a usage-and-attitude survey, was conducted in secondary centers across Mumbai, India. The study surveyed 77 physicians, including those specializing in diabetes.

Evaluating the effectiveness of anti-Nogo treatment in spinal cord injuries.

As humans, we cannot regenerate axons within the central nervous system (CNS), therefore, making any damage to it permanent. This leads to the loss of sensory and motor function below the site of injury and can be crippling to a person's health. Spontaneous recovery can occur from plastic changes, but it is minimal.

Challenges In Widening Participation Outreach: Is Enough Being Done To Tackle The Under-Representation Of Low-Income Students In Medicine?

Widening Participation (WP) in medicine refers to all theory, activities and policy concerned with removing barriers to entering medical school for students from lower income and under-represented backgrounds. Medical schools and other institutions including; the Medical Schools Council, the Office for Fair Access, the Higher Education Funding Council for England, have been committed to improving Widening Participation for more than a decade. As senior medical students and academics, we have been actively involved with WP work at our respective medical schools and in conjunction with the British Medical Association (BMA) and the Medical Schools Council (MSC).

Current perspective on the role of insulin and glucagon in the pathogenesis and treatment of type 2 diabetes mellitus.

According to the World Health Organization, 422 million adults worldwide live with diabetes mellitus (DM), a significant portion of whom have type 2 diabetes. The discovery of insulin as a key regulator of glucose metabolism has revolutionized our understanding of DM and provided several therapeutic avenues. Most studies have so far predominantly focused on the role of insulin in type 2 diabetes.

What are the links between hypoxia and Alzheimer's disease?

Alzheimer's disease (AD) is the most common neurodegenerative disease. Histological characterization of amyloid plaques and neurofibrillary tangles in the brains of AD patients, alongside genetic studies in individuals suffering the familial form of the disease, has fueled the accumulation of the amyloid-β protein as the initial pathological trigger of disease. Association studies have recently showed that cerebral hypoxia, via both genetic and epigenetic mechanisms, increase amyloid-β deposition by altering expression levels of enzymes involved in the production/degradation of the protein.

Not Just a Medical Student: Delivering Medical Education Through a Short Video Series on Social Media.

"Not Just a Medical Student" is an innovative bite-size medical education video series founded and hosted on social media. Its primary aim is to inspire tomorrow's doctors to be creative while engaging and informing them with the latest innovations, technology, and conferences within various specialties. To our knowledge, these themes are scarcely covered in the structured medical curriculum.

Historical BCG vaccination combined with drug treatment enhances inhibition of mycobacterial growth ex vivo in human peripheral blood cells.

Tuberculosis (TB) is a leading infectious cause of death globally. Drug treatment and vaccination, in particular with Bacillus Calmette-Guérin (BCG), remain the main strategies to control TB. With the emergence of drug resistance, it has been proposed that a combination of TB vaccination with pharmacological treatment may provide a greater therapeutic value.

How the discovery of rituximab impacted the treatment of B-cell non-Hodgkin's lymphomas.

Non-Hodgkin's lymphoma (NHL) is the sixth-most common cancer in the UK, accounting for around 13,700 new cases every year. Until the late 1990s, treatment relied on intensive chemotherapy, such as CHOP (cyclophosphamide-doxorubicin HCl-vincristine [Oncovin]-prednisone). The use of standard CHOP therapy and its variations had resulted in poor five-year survival rates (as low as 26%), particularly in patients with aggressive NHL.