Pathogenesis, Diagnosis, and Management of Chronic Thromboembolic Pulmonary Hypertension.

Chronic thromboembolic pulmonary hypertension (CTEPH) is thought to occur as a sequelae of thromboembolic processes in the pulmonary vasculature. The pathophysiology of CTEPH is multifactorial, including impaired fibrinolysis, endothelial dysregulation, and hypoxic adaptations. The diagnosis of CTEPH is typically delayed considering the nonspecific nature of the symptoms, lack of screening, and relatively low incidence.

Known Unknowns in the Contemporary Management of High-Risk Pulmonary Embolism: What Do the Guidelines Tell Us.

Pulmonary embolism (PE) is a life-threatening condition with increasing hospital admissions. Prompt identification and treatment of PE patients with hemodynamic collapse are essential. Conflicting recommendations and weak evidence hinder effective management of PE, resulting in unchanged mortality rates despite advancements in therapies.

Novel Risk Stratification and Hemodynamic Profiling in Acute Pulmonary Embolism: A Proposed Classification Inspired by Society for Cardiovascular Angiography and Intervention Shock Staging.

Treatment options for patients with acute pulmonary embolism (PE) and right ventricular shock (RVS) have grown exponentially. Therapy options include anticoagulation, systemic thrombolysis, catheter-based thrombolysis/ thrombectomy, and may include short-term mechanical circulatory support. However, the incidence of short-term morbidity and mortality has not changed despite the emergence of several advanced therapies in acute PE.

The Intersection of Pulmonary Vascular Disease and Hypoxia-Inducible Factors.

Hypoxia-inducible factors (HIFs) are a family of nuclear transcription factors that serve as the master regulator of the adaptive response to hypoxia. In the lung, HIFs orchestrate multiple inflammatory pathways and signaling. They have been reported to have a major role in the initiation and progression of acute lung injury, chronic obstructive pulmonary disease, pulmonary fibrosis, and pulmonary hypertension.

Relationship of fractional exhaled nitric oxide with blood eosinophilia in characterizing type-2 airway inflammation in treatment-naïve patients with chronic obstructive pulmonary disease.

Fractional exhaled nitric oxide (FeNO), a sensitive and reproducible, non-invasive biomarker for type-2 (T2) inflammation in asthma, remains underutilized in chronic obstructive pulmonary disease (COPD). We investigated the potential role of FeNO and its relationship with blood eosinophilia in characterizing T2 airway inflammation in COPD. A single-center prospective observational study was conducted in 75 treatment-naïve adult patients with stable COPD and 75 age-sex-matched controls.

Impact of disease location and laterality on hemodynamic response following pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension.

Background: In patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing pulmonary thromboendarterectomy (PTE), obstructive disease burden predicts positive hemodynamic responsiveness. However, the effect of disease location (upper, middle, or lower lobes) and lung laterality (right or left) has not been studied.

Objectives: Examine the effect of obstructive disease location and laterality on hemodynamic response following PTE.

Exosome-Mediated Strategies for Melanoma Eradication: A Comprehensive Review.

Introduction: Exosomes, which are vesicles that are naturally derived and contain a biomolecular payload, are promising vehicles for melanoma therapy because of their biocompatibility, targeting capabilities, and stability. This review emphasizes their capacity to circumvent the constraints of conventional treatments.

Methods: We carried out a comprehensive search of PubMed, ScienceDirect, and Google Scholar for peer-reviewed articles published between 2015 and 2024 utilizing terms such as "exosomes," "melanoma," and "chemotherapy.

Association between frailty, use of advanced therapies, in-hospital outcomes, and 30-day readmission in elderly patients admitted with acute pulmonary embolism.

Background: Frailty increases vulnerability to morbidity and mortality among elderly individuals, particularly those with acute pulmonary embolism (PE). Elderly patients, especially frail ones, remain underrepresented in studies evaluating advanced PE therapies, creating uncertainty regarding therapy utilization and outcomes.

Methods: Using the National Readmission Database (NRD), elderly patients (>75 years) admitted with acute PE between 2016 and 2020 were identified via ICD-10 codes.

Risk stratification using the SCAI SHOCK classification in patients with acute pulmonary embolism.

Background: Pulmonary embolism (PE) is a leading cause of cardiovascular mortality, with high-risk cases exhibiting significant heterogeneity in treatment and outcomes. Existing classification systems fail to differentiate PE patients requiring vasopressor support from those experiencing cardiac arrest. This study applies the Society for Cardiovascular Angiography and Interventions (SCAI) shock classification to stratify high-risk PE patients and assess mortality differences.

Propensity matched analysis of single access technique for Impella-assisted unprotected left main percutaneous coronary intervention.

Background: The single access for high-risk percutaneous coronary intervention (SHiPCI) technique is an intriguing alternative to traditional dual access Impella-assisted PCI, potentially reducing access-site complications. Current data is limited to retrospective case studies.

Objectives: To analyze procedural complications and clinical outcomes of SHiPCI.

Socioeconomic Disparities in the Care of for High-Risk Pulmonary Embolism in the United States, 2016 to 2020.

There are limited data on the impact of socioeconomic factors on the management and outcomes of high-risk acute pulmonary embolism (PE). Using the National Inpatient Sample (NIS) from 2016 to 2020, we identified adult (≥18 years) admissions with high-risk PE (defined as PE with one of: cardiogenic shock, vasopressor use, or cardiac arrest). Socioeconomic determinants included sex, race, insurance payer, and economic status.

Transforming Breast Cancer Therapy: The Pivotal Role of Nanoparticles.

Introduction: Globally, breast cancer (BC) affects a greater number of women than any other kind of cancer, and it is the second leading cause of death after lung cancer. The current standard of care for cancer treatment is the surgical excision of the malignant tumor followed by adjuvant therapy with chemotherapy or radiation. Regrettably, the side effects of radiation and chemotherapy frequently cause harm to healthy tissues and organs, hence limiting the effectiveness of these treatments in addressing BC.

Alzheimer's Disease and Polymeric Nanocarriers: Synergistic Advances in Targeted Drug Delivery.

Introduction: Alzheimer's disease (AD) is a prominent neurodegenerative ailment characterized by the constraints of conventional therapies stemming from insufficient medication transport to the brain. This review examines the function of polymeric nanocarriers (PNCs) in improving therapeutic efficacy for Alzheimer's disease treatment.

Methods: We analyze the principal obstacles to Alzheimer's disease drug delivery: the blood-brain barrier, the blood-cerebrospinal fluid barrier, and multidrug resistance proteins.

Exploring the Therapeutic Potential of Vesicular Nanocarrier Systems for Elimination of Skin Cancer.

Background: Skin cancer, a common malignancy worldwide, has increased incidence and mortality. Thus, it is a public health issue and a significant illness burden, which increases treatment costs. Chemotherapy and surgery are used to treat skin cancer.

Precision Therapy for Prostate Cancer: Advancements in Polymeric Nanocarrier Systems.

Introduction: Prostate cancer is a major worldwide health concern, and existing treatments often face challenges such as drug resistance, systemic toxicity, and insufficient targeting. Polymeric nanocarriers are currently employed as sophisticated tools in the field of oncology, offering the possibility to augment the administration and efficacy of anticancer therapies. In order to effectively eradicate prostate cancer, this review delves into the function of polymeric nanocarriers.

Hemodynamic Effects and Clinical Outcomes of Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation (LAVA-ECMO) in Cardiogenic Shock.

Left atrial veno-arterial extracorporeal membrane oxygenation (LAVA-ECMO) in cardiogenic shock (CS) is a novel mechanical cardiocirculatory support strategy that provides robust cardiocirculatory support and simultaneous left and right atrial venting by way of a multifenestrated transeptal catheter. We performed a single-center retrospective analysis of all patients aged ≥18 years with CS who underwent LAVA-ECMO at a quaternary care institution from 2018 to 2023. Clinical outcomes and prehemodynamics and posthemodynamics were evaluated.

National Trends for Temporary Mechanical Circulatory Support Utilization in Patients With Cardiogenic Shock From Decompensated Chronic Heart Failure: Incidence, Predictors, Outcomes, and Cost.

Background: Trends in temporary mechanical circulatory support (tMCS) use with associated outcomes and cost in cardiogenic shock secondary to decompensated chronic heart failure (HF-CS) remains poorly understood. We describe trends in tMCS use, associated outcomes, and cost in HF-CS.

Methods: We included adults enrolled in a national insurance claims dataset with HF-CS who received intra-aortic balloon pump (IABP), Impella, or extracorporeal membrane oxygenation (ECMO) without acute coronary syndrome, or postcardiotomy shock.

Clinical Outcomes of Percutaneous Coronary Intervention in Amyloidosis, Sarcoidosis, and Hemochromatosis.

Background: Infiltrative diseases (IDs), including amyloidosis, sarcoidosis, and hemochromatosis, are characterized by abnormal cellular infiltration in multiple organs, including the heart. The prognosis of percutaneous coronary intervention (PCI) patients with underlying IDs has not been well-studied. We evaluated the prevalence of IDs in patients undergoing PCI and their association with post-PCI outcomes.