IMPELLA VERSUS EXTRACORPOREAL MEMBRANE OXYGENATION IN CARDIOGENIC SHOCK: A SYSTEMATIC REVIEW AND META-ANALYSIS.

Background: Cardiogenic shock (CS) carries high mortality. The roles of specific mechanical circulatory support (MCS) systems are unclear. We compared the clinical outcomes of Impella versus extracorporal membrane oxygenation (ECMO) in patients with CS.

Prospective validation and application of the Trauma-Specific Frailty Index: Results of an American Association for the Surgery of Trauma multi-institutional observational trial.

Background: The frailty index is a known predictor of adverse outcomes in geriatric patients. Trauma-Specific Frailty Index (TSFI) was created and validated at a single center to accurately identify frailty and reliably predict worse outcomes among geriatric trauma patients. This study aims to prospectively validate the TSFI in a multi-institutional cohort of geriatric trauma patients.

A Case of Pleural Tuberculosis vs Latent Tuberculosis Reactivation as a Result of COVID-19 Infection and Treatment.

The reactivation of latent tuberculosis occurs when a patient living with enters a state where the immune system is suppressed. Since early 2021, the standard of care has been to provide corticosteroids in patients with COVID-19 infection in hospitalized patients receiving supplemental oxygen or mechanical ventilation. The immunomodulatory effects of corticosteroids are potentially detrimental for patients with latent vs active tuberculosis, with concomitant SARS-CoV2 infection.

Two Case Reports of Patients With Transverse Myelitis as a Complication of SARS-CoV-2 Infection.

Transverse myelitis is a nontraumatic spinal cord injury that presents with sudden onset weakness, sensory deficits, and autonomic dysfunction. It can be caused by multiple etiologies including malignancy, autoimmune disorders, viral, bacterial, or fungal infections, and environmental factors. In this article, we describe cases of two elderly male patients affected by the SARS-CoV-2 virus.

A Unique Presentation of Pulmonary Vein Thrombosis in a Patient With Rapidly Progressive Metastatic Pelvic Myxofibrosarcoma.

Pulmonary vein thrombosis (PVT) is an uncommon but often lethal disease with non-specific manifestations. Herein, we present a case of an elderly woman with a past medical history significant for limited-stage pelvic myxofibrosarcoma (MFS), who was admitted with subacute weakness and worsening dyspnea. Over the course of hospitalization, CT angiography was performed, which demonstrated a filling defect in the inferior left pulmonary vein consistent with PVT, in addition to evidence of widespread metastatic disease.

Metastatic Rectal Adenocarcinoma in Familial Adenomatous Polyposis: A Case of Socioeconomic Factors Influencing Surveillance Endoscopy.

Familial adenomatous polyposis (FAP) is a rare syndrome caused by adenomatous polyposis coli () gene mutation resulting in the development of hundreds of adenomatous colorectal polyps. The disease process usually manifests fully by the second decade of life. Total colectomy or restorative proctocolectomy is often required to prevent the development of colorectal adenocarcinoma.

Epidemiologic and socioeconomic factors impacting hepatitis B virus and related hepatocellular carcinoma.

Chronic Hepatitis B is a highly prevalent disease worldwide and is estimated to cause more than 800000 annual deaths from complications such as cirrhosis and hepatocellular carcinoma (HCC). Although universal hepatitis B vaccination programs may have reduced the incidence and prevalence of chronic hepatitis B and related HCC, the disease still imposes a significant healthcare burden in many endemic regions such as Africa and the Asia-Pacific region. This is especially concerning given the global underdiagnosis of hepatitis B and the limited availability of vaccination, screening, and treatment in low-resource regions.

Intrathecal Methotrexate-Induced Aseptic Meningitis in a Patient with Acute Lymphoblastic Leukemia.

The central nervous system is often a site of spread for patients with acute lymphoblastic leukemia (ALL). ALL is often treated with ongoing intrathecal chemotherapy with the most common regimens including methotrexate and/or cytarabine. Uncommonly, intrathecal methotrexate has been associated with stroke-like symptoms.

Takayasu's Arteritis With Acute Severe Aortic Regurgitation Requiring a Bio-Bentall Procedure.

Aortitis is a rare form of vasculitis that is associated with significant morbidity and mortality through the development of aneurysms, aortic rupture, dissection, and thrombotic occlusions. Common causes for non-infectious large vessel vasculitis include Takayasu's arteritis and giant cell arteritis. Delayed diagnosis and treatment can be devastating, resulting in lifelong disability or death.

Neural Net Modeling of Checkpoint Inhibitor Related Myocarditis and Steroid Response.

Background: Serious but rare side effects associated with immunotherapy pose a difficult problem for regulators and practitioners. Immune checkpoint inhibitors (ICIs) have come into widespread use in oncology in recent years and are associated with rare cardiotoxicity, including potentially fatal myocarditis. To date, no comprehensive model of myocarditis progression and outcomes integrating time-series based laboratory and clinical signals has been constructed.

Cephalexin-Induced Leukocytoclastic Vasculitis.

Although allergies to antibiotics are commonly stated, allergies to cephalosporin antibiotics are uncommonly reported. Furthermore, dermatologic and systemic reactions from cephalosporin exposure involving end-organ damage are rare. We present a case of cephalexin, a cephalosporin, induced hypersensitivity vasculitis causing characteristic non-blanching purpuric lesions along with acute kidney failure necessitating hospitalization, corticosteroids, and initiation of hemodialysis.

The Impact of the Fascia Iliaca Block Beyond Perioperative Pain Control in Hip Fractures: A Retrospective Review.

Background: Geriatric hip fractures are common injuries that are associated with high morbidity and mortality. Adequate pain control remains a challenge as the altered physiology in elderly patients makes use of traditional analgesics challenging. The use of regional anesthetics, specifically the fascia iliaca compartment block (FICB), in the perioperative period has been shown to decrease opioid use in this population.

Comparative risk of pulmonary adverse events with transfusion of pathogen reduced and conventional platelet components.

Background: Platelet transfusion carries risk of transfusion-transmitted infection (TTI). Pathogen reduction of platelet components (PRPC) is designed to reduce TTI. Pulmonary adverse events (AEs), including transfusion-related acute lung injury and acute respiratory distress syndrome (ARDS) occur with platelet transfusion.

Invasive Management of Vertebrobasilar Artery Stenosis and Occlusion: A Meta-Analysis on Efficacy and Safety Endpoints.

Vertebrobasilar angioplasty and stenting or mechanical thrombectomy (MT) using a stent retriever or suction thrombectomy are effective interventions in managing acute ischemic stroke caused by vertebrobasilar artery occlusion (VBAO). This study aims to investigate the safety and efficacy of self-expanding stents and balloon angioplasty in managing ischemic stroke. We reviewed the literature for relevant clinical trials and included those reporting the following primary outcomes: successful recanalization, favorable clinical outcome, and stenosis degree change.

Injury Characteristics, Outcomes, and Health Care Services Use Associated With Nonfatal Injuries Sustained in Mass Shootings in the US, 2012-2019.

Importance: Civilian public mass shootings (CPMSs) in the US result in substantial injuries. However, the types and consequences of these injuries have not been systematically described.

Objective: To describe the injury characteristics, outcomes, and health care burden associated with nonfatal injuries sustained during CPMSs and to better understand the consequences to patients, hospitals, and society at large.

Outcomes With Left Ventricular Assist Device in End-Stage Renal Disease: A Systematic Review.

Renal dysfunction is a common comorbidity in patients with advanced heart failure who may benefit from mechanical circulatory support (MCS). Unfortunately, renal function may result after left ventricular assist device (LVAD) implantation. The purpose of this study is to examine the outcomes of advanced heart failure patients with end-stage renal disease (ESRD) requiring mechanical circulatory support as a bridge to transplant (BTT) or destination therapy (DT).

Comparative Assessment of the Long-Term Efficacy of Home-Based Versus Center-Based Cardiac Rehabilitation.

Cardiac rehabilitation programs support the health, wellness, and recovery of patients with cardiovascular conditions. This systematic review attempts to expand these findings while analyzing the latest randomized controlled trials (RCTs) focusing on the long-term advantages of home/center-based cardiac rehabilitation interventions. This study also comparatively analyzes the benefits of opting for home-based cardiac rehabilitation instead of center-based measures to improve the long-term clinical outcomes of cardiac patients.

Listeria Meningitis in a Patient With Plaque Psoriasis on Ustekinumab Therapy.

Listeria monocytogenes is a foodborne infection and is a leading cause of meningitis. The at-risk population includes patients over age 65, neonates, pregnant females, and patients with impaired cell immunity. Ustekinumab is a human monoclonal antibody that binds to and interferes with the proinflammatory cytokines, interleukin-12 (IL-12) and interleukin-23(IL-23).

Cost-Savings Analysis of an Individualized Exercise Oncology Program in Early-Stage Breast Cancer Survivors: A Randomized Clinical Control Trial.

Purpose: In an attempt to promote the integration of exercise oncology as a standard part of clinical practice, economic evaluations are warranted. Thus, the purpose of this study was to prospectively analyze cost savings of an individualized exercise oncology program when patients were randomly assigned.

Methods: For this open-label, randomized, prospective, comparative clinical trial, patients with early-stage breast cancer (stage I-II) were randomly assigned into two groups: the control group (CG, n = 120) and the exercise training group (EX, n = 123).

Prolonged Bacteremia With Abdominal Abscesses Secondary to Traumatic Injuries From Pet Dogs: A Case Report.

is a non-spore forming gram-positive rod considered to be normal flora of the oropharynx and gastrointestinal tract. Additionally, spp. are commonly used as probiotics and other commercial products.

PACS downtime drill: testing departmental workflow with an enterprise imaging viewer and archive.

In today's workflow, radiologists rely on the picture archiving and communication system (PACS) to view images. Unplanned downtime causes significant delays in patient care and lengthy downtimes can have lasting effects on patient care and end-user confidence. The purpose of this manuscript is to describe the planning and implementation of a disaster drill where the departmental PACS was taken off-line and the hospital enterprise viewer was used for departmental image interpretation.

Epidemiology and Trends in Survival of Systemic Sclerosis in Olmsted County (1980-2018): A Population-based Study.

Background/purpose: To update the epidemiology of systemic sclerosis (SSc) and evaluate the performance of the ACR/EULAR 2013 vs. 1980 ARA classification criteria in a U.S.

Anaphylaxis to Ciprofloxacin Requiring Emergent Surgical Cricothyrotomy.

Unlabelled: Although allergies to antibiotics are commonly stated, anaphylactic reactions are uncommonly reported. This is especially the case with reactions to fluoroquinolone antibiotics. Furthermore, airway emergencies are rare.

Sphingomonas paucimobilis bacteremia and tricuspid valve endocarditis in a patient with intravenous drug use.

is an aerobic, yellow-pigmented, glucose non-fermenting, gram negative bacillus that is a rare cause of human infection found mostly in the immunocompromised and also in intravenous (IV) drug users. We report a case of a 31-year-old female with current IV drug use, who presented with chest pain and was diagnosed with tricuspid valve endocarditis with bacteremia and pulmonary infarction of the right middle lobe. The patient initially presented with sharp right sided chest pain.