Mucorales Endocarditis: A Case Series and Review of the Literature.

Mucorales endocarditis is an extremely rare and devastating disease, with few cases reported in the literature. The infection is predominantly found in immunocompromised patients, although a few cases involving immunocompetent individuals have been reported. We reviewed all cases of mucor endocarditis reported to date with a focus on demographics, clinical presentations, and the range of predisposing conditions, including immunosuppressive states, recent surgery, and cardiac device implantation.

Early initiation of SGLT2 inhibitors in acute myocardial infarction and cardiovascular outcomes, an updated systematic review and meta-analysis.

Background: Sodium-glucose cotransporter-2 (SGLT2) inhibitors increase survival rate in heart failure, but early initiation of these agents after acute myocardial infarction (MI) is controversial.

Methods: We searched PubMed, Scopus, Embase, and ClinicalTrial.gov for randomized clinical trials (RCTs) and propensity score matched (PSM) cohort studies up to September 29,2024.

Zilebesiran: A Novel RNA Interference Therapeutic for Hypertension.

Hypertension remains a leading modifiable risk factor for cardiovascular morbidity and mortality, yet blood pressure control rates are suboptimal, partly due to adherence challenges with daily medications. Zilebesiran is an investigational small interfering RNA therapy targeting hepatic angiotensinogen synthesis to achieve prolonged suppression of the renin-angiotensin-aldosterone system. By conjugating the small interfering RNA to N-acetylgalactosamine, zilebesiran is delivered specifically to hepatocytes, leading to >90% reductions in circulating angiotensinogen and consequently lower angiotensin II levels.

Evaluation of Enhanced External Counter Pulsation (EECP) as an Alternative Treatment Modality for Hypertension: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis evaluate the efficacy of enhanced external counterpulsation (EECP) in reducing blood pressure among hypertensive patients. From an initial 323 articles, 37 studies involving 1504 patients met the inclusion criteria, with 11 included in the meta-analysis. EECP therapy durations ranged from 0.

Advances in the management of obstructive hypertrophic cardiomyopathy: The role of mavacamten.

Introduction: Hypertrophic cardiomyopathy (HCM) is a common inherited cardiovascular disorder characterized by asymmetric left ventricular hypertrophy and increased risk of sudden cardiac death. While current treatments like beta-blockers, calcium channel blockers, and invasive procedures provide symptom relief, they do not prevent disease progression. Mavacamten, a first-in-class cardiac myosin inhibitor, offers a promising alternative by directly targeting the underlying cause of left ventricular outflow tract (LVOT) obstruction in obstructive HCM.

Maternal and neonatal outcomes after delayed vs early cord clamping at cesarean delivery: a systematic review and meta-analysis.

Objective: This study aimed to systematically review maternal and neonatal outcomes after delayed cord clamping compared with early cord clamping at the time of cesarean delivery.

Data Sources: MEDLINE, Embase, and ClinicalTrials.gov were searched from inception through October 5, 2023.

Advancing heart failure management: a comprehensive review of current and emerging therapies for heart failure with preserved ejection failure.

Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome characterized by diastolic dysfunction and high morbidity. It presents significant challenges in diagnosis and treatment due to its heterogeneous etiology and pathophysiology. This review evaluates the efficacy and clinical utility of current and emerging pharmacological therapies for HFpEF, emphasizing personalized approaches to improve patient outcomes.

Predictive Accuracy of 24-Hour Ambulatory Blood Pressure Monitoring Clinic Blood Pressure for Cardiovascular and All-Cause Mortality: A Systematic Review and Meta-Analysis.

Introduction: According to current clinical practice guidelines, Ambulatory Blood Pressure Measurement (ABPM) is recommended to confirm diagnoses of hypertension. It remains unclear as to which method is superior in predicting mortality outcomes.

Methods: Prospective observational studies, comparing ABPM with Clinical Blood Pressure Measurements (CBPM), were included with outcomes of the study being all-cause and cardiovascular mortality.

Sickle Cell Trait and Vascular Health: Insights into Complications and Management.

Sickle cell trait was once considered to benign hereditary condition, besides the association of renal medullary carcinoma, affecting red blood cells. The inherited disorder creates several health issues under various conditions, such as dehydration, hypoxia, or extreme physical exertion. Healthcare professionals and patients with the disorder should understand the importance of vascular complications in sickle cell traits.

Right Ventricular Myocardial Infarction: Pathophysiology, Diagnosis, and Therapeutic Approaches.

Right ventricular myocardial infarction (RVMI) is a significant and distinct form of acute myocardial infarction associated with considerable morbidity and mortality. It occurs most commonly due to proximal right coronary artery obstruction, often in conjunction with inferior myocardial infarction. RVMI poses unique diagnostic and therapeutic challenges due to the anatomical and functional differences between the right and left ventricles.

Construction and characterization of chimeric FcγR T cells for universal T cell therapy.

Background: Several approaches are being explored for engineering off-the-shelf chimeric antigen receptor (CAR) T cells. In this study, we engineered chimeric Fcγ receptor (FcγR) T cells and tested their potential as a versatile platform for universal T cell therapy.

Methods: Chimeric FcγR (CFR) constructs were generated using three distinct forms of FcγR, namely CD16A, CD32A, and CD64.

Cardiorenal outcomes associated with sodium-glucose co-transporter-2 inhibitors in chronic kidney disease stage 5 (CKD V): A propensity score-matched analysis.

Background: There remains a paucity of data regarding the cardio-renal benefits of sodium-glucose co-transporter-2 inhibitors (SGLT2i) in patients with chronic kidney disease stage 5 (CKD V) based on major clinical trials.

Objective: This retrospective study aimed to identify potential cardiovascular and renal outcomes associated with SGLT2i use in CKD V patients.

Methods: We queried the TriNetX Global collaborative network from Jan 2014 - Aug 2023 for patients ≥18 years diagnosed with CKD V but not on dialysis.

Extracorporeal Membrane Oxygenation (VA-ECMO) in Management of Cardiogenic Shock.

Cardiogenic shock is a critical condition of low cardiac output resulting in insufficient systemic perfusion and end-organ dysfunction. Though significant advances have been achieved in reperfusion therapy and mechanical circulatory support, cardiogenic shock continues to be a life-threatening condition associated with a high rate of complications and excessively high patient mortality, reported to be between 35% and 50%. Extracorporeal membrane oxygenation can provide full cardiopulmonary support, has been increasingly used in the last two decades, and can be used to restore systemic end-organ hypoperfusion.

ACR-ARS Practice Parameter on Informed Consent Radiation Oncology.

Objectives: Consent is a communication process between the patient and a health care provider, in which both parties have the opportunity to ask questions and exchange information relevant to the patient's diagnosis and treatment. The process of informed consent is designed to protect a patient's autonomy in their medical decision-making in the context of an asymmetric relationship with the health care system. A proper consent process assures a patient's individual autonomy, reduces the opportunity for abusive conduct or conflicts of interest, and raises trust levels among participants.

CAR T cell therapy for T cell leukemia and lymphoma: latest updates from 2022 ASH Annual Meeting.

Due to the concern of fratricide, clinical development of CAR T cells for the therapy of T cell malignancies lags behind that for B cell malignancies. Attempts are being made to revise T cell biomarkers so that the re-engineered CAR T cells can target T cell malignancies. CD3 and CD7 are the two pan-T cell surface biomarkers that have been either knocked out or knocked down through genome base- editing technology or by protein expression blockers so that the re-engineered T cells can target T cells without fratricide.

Postural Tachycardia Syndrome and COVID-19: Focus on Ivabradine Therapy.

In this article we discuss the association of postural orthostatic tachycardia syndrome (POTS) with coronavirus-19 (COVID-19), ivabradine's unique mechanism of action, and its use in POTS patients. We highlight the pathophysiology and common etiologies of POTS, including preceding viral infections, vaccines, trauma, surgeries, and other stressors. COVID-19, a viral illness, has been associated with POTS through a variety of mechanisms that are not yet well understood.

Healthcare Benefits of Preoperative Tamsulosin in Patients Before Ureteroscopy.

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Novel agents and regimens for hematological malignancies: recent updates from 2020 ASH annual meeting.

Antibodies and chimeric antigen receptor-engineered T cells (CAR-T) are increasingly used for cancer immunotherapy. Small molecule inhibitors targeting cellular oncoproteins and enzymes such as BCR-ABL, JAK2, Bruton tyrosine kinase, FLT3, BCL-2, IDH1, IDH2, are biomarker-driven chemotherapy-free agents approved for several major hematological malignancies. LOXO-305, asciminib, "off-the-shelf" universal CAR-T cells and BCMA-directed immunotherapeutics as well as data from clinical trials on many novel agents and regimens were updated at the 2020 American Society of Hematology (ASH) Annual Meeting.

Complex Abdominal Wall Reconstruction in Neutropenic Patients.

The aim of our study was to determine whether patients with neutropenia (absolute neutrophil count (ANC) ≤1,500 cells/µL) had higher rates of surgical site infection after elective abdominal wall reconstruction. This was a case series from a prospective complex abdominal wall reconstruction cohort describing the surgical outcomes of 4 neutropenic patients (ANC ≤1,500 cells/µL) within 48 hours of index operation. Median age was 55 years, 3 patients were female.

Part 1: Disease of the Heart and Liver: A Relationship That Cuts Both Ways.

The heart and the liver display multifaceted, complex interactions that can be divided into cardiac effects of liver disease, hepatic effects of heart disease, and disease processes affecting both organs. In part 1 of this 2 part series, we discuss how acute and chronic heart failure can have devastating effects on the liver, such as acute cardiogenic liver injury and congestive hepatopathy. On the other hand, primary liver disease, such as cirrhosis, can lead to a plethora of cardiac insults representative in cirrhotic cardiomyopathy as systolic dysfunction, diastolic dysfunction, and electrophysiological disturbances.