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2.
Clin Case Rep ; 12(5): e8905, 2024 May.
Article in English | MEDLINE | ID: mdl-38711841

ABSTRACT

This case demonstrated the complex pathophysiology of DRESS syndrome presenting with latent human herpes virus infection reactivation due to exposure to sulfasalazine and/or hydroxychloroquine. Patients who do not initially fulfill the diagnostic criteria on admission may evolve and eventually fulfill the criteria. Steroid dose tapering is required to prevent flaring.

5.
J Arrhythm ; 39(6): 992-996, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38045467

ABSTRACT

Background: We conducted a study to evaluate the risk of atrial fibrillation (AF) and atrial flutter (AFL) in periodontal disease (PD) patients. Methods: Cohort studies that evaluate the risk of AF or AFL in PD patients were included. The risk was expressed in the pooled odd ratio (OR) with 95% confidence interval (CI). Results: A total of four cohort studies were included. We found that patients with PD have a significantly higher risk of AF/AFL compared to those without PD with the pooled OR of 1.33 (95% CI 1.29-1.38; p = 0.357, I 2 = 3.0%). Conclusions: PD increases the risk of AF and AFL.

6.
Article in English | MEDLINE | ID: mdl-37868245

ABSTRACT

Acute respiratory distress syndrome (ARDS) is a life-threatening lung injury characterized by rapid onset of widespread inflammation in the lungs. Multiple risk factors, including pneumonia, non-pulmonary sepsis, aspiration of gastric contents or inhalation injury, have been reported, to cause ARDS. We present a case of a healthy young woman in her first trimester with vaping-induced lung injury who presented with spontaneous pneumothorax and acute respiratory distress syndrome with concomitant influenza A and rhinovirus infection followed by methicillin-resistant Staphylococcus aureus pneumonia.

7.
Article in English | MEDLINE | ID: mdl-37868676

ABSTRACT

Eosinophilia with pulmonary involvement is characterized by the presence of peripheral blood eosinophilia, typically >500 cells/mm3, nonspecific pulmonary symptoms, and radiographic evidence of pulmonary disease. Clinical, laboratory, and radiologic features can be overlapping in these diseases, thus, it is wise to approach eosinophilia with pulmonary involvement systematically to determine the diagnosis and provide definitive treatment for a better outcome. The authors present a case of idiopathic chronic eosinophilic pneumonia in a patient with a long history of chronic obstructive pulmonary disease (COPD) which was resolved by corticosteroid.

8.
Clin Case Rep ; 11(11): e8070, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37900717

ABSTRACT

Key Clinical Message: Pre-bariatric surgery dietary recommendations should take into account daily protein intake and other risk factors for kidney injury. This is important because a high protein intake can potentially lead to kidney injury. Abstract: Bariatric surgery has been shown to be a highly effective intervention for achieving weight loss and reducing obesity related-comorbidities. Acute kidney injury (AKI) is considered one of the common complications in perioperative and post-bariatric surgery. However, pre-bariatric surgery AKI has never been reported. Several studies demonstrated that pre-bariatric surgery weight loss improved surgical outcomes and decrease postoperative complications. Some diet regimens have been introduced including low-caloric diet (LCD), very-low caloric diet (VLCD), and very-low caloric ketogenic diet (VLCKD). We present a patient who develops AKI after 10 days of having a high-protein diet from a pre-bariatric weight loss strategy.

9.
Clin Case Rep ; 11(10): e7960, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37780929

ABSTRACT

Key Clinical Message: Immune thrombocytopenic purpura (ITP) is very challenging to diagnose with concurrent comorbidities affecting platelet count including PAH and autoimmune thyroid disease. ITP resolution can be achieved with tailored treatment of the underlying conditions to avoid adverse events. Abstract: Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by a platelet count of <100 × 109/L in the absence of other causes of thrombocytopenia. It is classified as primary or idiopathic and secondary due to various coexisting conditions, including autoimmune thyroid diseases. It is especially challenging when the patient has comorbidities that affect platelet count easily, leading to anchoring bias. The first-line treatment of ITP is corticosteroids, and it is also recommended to treat the primary causes of secondary ITP. Here, the authors report a case of secondary ITP in a patient with a recent diagnosis of Grave's disease and a history of idiopathic pulmonary hypertension with baseline chronic thrombocytopenia, possible mechanisms, and treatment strategies with a multidisciplinary approach.

10.
Clin Case Rep ; 11(10): e8002, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37808580

ABSTRACT

Key Clinical Message: In suspected cases of systemic vasculitis, imaging studies should include the pulmonary artery. This is a rare case of Takayasu arteritis with a large pulmonary aneurysm. Medical management is the first line and vascular intervention if fails prior. Abstract: Takayasu arteritis (TA) should be suspected in young women presented with hypertension, carotidynia, and claudications. Pulmonary artery involvement is frequent, occurring in 20%-50% of patients with TA. However, this case highlights the rare presentation of TA with a large pulmonary aneurysm and minimal aortic involvement. Medical management including immunosuppressive agents and biological therapies remains an important role, with vascular intervention remains as an option if medical therapy failed.

11.
Br J Cardiol ; 30(1): 5, 2023.
Article in English | MEDLINE | ID: mdl-37705836

ABSTRACT

Low high-density lipoprotein-cholesterol (HDL-C) concentration is among the strongest independent risk factors for cardiovascular disease, however, studies to assess the cardioprotective effect of normal or high HDL-C level are lacking. To determine the prognostic impact of initial serum HDL-C level on in-hospital major adverse cardiovascular and cerebrovascular events (MACCE) and the one-year all-cause mortality in patients presenting with ST-elevation myocardial infarction (STEMI) we performed a retrospective analysis of the data from 1,415 patients presenting with STEMI in a tertiary-care centre equipped with a 24-hour-ready catheterisation laboratory. The period from June 2014 to June 2017 was reviewed with a follow-up as regards one-year all-cause mortality. Patients were divided into two groups according to HDL-C level. HDL-C <40 mg/dL (2.22 mmol/L) was considered low, while HDL-C ≥40 mg/dL was considered normal. There were 1,109 patients with low HDL-C, while 306 had normal HDL-C levels, which was statistically significant (p<0.001). Total MACCE and all-cause mortality were significantly lower in patients with normal HDL-C (p=0.03 and p=0.01, respectively). In conclusion, this retrospective study to assess the prognostic effect of HDL-C in patients presenting with STEMI, found normal HDL-C level was associated with lower in-hospital MACCE and all-cause mortality at one-year follow-up.

13.
Clin Case Rep ; 11(7): e7642, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37469369

ABSTRACT

Membranous interventricular septal (MIVS) aneurysm is a rare often asymptomatic, accidentally discovered congenital anomaly, which might be complicated with right ventricular obstruction, rupture, thromboembolism, and conduction abnormalities.

14.
Am J Cardiovasc Dis ; 13(3): 177-182, 2023.
Article in English | MEDLINE | ID: mdl-37469535

ABSTRACT

BACKGROUND: An increased heart rate (HR) is deleterious in patients with decompensated heart failure. Ivabradine, an HR lowering agent which acts by inhibiting the If current in the sinoatrial node, is indicated for chronic heart failure with reduced ejection fraction. However, data regarding the safety and efficacy of ivabradine in acute decompensated heart failure is limited. This retrospective observational study aimed to investigate the effects of ivabradine on morbidity and short-term mortality of hospitalized patients with acute decompensated heart failure. METHODS: A total of 998 patients with acute decompensated heart failure on top of a chronic status from 1/5/2014 to 1/5/2019 who were already on guideline-directed treatment including a beta-blocker were included. Patients were divided into two groups, the first group (No-ivabradine) where patients continued the same dose of beta-blocker alone while the second group (ivabradine group) ivabradine 5 mg BID was added in addition to the same dose of beta-blocker. Patients with hemodynamic instabilities were excluded from the study. Propensity matching was performed to exclude confounding factors. RESULTS: There was no significant difference between groups regarding baseline patient characteristics, laboratory, and echocardiographic data. There were significant differences between groups regarding average HR (87 ± 15 and 90 ± 12 bpm in ivabradine and control groups, consecutively, P = 0.0006*) and length of hospital stay (5.3 ± 2.3 and 7.7 ± 5.6 days in ivabradine and control groups, consecutively, P < 0.0001*). However, there were no differences in rehospitalization and mortality rates at 1 month and 6 months. CONCLUSION: In a retrospective cohort study aimed to investigate the effects of ivabradine on morbidity and short-term mortality of hospitalized patients with acute decompensated heart failure. Ivabradine was associated with significantly lower average HR and length of hospital stay. However, there was no benefit in the reduction of rehospitalization and mortality rates at 1- and 6-month follow-ups.

15.
Am J Cardiovasc Dis ; 13(3): 162-167, 2023.
Article in English | MEDLINE | ID: mdl-37469536

ABSTRACT

BACKGROUND: A wide range of cardiac arrhythmias were reported in the setting of active infection or as a complication of COVID-19. The main pathophysiology can be attributed to dysautonomia or autonomic nervous system dysfunction. Postural orthostatic tachycardia syndrome (POTS) is a complex, multisystemic disorder affecting usually younger age with tachycardia at rest or with minimal effort being the main symptom. Data regarding the safety and efficacy of ivabradine in POTS treatment is limited to small studies and case reports. METHODS: This prospective observational study included a total of 55 COVID-19-associated POTS patients after the exclusion of other causes of tachycardia. Ivabradine 5 mg twice daily was initiated. Re-assessment of patients' symptoms, heart rate, and heart rate variability (HRV) parameters' changes after 3 days of ivabradine therapy was done. RESULTS: The mean age of the included patients was 30.5±6.9 years with 32 patients being males (58.2%). 43 of 55 (78%) of the included patients reported significant improvement of the symptoms within 7 days of ivabradine therapy. 24-hour heart rate (minimum, average, and maximum) was significantly lower (p-value < 0.0001*, = 0.001*, < 0.0001* consecutively) with a significant difference in HRV time-domain parameters (SDNN, rMSSD) (p-value < 0.0001*) after ivabradine therapy. CONCLUSION: In a prospective study that evaluated the effects of ivabradine in post-COVID-19 POTS, patients treated with ivabradine reported improvement of their symptoms within 7 days of ivabradine treatment with a significant reduction of 24-hour average, minimum, and maximum heart rate, and improvement of HRV time domains parameters. Ivabradine might be a useful option to relieve symptoms of tachycardia in COVID-19 POTS. Further research is required to confirm the safety and efficacy of ivabradine in POTS treatment.

17.
ACS Appl Mater Interfaces ; 15(28): 33514-33524, 2023 Jul 19.
Article in English | MEDLINE | ID: mdl-37406352

ABSTRACT

Tuning the electrocatalytic properties of MoS2 layers can be achieved through different paths, such as reducing their thickness, creating edges in the MoS2 flakes, and introducing S-vacancies. We combine these three approaches by growing MoS2 electrodes by using a special salt-assisted chemical vapor deposition (CVD) method. This procedure allows the growth of ultrathin MoS2 nanocrystals (1-3 layers thick and a few nanometers wide), as evidenced by atomic force microscopy and scanning tunneling microscopy. This morphology of the MoS2 layers at the nanoscale induces some specific features in the Raman and photoluminescence spectra compared to exfoliated or microcrystalline MoS2 layers. Moreover, the S-vacancy content in the layers can be tuned during CVD growth by using Ar/H2 mixtures as a carrier gas. Detailed optical microtransmittance and microreflectance spectroscopies, micro-Raman, and X-ray photoelectron spectroscopy measurements with sub-millimeter spatial resolution show that the obtained samples present an excellent homogeneity over areas in the cm2 range. The electrochemical and photoelectrochemical properties of these MoS2 layers were investigated using electrodes with relatively large areas (0.8 cm2). The prepared MoS2 cathodes show outstanding Faradaic efficiencies as well as long-term stability in acidic solutions. In addition, we demonstrate that there is an optimal number of S-vacancies to improve the electrochemical and photoelectrochemical performances of MoS2.

18.
Clin Case Rep ; 11(6): e7598, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37323274

ABSTRACT

COVID-19 infection can be complicated by secondary bacterial infections including pneumonia and empyema resulting in worse outcomes. Empyema management includes empirical antibiotic therapy and drainage with a favorable prognosis in most cases. Abstract: Empyema necessitans is a rare complication of poorly or uncontrolled empyema thoracis resulting in the dissection of pus through the soft tissues and skin of the chest wall resulting in a fistula between the pleural cavity and the skin. Previous reports indicate that secondary bacterial pneumonia can complicate the course of a COVID-19 infection even in immunocompetent patients resulting in worse outcomes. Management of empyema includes empirical antibiotic therapy and drainage with a favorable prognosis in most cases.

19.
Clin Case Rep ; 11(6): e7544, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37323288

ABSTRACT

The role of 3D echocardiography has been increasing in the management of patients with congenital heart disease (CHD), particularly in pre-surgical planning, catheter-guided interventions, and functional assessment of the heart.

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