Trends in the Prevalence of Infiltrative Cardiomyopathy Among Patients With in-Hospital Cardiac Arrest.

Sarcoidosis, amyloidosis, hemochromatosis and scleroderma are the most forms of infiltrative/nonischemic cardiomyopathy (NICM) associated with sudden cardiac death. In patients who undergo in-hospital cardiac arrest, a high index of suspicion is required to rule out NICM as an underlying contributor. We aimed to analyze the prevalence of NICM among patients with in-hospital cardiac arrest and identify factors associated with increased mortality. We analyzed data from the National Inpatient Sample, and identified patients who were hospitalized across 10 years from 2010 to 2019 with a diagnosis of cardiac arrest and NICM. The total number of patients with in-hospital cardiac arrest was 19,34,260. The total number with NICM was 14,803 (0.77%). Mean age was 63 years. Overall prevalence of NICM across the years ranged between 0.75% to 0.9%, with a significant temporal increase (P < 0.01). Incidence of in-hospital mortality ranged between 61% to 76% for females and 30% to 38% for males. The following comorbidities were more prevalent in patients with NICM than those without: heart failure, chronic obstructive pulmonary disease (COPD), chronic kidney disease, anemia, malignancy, coagulopathy, ventricular tachycardia, acute kidney injury and stroke. The following factors were independent predictors of in-hospital mortality-age, female gender, Hispanic race, history of COPD and presence of malignancy (P = 0.042). The prevalence of infiltrative cardiomyopathy in patients with in-hospital cardiac arrest is increasing. Females, older patients and Hispanic population are at an increased risk of mortality. Sex and race-based disparities in the prevalence of NICM in patients with in-hospital cardiac arrest is an area of further research.

Cu(OAc)2 catalysed aerobic oxidation of aldehydes to nitriles under ligand-free conditions.

An economically efficient and environmentally benign approach for the direct oxidative transformation of aldehydes to nitriles has been developed using commercially available non-toxic copper acetate as an inexpensive catalyst and ammonium acetate as the source of nitrogen in the presence of aerial oxygen as an eco-friendly oxidant under ligand-free conditions. The reactions were associated with high yield and various sensitive moieties like allyloxy, benzyloxy, t-butyldimethylsilyloxy, hetero-aryl, formyl, keto, chloro, bromo, methylenedioxy and cyano were well tolerated in the aforesaid method. The kinetic studies showed first order dependency on the aldehyde substrate in the reaction rate. The reaction was faster with the electron deficient aldehydes as confirmed by Hammett analysis. Moreover, the present oxidative method was effective on larger scales showing potential for industrial application.

Cardiovascular Manifestations of COVID-19.

Coronavirus disease 2019 (COVID-19) first emerged in a group of patients who presented with severe pneumonia in Wuhan, China, in December 2019. A novel virus, now called SARSCoV- 2 (Severe Acute Respiratory Syndrome Coronavirus-2), was isolated from lower respiratory tract samples. The current outbreak of infection has spread to over 100 countries and killed more than 340,000 people as of 25th May, 2020. The predominant clinical manifestation of COVID-19 is a respiratory disease- ranging from mild flu-like symptoms to fulminant pneumonia and Acute Respiratory Distress Syndrome (ARDS). Patients with pre-existing cardiovascular risk factors are considered more susceptible to the virus, and these conditions are often worsened by the infection. Furthermore, COVID-19 infection has led to de novo cardiac complications, like acute myocardial injury and arrhythmias. In this review, we have focused on the cardiovascular manifestations of COVID-19 infection that have been reported in the literature so far. We have also outlined the effect of pre-existing cardiovascular disease as well as risk factors on the clinical course and outcomes of COVID-19 infection.

Transcatheter Aortic Valve Replacement Valve in Transcatheter Aortic Valve Replacement Valve for Severe Periprosthetic Regurgitation.

The management of postprocedure severe aortic periprosthetic regurgitation after transcatheter aortic valve replacement (TAVR) is unknown. While valve-in-valve TAVR has been associated with favorable outcomes for degenerative surgically implanted bioprosthetic valves, there are no evidence-based guidelines for immediate TAVR valve in TAVR valve for periprosthetic regurgitation. We present a patient who underwent a TAVR valve in TAVR valve implantation within 48 h of her first procedure and showed a good response.

Implantation of Leadless Pacemaker for the Development of New Left Bundle Branch Block and Symptomatic Pause Following Transcatheter Aortic Valve Replacement.

Cardiac conduction disturbances such as left bundle branch block (LBBB) and atrioventricular blocks (AVB) occur frequently following transcatheter aortic valve replacement (TAVR) and may be associated with adverse clinical events. There is a lack of consensus regarding permanent pacemaker implantation in the case of occurrence of TAVR-related bundle branch blocks or combination of AVB and bundle blocks. Furthermore, there are no guidelines regarding the use of the leadless pacemaker in this setting. We present a patient who underwent successful implantation of a leadless pacemaker for a new LBBB post-TAVR.

Hemiplegia as a presentation of HIV infection in children: A report of 3 cases.

Strokes are a rare neurological manifestation of HIV infection in children with multifactorial etiologies. We present three HIV-infected children who presented to us with stroke out of which two had cerebral infarcts and who responded to antiretroviral therapy (ART). Third patient had tuberculous meningitis who was lost to follow-up before ART could be initiated.

Liver abscess in a boy with hyper IgE syndrome.

Hyper immunoglobulin-E syndrome is a rare primary immunodeficiency disease, characterized by the classical triad of recurrent staphylococcal skin abscesses, pneumonia with pneumatocele formation, and elevated levels of serum IgE, usually over 2000 IU/mL. Chronic granulomatous disease, hyper IgE, and complement deficiencies are immunopathologies known to be associated with liver abscesses. We present a 2 ½-year-old boy with liver abscess and associated hyper IgE.

Immune reconstitution syndrome in a human immunodeficiency virus infected child due to giardiasis leading to shock.

Human immunodeficiency virus (HIV)-associated immune reconstitution inflammatory syndrome has been reported in association with tuberculosis, herpes zoster (shingles), Cryptococcus neoformans, Kaposi's sarcoma, Pneumocystis pneumonia, hepatitis B virus, hepatitis C virus, herpes simplex virus, Histoplasma capsulatum, human papillomavirus, and Cytomegalovirus. However, it has never been documented with giardiasis. We present a 7-year-old HIV infected girl who developed diarrhea and shock following the initiation of antiretroviral therapy, and her stool showed the presence of giardiasis.