Syndromes of Concurrent Hypertension, Diastolic Dysfunction, and Pulmonary or Peripheral Edema in Cardio-Oncology: Case Studies, Literature Review, and New Classification System.

OPINION STATEMENT: Individuals who have ever been diagnosed with cancer are at increased risk for cardiovascular conditions during and after cancer treatment. Especially during cancer treatment, cardiovascular conditions can manifest in many ways, including peripheral or pulmonary edema. Edema can indicate volume overload affecting the heart even without other unequivocal evidence of apparent diastolic or systolic left ventricular dysfunction, particularly at rest. We propose a novel algorithm to streamline the diagnostic evaluation and cardiovascular classification for cancer patients with edema. We initially advise prompt evaluation with a chest X-ray and echocardiogram. We then suggest classification into one of five categories based on the timing of presentation of edema relative to cancer treatment, as well as echocardiography results and the presence or absence of hypertension or lymphatic causes of edema. This classification tool can then be utilized to guide further cardiovascular management suggestions. These concurrent syndromes presenting as edema may indicate the development or aggravation of undiagnosed diastolic dysfunction with or without hypertension, even if transiently present only while on cancer treatment.

The role of precautions: Organising a medical conference during COVID-19 pandemic-Lessons from IADVL MIDDERMACON 2021.

Background: The use of virtual platforms for clinical meetings has become the default approach during this pandemic era. Organising an offline conference during a pandemic is a challenge and is possible if the participating crowd is vaccinated and is willing to follow appropriate pandemic protocols. Objective: To determine the feasibility of conducting a conference among mostly vaccinated delegates using standard precautionary protocols. Methods: This study was conducted at IADVL MIDDERMACON 2021, held in Mangalore, India, in late October 2021, during the phase of decline of the Delta variant of SARS-CoV-2. The study population included all conference attendees, including support staff. Details were collected about their vaccination status, comorbidities, and mode of travel to the conference venue. An reverse-transcription polymerase chain reaction (RT-PCR) test was done randomly among the attendees for COVID-19 infection. A post-conference assessment and RT-PCR tests were done at the end of 2 weeks to assess the occurrence of infections among study participants. Results: A total of 1744 people were present at the venue, of which 576 (33.03%) participated in the study. The percentage of fully vaccinated was 88.88% (512/576). The majority had taken the vaccine Covishield (manufactured by AstraZeneca), that is, 85.06% (490/576). Infection post the conference was reported in 0.195% (1/576). Conclusions: Holding large gatherings like medical conferences pose a challenge during a pandemic. However, to increase the benefits of the conference, it is advisable to hold them offline with vaccinated delegates, follow the advice of the conference organising committee, and practise safe precautionary measures.