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Diffuse Large B Cell Lymphoma presenting as Right Atrial Mass and Cardiac Tamponade
No full textDiffuse large B-cell lymphoma (DLBCL) is the most prevalent histologic subtype of non-Hodgkin lymphomas. It usually presents with nodal involvement (cervical, mediastinal, or abdominal), but approximately 30% of patients will exhibit extranodal involvement, with 2-4% presenting as a primary cardiac mass. Multimodal imaging is essential to distinguish these masses from other common benign lesions and to assist in surgical planning. Here, we report a case of DLBCL manifested as a right atrial mass, pericardial effusion, and cardiac tamponade. Transesophageal echocardiogram (TEE) and cardiac magnetic resonance imaging (CMR) were complementary to transthoracic echocardiogram in diagnosing the cardiac neoplasm, with positron emission tomography (PET-CT) aiding in staging and localizing the primary tumor. Biopsy of the cardiac mass or extracardiac involvement confirms the histopathological subtype and guides the treatment. Although primary and secondary cardiac tumors have poor outcomes, early diagnosis and aggressive treatment can influence prognosis.
Keywords: DLBCL; cardiovascular imaging; lymphoma; right atrial mass; tamponade
D-Mannose for prevention of recurrent urinary tract infection in adult women: An updated systematic review and meta-analysis of randomized controlled trials
No full textPurpose: Approximately 50%-60% of adult women experience at least one episode of urinary tract infection (UTI) during their lifetime, with 20%-24% of them experiencing recurrence within a year. Several randomized controlled trials have explored the efficacy and safety of D-mannose for the prevention of UTI in adult women but reported conflicting results.
Objective: We performed a meta-analysis comparing D-mannose with placebo or no treatment for the prevention of UTI in adult women.
Methods: We systematically searched PubMed, Scopus, and Cochrane Central databases for studies comparing D-mannose with placebo or no treatment for the prevention of UTI in adult women. The outcomes of interest were recurrent UTIs during follow-up and adverse events. Heterogeneity was assessed using I2 statistics. Analysis followed the PRISMA guideline and was registered in the PROSPERO database.
Results: The systematic review identified 4 randomized controlled trials (RCTs) including 890 participants (D-mannose n = 447, 50.22%). Recurrent UTI (RR 0.44; 95% CI 0.18-1.11; p = .082; I2 = 90%) and adverse events (RR 2.19; 95% CI 0.68-7.05; p = .190; I2 = 79%) did not differ significantly between the groups at the end of follow-up.
Conclusion: Prophylaxis with D-mannose did not cause any difference in the risk of recurrent UTI during follow-up and adverse events in adult women. Fewer number of studies and heterogeneity in the results make it difficult to draw conclusions about the efficacy of D-mannose in preventing recurrent UTI. More placebo-controlled RCTs are required to confirm the efficacy and safety.
Keywords: D-mannose; recurrent UTI; urinary tract infection
Intravascular imaging vs. angiography alone to guide percutaneous coronary intervention in older adults: a meta-analysis of randomized controlled trials
No full textBackground: Older adults undergoing percutaneous coronary intervention (PCI) face unique challenges due to complex anatomy and comorbidities. Intravascular imaging [including intravascular ultrasound (IVUS) and optical coherence tomography (OCT)] has been shown to improve PCI outcomes, but its benefits in older adults are less well established. We conducted a meta-analysis of randomized controlled trials (RCTs) to compare intravascular imaging with angiography alone to guide PCI in older adults.
Methods: Cochrane, PubMed, and Scopus were searched for RCTs comparing intravascular imaging (IVUS or OCT) vs. angiography alone in adults aged ≥65 years. The outcome of interest was major adverse cardiovascular events (MACE) at the longest follow-up, as defined by each trial. Subgroup analyses were performed based on intravascular imaging modality, age group, and lesion complexity. Data were pooled using random-effects models, and heterogeneity was assessed using Higgins\u27 I² statistic.
Results: Nine RCTs (n = 7164, intravascular imaging = 3703, angiography alone = 3461) met the inclusion criteria. Intravascular imaging significantly reduced MACE compared with angiography alone [relative risk (RR) 0.66, 95% confidence interval (CI) 0.56-0.77; P \u3c 0.001; I² = 0%]. IVUS demonstrated superiority over angiography alone (RR 0.55, 95% CI 0.43-0.72; P \u3c 0.001; I² = 0%), while OCT demonstrated only a trend toward MACE reduction (RR 0.80, 95% CI 0.62-1.02). Subgroup analyses indicated consistent benefits with intravascular imaging for adults aged ≥65 and ≥70 years, respectively, and among those with complex coronary lesions (RR 0.65, 95% CI 0.53-0.79; P \u3c 0.001).
Conclusion: Intravascular imaging guidance, especially IVUS, reduces MACE in older adults undergoing PCI compared with angiography alone.
Keywords: angiography; coronary artery disease; intravascular imaging; intravascular ultrasound; older; optical coherence tomography; percutaneous coronary intervention
Baystate Health Nursing: Together in Excellence Newsletter - November 2025
No full textBaystate Health Nursing: Together in Excellence Newsletter - November 2025https://scholarlycommons.libraryinfo.bhs.org/baystate_health_nursing_newsletters/1000/thumbnail.jp
Implementing a Standardized Peritoneal Dialysis Catheter Adapter: Will it Reduce Risk of Peritonitis?
No full texthttps://scholarlycommons.libraryinfo.bhs.org/nursing_artof_questioning_innovation2025/1019/thumbnail.jp
Improving the No-Show Rates for Pediatric Outpatient Clinic
No full texthttps://scholarlycommons.libraryinfo.bhs.org/nursing_artof_questioning_innovation2025/1010/thumbnail.jp
From Paper to Platform: Transitioning Postpartum Education to BabyScripts
No full texthttps://scholarlycommons.libraryinfo.bhs.org/nursing_artof_questioning_innovation2025/1001/thumbnail.jp
COPD Readmission Action Plan
No full texthttps://scholarlycommons.libraryinfo.bhs.org/nursing_artof_questioning_innovation2025/1000/thumbnail.jp
Rest Assured: Evaluating Melatonin’s Role in Improving Sleep Among Hospitalized Older Adults
No full texthttps://scholarlycommons.libraryinfo.bhs.org/nursing_artof_questioning_innovation2025/1029/thumbnail.jp