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Comparative Long-Term Outcomes of Cell Therapy and Cardiac Rehabilitation in the Treatment of Non-ischemic Dilated Cardiomyopathy
Get PDFThis systematic review explores long-term treatment approaches for non-ischemic dilated cardiomyopathy, comparing cell therapy and cardiac rehabilitation. Cardiomyopathy is characterized by the progressive thinning and deterioration of cardiac muscle and is a significant cause of heart failure. Various treatment modalities have been developed to combat cardiomyopathy and prevent the onset of heart failure, with more recent efforts focusing on cell therapy—particularly allogeneic and autologous stem cell transplants. The efficacy of these novel treatments was compared to more established regimens, particularly cardiac rehabilitation. Studies demonstrate that both treatment modalities are associated with a significant overall improvement in ejection fraction (effect size = 1.12). The findings overall suggest that a combined treatment strategy—incorporating cardiac rehabilitation, cell therapy, as well as conventional pharmacologic management—may offer mortality benefits and increase myocardial function over the long term
Outcomes of Octogenarians, Nonagenarians, and Centenarians That Underwent Left Atrial Appendage Occlusion: A population-based study
Get PDFAn evaluation of that national inpatient sample database to explore the outcomes for patients above the age of seventy who underwent left atrial appendage occlusion
Pre-Operative Clinical Characteristics Vary by Race in Patients with Obesity Undergoing Bariatric Surgery
Get PDFBackground Data and Purpose: With the increasing prevalence of obesity, it impacts the practice of surgeons across various specialties. Non-bariatric surgeons are confronted with morbid obesity need clinical insight in managing medically fragile patients. The objective of this study is to identify pre-operative clinical variation by race among surgical patients with obesity.
Methods: Pre-operative data from 156,502 bariatric surgery patients were analyzed in four groups: Caucasian (C; n=125,492), African American (AA; n=18,226), Hispanic (H; n=12,405), and Asian (A; n=379). Data: Demographics, weight, BMI, and 33 obesity co-morbidities. Statistics: Chi-square and ANOVA.
Results: Pre-operative C/AA/H/A weight (KG) (130+-27/135+-28/127+-27/122+-26), BMI (46+-8/48+-9/47+-8/45+-7), % female (77/86/77/73), % \u3e50 years old (39/24/20/21), and unemployment (26/23/24/18) varied by race (p\u3c 0.0001). 33 co-morbidities and unemployment varied by race. C had highest gastroesophageal reflux (GERD), ischemic heart disease (IHD), obesity hypoventilation (OHS), sleep apnea (OSA), peripheral vascular disease (PVD), leg edema (LE), deep vein thrombosis/pulmonary embolism (DVT/PE), back pain, irregular menses (IM), musculoskeletal pain, pseudotumor cerebri (PTC), psychological impairment (PI), stress urinary incontinence (SUI), abdominal hernia, panniculitis, cholelithiasis, psychological diagnosis, fibromyalgia, impaired functional status (IFS), and depression. C also had the highest unemployment rates. AA had the highest angina, asthma, chronic heart failure (CHF), gout, and hypertension. H was highest substance use. A had highest diabetes, dyslipidemia, liver disease, PCOS, and tobacco/alcohol use.
Conclusions: Surgical patients with obesity vary clinically by race. This provides all surgeons and physicians who manage medically complex patients with morbid obesity with advanced knowledge, supplemental to clinical judgement, that may facilitate risk-specific pre-operative preparation and peri-operative management
Exploring the Effects of Target Race, Gender, and Weight on Pain Perception
Get PDFHealthcare equity is an essential right, and while the quality of care is assumed to be uniform, notable disparities in care are associated with factors of race, gender, and weight-particularly in the domain of pain evaluation and care. In experimental work, target race and gender have varying, and interacting effects on visual thresholds for perceiving painful expressions. Racial bias in pain perception is well established as participants see pain on black faces less readily than pain on white faces; gender also impacts pain treatment, where women are susceptible to having their pain discredited. Across two experiments, the influence of weight on pain perception and care interact with factors such as race and gender. Participants observed pain less readily in Black and light female target faces. Pain evaluation matches trends in pain treatment in the female condition, as participants recommended less pain treatment for black targets and lighter weight targets. In male targets, the effect of race on pain perception is observed in the lighter weight condition, but not in the heavier weight condition, possibly suggesting that weight is acting as a buffer against racial bias in male targets. Weight has differing effects in pain treatment in male targets, compared to female targets. Light weight white male target’s pain is treated to a higher degree than heavier weight male targets; whereas heavy weight black male target’s pain is more readily treated than light weight black male targets. Racial bias in pain perception is consistent across domains of gender and weight. Weight appears to have consistent effects in pain treatment in female targets across race, whereas weight had varying effects in the treatment of male targets across race
Clinical Outcomes for Smokers with Early-Onset Colorectal Cancer: An Analysis of the National Inpatient Sample
Get PDFWe sought to examine the national inpatient sample database to describe in-hospital outcomes among smokers with EOCRC. The NIS was searched for hospitalizations of adult patients with EOCRC, defined as all-cause colorectal cancer in patients 50 years old or younger. In this nationally representative population‐based retrospective cohort study, hyperlipidemia was associated with higher mortality
Clinical Outcomes of Left Atrial Appendage Occlusion in Patients with Hyperlipidemia: A Nationwide Analysis
Get PDFWe sought to examine the national inpatient sample database to explore in-hospital outcomes for patients with HDL with AF who underwent LAAO
Mitral Kombat: A Case of Paravalvular Leak and Hemolysis After TMVR
Get PDFA 71-year-old woman with prior TMVR presented with dyspnea, jaundice, and hypoxia. She was found to have severe anemia with lab evidence of mechanical intravascular hemolysis due to a paravalvular leak (PVL), a known TMVR complication. This case highlights the importance of recognizing post-operative complications in valve replacement patients, including PVL-related hemolysis
The Effectiveness of RAS Treatment in Improving Gait Patterns in Patients with Parkinson’s Disease: A Literature Review
Get PDFParkinson’s Disease (PD) is a neurodegenerative disorder involving the loss of dopaminergic neurons leading to symptoms such as tremor and gait disturbance. This results in the classic shuffling gait: stooped posture, variation in stride length, variation in cadence, reduced gait velocity, inability to maintain a steady rhythm, and an increased fear of falling. This study’s objective is to review the current literature on the use of rhythmic auditory stimulation (RAS)Ⓡ as a treatment option for PD. Previous research has looked at RASⓇ as a potential non-pharmacologic treatment because researchers hypothesize that listening to music produces an external rhythm that the patient may be able to follow and synchronize their steps to. Through database review of articles searched with terms “Rhythmic auditory stimulationⓇ in gait training for Parkinson’s disease patients” and “RASⓇ therapy familiar music Parkinson’s”, 24 unique interventional studies were selected that fit the criteria of assessing patients with mild-moderate PD with or without comorbid dementia, were written in English, investigated the effects on gait quality, and discussed relevant neural pathways. Many other populated results dealt with the use of RASⓇ as non-PD treatment or were not measuring improvements in gait. Overall, the utilization of RASⓇ intervention demonstrated an improvement in gait quality in addition to perceptual and motor timing. However, the included interventional studies were limited in sample size and were conducted within one institution. Future research could look to increase sample sizes and expand participating research centers to increase generalizability. In addition, future studies could investigate whether live vs recorded music would make a difference in the patient’s ability to sense and follow the rhythm as live music may produce more tangible vibrations for the patient to follow
A Systematic Review on Cinacalcet’s Effect in Reducing PTH Serum Levels in Peritoneal Dialysis Patients
Get PDFBackground: Patients with Chronic Kidney Disease (CKD) have low calcium levels. Low blood calcium triggers the parathyroid gland to constantly secrete parathyroid hormone (PTH) in an attempt to raise blood calcium levels back to normal. One way PTH tries to do this is by removing calcium from bone. Chronically high PTH levels leads to increased bone resorption and increases the risk for bone fractures and mortality risk. This phenomenon is called secondary hyperparathyroidism (SHPT). Calcimimetics, like cinacalcet (sensipar), act similarly to calcium by binding allosterically to Calcium-Sensing Receptors (CaSR) on the parathyroid gland, thereby reducing PTH levels. The effect of cinacalcet in Hemodialysis (HD) patients has been extensively studied, but little has been studied in Peritoneal Dialysis (PD) patients. This review attempts to address this gap in the literature.
Methods: We used PubMed to find articles and obtained information from a variety of studies including Randomized controlled trials and meta analyses.
Results: Results show that cinacalcet decreases serum PTH levels in PD patients compared to baseline and control levels. The literature studied these effects over a 7-12 month period.
Discussion and future directions: The results indicate that cinacalcet reduces PTH levels in PD patients; however, more clinical trials are needed to understand its effect in reducing all-cause mortality in this population. Further research on how other calcimimetics, like etelcalcetide and evocalcet, affect PD patients should also be studied. This research can help inform nephrologists on the best ways to treat SHPT in their dialysis patients
Efficacy of Platelet-Rich Plasma in the Management and Treatment of Achilles Tendon Ruptures: A Literature Review
Get PDFBackground
In the world of regenerative medicine, platelet-rich plasma (PRP) has gained much attention as a potential enhancer of musculoskeletal healing. However, despite promising results in many applications, the use of PRP in Achilles tendon ruptures (ATR) remains a topic of debate. While some studies suggest potential benefits in terms of pain reduction and early-phase healing, others report no significant difference in clinical or functional outcomes compared to standard treatment. This inconsistency underscores the need for further investigation into PRP’s role in tendon repair, particularly in high-stress, load-bearing structures such as the Achilles tendon.
Objective
This review aims to evaluate the current literature highlighting the efficacy of standard nonoperative PRP, including when combined with nonoperative modalities, for the treatment of ATR.
Methods
A literature search was conducted across three major databases (1995–2024) using a curtailed search string, with key terms such as Achilles Tendon Rupture and Platelet-Rich Plasma”. Ten studies met inclusion criteria based on patient population, intervention type, and functional outcome measures (ATRS, VISA-A, VAS).
Results
Findings across studies were mixed. Historical studies (e.g., Anitua, Marx) demonstrated enhanced bone and soft tissue healing with PRP. However, more recent RCTs (Boesen, Keene, Kearney) found no significant differences in pain, function, or range of motion when comparing PRP to placebo. Meta-analyses (Nauwelaers, Chen) confirmed a lack of long-term benefit. Some short-term gains in muscle strength and ROM (Zou) were observed but diminished over time. Variability in PRP preparation and administration likely contributed to inconsistent results.
Conclusion
Current evidence does not support the routine use of PRP for ATR due to inconsistent outcomes and lack of standardized protocols. Future research should focus on optimizing PRP formulation, timing, and patient selection to determine its true clinical value. Until then, PRP for ATR remains an adjunctive therapy with uncertain benefit