Transition to heart transplantation in post-myocardial infarction ventricular septal rupture: a systematic review.

Post-myocardial infarction ventricular septal rupture (MI-VSR) remains a dreadful complication with dismal prognosis. Surgical repair is the primary treatment strategy, whereas the role of heart transplantation (HT) as a primary option in MI-VSR is limited to case reports (CRs). We performed a systematic review of CRs to describe in-hospital mortality, and survival at 6 and 12 months in adult patients with MI-VSR treated with HT as a primary or bailout strategy. We performed a comprehensive search of Web of Science, PubMed, and Ovid Medline. The last search was completed on March 10, 2020. An aggregated score based on the CARE case report guideline was used to assess the quality of the CRs. We included CRs that described adult patients with MI-VSR treated with HT as a primary or bailout strategy. A total of 14 CRs between 1994 and 2015 were included, retrieving and analyzing the characteristics of 17 patients. A total of 12 patients underwent HT, with HT being the primary strategy in 8 patients and a bailout strategy for 4 patients following initial surgical repair, while 5 patients died awaiting HT under mechanical circulatory support (MCS), accounting for the total in-hospital mortality of this series (29%). Regarding long-term outcomes, 6 patients were reported to be alive at 6 months and 1 year after HT, while information was missing in the remaining 6 patients. In conclusion, HT supported by the use of temporary and durable MCS as a bridge to HT could be a feasible primary or bailout strategy to reduce the high in-hospital mortality of patients with MI-VSR.

Use of computed tomography coronary calcium score for prediction of cardiovascular events in cancer patients: a retrospective cohort analysis.

BACKGROUND: CT- coronary calcium score, is one of the most studied and widely available modalities in cardiovascular medicine. Coronary artery calcium score (CACS) is an established predictor of coronary artery disease. The 'standard of care' diagnostic modality to measure CACS is ECG-gated Cardiac Multi-Detector Computed Tomography. There is convincing evidence of a strong association between CACS and major cardiovascular (CV) events in asymptomatic individuals. Cancer patients (C) may have a higher risk for CV disease than non-cancer patients (NC) related not only to cancer treatments but also to shared biological factors and pathways. Thus, identifying tools for early detection of CV disease in this population is of utmost importance. METHODS: A retrospective cohort analysis was performed with patients from Cleveland Clinic Florida and Ohio who had CACS from 2017 to 2021. Patients who had cancer diagnosis prior to CACS were matched to NC for age and sex. CV events after their index CACS events were compared between C and NC, and matched control and propensity analysis were conducted. RESULTS: Ten thousand seven hundred forty-two patients had CACS; 703 cancer patients had CACS and were eligible. Extensive CACS (> 400) were significantly higher in cancer, 94 (13.37%) vs non-cancer patients, 76 (10.83%), P = 0.011. Furthermore, after propensity matched analysis, CACS > 400 was 14.8% in C vs 9.6% in NC, P = < 0.05. CV events were similar in both cohorts (p = NS), despite less CV risk factors in cancer patients (P = < 0.05). For the combined moderate (101-400) & extensive (> 400) CACS, the prevalence of stroke and peripheral arterial disease, a marker of systemic atherosclerosis, was significantly higher in patients with cancer (P < 0.01). CONCLUSIONS: Despite having fewer CV risk factors in our study, similar CACS in cancer patients are suggestive of a higher prevalence of CV disease independent of traditional risk factors. High CACS and the overall prevalence of vascular events were more frequent in patients with cancer. Higher prevalence of peripheral arterial disease and cerebrovascular accident further suggests the increased atherosclerotic burden in C.

Analysis of the Effects of Lockdown on Staff and Students at Universities in Spain and Colombia Using Natural Language Processing Techniques.

The aim of this study is to analyze the effects of lockdown using natural language processing techniques, particularly sentiment analysis methods applied at large scale. Further, our work searches to analyze the impact of COVID-19 on the university community, jointly on staff and students, and with a multi-country perspective. The main findings of this work show that the most often related words were "family", "anxiety", "house", and "life". Besides this finding, we also have shown that staff have a slightly less negative perception of the consequences of COVID-19 in their daily life. We have used artificial intelligence models such as swivel embedding and a multilayer perceptron as classification algorithms. The performance that was reached in terms of accuracy metrics was 88.8% and 88.5% for students and staff, respectively. The main conclusion of our study is that higher education institutions and policymakers around the world may benefit from these findings while formulating policy recommendations and strategies to support students during this and any future pandemics.

Levels of Evidence within Cardiovascular Medicine Research in Saudi Arabia: A Systematic Review.

International commitments to reduce the prevalence of non-communicable disease have led the Government of Saudi Arabia to invest more in research related to cardiovascular disease. However, the strength of evidence derived from these research activities remains unclear. The aim of our study was to examine the level of evidence within clinical Cardiovascular Medicine research in Saudi Arabia. We conducted a systematic review of published articles that included a population from Saudi Arabia. Electronic databases EMBASE and MEDLINE (Ovid) were searched up to 25th of April 2021, supplemented by a second search in CENTRAL (Cochrane Central Register of Controlled Trials) and www.clinicaltrials.gov. In addition, the Snowball- and Pearl-growing methods of search were conducted for finding additional eligible articles. Finally, a search was conducted in PubMed database for all eligible articles published by Journal of the Saudi Heart Association from the first indexed issue up to April 2021. Level of evidence of reviewed articles was determined using the Oxford Level of Evidence 2 scale. We calculated the mean level of evidence over 5-year periods, and explored evidence for a time trend for number of published articles and LOE using linear regression. Of the 1113 records identified, 418 met the inclusion criteria for analysis. The articles were published between September 1986 and March 2021. More than half of the included articles were level IV studies (n = 242, 57.8%). Furthermore, we observed no trend over the years for increased mean of level of evidence (ß = -0.07, 95% CI [-0.20, -0.06], p = 0.236). Overall, the level of evidence produced by the articles in clinical Cardiovascular Medicine in Saudi Arabia is very low. Prioritizing higher-quality research is critical to produce the clinical practices and policies necessary to reduce the burden of cardiovascular diseases in Saudi Arabia.