Diabetes mellitus impact on left ventricular assist device outcomes in heart failure patients: National Inpatient Sample study.

Aim: Diabetes mellitus (DM) is a recognized risk factor for heart failure (HF), increasing the likelihood of requiring left ventricular assist device (LVAD) therapy. Objective: This retrospective cohort study aims to assess the impact of DM on LVAD patients, focusing on in-hospital mortality as the primary outcome. Methods: Utilizing the National Inpatient Sample administrative database, data from 11,506 adult HF patients who underwent LVAD implantation were analyzed. Results: Of the patients, 44.28% had diabetes. Adjusting for various factors, diabetic patients exhibited shorter hospital stays, lower admission costs and similar in-hospital mortality rates compared with non-diabetic patients. Conclusion: These findings enhance our understanding of the risks and benefits of LVAD therapy in patients with refractory HF and DM.

In-hospital outcomes of PCI in patients who have ESRD vs non-ESRD patients, a retrospective study involving a National Inpatient Sample (NIS) database.

BACKGROUND: Cardiovascular disease is the leading cause of death for patients with end-stage renal disease (ESRD). ESRD is known to affect a large portion of the American population. Previous data for patients undergoing percutaneous coronary intervention (PCI) in the setting of ESRD for Acute Coronary Syndrome (ACS) and non-ACS etiologies have shown to have an increase in in-hospital mortality, and prolonged hospitalization among other complications. METHODS: The national inpatient sample (NIS) was used to identify patients who underwent PCI between the years 2016-2019. Patients were then grouped into those with ESRD on renal replacement therapy (RRT). Logistic regression models were employed to assess the primary outcome of in-hospital mortality, while linear regression models were utilized to evaluate secondary outcomes, including hospitalization cost and length of stay. RESULTS: A total of 21,366 unweighted observations were initially included, consisting of 50 % ESRD patients and 50 % randomly selected patients without ESRD who underwent PCI. These observations were weighted to represent a national estimate of 106,830 patients. The mean age of the study population was 65 years, and 63 % of the patients were male. The ESRD group had a greater representation of minority groups compared to the control group. The in-hospital mortality rate was significantly higher in the ESRD group compared to the control group, with an odds ratio of 1.803 (95 % CI: 1.502 to 2.164; p-value of 0.0002). Additionally, the ESRD group had significantly higher healthcare costs and longer length of stay, with a mean difference of $47,618 (95 % CI: $42,701 to $52,534, p-value <0.0001) and 2.933 days (95 % CI, 2.729 to 3.138 days, p-value <0.0001), respectively. CONCLUSION: In-hospital mortality, cost, and length of stay for patients undergoing PCI were found to be significantly greater in the ESRD group.

COVID-19-Induced Complete Heart Block: Case Series and Literature Review.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has led to the emergence of a wide range of complications, including those affecting the cardiovascular system. In this case series, we present four patients who developed complete atrioventricular block, a serious and potentially life-threatening heart rhythm disorder, during the course of their coronavirus disease 2019 (COVID-19) illness. The mechanisms by which SARS-CoV-2 may lead to arrhythmias are not fully understood but may involve direct infection and damage to heart tissue, as well as inflammation and cytokine storms. The extent and duration of complete heart block varied among these cases, highlighting the need for further research to understand the spectrum of disease and to improve mortality and morbidity in future waves of SARS-CoV-2 infections. We hope that this case series will draw attention to this serious complication of COVID-19 and inspire further research to improve management and outcomes for affected patients.

Third-Degree Heart Block Associated With Saddle Pulmonary Embolism: A Rare Sequelae of COVID-19-Induced Hypercoagulable State.

The pathophysiology of coronavirus disease 2019 (COVID-19) involves multi-organ dysfunction, particularly involving the respiratory, cardiovascular and hematological systems. This dysfunction is partly due to systemic inflammation causing a wide array of pathological sequelae thus posing a significant challenge to management despite the advances in treatment made thus far. In this report, we present a COVID-19 patient who developed a transient complete heart block and was temporarily paced as a complication of a saddle pulmonary embolus (PE). The mechanism of complete heart block is unclear, may be related to strain, ischemia, or vagal response. We believe that this is a unique sequence of events in a COVID-19 patient and, to our knowledge, is the first of its kind to be reported.

Connected Motherhood: Social Support for Moms and Moms-to-Be on Facebook.

BACKGROUND: Research addressing online social support, especially for new mothers, has typically focused on forums and dedicated Web sites, and not on social networking sites like Facebook. Here we expand on this existing body of work by addressing a Facebook page, Ask the Chicks, themed around questions and answers related to motherhood. Using the uses and gratification lens, we explore motivations for participation as they relate to engagement with the page. MATERIALS AND METHODS: Individuals were recruited to participant in an online survey through posts on the Ask the Chicks Facebook page made by the page owner over a 1-week period. To be eligible to complete the survey, participants had to be 18 years old or older, female, and pregnant or have at least one child under the age of 5 years. RESULTS: Analyses of survey data collected from users of the page (n=647) revealed that engagement has a positive relationship with the motives of relaxing entertainment, expressive information sharing, social interaction, and information seeking. CONCLUSIONS: Online support groups, and especially Facebook, appear to be a more convenient method than traditional online support groups for people who want to obtain information about certain topics, in this case, about motherhood and raising kids. Having this type of social support tool is important, as social support has been found to reduce levels of stress, which can improve overall health and quality of life. This study provides a better understanding of why people use this type of social support group for questions about parenting.

It's complicated: Facebook users' political participation in the 2008 election.

In the 2008 U.S. presidential election, social network sites such as Facebook allowed users to share their political beliefs, support specific candidates, and interact with others on political issues. But do political activities on Facebook affect political participation among young voters, a group traditionally perceived as apathetic in regard to civic engagement? Or do these activities represent another example of feel-good participation that has little real-world impact, a concept often referred to as "slacktivism"? Results from a survey of undergraduate students (N = 683) at a large public university in the Midwestern United States conducted in the month prior to the election found that students tend to engage in lightweight political participation both on Facebook and in other venues. Furthermore, two OLS regressions found that political activity on Facebook (e.g., posting a politically oriented status update, becoming a "fan" of a candidate) is a significant predictor of other forms of political participation (e.g., volunteering for an organizing, signing a paper or online petition), and that a number of factors--including intensity of Facebook use and the political activity users see their friends performing on the site--predict political activity on Facebook. Students' perceptions regarding the appropriateness of political activity on Facebook, as well as the specific kinds of political activities they engaged in and witnessed within the site, were also explored.

Defective arachidonate release and PGE2 production in Gi alpha2-deficient intestinal and colonic subepithelial myofibroblasts.

BACKGROUND: Mice lacking the pertussis toxin-sensitive G-protein subunit Gi alpha2 spontaneously develop colitis and colon cancer. In the gut, arachidonate-derived prostaglandin E2 (PGE2) modulates intestinal immune responses and epithelial restitution and is derived largely from subepithelial myofibroblasts. METHODS: We tested whether known decreases in arachidonate release in cells lacking Gi alpha2 would result in decreased PGE2 production and tissue PGE2 levels. PGE2 levels were significantly decreased in the colon of Gi alpha2-/- mice. RESULTS: Gi alpha2-/- myofibroblasts from the small intestine and colon both released asymptotically equal to 50% less arachidonate and 3- to 7-fold less PGE2 and 6-keto PGF1alpha in response to adenosine triphosphate, thrombin, tumor necrosis factor-alpha, or lipopolysaccharide, in a partially cyclooxygenase (COX)-2-dependent manner. Decreased arachidonate release did not appear to be caused by a defect in cPLA2 translocation in the absence of Gi alpha2. Basal myofibroblast COX-1 and COX-2 expression was downregulated in Gi alpha2-/- cells. No differences in proliferation rates were found between serum-starved or serum-activated wild-type (WT) and Gi alpha2-/- myofibroblasts. Finally, treatment of Gi alpha2-/- mice with the EP4-specific PGE2 receptor agonist ONO-AE1-329 significantly decreased the severity of established colitis. CONCLUSIONS: These findings confirm a requirement for Gi alpha2 in intestinal and colonic myofibroblast-derived prostanoid production and confirm the importance of mucosal PGE2 in the suppression of colitis.

Induction of mucosal and systemic immune responses against human carcinoembryonic antigen by an oral vaccine.

Carcinoembryonic antigen (CEA) is a tumor-associated antigen targeted for the development of colorectal tumor vaccines. In this study, we developed papillomavirus pseudoviruses encoding the truncated CEA without NH2-terminal signal peptide (PV-CEA) as an oral vaccine to induce CEA-specific CTL responses. In CEA transgenic (CEA-Tg) mice orally immunized with PV-CEA, the immunologic tolerance to CEA as a "self-antigen" was overcome and both mucosal and systemic CEA-specific cytolytic activities were detected by in vitro 51Cr release assays. In a tumor prevention model, the growth rate of CEA+ tumors was significantly delayed in CEA-Tg mice orally immunized with PV-CEA when compared with the control vaccine. Further, the IFN-gamma enzyme-linked ImmunoSPOT and in vitro 51Cr release assay results showed that HLA-A2-restricted, CEA-specific CTL responses were induced in both mucosal and systemic lymphoid tissues in A2 transgenic mice after oral immunization with PV-CEA. Finally, we showed that coadministration of papillomavirus pseudoviruses encoding interleukin-2 with PV-CEA enhanced the generation of A2-restricted, CEA-specific CTLs in aged CEA/A2 double transgenic mice, which were more clinically relevant. Our data suggest that PV-CEA pseudovirus vaccine is a promising oral CEA vaccine for humans to induce CEA-specific CTLs at the site of colorectal tumors (i.e., intestinal mucosa), which might efficiently eliminate CEA+ colorectal tumor cells in the mucosa.