ABSTRACT
Heart failure (HF) poses a significant healthcare burden, with distinct subtypes based on ventricular function. HF with preserved ejection fraction (HFpEF) presents unique epidemiological and mechanistic features compared to HF with reduced ejection fraction (HFrEF). The pathophysiology of HFpEF is complex and involves multiple factors. Current pharmacological therapies for HFpEF remain suboptimal, with inconsistent mortality outcomes observed despite improvements in symptoms and quality of life. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have emerged as promising agents in HF management and hospitalizations, particularly in HFpEF patients. The cardioprotective mechanisms of SGLT2 inhibitors are multifactorial. In this article, we performed a comprehensive review of SGLT2 inhibitor use in HFpEF and discussed the implications in the management of HF.
ABSTRACT
Idiopathic pulmonary fibrosis (IPF) presents a clinical challenge characterized by progressive fibrosis and destruction of lung tissue. Despite recent advancements, including antifibrotic medications like pirfenidone and nintedanib, IPF remains a chronic and often fatal condition with limited treatment options. This article provides an overview of the current treatment modalities for IPF and explores the need for new therapeutic approaches. Antifibrotic medications have shown efficacy in slowing disease progression but are not curative and may not be suitable for all patients. Ongoing research focuses on emerging therapies such as stem cell therapy, immunomodulatory agents, and novel pharmacological targets like phosphodiesterase 4B (PDE4B) inhibitors. While these treatments offer promise, there remains an unmet need for effective therapies capable of halting or reversing fibrotic lung damage.
ABSTRACT
Sepsis and septic shock represent critical conditions, often necessitating vasopressor support in the intensive care unit (ICU). Midodrine, an oral vasopressor, has gathered attention as a potential adjunct to vasopressor therapy, aiming to facilitate weaning and improve clinical outcomes. However, the efficacy of midodrine remains questionable, with conflicting evidence from clinical trials and meta-analyses. This article provides a comprehensive review of the literature on midodrine's role in ICU settings by gathering evidence from multicenter trials, retrospective studies, and meta-analyses. While some studies suggest a limited benefit of midodrine in expediting vasopressor weaning and reducing ICU/hospital stays, others report potential advantages, particularly in reducing mortality rates among septic shock patients. Ongoing efforts aim to address knowledge gaps surrounding midodrine's efficacy and safety.
ABSTRACT
The literature describes religious coping as an important predictor of mental well-being. Present study is aimed at extending this knowledge by assessing whether specific religious coping regulates specific cognitive emotional responses to improve well-being during Covid pandemic, an extreme international event with significant impacts on individuals and communities. A sample of young adults responded to self-report measures of negative and positive religious coping, positive reappraisal, self-blaming, and mental well-being. Results revealed that positive religious coping was a positive predictor of mental well-being and positive reappraisal mediated this positive link. Also, gender and physical health status significantly interacted with positive reappraisal to predict mental well-being in these mediational associations. More specifically, indirect effects of positive reappraisal were positive and significant for men and for participants with better physical health compared with women and those with poor physical health. However, negative religious coping was not a significant correlate of mental well-being but a positive correlate of self-blame. Results suggest that positive religious coping facilitates positive regulation of emotions for improved mental well-being in young adults and particularly young men.
ABSTRACT
Here we report a case of a 65-year-old female, where we encountered acute glomerulonephritis. The patient initially presented with a hemorrhagic blister involving the second through fourth toes with serosanguinous discharge and was on hydralazine for blood pressure control. Differentials included Staphylococcus-associated/lupus nephritis/anti-neutrophil cytoplasmic autoantibody (ANCA) vasculitis. Still, detailed history and meticulous clinical approach with supporting labs and imaging helped us to narrow it to Staphylococcus-associated glomerulonephritis, which is rarely encountered in clinical practice and is associated with high mortality. The management of the patient resulted in a positive outcome and she was discharged home.
ABSTRACT
Subacute thyroiditis is usually a self-limiting inflammatory condition. The clinical presentation varies from person to person, but usually includes neck pain or discomfort and a painful diffuse goiter. There is at times a transient episode of hyperthyroidism followed by euthyroidism and sometimes hypothyroidism. We describe the case of a previously healthy 29-year-old female presenting with symptoms consistent with subacute thyroiditis. The patient had recently recovered from a mild episode of COVID-19 infection. Labs and imaging were consistent with the clinical diagnosis of subacute thyroiditis. The patient was provided symptomatic treatment with prednisone and atenolol and had an uneventful recovery.
