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Journal of Clinical Cardiology
ISSN: 2694-5088
Volume 4, Issue 2, p29-62
Articles published in this issue are Open Access and licensed under Creative Commons Attribution License (CC BY NC) where the readers can reuse, download, distribute the article in whole or part by mentioning proper credits to the authors.
Improve Survival of Out of Hospital Cardiac Arrest with Video-directed Chest Compressions
Background: Cardiovascular disease has been the leading cause of mortality worldwide for the past century, but advancements in health intervention have led to a decline of over 20%. However, the Out of Hospital Cardiac Arrest (OHCA) mortality rate remains unacceptably high, exceeding 90% over the past few decades. The primary reasons are the lack of cardiopulmonary resuscitation (CPR) knowledge and delayed medical response [1].
J Clin Cardiol, 2023, Volume 4, Issue 2, p29-35 | DOI: 10.33696/cardiology.4.042The Use of CHA2DS2-VASc Score to Predict Functional Outcomes of Mechanical Thrombectomy
Background: Mechanical thrombectomy is widely used for revascularization of acute ischemic strokes from large vessel occlusions. Functional outcomes following mechanical thrombectomy are typically assessed using the modified Rankin scale. CHA2DS2-VASc score is commonly used to estimate the stroke risk of patients with atrial fibrillation, but studies have verified its use in other various situations. Our study aimed to assess the utility of CHA2DS2-VASc score in predicting outcomes of patients undergoing mechanical thrombectomy.
J Clin Cardiol, 2023, Volume 4, Issue 2, p36-43 | DOI: 10.33696/cardiology.4.043Short-Term Outcomes Following Transcatheter Aortic Valve Implantation: Classical Low-Flow Low-Gradient Versus Normal-Flow Low-Gradient Severe Aortic Stenosis
Background: Both classical severe low-flow low-gradient aortic stenosis (LFLG-AS) and severe normal-flow low-gradient aortic stenosis (NFLG-AS) patients undergo transcatheter aortic valve implantation (TAVI). However, few studies have compared outcomes between the two groups. Our study aimed to assess short term post-TAVI outcomes between classical LFLG-AS and NFLG-AS.
J Clin Cardiol, 2023, Volume 4, Issue 2, p44-51 | DOI: 10.33696/cardiology.4.044EASI Monitoring: An Alternative to Conventional Electrocardiography in the Recording of Ventricular Tachycardia
This study compares the EASI monitoring setting with the conventional 12-lead electrocardiogram (ECG) in patients experiencing ventricular tachycardia (VT) episodes. The results revealed that the EASI monitoring setting demonstrated a VT morphology that closely resembled that of the conventional ECG in the majority of cases. This finding suggests that EASI monitoring could serve as a valuable alternative in situations where obtaining a conventional ECG is either risky or not feasible.
J Clin Cardiol, 2023, Volume 4, Issue 2, p52-57 | DOI: 10.33696/cardiology.4.045COVID Pneumonia, Non-ST Elevation Myocardial Infarction, QRS Fragmentation, and Electrocardiographic Wavy Triple or Yasser's Sign in Hodgkin Lymphoma-Prognostic Influence and Serious Outcome
The COVID-19 virus with severe acute respiratory syndrome (SARS) has a remarkable effect on morbidity and mortality. Non-ST elevation myocardial infarction (NSTEMI) is a category of acute coronary syndrome (ACS) that may represent a primary cardiac manifestation of COVID-19 disease. The QRS-complex fragmentation had been considered a hallmark of structural heart disease. Wavy triple, an electrocardiographic sign (Yasser’s sign) is a new specific diagnostic sign and therapeutic guide for hypocalcemia.
J Clin Cardiol, 2023, Volume 4, Issue 2, p58-62 | DOI: 10.33696/cardiology.4.046Angioimmunoblastic T cell Lymphoma Microenvironment
Angioimmunoblastic T cell lymphoma (AITL) is one of the most common T-cell lymphomas, second only to peripheral T-cell lymphoma not otherwise specified (PTCL-NOS). Initially AITL was considered a non-malignant lymphadenopathy with immune hyperactivation, nowadays being classified as a PTCL.
Paradoxical Low Flow Aortic Stenosis: A Clinical Dilemma
Internists as well as cardiologists often receive echocardiogram reports which failed to offer a clear definition of the aortic stenosis (AS) severity due to discordant data regarding the aortic valve gradients and the valve area. Sometimes AS appears severe according to the valve area criteria, in spite of the fact that gradients across the valve are not in the severe range.
Reduced BCR Signaling and a Metabolic Shift Accompanies Malignant Progression of Follicular Lymphoma: A Lesson from Transcriptomics
Lymphoma represents the most common form of hematological malignancy in the developed world, accounting for 3.6% of all cancers and 55.6% of all blood cancers in Europe, with non-Hodgkin lymphomas (NHL) representing 90% of cases.
Lack of Prognostic Significance of Pretreatment Total Metabolic Tumor Volume on Event-free Survival at 24 Months in Diffuse Large B-cell Lymphoma
Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease with variable outcomes. The majority of patients benefit from chemo-immunotherapy; however, 30 to 40% relapse after first-line treatment, and 10% are refractory to first-line treatment. This variability in outcome has led to the identification of prognostic factors to stratify patients based on their risk of relapse. The five-factor international prognostic index (IPI) was formulated for such risk stratification more than 20 years ago, based on clinical information obtained from patients with aggressive lymphomas treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)-like chemotherapy. The addition of rituximab to CHOP chemotherapy led to improved outcomes, diminishing the discriminatory capacity of IPI amongst risk groups. Efforts to enhance the prognostic model by adding or defining new factors have only led to minor improvements without the ability to identify patients at risk of an inferior outcome.
Epidemiologic, Clinical, and Biological Characteristics of Adult T-cell Leukemia/Lymphoma in Martinique (1983- 2013)
Adult T-cell leukemia/lymphoma (ATL) was first described in the Southwest islands of Japan in 1977 [1]. Then, the HTLV-1 (human T-lymphotropic virustype 1) was isolated in the United States in 1981 in two patients, one with mycosis fungoïdes and the other with Sezary syndrome [2,3], which have been consequently renamed.
Mantle Cell Lymphoma and Hematopoietic Cell Transplantation in the Era of Cellular Therapy
Mantle cell lymphoma (MCL) is a rare subtype of non- Hodgkin Lymphoma (NHL) characterized by cyclin D1 translocations. Outcomes are heterogenous, but the disease is generally incurable. High-risk patients been shown to have a median overall survival (OS) of only 37 months and 20% five-year OS. In some patients, the disease is more indolent; such cases are associated with leukemic phase of the disease, SOX11-negativity, and mutated IGHV. Additionally, even across SOX11 positive cases outcomes vary, with worse overall survival in MCL with cytoplasmic staining as compared to nuclear staining. For patients with indolent clinical behavior, observation is frequently employed, and large case series suggest the possibility of prolonged periods before treatment becomes necessary, as long as 128 months, and favorable outcomes even once treatment has been initiated.
Breast Implant-associated Anaplastic Large Cell Lymphoma: A Review with Emphasis on the Role of Brentuximab Vedotin
Anaplastic large cell lymphoma (ALCL) represents a heterogeneous group of T-cell lymphomas, which characteristically express CD30 and are associated with translocations involving the anaplastic lymphoma kinase (ALK) gene on chromosome 2p23 [1]. Systemic ALCL, which may be subclassified by the presence or absence of
Unmasking the Master of Disguise: Defining Advancements in Diagnosis of Intravascular Large B-cell Lymphoma
Intravascular B cell lymphoma (IVBCL) is notoriously difficult to diagnose as the clinical manifestations are protean, and the patterns seen with routine labs and imaging are non-specific. Furthermore, the disease follows an aggressive course and is often fatal within a matter of weeks to months from symptom onset, unless recognized and treated appropriately. This has historically meant that diagnosis was made at autopsy for many patients. Over the past few decades, however, scientific and clinical literature have slowly accumulated to better characterize and raise clinical awareness of this disease. In this paper, we will review the characteristics that make this diagnosis challenging, and then discuss new and emerging diagnostic avenues.
Lower 24-Month Relative Survival among Black Patients with Non- Hodgkin’s Lymphoma: An Analysis of the SEER Data 1997-2015
Recent progress in the therapies used for patients with Non- Hodgkin’s lymphoma (NHL) has improved survival. In 2020, 77,240 people were diagnosed with NHL. Although it accounts for 4% of all cancers, the incidence has been reported to be decreasing in the last few years. About 26% of people will expire from NHL (15% males and 11% females).Non-Hodgkin lymphoma arises from the clonal expansion of B, T, and natural killer (NK) cells. There is a significant degree of heterogeneity in NHL and this is likely related to different degrees of differentiation and maturation of these cells. These hematological malignancies exhibit different tumor behavior and are responsive to different chemotherapy agents which impacts clinical outcomes. There are patients who can be cured with current regimens; however, subtypes such as indolent and some aggressive lymphomas remain incurable necessitating treatment with new therapies including immunotherapy, targeted therapy, CAR T cells, and hematopoietic stem cell transplant.
Flavopiridol (Alvocidib), a Cyclin-dependent Kinases (CDKs) Inhibitor, Found Synergy Effects with Niclosamide in Cutaneous T-cell Lymphoma
Flavopiridol (FVP; alvocidib), an FDA-approved orphan drug, has been studied in clinical trials under both single treatment and combination scenarios; several singleagent Phase I and Phase II clinical trials against leukemia, lymphomas, and solid tumors are active. To date, there have been more than 50 clinical trials involving FVP in the United States. Unfortunately, almost half of patients on FVP clinical trials showed serious adverse effects, implicating appropriate dosages need to be found and an alternative way to circumvent the toxicity of FVP with synergistic agents.
Commentary: Use of BACTRAC Proteomic Database-Uromodulin Protein Expression During Ischemic Stroke
Uromodulin (UMOD) is a glycoprotein expressed by the epithelial cells of the thick ascending limb of Henle’s loop in the kidney. Research has shown that increased uromodulin expression may be associated with lower risk of cardiovascular disease in adults.
BeEAM Conditioning for Autologous Transplant in Lymphoma: A Review of the Evidence, Safety and Efficacy
The ground-breaking PARMA and CORAL trials have substantiated high dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) as standard of care in the treatment of chemosensitive and relapsed Non-Hodgkin’s Lymphoma (NHL). Additionally, the regimen has proven effective in the treatment of relapsed and resistant Hodgkin’s Lymphoma (HL). Globally, carmustine (BCNU), etoposide, cytarabine and melphalan (BEAM) has been the most widely used conditioning regimen of the past 30 years. BEAM conditioning is generally well-tolerated and effective, with the most common toxicity being oral and gastrointestinal mucositis. Despite this, some transplant centres have transitioned from BEAM HDCT to a newer regiment referred to as BeEAM, which replaces BCNU for bendamustine. The movement appears to be primarily driven by a worldwide scarcity of BCNU, which has led to affordability issues. This dramatic rise in drug cost is not insignificant. Between 2013 and 2015, the price of BCNU increased from $200 (CAD) / 100 mg vial to $4,965.14 (CAD) / 100 mg vial.
Body Iron Overload is a Determining Factor in Brain Damage in Acute Ischemic Stroke
Stroke is the second largest cause of death worldwide, with a world annual mortality incidence of about 5.5 million people, and it is also the leading cause of disability worldwide with 50% of survivors being chronically disabled.
Two Cases of Burkitt Lymphoma Presenting as Solid Ovarian Masses
Endemic Burkitt lymphoma has been associated with the Epstein Barr Virus (EBV), particularly in malaria-endemic regions. Primary ovarian Burkitt is an infrequent entity of this disease, and its diagnosis still poses a challenge.
Improve Survival of Out of Hospital Cardiac Arrest with Video-directed Chest Compressions
Background: Cardiovascular disease has been the leading cause of mortality worldwide for the past century, but advancements in health intervention have led to a decline of over 20%. However, the Out of Hospital Cardiac Arrest (OHCA) mortality rate remains unacceptably high, exceeding 90% over the past few decades. The primary reasons are the lack of cardiopulmonary resuscitation (CPR) knowledge and delayed medical response [1].
Antimicrobial Prophylaxis in Lymphoma by Chemotherapy Regimen
Treatment of lymphomas involves a wide variety of chemotherapy, immunotherapy, and targeted-agents tailored to disease biology and patient characteristics. Each of these regimens carry their own risk of opportunistic infections in an immunocompromised population. In addition to the treatment associated immunosuppression, lymphoma itself is immunosuppressive. Lymphoma associated immunosuppression is secondary to increased production of abnormal lymphocytes
The Use of CHA2DS2-VASc Score to Predict Functional Outcomes of Mechanical Thrombectomy
Background: Mechanical thrombectomy is widely used for revascularization of acute ischemic strokes from large vessel occlusions. Functional outcomes following mechanical thrombectomy are typically assessed using the modified Rankin scale. CHA2DS2-VASc score is commonly used to estimate the stroke risk of patients with atrial fibrillation, but studies have verified its use in other various situations. Our study aimed to assess the utility of CHA2DS2-VASc score in predicting outcomes of patients undergoing mechanical thrombectomy.
Short-Term Outcomes Following Transcatheter Aortic Valve Implantation: Classical Low-Flow Low-Gradient Versus Normal-Flow Low-Gradient Severe Aortic Stenosis
Background: Both classical severe low-flow low-gradient aortic stenosis (LFLG-AS) and severe normal-flow low-gradient aortic stenosis (NFLG-AS) patients undergo transcatheter aortic valve implantation (TAVI). However, few studies have compared outcomes between the two groups. Our study aimed to assess short term post-TAVI outcomes between classical LFLG-AS and NFLG-AS.
EASI Monitoring: An Alternative to Conventional Electrocardiography in the Recording of Ventricular Tachycardia
This study compares the EASI monitoring setting with the conventional 12-lead electrocardiogram (ECG) in patients experiencing ventricular tachycardia (VT) episodes. The results revealed that the EASI monitoring setting demonstrated a VT morphology that closely resembled that of the conventional ECG in the majority of cases. This finding suggests that EASI monitoring could serve as a valuable alternative in situations where obtaining a conventional ECG is either risky or not feasible.
COVID Pneumonia, Non-ST Elevation Myocardial Infarction, QRS Fragmentation, and Electrocardiographic Wavy Triple or Yasser's Sign in Hodgkin Lymphoma-Prognostic Influence and Serious Outcome
The COVID-19 virus with severe acute respiratory syndrome (SARS) has a remarkable effect on morbidity and mortality. Non-ST elevation myocardial infarction (NSTEMI) is a category of acute coronary syndrome (ACS) that may represent a primary cardiac manifestation of COVID-19 disease. The QRS-complex fragmentation had been considered a hallmark of structural heart disease. Wavy triple, an electrocardiographic sign (Yasser’s sign) is a new specific diagnostic sign and therapeutic guide for hypocalcemia.
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