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Article: An Unusual Case of Hemorrhagic Pleuropericarditis After COVID-19 Vaccination.

Javed, Aneeqa / Medina, Yelizaveta / Tian, Julia / Alvi, Muhammad Junaid / Sahra, Syeda / Rojas-Marte, Geurys

2022 Volume 14, Issue 5, Page(s) e24828

Abstract: As coronavirus disease 2019 (COVID-19) vaccines are being increasingly administered worldwide, subsequent side effects, such as myocarditis, pericarditis, and myopericarditis, are becoming increasingly more common. Our case describes a 64-year-old male ... ...

Abstract	As coronavirus disease 2019 (COVID-19) vaccines are being increasingly administered worldwide, subsequent side effects, such as myocarditis, pericarditis, and myopericarditis, are becoming increasingly more common. Our case describes a 64-year-old male who developed chest pain and shortness of breath one week after receiving the Moderna (Cambridge, Massachusetts) COVID-19 mRNA vaccine. He was found to have a large, left-sided pleural effusion and a small pericardial effusion. The patient underwent thoracentesis and video-assisted thoracoscopic procedure with chest tube placement, which drained bloody pleural and pericardial fluid. He was treated with a course of colchicine. Subsequent imaging revealed the resolution of pericardial and pleural effusions, along with the resolution of symptoms.
Language	English
Publishing date	2022-05-08
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.24828
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Article: Rare Case of Reversible Pulmonary Arterial Hypertension Secondary to Cyclophosphamide and Doxorubicin Chemotherapy.

Javed, Aneeqa / Medina, Yelizaveta / Bux, Amber / Sahra, Syeda / Rojas-Marte, Geurys

Cureus

2022 Volume 14, Issue 6, Page(s) e26207

Abstract: Pulmonary arterial hypertension (PAH), characterized as a resting mean pulmonary artery pressure greater than 25 mmHg, is due to the narrowing of the pulmonary arteries, which can be idiopathic, inherited, or drug-related. Alkylating agents, including ... ...

Abstract	Pulmonary arterial hypertension (PAH), characterized as a resting mean pulmonary artery pressure greater than 25 mmHg, is due to the narrowing of the pulmonary arteries, which can be idiopathic, inherited, or drug-related. Alkylating agents, including cyclophosphamide, are a risk factor for developing the pulmonary veno-occlusive disease. Drug-induced PAH is extremely rare. A 59-year-old female with newly diagnosed invasive ductal carcinoma of the right breast and high-grade ductal carcinoma in situ of the left breast was initiated treatment with doxorubicin and cyclophosphamide. About one week after receiving the first cycle, the patient developed worsening lower extremity edema and shortness of breath. She was then hospitalized, and a transthoracic echocardiogram and coronary angiogram revealed PAH. The team then changed the breast cancer treatment regimen to Taxol and carboplatin, and PAH was resolved in a follow-up echocardiogram after five months. This report has described the first case of PAH directly related to cyclophosphamide and doxorubicin. It is imperative to promptly recognize this rare but important side-effect as early diagnosis and response can potentially reverse the disease progression.
Language	English
Publishing date	2022-06-22
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.26207
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Article ; Online: Corrigendum to: Outcomes in patients with severe COVID-19 disease treated with tocilizumab: a case-controlled study.

Rojas-Marte, G / Khalid, M / Mukhtar, O / Hashmi, A T / Waheed, M A / Ehrlich, S / Aslam, A / Siddiqui, S / Agarwal, C / Malyshev, Y / Henriquez-Felipe, C / Sharma, D / Sharma, S / Chukwuka, N / Rodriguez, D C / Alliu, S / Le, J / Shani, J

QJM : monthly journal of the Association of Physicians

2021 Volume 116, Issue 8, Page(s) 733

Language	English
Publishing date	2021-01-14
Publishing country	England
Document type	Published Erratum
ZDB-ID	1199985-8
ISSN	1460-2393 ; 0033-5622 ; 1460-2725
ISSN (online)	1460-2393
ISSN	0033-5622 ; 1460-2725
DOI	10.1093/qjmed/hcaa266
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Article: Outcomes in Patients With COVID-19 Disease and High Oxygen Requirements.

Rojas-Marte, Geurys / Hashmi, Arsalan Talib / Khalid, Mazin / Chukwuka, Nnamdi / Fogel, Joshua / Munoz-Martinez, Alejandro / Ehrlich, Samantha / Akbar Waheed, Maham / Sharma, Dikshya / Sharma, Shaurya / Aslam, Awais / Siddiqui, Sabah / Agarwal, Chirag / Malyshev, Yuri / Henriquez-Felipe, Carlos / Shani, Jacob

Journal of clinical medicine research

2021 Volume 13, Issue 1, Page(s) 26–37

Abstract: Background: Approximately 19% of people infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) progress to severe or critical stages of the coronavirus disease 2019 (COVID-19) with a mortality rate exceeding 50%. We aimed to ... ...

Abstract	Background: Approximately 19% of people infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) progress to severe or critical stages of the coronavirus disease 2019 (COVID-19) with a mortality rate exceeding 50%. We aimed to examine the characteristics, mortality rates, intubation rate, and length of stay (LOS) of patients hospitalized with COVID-19 disease with high oxygen requirements (critically ill). Methods: We conducted a retrospective analysis in a single center in Brooklyn, New York. Adult hospitalized patients with confirmed COVID-19 disease and high oxygen requirements were included. We performed multivariate logistic regression analyses for statistically significant variables to reduce any confounding. Results: A total of 398 patients were identified between March 19th and April 25th, 2020 who met the inclusion criteria, of which 247 (62.1%) required intubation. The overall mortality rate in our study was 57.3% (n = 228). The mean hospital LOS was 19.1 ± 17.4 days. Patients who survived to hospital discharge had a longer mean LOS compared to those who died during hospitalization (25.4 ± 22.03 days versus10.7 ± 1.74 days). In the multivariate analysis, increased age, intubation and increased lactate dehydrogenase (LDH) were each independently associated with increased odds of mortality. Diarrhea was associated with decreased mortality (OR 0.4; CI 0.16, 0.99). Obesity and use of vasopressors were each independently associated with increased intubation. Conclusions: In patients with COVID-19 disease and high oxygen requirements, advanced age, intubation, and higher LDH levels were associated with increased mortality, while diarrhea was associated with decreased mortality. Gender, diabetes, and hypertension did not have any association with mortality or length of hospital stay.
Language	English
Publishing date	2021-01-12
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2548987-2
ISSN	1918-3011 ; 1918-3003
ISSN (online)	1918-3011
ISSN	1918-3003
DOI	10.14740/jocmr4405
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Article ; Online: An avulsed radial artery with a high take-off.

Rojas-Marte, Geurys / Chen, On / Verma, Shivani / Rao, Atul / Shani, Jacob / Ayzenberg, Sergey

Vascular

2015 Volume 23, Issue 2, Page(s) 197–200

Abstract: A 63-year-old female was diagnosed with severe aortic stenosis, who underwent a diagnostic coronary angiography via transradial approach prior an aortic-valve replacement. After imaging the left coronary system, entrapment of the diagnostic catheter was ... ...

Abstract	A 63-year-old female was diagnosed with severe aortic stenosis, who underwent a diagnostic coronary angiography via transradial approach prior an aortic-valve replacement. After imaging the left coronary system, entrapment of the diagnostic catheter was encountered as a result of spasm of the radial artery. An arteriogram of the arm revealed an anatomical variation in the radial artery (high take-off). Several attempts to remove the entrapped catheter resulted in avulsion of the artery, which was managed successfully with coil embolization. To our knowledge, no such complication has been reported.
MeSH term(s)	Aortic Valve Stenosis/diagnosis ; Aortic Valve Stenosis/surgery ; Catheters ; Coronary Angiography/methods ; Female ; Forearm/blood supply ; Humans ; Middle Aged ; Radial Artery/surgery ; Treatment Outcome
Language	English
Publishing date	2015-04
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2137151-9
ISSN	1708-539X ; 1708-5381
ISSN (online)	1708-539X
ISSN	1708-5381
DOI	10.1177/1708538114540640
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Zs.A 4277: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Medication-induced Takotsubo Cardiomyopathy presenting with cardiogenic shock-utility of extracorporeal membrane oxygenation (ECMO): case report and review of the literature.

Rojas-Marte, Geurys / John, Jinu / Sadiq, Adnan / Moskovits, Norbert / Saunders, Paul / Shani, Jacob

Cardiovascular revascularization medicine : including molecular interventions

2015 Volume 16, Issue 1, Page(s) 47–51

Abstract: Takotsubo cardiomyopathy (TTC) is a transient condition that affects the myocardium and is seen mostly in post-menopausal women secondary to an emotional or physical stressor; however, certain drugs have been described as cause of this syndrome. We ... ...

Abstract	Takotsubo cardiomyopathy (TTC) is a transient condition that affects the myocardium and is seen mostly in post-menopausal women secondary to an emotional or physical stressor; however, certain drugs have been described as cause of this syndrome. We report the case of a young female with medication--induced TTC, who presented with cardiogenic shock as initial manifestation, treated successfully with extracorporeal membrane oxygenation (ECMO). To our knowledge, this is the first case in the literature describing the use of ECMO in cardiogenic shock due to medication-induced TTC.
MeSH term(s)	Adult ; Diphenhydramine/poisoning ; Electrocardiography ; Extracorporeal Membrane Oxygenation ; Female ; Hemodynamics/drug effects ; Humans ; Ibuprofen/poisoning ; Recovery of Function ; Shock, Cardiogenic/chemically induced ; Shock, Cardiogenic/diagnosis ; Shock, Cardiogenic/physiopathology ; Shock, Cardiogenic/therapy ; Takotsubo Cardiomyopathy/chemically induced ; Takotsubo Cardiomyopathy/diagnosis ; Takotsubo Cardiomyopathy/physiopathology ; Takotsubo Cardiomyopathy/therapy ; Time Factors ; Treatment Outcome ; Ventricular Function, Left/drug effects
Chemical Substances	Diphenhydramine (8GTS82S83M) ; Ibuprofen (WK2XYI10QM)
Language	English
Publishing date	2015-01
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2212113-4
ISSN	1878-0938 ; 1553-8389
ISSN (online)	1878-0938
ISSN	1553-8389
DOI	10.1016/j.carrev.2014.07.004
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Zs.A 5562: Show issues

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Article ; Online: Heart block and Lyme carditis.

Rojas-Marte, G / Chadha, S / Topi, B / Hollander, G / Shani, J

QJM : monthly journal of the Association of Physicians

2014 Volume 107, Issue 9, Page(s) 771–772

MeSH term(s)	Anti-Bacterial Agents/administration & dosage ; Ceftriaxone/administration & dosage ; Electrocardiography ; Heart Block/diagnosis ; Heart Block/etiology ; Humans ; Lyme Disease/complications ; Lyme Disease/drug therapy ; Lyme Disease/physiopathology ; Male ; Myocarditis/drug therapy ; Myocarditis/etiology ; Myocarditis/physiopathology ; Syncope/etiology ; Treatment Outcome ; Young Adult
Chemical Substances	Anti-Bacterial Agents ; Ceftriaxone (75J73V1629)
Language	English
Publishing date	2014-09
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1199985-8
ISSN	1460-2393 ; 0033-5622 ; 1460-2725
ISSN (online)	1460-2393
ISSN	0033-5622 ; 1460-2725
DOI	10.1093/qjmed/hcu021
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Article ; Online: Outcomes in patients with severe COVID-19 disease treated with tocilizumab: a case-controlled study.

QJM : monthly journal of the Association of Physicians

2020 Volume 113, Issue 8, Page(s) 546–550

Abstract: Background: COVID-19 is an ongoing threat to society. Patients who develop the most severe forms of the disease have high mortality. The interleukin-6 inhibitor tocilizumab has the potential to improve outcomes in these patients by preventing the ... ...

Abstract	Background: COVID-19 is an ongoing threat to society. Patients who develop the most severe forms of the disease have high mortality. The interleukin-6 inhibitor tocilizumab has the potential to improve outcomes in these patients by preventing the development of cytokine release storm. Aims: To evaluate the outcomes of patients with severe COVID-19 disease treated with the interleukin-6 inhibitor tocilizumab. Methods: We conducted a retrospective, case-control, single-center study in patients with severe to critical COVID-19 disease treated with tocilizumab. Disease severity was defined based on the amount of oxygen supplementation required. The primary endpoint was the overall mortality. Secondary endpoints were mortality in non-intubated patients and mortality in intubated patients. Results: A total of 193 patients were included in the study. Ninety-six patients received tocilizumab, while 97 served as the control group. The mean age was 60 years. Patients over 65 years represented 43% of the population. More patients in the tocilizumab group reported fever, cough and shortness of breath (83%, 80% and 96% vs. 73%, 69% and 71%, respectively). There was a non-statistically significant lower mortality in the treatment group (52% vs. 62.1%, P = 0.09). When excluding intubated patients, there was statistically significant lower mortality in patients treated with tocilizumab (6% vs. 27%, P = 0.024). Bacteremia was more common in the control group (24% vs. 13%, P = 0.43), while fungemia was similar for both (3% vs. 4%, P = 0.72). Conclusion: Our study showed a non-statistically significant lower mortality in patients with severe to critical COVID-19 disease who received tocilizumab. When intubated patients were excluded, the use of tocilizumab was associated with lower mortality.
MeSH term(s)	Adult ; Aged ; Antibodies, Monoclonal, Humanized/therapeutic use ; Betacoronavirus ; COVID-19 ; Case-Control Studies ; Coronavirus Infections/drug therapy ; Coronavirus Infections/mortality ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Male ; Middle Aged ; New York City/epidemiology ; Oxygen Inhalation Therapy ; Pandemics ; Pneumonia, Viral/drug therapy ; Pneumonia, Viral/mortality ; Receptors, Interleukin-6/antagonists & inhibitors ; SARS-CoV-2 ; Severity of Illness Index ; Treatment Outcome ; COVID-19 Drug Treatment
Chemical Substances	Antibodies, Monoclonal, Humanized ; IL6R protein, human ; Immunosuppressive Agents ; Receptors, Interleukin-6 ; tocilizumab (I031V2H011)
Keywords	covid19
Language	English
Publishing date	2020-06-18
Publishing country	England
Document type	Journal Article
ZDB-ID	1199985-8
ISSN	1460-2393 ; 0033-5622 ; 1460-2725
ISSN (online)	1460-2393
ISSN	0033-5622 ; 1460-2725
DOI	10.1093/qjmed/hcaa206
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Article: Electrocardiographic Associations Seen with Obstructive Sleep Apnea.

Shankar, Shyam / Gupta, Sushilkumar Satish / Rojas-Marte, Geurys / Demir, Selma / Saxena, Abhinav / Obiagwu, Chukwudi / Aggarwal, Nidhi / Rai, Anand Kumar / Kamholz, Stephan / Shetty, Vijay / Kupfer, Yizhak

Sleep disorders

2019 Volume 2019, Page(s) 9704785

Abstract: Background: Obstructive sleep apnea (OSA) is a chronic respiratory disorder associated with repeated nocturnal partial or complete collapse that is often underdiagnosed and associated with multiple comorbidities. The association between specific ... ...

Abstract	Background: Obstructive sleep apnea (OSA) is a chronic respiratory disorder associated with repeated nocturnal partial or complete collapse that is often underdiagnosed and associated with multiple comorbidities. The association between specific features on an electrocardiogram and OSA has not been well studied. This retrospective study attempts to bridge this gap in knowledge. Methods: A total of 265 patients' medical records were reviewed retrospectively. Specific features of their electrocardiograms and their association with the severity of OSA were studied from April 2014 to May 2016. 215 patients were included in the final analysis. Tests of group difference between OSA patients and controls were done using student's t-tests for continuous variables and using chi-square tests for categorical outcomes. Multivariate tests of differences between OSA and control patients were done using logistic regression to control for possible confounding factors. Results: A total of 215 patients with diagnosed OSA and 41 controls in whom OSA was ruled out using polysomnography were compared. Males were more likely to present with OSA than females (93 % versus 76 %; p < 0.001). OSA patients were also significantly older: 52.18 ± 14.04 versus 44.55 ± 14.64; p = 0.002. Deep S waves in V5-6 (p=0.014) and RS pattern with Deep S waves in leads I and AVF (p=0.017) were both significantly associated with OSA based on univariate comparisons. These findings lost significance in the multivariate analysis. Conclusion: The idea of using an electrocardiogram in aiding in the assessment of OSA is attractive and feasible, as it is a safe, noninvasive, and cost-effective method. Our results can be used for early risk stratification in patients with OSA.
Language	English
Publishing date	2019-02-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2619778-9
ISSN	2090-3553 ; 2090-3545
ISSN (online)	2090-3553
ISSN	2090-3545
DOI	10.1155/2019/9704785
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Article ; Online: Should COVID-19 patients >75 years be Ventilated? An Outcome Study.

Raheja, H / Chukwuka, N / Agarwal, C / Sharma, D / Munoz-Martinez, A / Fogel, J / Khalid, M / Hashmi, A T / Ehrlich, S / Waheed, M A / Siddiqui, S / de Brito Gomes, B A / Aslam, A / Merino Gualan, C J / Aftab, I / Tiwari, A / Singh, S / Pouching, K / Somal, N /

Shani, J / Rojas-Marte, G

QJM : monthly journal of the Association of Physicians

2021 Volume 114, Issue 3, Page(s) 182–189

Abstract: Background: Elderly patients with COVID-19 disease are at increased risk for adverse outcomes. Current data regarding disease characteristics and outcomes in this population are limited.: Aim: To delineate the adverse factors associated with outcomes ...

Abstract	Background: Elderly patients with COVID-19 disease are at increased risk for adverse outcomes. Current data regarding disease characteristics and outcomes in this population are limited. Aim: To delineate the adverse factors associated with outcomes of COVID-19 patients ≥75 years of age. Design: Retrospective cohort study. Methods: Patients were classified into mild/moderate, severe/very severe and critical disease (intubated) based on oxygen requirements. The primary outcome was in-hospital mortality. Results: A total of 355 patients aged ≥75 years hospitalized with COVID-19 between 19 March and 25 April 2020 were included.Mean age was 84.3 years. One-third of the patients developed critical disease. Mean length of stay was 7.10 days. Vasopressors were required in 27%, with the highest frequency in the critical disease group (74.1%). Overall mortality was 57.2%, with a significant difference between severity groups (mild/moderate disease: 17.4%, severe/very severe disease: 71.3%, critical disease: 94.9%, P < 0.001).Increased age, dementia, and severe/very severe and critical disease groups were independently associated with increased odds for mortality while diarrhea was associated with decreased odds for mortality (OR: 0.12, 95% CI: 0.02-0.60, P < 0.05). None of the cardiovascular comorbidities were significantly associated with mortality. Conclusion: Age and dementia are associated with increased odds for mortality in patients ≥75 years of age hospitalized with COVID-19. Those who require intubation have the greatest odds for mortality. Diarrhea as a presenting symptom was associated with lower odds for mortality.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; COVID-19/epidemiology ; COVID-19/mortality ; COVID-19/therapy ; Decision Making ; Female ; Hospital Mortality ; Humans ; Male ; New York City/epidemiology ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/mortality ; Pneumonia, Viral/therapy ; Pneumonia, Viral/virology ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index
Language	English
Publishing date	2021-02-12
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	1199985-8
ISSN	1460-2393 ; 0033-5622 ; 1460-2725
ISSN (online)	1460-2393
ISSN	0033-5622 ; 1460-2725
DOI	10.1093/qjmed/hcab029
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