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  1. Article: Biologic Therapy in HIV: To Screen or Not to Screen.

    Davis, Willam / Vavilin, Ilan / Malhotra, Nidhi

    Cureus

    2021  Volume 13, Issue 6, Page(s) e15941

    Abstract: Biologic therapy has revolutionized the management of chronic inflammatory diseases, including inflammatory bowel disease (IBD). Before the initiation of therapy, it is critical to rule out prior infection of chronic hepatitis B virus (HBV) and ... ...

    Abstract Biologic therapy has revolutionized the management of chronic inflammatory diseases, including inflammatory bowel disease (IBD). Before the initiation of therapy, it is critical to rule out prior infection of chronic hepatitis B virus (HBV) and tuberculosis (TB). However, screening for human immunodeficiency virus (HIV) is not as routinely completed. We present a case of a 56-year-old male on ustekinumab for the management of Crohn's disease, found to have undiagnosed human immunodeficiency virus (HIV) with progression to acquired immunodeficiency syndrome (AIDS).
    Language English
    Publishing date 2021-06-26
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.15941
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Impella Management for the Cardiac Intensivist.

    Papolos, Alexander I / Barnett, Christopher F / Tuli, Aakash / Vavilin, Ilan / Kenigsberg, Benjamin B

    ASAIO journal (American Society for Artificial Internal Organs : 1992)

    2022  Volume 68, Issue 6, Page(s) 753–758

    Abstract: The Impella mechanical circulatory support (MCS) system is a catheter-based continuous flow cardiac assist device that is widely used in the treatment of cardiogenic shock in medical and surgical cardiac intensive care units. As with all forms of MCS, ... ...

    Abstract The Impella mechanical circulatory support (MCS) system is a catheter-based continuous flow cardiac assist device that is widely used in the treatment of cardiogenic shock in medical and surgical cardiac intensive care units. As with all forms of MCS, device-related complications remain a major concern, the incidence of which can be mitigated by adhering to a few fundamental concepts in device management. The purpose of this review is to comprehensively describe our strategy for managing, repositioning, and weaning the Impella catheter.
    MeSH term(s) Catheters/adverse effects ; Heart-Assist Devices/adverse effects ; Humans ; Intensive Care Units ; Retrospective Studies ; Shock, Cardiogenic/surgery ; Treatment Outcome
    Language English
    Publishing date 2022-02-16
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 759982-1
    ISSN 1538-943X ; 0162-1432 ; 1058-2916
    ISSN (online) 1538-943X
    ISSN 0162-1432 ; 1058-2916
    DOI 10.1097/MAT.0000000000001680
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  3. Article: Contemporary approach to cardiogenic shock care: a state-of-the-art review.

    Mehta, Aditya / Vavilin, Ilan / Nguyen, Andrew H / Batchelor, Wayne B / Blumer, Vanessa / Cilia, Lindsey / Dewanjee, Aditya / Desai, Mehul / Desai, Shashank S / Flanagan, Michael C / Isseh, Iyad N / Kennedy, Jamie L W / Klein, Katherine M / Moukhachen, Hala / Psotka, Mitchell A / Raja, Anika / Rosner, Carolyn M / Shah, Palak / Tang, Daniel G /
    Truesdell, Alexander G / Tehrani, Behnam N / Sinha, Shashank S

    Frontiers in cardiovascular medicine

    2024  Volume 11, Page(s) 1354158

    Abstract: Cardiogenic shock (CS) is a time-sensitive and hemodynamically complex syndrome with a broad spectrum of etiologies and clinical presentations. Despite contemporary therapies, CS continues to maintain high morbidity and mortality ranging from 35 to 50%. ... ...

    Abstract Cardiogenic shock (CS) is a time-sensitive and hemodynamically complex syndrome with a broad spectrum of etiologies and clinical presentations. Despite contemporary therapies, CS continues to maintain high morbidity and mortality ranging from 35 to 50%. More recently, burgeoning observational research in this field aimed at enhancing the early recognition and characterization of the shock state through standardized team-based protocols, comprehensive hemodynamic profiling, and tailored and selective utilization of temporary mechanical circulatory support devices has been associated with improved outcomes. In this narrative review, we discuss the pathophysiology of CS, novel phenotypes, evolving definitions and staging systems, currently available pharmacologic and device-based therapies, standardized, team-based management protocols, and regionalized systems-of-care aimed at improving shock outcomes. We also explore opportunities for fertile investigation through randomized and non-randomized studies to address the prevailing knowledge gaps that will be critical to improving long-term outcomes.
    Language English
    Publishing date 2024-03-13
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2781496-8
    ISSN 2297-055X
    ISSN 2297-055X
    DOI 10.3389/fcvm.2024.1354158
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: A Band That Causes Leaky Valves: Severe Mitral Regurgitation due to Left Atrial Fibrous Band-A Case Report and Literature Review.

    Nnaoma, Christopher / Sandhu, Gurdarshan / Sossou, Christoph / Vavilin, Ilan / Bustillo, Jose / Garg, Anshu

    Case reports in cardiology

    2019  Volume 2019, Page(s) 2458569

    Abstract: Left atrial fibrous band is a rare clinical and echocardiographic finding characterized by the presence of a fibrous band attached to the mitral valve. Diagnosis is accomplished with transesophageal echocardiography (TEE), live 3D imaging, or cardiac MRI. ...

    Abstract Left atrial fibrous band is a rare clinical and echocardiographic finding characterized by the presence of a fibrous band attached to the mitral valve. Diagnosis is accomplished with transesophageal echocardiography (TEE), live 3D imaging, or cardiac MRI. Most patients are asymptomatic and incidental findings. However, in rare cases, an atrial fibrous band can produce symptoms such as dyspnea on exertion, fatigue, and lightheadedness secondary to mitral regurgitation (MR) which can lead to heart failure if unattended to. More serious complications such as cardioembolic phenomenon can occur. We herein report a case of a 55-year-old male with hypertension who presented with dyspnea on exertion and chest pain. Transthoracic echocardiography (TTE) showed mitral valve prolapse with moderate to severe mitral regurgitation. TEE showed an atrial fibrous band. Given the patient's poor exercise tolerance, he was taken to surgery for a mitral annuloplasty.
    Language English
    Publishing date 2019-03-19
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2627627-6
    ISSN 2090-6412 ; 2090-6404
    ISSN (online) 2090-6412
    ISSN 2090-6404
    DOI 10.1155/2019/2458569
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Implications of Misclassification of Type 2 Myocardial Infarction on Clinical Outcomes.

    Hawatmeh, Amer / Thawabi, Mohammad / Aggarwal, Rashmi / Abirami, Chandra / Vavilin, Ilan / Wasty, Najam / Visveswaran, Gautam / Cohen, Marc

    Cardiovascular revascularization medicine : including molecular interventions

    2019  Volume 21, Issue 2, Page(s) 176–179

    Abstract: Background: Patients with type 2 myocardial infarction (MI) are often classified under the diagnosis of non-ST-segment-elevation MI (NSTEMI) despite the significant differences in clinical characteristics, management, and outcomes between type 2 MI and ... ...

    Abstract Background: Patients with type 2 myocardial infarction (MI) are often classified under the diagnosis of non-ST-segment-elevation MI (NSTEMI) despite the significant differences in clinical characteristics, management, and outcomes between type 2 MI and type 1 NSTEMI. This may have significant implications that can lead to inaccurate assessment of quality measures by MI quality review programs.
    Methods: A single-center retrospective study of 1224 patients discharged with the diagnosis of type 1 NSTEMI between January 2015 and September 2017. Based on the third universal definition of MI, we stratified patients into type 2 MI or type 1 NSTEMI. Patient's characteristics, comorbidities, medications prescribed during hospitalization and at discharge, readmissions within 30 days after discharge, and diagnostic and therapeutic interventions data was collected. The primary goal of this study was to identify how often type 2 MI patients were misclassified as type 1 NSTEMI, we also assessed the differences in treatment and outcomes between type 2 MI and type 1 NSTEMI.
    Results: 1224 patients assigned the ICD-9 and ICD-10 codes of type 1 NSTEMI at discharge were evaluated for study inclusion. After application of the inclusion criteria, 945 patients were included in the final analysis. Of these 945 patients, 281 (29.7%) patients were classified as type 2 MI and 664 (70.3%) patients were classified as type 1 NSTEMI. Patients with type 2 MI were older, more likely to have systolic heart failure, had lower peak troponin levels, were less likely to receive aspirin, P2Y12 inhibitors and statin at discharge, and had longer length of stay. Compared with type 1 NSTEMI patients, those with type 2 MI had higher all cause 30-day mortality (13.5% versus 2.9%, P < 0.0001) (RR: 4.65; 95% CI, 2.85-9.65). After adjusting for patient demographics, comorbidities, and medications, patients with type 2 MI were still more likely to die within 30 days after discharge (RR: 2.89; 95% CI, 1.58-7.46). In addition, patients with type 2 MI were more likely to be readmitted within 30 days after discharge than patients with type 1 NSTEMI (17.7% versus 13.9%, P < 0.01) (RR: 1.27; 95% CI, 1.08-2.5).
    Conclusions: Close to one third of patients given the diagnosis of type 1 NSTEMI at discharge at our institution were type 2 MI patients. Patients with type 2 MI are managed differently from type 1 NSTEMI patients and have higher 30-day mortality and readmission rate. Misclassification of type 2 MI as type 1 NSTEMI can have a significant impact on hospitals MI clinical performance and quality measures.
    MeSH term(s) Age Factors ; Aged ; Aspirin/therapeutic use ; Comorbidity ; Diagnostic Errors ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Length of Stay ; Male ; Non-ST Elevated Myocardial Infarction/classification ; Non-ST Elevated Myocardial Infarction/diagnosis ; Non-ST Elevated Myocardial Infarction/mortality ; Non-ST Elevated Myocardial Infarction/therapy ; Patient Discharge ; Patient Readmission ; Platelet Aggregation Inhibitors/therapeutic use ; Predictive Value of Tests ; Prognosis ; Purinergic P2Y Receptor Antagonists/therapeutic use ; Quality Indicators, Health Care ; Retrospective Studies ; Risk Factors ; Terminology as Topic ; Time Factors
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Platelet Aggregation Inhibitors ; Purinergic P2Y Receptor Antagonists ; Aspirin (R16CO5Y76E)
    Language English
    Publishing date 2019-04-12
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 2212113-4
    ISSN 1878-0938 ; 1553-8389
    ISSN (online) 1878-0938
    ISSN 1553-8389
    DOI 10.1016/j.carrev.2019.04.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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