Bridgeport Hospital

Background Autosomal dominant polycystic kidney disease (ADPKD) is associated with various cardiovascular abnormalities, including spontaneous coronary artery dissection and atrial fibrillation. However, limited data exist to describe the association between ADPKD and acute coronary syndrome or heart failure. Aims This systematic review and meta‐analysis evaluated the occurrence of cardiovascular events among patients with ADPKD compared to those without ADPKD. Methods A comprehensive literature search was conducted using Embase, PubMed and Scopus databases. Of 416 initially identified articles, 18 of them were reviewed in detail, and three cohort studies, comprising a total of 7888 patients with ADPKD, were included in the final analysis. Results In comparison with patients without ADPKD, the pooled data revealed that ADPKD patients had a significantly higher odds of any adverse cardiovascular events (odds ratio (OR) 1.36; 95% confidence interval (CI): 1.24–1.28), including myocardial infarction (OR 1.86; 95% CI: 1.05–3.32) and congestive heart failure (OR 1.36; 95% CI: 1.22–1.51). However, there was no significant difference in mortality (OR 1.37; 95% CI: 0.77–2.44). Conclusion Patients with ADPKD are at a significantly increased risk for major adverse cardiovascular events, such as myocardial infarction and congestive heart failure. Despite the elevated risk of these cardiovascular complications, no significant difference in overall mortality was observed. Further studies are needed to assess ADPKD's cardiovascular risk and possible preventive strategies.

Ischemic strokes can cause vertigo, particularly when involving the posterior circulation of the brain. Prior research has suggested that thin-Sect. (3 mm) axial or coronal DWI may improve the detection of ischemic stroke compared to thick (5 mm) DWI. However, relative sensitivity of differing thin DWI sequences is unknown. In this retrospective cohort study, we compare the sensitivity of thin coronal DWI and thin axial DWI in detection of brain ischemia. Retrospective study at a single institution (2/18/2020–8/31/2023) of patients who presented to the emergency department with vertigo/dizziness and underwent an abbreviated MRI protocol (3 mm axial DWI, 3 mm coronal DWI, axial FLAIR, and axial SWI). For each case with an ischemic lesion, the visibility of infarct on thin axial and coronal DWIs was rated; location and size were also recorded. Visibility on either sequence was considered the reference standard. Sensitivity was compared with McNemar’s test. 615 abbreviated MRI examinations were performed; 24/615 (3.9%) had an ischemic lesion (15 cerebral, 7 brainstem, 13 cerebellar). 24 of these MRI examinations with ischemic lesions were performed using 3 mm axial MRI and on 3T MRI. All lesions (24/24) were visible on thin axial DWI (100% sensitivity, 95% CI: 0.95-1.00). Fewer lesions (20/24) were seen on thin coronal DWI (83% sensitivity, 95% CI: 0.72–0.91). The difference in sensitivity was statistically significant (p = 0.0374). Lesions not visible on coronal DWI were 2–8 mm in size, the largest in the middle cerebellar peduncle. Thin coronal DWI may not improve additional diagnostic utility beyond thin axial DWI for the detection of ischemia in patients with dizziness. When designing protocols tailored for stroke detection (particularly in the posterior circulation), replacing conventional (5 mm) DWI with thin (3 mm) axial DWI may be preferable to adding a thin coronal sequence.

Background The integration of artificial intelligence (AI) into cardiovascular procedures has significantly advanced diagnostic accuracy, outcome prediction, and robotic-assisted surgeries. However, a comprehensive bibliometric analysis of AI’s impact in this field is lacking. This study examines research trends, key contributors, and emerging themes in AI-driven cardiovascular interventions. Methods We retrieved relevant publications from the Web of Science Core Collection and analyzed them using VOSviewer, CiteSpace, and Biblioshiny to map research trends and collaborations. Results AI-related cardiovascular research has grown substantially from 1993 to 2024, with a sharp increase from 2020 to 2023, peaking at 93 publications in 2023. The USA (127 papers), China (79), and England (31) were the top contributors, with Harvard University leading institutional output (17 papers). Frontiers in Cardiovascular Medicine was the most prolific journal. Core research themes included “machine learning,” “mortality,” and “cardiac surgery,” with emerging trends in “association,” “implantation,” and “aortic stenosis,” underscoring AI’s expanding role in predictive modeling and surgical outcomes. Conclusion AI demonstrates transformative potential in cardiovascular procedures, particularly in diagnostic imaging, predictive modeling, and patient management. This bibliometric analysis highlights the growing interest in AI applications and provides a framework for integrating AI into clinical workflows to enhance diagnostic accuracy, treatment strategies, and patient outcomes.

Background The application of artificial intelligence (AI) in cardiac imaging has rapidly evolved, offering enhanced accuracy and efficiency in the diagnosis and management of cardiovascular diseases. This bibliometric study aimed to evaluate research trends, impact, and scholarly output in this expanding field. Methods A systematic search was conducted on 14 August 2024, using the Web of Science Core Collection database. VOSviewer, CiteSpace, and Biblioshiny were utilized for data analysis. Results The findings revealed a significant increase in publications on AI in cardiovascular imaging, particularly from 2018 to 2023, with the United States leading in research output. England and the United States have emerged as central hubs in the global research network, highlighting their role in generating high-quality and impactful publications. The University of London was identified as the top contributing institution, while Frontiers in Cardiovascular Medicine was the most prolific journal. Keyword analysis highlighted machine learning, echocardiography, and diagnosis as the most frequently occurring terms. A time trend analysis showed a shift in research focus towards AI applications in cardiac computed tomography (CT) and magnetic resonance imaging (MRI), with recent keywords like ejection fraction, risk, and heart failure reflecting emerging areas of interest. Conclusion Healthcare providers should consider integrating AI tools into cardiovascular imaging practice, as AI has demonstrated the potential to enhance diagnostic accuracy and improve patient outcomes. This study highlights the rising importance of AI in personalized and predictive cardiovascular care, urging healthcare providers to stay informed about these advancements to enhance clinical decision-making and patient management.

Background Umbrella review studies have become increasingly vital in evidence synthesis, offering a comprehensive overview by analyzing multiple systematic reviews and meta-analyses. This bibliometric study aimed to delineate the growth and thematic evolution of umbrella reviews within evidence-based medicine, illuminating their integral role in synthesizing high-level evidence. Methods Utilizing the Web of Science Core Collection, we performed a search for publications on umbrella reviews, identifying relevant articles through a refined strategy. Analytical tools including VOS Viewer and CiteSpace were employed to visualize connections and trends among the gathered data, converting intricate bibliometric information into comprehensible visual maps. Results Our search yielded 2965 pertinent publications, highlighting a marked growth in research output, particularly from 2010 to 2023. The United States, United Kingdom, and China were predominant in this field, with leading institutions like King’s College London and the University of Toronto at the forefront. The analysis identified major journals such as BMJ Open and PLOS One as key publishers. Co-citation and keyword analysis revealed current research focuses, with recent trends emphasizing COVID-19 and mental health. The study also uncovered a robust international collaboration network, underscoring the global impact of umbrella reviews. Conclusion This bibliometric analysis confirms the expanding influence and utility of umbrella reviews in medical research and decision-making. By charting the evolution and current trends in this field, our study not only showcases the geographical and institutional distribution of research but also guides future scholarly efforts to advance evidence synthesis methodologies.

Background: Identifying acute ischemic stroke (AIS) risk factors is crucial in risk stratification and prevention measures. Here, we conducted a gender-based analysis of AIS in resource-limited settings. Method: This retrospective study included 80 AIS patients (40 male and 40 female) who were admitted to Al-Thora General Hospital in Ibb, Yemen, between June and September 2023. Clinical characteristics and laboratory findings were obtained from patient medical records. Univariate analyses were conducted by analyzing factors associated with AIS between different genders using odds ratio (OR) and 95% confidence interval (CI). Results: The mean age of females and males were 55.5 ± 17.6 years and 67.2 ± 12.4 years, respectively. According to the results of the univariate analysis, the following factors were statistically significant predictors of stroke in males: age >60 years (OR: 9.06; 95% CI: 2.11–63.31, p = 0.008), history of hypertension (OR: 3.78; 95% CI: 1.34–11.84, p = 0.024), active smoking (OR: 9.00; 95% CI: 3.39–26.00, p < 0.001), Khat chewing (OR:12.67; 95% CI: 3.23–84.73, p = 0.001), history of cardiovascular disease (CVD) (OR: 5.67; 95% CI: 2.04–17.71, p = 0.001), and severe stroke as measured by the National Institutes of Health Stroke Scale (NIHSS) (OR: 3.84; 95% CI: 1.18–14.16, p = 0.032). In contrast, shortened activated partial thromboplastin time (APTT) =28.4 seconds (OR: 0.22; 95% CI: 0.08–0.56, p = 0.002) was statistically significantly associated with AIS in women. Conclusion: Our study reveals that males aged over 60 years were at a higher risk of experiencing strokes, particularly those with a history of hypertension, smoking, Khat chewing, CVD, and severe scores on the NIHSS. Conversely, females with shorter APTTs (≤28.4 seconds) were more vulnerable. Effective preventive measures and risk management can prevent the occurrence of most AIS, particularly in environments with limited resources.

Background: Induction of labor (IOL) is the iatrogenic stimulation of uterine contractions before the onset of spontaneous labor, and it is used as a therapeutic option when the potential maternal and/or fetal benefits outweigh the associated risks. Given that IOL as an intervention can be detrimental to both mother and child, it is crucial to ensure that the benefits of the shift in clinical practice exceed the risks. Since little is known about IOL in Yemen, this study was conducted to identify the predictive factors of IOL success or failure. Methods: A retrospective cross-sectional study was conducted on laboring mothers who gave birth following IOL at Al-Thora General Hospital, Ibb, Yemen, over a three-year period, from June 2019 to January 2022. All eligible participants were enrolled at admission using structured questionnaires and quota sampling techniques until the desired sample size was achieved. Data on the parturient’s sociodemographic characteristics, induction methods, and outcomes were taken from personal case files and the hospital’s maternity/delivery register. The factors influencing IOL outcomes were determined using a logistic regression analysis. Results: The average age of the 505 individuals induced into labor was 26.99 ± 6.24 years, and the majority of them (46.1%) were in the 25–34 age range. A significant proportion (74.3%) lived in urban areas, and the majority (66.1%) regularly attended perinatal care. Premature rupture of membranes (PROM) was the main cause of IOL at 65.1%. Following IOL, 444 women (87.9%) gave birth vaginally. A total of 61 (12.1%) cases had cesarean deliveries. Multivariate logistic regression analysis revealed that the odds ratio (OR) for significantly predicting IOL success for mothers aged 25–34 years was 0.46 (95% CI: 0.26–0.84, p = 0.013). The adjusted OR (AOR) indicated that multiparity (AOR: 0.24; 95% CI: 0.12–0.49, p < 0.001), misoprostol use for induction (AOR: 0.34; 95% CI: 0.18–0.65, p < 0.001), PROM (AOR: 0.34; 95% CI: 0.15–0.78, p = 0.011), and oligohydramnios cases (OR: 0.19, 95% CI: 0.04–1.00, p = 0.050) significantly predicted IOL success. Conversely, maternal complications (OR: 1.41; 95% CI: 0.13–15.13), maternal age exceeding 34 years (OR: 1.23; 95% CI: 0.48–3.19), gestational age between 37 and 40 weeks (OR: 1.28; 95% CI: 0.48–3.41) or beyond 40 weeks (OR: 1.42; 95% CI: 0.36–5.53), baby weight between 2 and 4 kg (OR: 1.39; 95% CI: 0.64–3.04), and post-term pregnancies (OR: 1.07; 95% CI: 0.32–3.49) all increased the risk of IOL failure. Conclusion: Mothers between the ages of 25 and 34 years, those with multiparity, misoprostol users, PROM cases, and oligohydramnios cases had higher rates of IOL success. In contrast, advanced maternal age, advanced gestational age, advanced baby weight, and post-term pregnancies were all associated with IOL failure. Therefore, in order to provide safe IOL care, healthcare professionals should take these factors into account. The majority of failed IOL determinants were associated with unjustified and inconsistent IOL indications. Therefore, developing well-established practical guidelines and avoiding unjustified case selection may help reduce IOL failure rates.

Purpose of the Review Pericardial diseases, although common, can present significant management challenges, notably in recurrent or refractory cases. This review highlights evidence-based diagnostic and therapeutic approaches, focusing on recent advancements. Recent Findings Emerging diagnostic techniques and therapeutic options have significantly enhanced the management of pericardial diseases including computed tomography-assisted pericardiocentesis, particularly in patients with poor visualization by transthoracic echocardiography. Therapeutic advances for the treatment of recurrent pericarditis include new immunosuppressive therapies with promising efficacy in reducing both recurrence rates and symptom burden. Summary Pericardial diseases are prevalent and often complex, requiring a tailored approach to management. Novel advances in imaging technologies and pharmacologic therapies have improved diagnostic precision and patient care. Continued research and clinical trials are essential to further refine these strategies.

Here, we report a case of a female adult patient presenting with fleshy lesions on her scalp who underwent elective excision, and two separate lesions were identified on histopathology. She was found to have an unusual concurrent presentation of syringocystadenoma papilliferum (SCAP) and basal cell carcinoma, emphasising the importance of differential diagnosis in cutaneous lesions. While SCAP is benign, the presence of basal cells necessitates careful monitoring and appropriate treatment. Factors contributing to the simultaneous occurrence of these lesions, such as genetic predisposition or environmental factors, warrant further investigation. Clinicians should be aware of the potential for concurrent skin lesions, particularly in sun-exposed areas. Comprehensive evaluation and management are crucial to ensure appropriate treatment and follow-up for patients presenting with multiple skin tumours.