Current Issue : October-December Volume : 2026 Issue Number : 4 Articles : 5 Articles
Prenatal diagnosis of critical congenital heart disease (cCHD) and subsequent perinatal recommendations are vital components of prenatal care that affect infant morbidity and mortality. However, there is limited understanding of the relationship between fetal cardiology prenatal care quality, infant outcomes, and maternal social determinants of health (SDoH). The aim of this study was to better understand this relationship, and to further characterize the continuum of prenatal to postnatal care in a population of maternal-infant dyads diagnosed with cCHD. This was a single-site, retrospective cohort study of 217 maternal-infant dyads with cCHD cared for between 2021 and 2022. A community deprivation index was used as a marker of maternal SDoH. 198 dyads had a prenatal cCHD diagnosis. Maternal deprivation was similar in those with prenatal versus postnatal diagnosis. The majority were identified on obstetric anatomy ultrasound, with median 15 days (IQR: 7, 28) from concern to fetal echocardiogram. Nearly all had perinatal delivery recommendations, while 73% had cardiothoracic surgery and 60% genetics referral. Only 76% of those diagnosed prenatally were alive at birth admission discharge. Multivariable analysis demonstrated an association between fetal cardiology visit cancelation and earlier gestational age at birth (β −1.5, 95% CI −2.9, −0.05); time to fetal echocardiogram and no-show visits were not associated with outcomes. There was no association between higher maternal deprivation and fetal cardiology care. In conclusion, cCHD represents a subset of lesions with high morbidity and mortality, with nearly 1 in 4 prenatally diagnosed patients not reaching birth admission discharge. Identifying areas for fetal cardiology care optimization has the potential to affect outcomes; however further research is needed to understand the relationship between visit cancelation and gestational age at birth, as well as the impact of care quality and SDoH on optimal care delivery....
Background: Left bundle branch area pacing (LBBAP) has emerged as a promising alternative to conventional biventricular pacing (BIVP) for cardiac resynchronization therapy (CRT). While previous data suggest LBBAP may provide superior outcomes, existing evidence needs more data. Methods: This retrospective study included all patients who underwent de- novo CRT at two centers in France (2022–2024). Procedural and clinical outcomes were compared between LBBAP and BIVP groups for de- novo CRT indications, using inverse probability weighting propensity score. Results: A total of 314 patients were included (75 LBBAP, 239 BIVP). Patients receiving LBBAP were older and more likely to have atrial fibrillation. Compared to BIVP, LBBAP was associated with shorter procedure time (96 vs. 128 min; p < 0.001), narrower paced QRS (128 vs. 139 ms; p < 0.001), and lower post- discharge device- related complications (1% vs. 11%; HR 0.10, 95% CI 0.01–0.84; p = 0.033). At 1- year, improvement in left ventricular ejection fraction (LVEF) was similar between groups (median ΔLVEF +15%; p = 0.438), as were hyper- response rates (52% vs. 60%; p = 0.231). After IPW- PS, no significant differences were observed in heart failure hospitalization (HR 0.99, 95% CI 0.40–2.64; p = 0.999), new- onset atrial fibrillation (HR 1.69, 95% CI 0.41–6.94; p = 0.492), sustained ventricular arrhythmias (HR 1.23, 95% CI 0.15–6.49; p = 0.828), overall (HR 1.10, 95% CI 0.44– 2.62; p = 0.801), and cardiovascular deaths (HR 0.92, 95% CI 0.27–2.79; p = 0.927). Conclusion: LBBAP is associated with comparable resynchronization and clinical outcomes to BIVP, with fewer late complications....
Objectives: Myelodysplastic syndromes (MDSs) are a heterogeneous group of clonal hematopoietic disorders characterized by ineffective hematopoiesis, genomic instability, and a high risk of progression to acute myeloid leukemia. Oxidative stress (OS) has emerged as a central factor in MDS pathophysiology, contributing to DNA damage, altered cellular signaling, and disease progression. Recent advances in artificial intelligence (AI) and machine learning (ML) offer a transformative approach for integrating multidimensional datasets including oxidative stress markers, hematologic parameters, and molecular profiles to enhance diagnosis, prognostication, and therapeutic monitoring in MDS. Methods: A comprehensive literature search was conducted in PubMed and Scopus, using the keywords “OS biomarkers,” “AI,” and “MDS”. Results: Modified redox biomarkers can be correlated with oxidative imbalance and disease progression. ML models such as neural networks, decision trees, and support vector machines effectively capture complex relationships among redox biomarkers, enhancing risk stratification and prediction of treatment response. AI-driven proteomic analyses further revealed OS-related protein signatures linked to MDS pathophysiology. Overall, AI and ML enable the transformation of multidimensional OS data into clinically actionable tools for personalized management in MDS. Conclusions: Integrating biomarker research with AI-based analytics holds promise for advancing personalized diagnostics, prognostication, and therapeutic strategies in MDS, paving the way toward precision medicine....
Background: In hematologic malignancies, treatment allocation and outcome prediction are traditionally driven by clinical and biological parameters. However, growing evidence suggests that non-clinical factors—such as psychosocial context, caregiver availability, organizational support, and digital health integration—play a pivotal role in patients’ ability to tolerate and adhere to complex therapeutic pathways. The concept of “resilience” may offer a more comprehensive framework to capture this multidimensional readiness to treatment. Methods: We conducted a narrative review of the literature focusing on patient and caregiver resilience in hematologic settings. PubMed, Scopus, and Web of Science were searched for studies published in English over the last 15 years, addressing clinical, psychosocial, organizational, and contextual determinants influencing treatment tolerance, continuity of care, and outcomes in hematology. Results: the literature highlights resilience as a dynamic construct shaped by clinical fitness, psychological resources, caregiver competence, social and family context, healthcare system organization, and access to supportive technologies such as telemedicine. Several domains emerged as recurrent determinants of resilience, yet no standardized, integrated assessment tool is currently available in routine hematologic practice. Conclusions: Resilience in hematology should be reframed as a multidimensional, context-dependent construct extending beyond traditional clinical fitness. Incorporating resilience-oriented assessment into clinical workflows may improve treatment personalization, optimize resource allocation, and enhance patient- and caregiver-centered care. Future research should focus on developing pragmatic, clinically applicable tools to operationalize resilience in real-world hematologic settings....
Objectives: To understand the current status of transfusion training for haematology specialty registrars in the UK and identify potential solutions for improvement. Background: Transfusion knowledge and experience are essential for all haematologists. There are concerns regarding inconsistencies with the delivery of transfusion training. Methods: A 30-question online survey was distributed using the SurveyMonkey platform to UK haematology specialty trainees in June–July 2023. Results: A total of 150 responses (response rate 24%) were received from trainees at different stages of training in 17 training regions. Forty-four percent (66/150) trainees had undertaken or were expected to undertake a dedicated transfusion post during their training; these were deemed to be educationally useful. Ninety-nine percent (149/150) trainees had managed transfusion queries at work. Most trainees (69%, 103/150) had received teaching in hospitals outside of a dedicated transfusion post. A high proportion (87%, 131/150) had attended a transfusion course provided by a national blood service. Levels of overall satisfaction with the transfusion training provided varied: very satisfied/ satisfied (30%), neutral (31%), dissatisfied/very dissatisfied (39%). The most common barriers to training selected were lack of exposure to the transfusion laboratory (75%), clashing clinical commitments taking priority (74%), and lack of provision of dedicated transfusion training (70%). Conclusion: There is mixed satisfaction with the transfusion training received by UK haematology registrars, evident from this survey. Protected time for transfusion training in dedicated transfusion posts and in other hospital posts, including laboratory time, is needed for all haematology trainees....
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