The following is a list of Mission hospitals.
A 60-year-old male with a history of decompensated chronic liver disease and resolving hepatic encephalopathy was transferred for further evaluation following a witnessed episode of prolonged asystole. The patient's admission electrocardiogram showed spontaneous transitions between a borderline R-P narrow complex rhythm and sinus rhythm. The rhythm was observed to be easily terminated with ventricular overdrive pacing via the temporary catheter. We questioned what the mechanism of the rhythm may be.
Heart failure (HF) is a complex syndrome with high morbidity and mortality. Despite advancements in treatment, its management remains a challenge. The objective of this study was to map the scientific landscape of artificial intelligence (AI) applications in HF management through a bibliometric analysis. Data were retrieved from the Web of Science Core Collection. Keywords related to AI and HF were used to identify relevant research articles. Various bibliometric tools, such as Biblioshiny, VOS viewer, and CiteSpace, were used for quantitative trends, collaboration networks, and thematic areas, which were assessed. A total of 1332 studies were included in the final analysis. Publication trends show a sharp increase in AI research related to HF from 2016 onward, with 317 studies published in 2025. The most frequent keywords in the field were heart failure (n = 599), machine learning (n = 516), and AI (n = 225). Other significant keywords included mortality (n = 201), diagnosis (n = 168), and risk (n = 162). Cluster analysis identified major research themes, including Cardiac & Cardiovascular Systems, Computer Science - Interdisciplinary Applications, Computer Science - Artificial Intelligence, Health Care Sciences & Services, Radiology, Nuclear Medicine & Medical Imaging, Cell Biology, Medical Informatics, Endocrinology & Metabolism, and Neurosciences. AI has rapidly become a central tool in HF management, with significant contributions from leading countries and institutions. However, further global collaboration and standardized reporting frameworks are needed to ensure the equitable translation of these technologies into clinical practice.
Accurate assessment of volume status in acute decompensated heart failure (ADHF) remains challenging. Point-of-care ultrasound (POCUS) offers a rapid, non-invasive approach to directly evaluate venous and pulmonary congestion. In this exploratory study, 25 veterans admitted with ADHF underwent serial POCUS examinations of jugular venous pressure (JVP), inferior vena cava (IVC) diameter and collapsibility, and pulmonary B-lines. Pulmonary B-lines were measured using a novel 4-quadrant method. Daily clinical assessments and laboratory data were used to adjudicate volume status. Associations between POCUS findings and clinical congestion were analyzed using chi-square testing. Twenty-four patients were included in the final analysis (mean age 76 years; 96% male; mean BMI 30.86 kg/m2). Elevated JVP on POCUS (≥10 cm H2O) and IVC diameter > 21 mm were strongly associated with clinical volume overload (p < 0.001 for both). B-lines showed no significant association (p = 0.806). Obesity limited bedside JVP evaluation but did not affect POCUS JVP acquisition. Combined JVP + IVC positivity produced the highest diagnostic concordance with overload status (p <0.001). POCUS assessment of JVP and IVC diameter provided a feasible and reliable method for evaluating congestion in hospitalized patients with ADHF. A novel four-quadrant method of lung ultrasound offered limited additional value.
Intra-abdominal desmoid tumours are rare, benign yet locally aggressive fibroblastic neoplasms that often mimic malignancies such as gastrointestinal stromal tumours (GIST) on imaging, making preoperative diagnosis challenging. We present the case of a woman in her mid-30s with a 6-month history of recurrent colicky abdominal pain and intermittent non-bilious vomiting during abdominal pain. Examination revealed a firm, mobile, non-tender mass in the right iliac fossa. Colonoscopy showed a submucosal caecal lesion without ulceration, and contrast-enhanced CT revealed a well-defined, heterogenous, enhancing lesion arising from the caecum suggestive of caecal GIST. Intraoperatively, a firm caecal mass with mesenteric fibrosis and terminal ileal dilatation was found. A limited right hemicolectomy was performed after a frozen section showed a spindle cell tumour. Immunohistochemistry demonstrated nuclear β-catenin positivity with negative C-kit (CD117), discovered on GIST 1 (DOG1), and desmin, confirming mesenteric desmoid fibromatosis. Surgery remains the mainstay of treatment in symptomatic cases.
