Patients with congestive heart failure (CHF) have increased hospital readmission rates and mortality if they are concomitantly diagnosed with cognitive decline and memory loss. Accordingly, we developed a preclinical model of CHF-induced cognitive impairment with the goal of developing novel protective therapies against CHF related cognitive decline. CHF was induced by ligation of the left coronary artery to instigate a myocardial infarction (MI). By 4- and 8-weeks post-MI, CHF mice had approximately a 50% and 70% decline in ejection fraction as measured by echocardiography. At both 4- and 8-weeks post-MI, spatial memory performance in CHF mice as tested using the Morris water task was significantly impaired as compared with sham. In addition, CHF mice had significantly worse performance on object recognition when compared with shams as measured by discrimination ratios during the novel object recognition NOR task. At 8-weeks post-MI, a subgroup of CHF mice were given Angiotensin (Ang)-(1-7) (50mcg/kg/hr) subcutaneously for 4 weeks. Following 3 weeks treatment with systemic Ang-(1-7), the CHF mice NOR discrimination ratios were similar to shams and significantly better than the performance of CHF mice treated with saline. Ang-(1-7) also improved spatial memory in CHF mice as compared with shams. Ang-(1-7) had no effect on cardiac function. Inflammatory biomarker studies from plasma revealed a pattern of neuroprotection that may underlie the observed improvements in cognition. These results demonstrate a preclinical mouse model of CHF that exhibits both spatial memory and object recognition dysfunction. Furthermore, this CHF-induced cognitive impairment is attenuated by treatment with systemic Ang-(1-7). (PsycINFO Database Record

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We present a case of a 74-year- old male with a complicated medical history who was admitted to theWe present a case of a 74-year-old male with a complicated medical history who was admitted to the medical floor for evaluation and management of failure to thrive and malnutrition. On hospital day 9 he became febrile and blood cultures were found to be positive for B. cereus and Enterobacter cloacae, which were persistent. He had an extensive negative workup for the cause of his bacteremia, however, we present a number of possibilities from his presentation and a literature review. Our case was consistent with other cases in the literature as our patient could be considered immunocompromised secondary to malnutrition and type II diabetes. B. cereus in blood cultures is often considered a contaminant but can be true bacteremia and should be worked up if multiple blood cultures are positive or if there is a clinical suspicion.

We present a case of a 51-year-old Caucasian male with thromboangiitis obliterans who previously underwent multiple amputations and presented with poor wound healing post-amputation. Despite cessation of tobacco use, patient's condition and wounds continued to worsen. After extensive and repeated history taking, it was discovered that his wife continued to be a heavy tobacco user and patient consistently had secondhand smoke exposure. This report describes an atypical presentation of progressive thromboangiitis obliterans as a result of secondhand smoke.