Metabolic dysfunction-associated fatty liver disease (MAFLD) is a growing global health concern which is driven by the increasing prevalence of diabetes and obesity. MAFLD is characterized by excessive fat accumulation in the liver, which encompasses a range of conditions, from simple hepatic steatosis to more severe forms. This condition is associated with various complications, including chronic kidney disease (CKD), Cardiovascular Disease (CVD), liver cirrhosis, and even malignancy. Recent research has highlighted a potential connection between gut dysbiosis and MAFLD, particularly in relation to CKD. This has underscored the significance of the gut-liver-kidney axis in understanding MAFLD's pathogenesis. Inflammation triggered by MAFLD increases the risk of CVD through multiple mechanisms linked to metabolic dysfunction. These mechanisms include heightened oxidative stress, systemic and hepatic insulin resistance, low-grade inflammation, and endothelial dysfunction. Hepatic steatosis and metabolic dysfunction are major diagnostic criteria for MAFLD, often coexisting with other liver ailments. This prospective review emphasizes the intricate associations between MAFLD, cardiovascular complications, renal issues, and hepatic diseases. Understanding the underlying pathophysiological pathways is crucial in comprehending the increased risk of CKD, CVD, and other hepatic complications in individuals with MAFLD.

Cardiovascular disease is the leading cause of death. In addition to the well-known risk factors associated with cardiovascular disease, such as age, diabetes mellitus, smoking, hypertension, and obesity, there has been a growing concern regarding cardiac complications stemming from the Gram-negative bacteria Helicobacter pylori . While H. pylori is most commonly associated with chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric lymphoma, it has also been implicated in extra gastric manifestations, encompassing cardiac, neurologic, ocular, and dermatologic issues. Key virulent factors for coronary artery disease include the vacuolating cytotoxin gene A and the cytotoxin-associated gene A. The most likely pathogenic mechanism of the relationship between H. pylori and coronary artery disease is initiating a chronic inflammatory process associated with infection and the modifications of classic risk factors. These alterations lead to the creation of prothrombotic and procoagulant environments. Here, we review the cardiac manifestations of H. pylori and the underlying pathophysiological mechanisms.

Bronchogenic cysts are closed sac-like cystic lesions resulting from abnormal budding of the primitive foregut during the early development of the alimentary and respiratory systems. We describe the case of a 54-year-old man who presented to the emergency department with complaints of fever, chills, shortness of breath, and a productive cough with intermittent hemoptysis for the past two to three months. Initial workup revealed a right lung hydropneumothorax with complete atelectasis of the right lung and a mass effect on the left lung. During intercostal drainage, pleural fluid analysis revealed empyema with E. coli treated with antibiotics. However, the symptoms persisted after five days of antibiotic treatment and drainage. A multidisciplinary team of thoracic surgeons, anesthesiologists, and pulmonologists was assembled due to the non-resolving nature of the lung abscess. The patient underwent a right middle lobe lobectomy with decortication via open thoracotomy, and a bronchogenic cyst, an uncommon cause of the lung abscess, was suggested by histopathological analysis.

Objective: An anonymous online survey was conducted at a university-affiliated health network to witness the impact of COVID-19 on Internal medicine residents and subspecialty fellows. Methods: This study involved a 28-question online survey for internal medicine residents and subspecialty fellows. Descriptive outcomes were provided for all respondents. We compared the impact of COVID-19 on training using a chi-square test for fellows versus residents, with a significance level of p < 0.05. Subgroup analyses and an open-ended question were also included. Results: The survey had a 67% response rate (52/78). Three-fourths of the respondents were residents (39/52), and the rest were fellows. Among all trainees, 33% (17/52) had <1 year of training left, with 59% (10/17) being residents. Overall, 82.7% (43/52) reported a "neutral or negative" impact on training, and 17.3% (9/52) reported a "positive or very positive" effect. 56% reported a decrease in procedures. In open-ended responses, 6 were positive, and 9 were negative. Conclusions: Our survey, consistent with current international literature, shows a negative impact on training due to changes in healthcare delivery during the pandemic. This led to a reduction in procedural opportunities and limited educational sessions. A follow-up study may help identify longer-lasting effects and areas for improvement.