Artificial intelligence (AI) and the introduction of Large Language Model (LLM) chatbots have become a common source of patient inquiry in healthcare. The quality and readability of AI-generated patient education materials (PEM) is the subject of many studies across multiple medical topics. Most demonstrate poor readability and acceptable quality. However, an area yet to be investigated is chemotherapy-induced cardiotoxicity. This study seeks to assess the quality and readability of chatbot created PEM relative to chemotherapy-induced cardiotoxicity. We conducted an observational cross-sectional study in August 2024 by asking 10 questions to 4 chatbots: ChatGPT, Microsoft Copilot (Copilot), Google Gemini (Gemini), and Meta AI (Meta). The generated material was assessed for readability using 7 tools: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Coleman-Liau Index (CLI), Simple Measure of Gobbledygook (SMOG) Index, Automated Readability Index (ARI), and FORCAST Grade Level. Quality was assessed using modified versions of 2 validated tools: the Patient Education Materials Assessment Tool (PEMAT), which outputs a 0% to 100% score, and DISCERN, a 1 (unsatisfactory) to 5 (highly satisfactory) scoring system. Descriptive statistics were used to evaluate performance and compare chatbots amongst each other. Mean reading grade level (RGL) across all chatbots was 13.7. Calculated RGLs for ChatGPT, Copilot, Gemini and Meta were 14.2, 14.0, 12.5, 14.2, respectively. Mean DISCERN scores across the chatbots was 4.2. DISCERN scores for ChatGPT, Copilot, Gemini, and Meta were 4.2, 4.3, 4.2, and 3.9, respectively. Median PEMAT scores for understandability and actionability were 91.7% and 75%, respectively. Understandability and actionability scores for ChatGPT, Copilot, Gemini, and Meta were 100% and 75%, 91.7% and 75%, 90.9% and 75%, and 91.7% and 50%, respectively. AI chatbots produce high quality PEM with poor readability. We do not discourage using chatbots to create PEM but recommend cautioning patients about their readability concerns. AI chatbots are not an alternative to a healthcare provider. Furthermore, there is no consensus on which chatbots create the highest quality PEM. Future studies are needed to assess the effectiveness of AI chatbots in providing PEM to patients and how the capabilities of AI chatbots are changing over time.

Heart failure with preserved ejection fraction (HFpEF) affects 32 million people worldwide and is responsible for tens of billions of dollars in healthcare expenditure annually, with costs primarily driven by hospitalizations. HFpEF is notoriously difficult to treat, but emerging studies suggest that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may be effective therapies. We performed a systematic review and meta-analysis of six randomized controlled trials with 5564 total participants investigating GLP-1 RAs in patients with HFpEF. Overall, no significant effect was noted for GLP-1 RAs on our primary outcomes of cardiovascular mortality and worsening heart failure (HF) events, although they were associated with improvement in quality of life measures. Furthermore, safety data favored the GLP-1 RA group, although tolerability did not differ compared with placebo. While the pooled analysis of all GLP-1 RAs showed neutral effects versus hard endpoints, sensitivity analyses excluding older-generation agents (exenatide) revealed a significant 41% reduction in HF events, suggesting that newer, more potent agents (semaglutide, tirzepatide) may offer disease-modifying benefits in HFpEF. Although future studies are needed, GLP-1 RAs appear to be promising for the treatment of HFpEF.

On January 30, 2020, the World Health Organization (WHO) declared the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic a worldwide emergency. Worldwide there have been 170 million cases of the resulting disease coronavirus 2019 (COVID-19), of those, 3.53 million have resulted in death. The Food and Drug Administration (FDA) with Mayo Clinic as the lead institution authorized COVID-19 convalescent plasma (CCP) for treatment of SARS-CoV-2 infection. Effective therapeutic window for CCP administration had yet to be defined. We addressed this gap by characterizing longitudinal biologic response and clinical outcomes of COVID-19 patients treated with CCP. Primary outcome was discharged to home/home health.

Atrial fibrillation (AF) is the most common arrhythmia worldwide and is associated with significant morbidity and mortality. Catheter ablation of AF has been shown to result in a significant reduction in AF burden and recurrence. Pulsed field ablation (PFA) is a new modality of catheter ablation that is noninferior to its thermal ablation counterparts, coupled with a more favorable safety profile. This study seeks to compare clinical outcomes between two PFA systems: PulseSelect™ (Medtronic, Minneapolis, MN, USA) (circular catheter) and FARAPULSE™ (Boston Scientific, Marlborough, MA, USA) (pentaspline catheter). Secondary aims are to evaluate the impacts of post-ablation mapping with a high-density mapping catheter (PAHDMC) and both procedure and fluoroscopy times on recurrence. Overall, across 895 patients with a median follow-up of 12.5 months, there was a recurrence rate of 39%. PFA system, PAHDMC, and procedure time all had no effect on recurrence. To our knowledge, this is the first study to compare recurrence rates between different PFA systems. Fluoroscopy time, however, was a significant predictor of recurrence. In the pentaspline catheter group, the odds of recurrence were 60% greater for every 15 min increase in fluoroscopy time. Future studies are needed to continue comparing outcomes amongst PFA systems and assess whether PAHDMC improves outcomes in PFAs.

Discitis and vertebral osteomyelitis are rare spinal infections that are difficult to diagnose due to nonspecific presentations. This case report describes a 62‐year‐old immunocompetent female presenting with recurrent lower back pain and imaging findings concerning for lumbosacral discitis. Initial cultures and biopsy were inconclusive, but surgical intervention confirmed vertebral osteomyelitis caused by an extended‐spectrum beta‐lactamase (ESBL)–producing Escherichia coli . The patient responded well to targeted carbapenem therapy and was placed on chronic suppressive treatment with minocycline. Our case highlights the diagnostic challenges of lumbosacral discitis and the importance of considering multidrug‐resistant, gram‐negative pathogens even in low‐risk patients.

Background: Infective endocarditis (IE) requires 4–6 weeks of intravenous antimicrobial therapy, and timely transition to outpatient parenteral antimicrobial therapy (OPAT) allows clinically stable patients to complete treatment outside the hospital. Because OPAT requires home infusion services or post-acute facility placement that typically depend on coverage, insurance status may strongly influence length of stay (LOS); national data on this association in IE remain limited. Methods: We performed a retrospective cross-sectional analysis of the 2016–2019 National Inpatient Sample (NIS) using ICD-10-CM codes I33 and I38 to identify adult IE hospitalizations. Patients were classified as insured (Medicare, Medicaid, or private insurance) or uninsured (self-pay or no charge). Outcomes included mean and prolonged LOS (>14 and >28 days), in-hospital mortality, discharge against medical advice (AMA), and hospitalization costs. Comparisons used chi-square and Student’s t-tests with appropriate NIS survey weighting. Multivariable Gamma regression (LOS, cost) and logistic regression (binary outcomes) were performed, adjusting for age, sex, race/ethnicity, income quartile, injection drug use (IDU), Elixhauser Comorbidity Index, and hospital characteristics, with an insurance × IDU interaction term. Results: Of 87,211 weighted IE hospitalizations, 81,667 (93.6%) were insured and 5544 (6.4%) were uninsured. Uninsured patients were younger (mean age 40.1 vs. 59.4 years) with lower comorbidity burden but higher injection drug use (IDU) prevalence (38.7% vs. 15.5%). Mean LOS was longer among the uninsured (15.5 vs. 12.4 days, p < 0.001); LOS > 14 days occurred in 35.8% vs. 26.6%, and LOS > 28 days in 18.5% vs. 9.2% (both p < 0.001). AMA discharge was four-fold higher among the uninsured (22.2% vs. 5.5%, p < 0.001), while unadjusted in-hospital mortality was similar (9.0% vs. 9.4%, p = 0.32). LOS and AMA disparities persisted in both IDU and non-IDU subgroups, with a six-fold AMA disparity among non-IDU patients (15.2% vs. 2.5%). Based on multivariable analysis, uninsured status remained independently associated with prolonged LOS > 28 days (adjusted odds ratio [aOR] 1.46, 95% CI 1.30–1.65), AMA discharge (aOR 3.51, 95% CI 3.10–3.97), and—after accounting for age and comorbidity differences—higher in-hospital mortality (aOR 1.25, 95% CI 1.10–1.43). Conclusions: Uninsured adults hospitalized with IE experienced longer stays, markedly higher AMA rates, and—after adjustment for age and comorbidity—higher in-hospital mortality than insured patients. These findings are consistent with nonclinical barriers to discharge—particularly limited OPAT and post-acute care access—and suggest that the younger, less comorbid profile of uninsured patients masks an underlying outcome disparity. The results identify uninsured IE patients as a population that may benefit from alternative care models and policy reforms expanding safe post-acute antimicrobial therapy.