Advanced heart failure (AHF) poses a significant challenge in modern cardiology, often necessitating surgical interventions to alleviate symptoms and improve patient outcomes. This article provides an overview of surgical interventions available for treating AHF, with a primary focus on established procedures such as heart transplantation, ventricular assist device implantation, and emerging techniques including minimally invasive approaches and novel device therapies. The efficacy, indications, and potential complications of these interventions are discussed, along with their roles in the comprehensive management of patients with AHF. Recent advancements in surgical techniques, patient criteria, and perioperative care strategies are highlighted. Within a multidisciplinary approach encompassing surgical expertise, medical management, and supportive care, surgical interventions play a crucial role in the holistic management of AHF, offering hope and improved prognosis for affected patients.

Shoulder injury related to vaccine administration (SIRVA) is a rare but potentially debilitating condition characterized by persistent shoulder pain and restricted movement that begins within 48 hours of vaccine administration into the deltoid region. Improper vaccine injection into the subacromial/subdeltoid region of the shoulder or glenohumeral joint can cause immune-mediated inflammatory response, adhesive capsulitis, rotator cuff tendonitis or tears, and septic subacromial bursitis or lytic lesions, among other injuries and reactions. The literature to date focuses on SIRVA prevention and early recognition, emphasizing proper vaccine administration techniques. With the aid of a formulated process that includes focused clinical history collection and thorough physical examination, clinicians can facilitate timely diagnosis and effective management of SIRVA, mitigating possible long-term complications. We present a case that illustrates the diagnostic challenge of SIRVA and highlights how affected patients may exhaust all nonoperative modalities, fail to find relief, and eventually require surgery. Literature is limited on surgical management of SIRVA; however, this case raises awareness of surgery as a management option in unusually refractory cases.

Acute immune system-mediated neuropathy, referred to as Guillain-Barré syndrome, is a common etiology of acutely acquired weakness that often presents with proximally spreading initial distal extremity weakness and paralysis. Less common manifestations include delayed facial nerve palsy and weakness, occurring in approximately 15% of patients. This case report highlights a rarer initial presentation of Guillain-Barré syndrome in a 43-year-old man initially presenting with unilateral upper facial weakness whose symptoms progressed to bilateral hand and foot numbness over a 2-week period.

We report the case of a 52-year-old man undergoing routine screening colonoscopy who was found to have a 3-cm submucosal mass in the sigmoid colon. Initial biopsy demonstrated S100 positivity, raising suspicion for ganglioneuroma (GN). Endoscopic ultrasound revealed a large hypoechoic submucosal lesion, and due to concern for possible gastrointestinal stromal tumor, size, and partial obstruction, the patient underwent partial colectomy. Surgical pathology confirmed a polypoid GN without atypia. Colonic GNs are rare, benign tumors derived from neural crest cells that may mimic other subepithelial lesions. Complete excision is typically curative, and though recurrence is uncommon, some experts advise follow-up imaging to monitor.

Neonatal sepsis remains a leading cause of morbidity and mortality among newborns worldwide, despite recent advances in recognition and management. Both early-onset and late-onset sepsis present significant challenges for neonates, particularly those born prematurely or with low birth weight. The severity and progression of the condition can be influenced by factors such as the timing of exposure, the host's immune response, and the virulence of the infecting pathogen. As intrapartum screening methods, novel diagnostic studies, and targeted antibiotic management strategies continue to evolve, it is essential for the practicing provider to understand the implications of this condition and to recognize and manage it appropriately.

Relative energy deficiency in sport (REDs) is a multisystem syndrome resulting from chronic low energy availability that impairs metabolic, reproductive, skeletal, cardiovascular, and psychological health in athletes of all genders. This article reviews the epidemiology and pathophysiology of REDs and outlines major complications, including low bone mineral density, stress fractures, infertility, and potential vascular dysfunction/cardiometabolic effects. Sex-specific considerations, including functional hypothalamic amenorrhea in females, are also explored. A practical diagnostic approach highlights focused history-taking, targeted laboratory evaluation, and application of the International Olympic Committee Relative Energy Deficiency in Sport Clinical Assessment Tool Version 2 for risk stratification. Management strategies center on restoring adequate energy availability through nutritional rehabilitation and training modification, supported by psychological care, optimization of calcium and vitamin D, and selective use of hormonal or bone-active therapies in refractory cases. Because many at-risk athletes first present to primary care, this article focuses on equipping clinicians with the knowledge and tools needed to recognize, evaluate, and manage REDs and to coordinate multidisciplinary care to prevent long-term morbidity.

Lipoprotein(a) (Lp(a)) is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD), independent of traditional risk factors such as low-density lipoprotein cholesterol (LDL-C). Major societies now broadly recognize Lp(a) as an independent cardiovascular risk factor, recommending universal screening among adults or at least targeted screening among select higher-risk groups. This article synthesizes current knowledge of the biochemistry, pathophysiology, clinical significance, laboratory assessment, available management options, and emerging therapies for elevated Lp(a) levels. Many guidelines suggest that Lp(a) testing is ready for broader clinical implementation, and its integration into routine practice may assist health care providers in identifying individuals at elevated cardiovascular risk and tailoring preventive interventions accordingly.