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Articles 91 - 120 of 2666

Full-Text Articles in Cardiovascular Diseases

Clustering Of Patients With Heart Disease, Mukadder Cinar Feb 2024

Clustering Of Patients With Heart Disease, Mukadder Cinar

Dissertations, Theses, and Capstone Projects

Heart disease, a leading cause of mortality worldwide, presents complex challenges in public health due to its varied manifestations. Accurate diagnosis and patient stratification are essential for effective management and improved outcomes. In response, this study employed machine learning techniques to analyze heart disease data obtained from UCI Machine Learning Repository, aiming to enhance patient care through advanced data analysis.

The study began with the application of K-Nearest Neighbors (KNN) classification, which categorized patients into 'Disease' and 'No Disease' groups. This preliminary step provided initial insights into the structure of the dataset. Subsequently, K-means clustering was applied in two rounds, …


Surgical Outcome Of Postinfarction Left Ventricular Free Wall Rupture, Chan-Young Na Jan 2024

Surgical Outcome Of Postinfarction Left Ventricular Free Wall Rupture, Chan-Young Na

The Texas Heart Institute Journal

BACKGROUND: Left ventricular free wall rupture (LVFWR) is a rare and fatal complication after acute myocardial infarction. Early recognition and aggressive treatment are recommended.

METHODS: Between August 1999 and February 2023, 11 patients aged between 64 and 79 years developed LVFWR after acute myocardial infarction (mean interval, 3.5 days). Three patients had active bleeding (blowout-type LVFWR), and the other 8 patients experienced the oozing or sealed state. Eight patients were treated using a sutureless technique with Teflon felt and glue, 2 patients were treated using the primary suture closure technique, and 1 was treated using both the primary suture and …


Comparison Of Perioperative And Postoperative Outcomes Among 3 Left Atrial Incisions: Conventional Direct, Transseptal, And Superior Septal Left Atriotomy, Estelle Démoulin, Dionysios Adamopoulos, Tornike Sologashvili, Mathieu Van Steenberghe, Jalal Jolou, Haran Burri, Christoph Huber, Mustafa Cikirikcioglu Jan 2024

Comparison Of Perioperative And Postoperative Outcomes Among 3 Left Atrial Incisions: Conventional Direct, Transseptal, And Superior Septal Left Atriotomy, Estelle Démoulin, Dionysios Adamopoulos, Tornike Sologashvili, Mathieu Van Steenberghe, Jalal Jolou, Haran Burri, Christoph Huber, Mustafa Cikirikcioglu

The Texas Heart Institute Journal

BACKGROUND: Achieving optimal exposure of the mitral valve during surgical intervention poses a significant challenge. This study aimed to compare perioperative and postoperative outcomes associated with 3 left atriotomy techniques in mitral valve surgery-the conventional direct, transseptal, and superior septal approaches-and assess differences during the surgical procedure and the postoperative period.

METHODS: Inclusion criteria were patients undergoing mitral valve surgery from January 2010 to December 2020, categorized into 3 cohorts: group 1 (conventional direct; n = 115), group 2 (transseptal; n = 33), and group 3 (superior septal; n = 59). To bolster sample size, the study included patients undergoing …


Cardiometabolic Health: Actionable Prevention Strategies And New Care Models, Omar Leonards, David Aguilar Jan 2024

Cardiometabolic Health: Actionable Prevention Strategies And New Care Models, Omar Leonards, David Aguilar

The Texas Heart Institute Journal

No abstract provided.


Association Between Regulatory T Cells And Ischemic Heart Disease: A Mendelian Randomization Study, Yucheng Hou, Ke Si, Jingyue Yang, Tan Liu, Basel Abdelazeem, Nonthikorn Theerasuwipakorn, Jingwei Zhao, Zhenya Shen Jan 2024

Association Between Regulatory T Cells And Ischemic Heart Disease: A Mendelian Randomization Study, Yucheng Hou, Ke Si, Jingyue Yang, Tan Liu, Basel Abdelazeem, Nonthikorn Theerasuwipakorn, Jingwei Zhao, Zhenya Shen

Journal Articles

BACKGROUND: An imbalance of innate and acquired immune responses is significantly involved in the pathophysiology of coronary atherosclerosis and the occurrence of ischemic heart disease (IHD). Regulatory T cells (Tregs) play an essential regulatory role in atherosclerotic plaque formation and maintenance; therefore, dysfunction of Tregs triggers the formation of atherosclerotic plaques and accelerates their progression. However, due to the inherent limitations of observational research, clinical evidence is limited concerning the relationship between the variation in peripheral Tregs and the risk of IHD, and the cause-and-effect relationship between these factors is unclear. Mendelian randomization (MR) uses genetic variation as a proxy …


The Impact Of Simulated Image Acquisition Time Reduction On Image Quality And Parameters Of Myocardial Perfusion Imaging Using A Dedicated Cardiac Camera, Alireza Khatami Jan 2024

The Impact Of Simulated Image Acquisition Time Reduction On Image Quality And Parameters Of Myocardial Perfusion Imaging Using A Dedicated Cardiac Camera, Alireza Khatami

Electronic Thesis and Dissertation Repository

Heart disease is the second leading cause of death in Canada, highlighting the crucial role of early diagnosis in disease management. Myocardial perfusion imaging (MPI), is widely employed for this purpose, involves injecting a radiopharmaceutical into the body, imaging its distribution with a gamma camera, and revealing cardiac blood flow patterns. A significant challenge in MPI is the lengthy 8 to 10 minutes required for stress and rest imaging, potentially causing patient discomfort and compromising image quality due to movement. In a clinical study with 26 patients, post-processed data manipulation simulated a reduction in MPI imaging time. The findings indicated …


Systolic Pulmonary Artery Pressure Thresholds Predictive Of Dyspnea On Stress Doppler Echocardiography In Mitral Stenosis, Saléha Lehachi, Fadila Daimellah, Saida Khelil, Zakia Bennoui, Djohar Hannoun, Youcef Laid, Rachid Mechmeche, Mohand Said Issad Jan 2024

Systolic Pulmonary Artery Pressure Thresholds Predictive Of Dyspnea On Stress Doppler Echocardiography In Mitral Stenosis, Saléha Lehachi, Fadila Daimellah, Saida Khelil, Zakia Bennoui, Djohar Hannoun, Youcef Laid, Rachid Mechmeche, Mohand Said Issad

Journal of the Saudi Heart Association

Background. On Stress Doppler Echocardiography (SDE) in mitral stenosis, the systolic pulmonary artery pressure (SPAP) threshold at peak exercise recommended by the guidelines as an indication for percutaneous mitral commissurotomy (PMC) used to be 60 mmHg. However, because of the paucity of studies, that threshold has been controversial. The Europeans stopped using the value in 2007, followed by the Americans in 2014.

Objective. Determine SPAP thresholds on SDE at peak exercise and post-exercise predictive of dyspnea as an indication for PMC in mitral stenosis.

Method and results. Three hundred mitral stenosis patients with a mitral valve area (MVA) ≤ 2 …


Maine Medical Center Experience With Explantation Of Left Ventricular Assist Devices, Laura Onderko, Lauren Vickerson, Andrew Schwartzman Jan 2024

Maine Medical Center Experience With Explantation Of Left Ventricular Assist Devices, Laura Onderko, Lauren Vickerson, Andrew Schwartzman

Journal of Maine Medical Center

No abstract provided.


Reverse Takotsubo Cardiomyopathy With Severe Dengue: Case Report From Pakistan., Warda Ajmal, Zahra Iftikhar, Asaad Akbar Khan Jan 2024

Reverse Takotsubo Cardiomyopathy With Severe Dengue: Case Report From Pakistan., Warda Ajmal, Zahra Iftikhar, Asaad Akbar Khan

Journal of Community Hospital Internal Medicine Perspectives

Takotsubo Cardiomyopathy is an established transient cardiomyopathy found predominately in females with intense emotional and physical strain. It has four notable variants: Apical, Mid-Ventricular, Basal and Focal. Mid Ventricular variant is also referred to as Reverse Takotsubo Cardiomyopathy. Dengue is a viral arthopod-borne tropical disease endemic to Pakistan, with multiple reports of cardiovascular involvement. We report an atypical presentation of a 17 year old male, suffering from Dengue Fever, who presented to a tertiary care hospital with Reverse Takotsubo Cardiomyopathy.


Common Heart Failure With Preserved Ejection Fraction Animal Models Yield Disparate Myofibril Mechanics, Axel J. Fenwick, Vivek P. Jani, D. Brian Foster, Thomas E. Sharp, Traci T. Goodchild, Kyle Lapenna, Jake E. Doiron, David J. Lefer, Joseph A. Hill, David A. Kass, Anthony Cammarato Jan 2024

Common Heart Failure With Preserved Ejection Fraction Animal Models Yield Disparate Myofibril Mechanics, Axel J. Fenwick, Vivek P. Jani, D. Brian Foster, Thomas E. Sharp, Traci T. Goodchild, Kyle Lapenna, Jake E. Doiron, David J. Lefer, Joseph A. Hill, David A. Kass, Anthony Cammarato

School of Medicine Faculty Publications

No abstract provided.


Contextualizing The Revised Patient Perception Of Patient-Centeredness (Pppc-R) Scale In Primary Healthcare Settings: A Validity And Reliability Evaluation Study, Yiyuan Cai, Pengfei Guo, Jiong Tu, Mengyao Hu, Lingrui Liu, Bridget L Ryan, Jing Liao, Rubee Dev, Yiran Li, Tianyu Huang, Ruilin Wang, Li Kuang, Ruonan Huang, Xinfang Li, Edmundo Roberto Melipillán, Shuaixiang Zhao, Wenjun He, Xiaohui Wang, Nan Zhang, Dong Roman Xu Jan 2024

Contextualizing The Revised Patient Perception Of Patient-Centeredness (Pppc-R) Scale In Primary Healthcare Settings: A Validity And Reliability Evaluation Study, Yiyuan Cai, Pengfei Guo, Jiong Tu, Mengyao Hu, Lingrui Liu, Bridget L Ryan, Jing Liao, Rubee Dev, Yiran Li, Tianyu Huang, Ruilin Wang, Li Kuang, Ruonan Huang, Xinfang Li, Edmundo Roberto Melipillán, Shuaixiang Zhao, Wenjun He, Xiaohui Wang, Nan Zhang, Dong Roman Xu

Journal Articles

BACKGROUND: An English version of the Patient Perception of Patient-Centeredness (PPPC) scale was recently revised, and it is necessary to test this instrument in different primary care populations.

AIM: This study aimed to assess the validity and reliability of a Chinese version of the PPPC scale.

DESIGN: A mixed method was used in this study. The Delphi method was used to collect qualitative and quantitative data to address the content validity of the PPPC scale by calculating the Content Validity Index, Content Validity Ratio, the adjusted Kappa, and the Item Impact Score. Confirmatory factor analysis (CFA) and exploratory factor analysis …


The Use Of Cardiac Magnetic Resonance In Hypertrophic Cardiomyopathy Over The Past 10 Years [2013-2023]: A Citespace-Based Bibliometric Analysis, Mengyao Hu, Yu Shen, Yipei Song, Shuhao Li, Pei Yang, Ao Kan, Qiming Fang, Yun Peng, Haibo Ren, Yajing Zhang, Lianggeng Gong Jan 2024

The Use Of Cardiac Magnetic Resonance In Hypertrophic Cardiomyopathy Over The Past 10 Years [2013-2023]: A Citespace-Based Bibliometric Analysis, Mengyao Hu, Yu Shen, Yipei Song, Shuhao Li, Pei Yang, Ao Kan, Qiming Fang, Yun Peng, Haibo Ren, Yajing Zhang, Lianggeng Gong

Journal Articles

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a common genetic cardiac disorder characterized by the hypertrophy of a segment of the myocardium. Cardiac magnetic resonance (CMR) has been widely used in the assessment of HCM. However, no bibliometric assessment has been conducted on the progress of research in this field. This study thus aimed to examine the current state of research into the application of CMR in HCM and the hotspots and trends that have emerged in this field over the past decade.

METHODS: A systematic search was conducted on the Web of Science regarding CMR in the assessment of HCM. The …


Does Serum Uric Acid To Creatinine Ratio Predict Mortality Risk In Patients With Heart Failure, Xiaoqing Xi, Jinfeng Cai, Chen Zhang, Xuefei Wang Jan 2024

Does Serum Uric Acid To Creatinine Ratio Predict Mortality Risk In Patients With Heart Failure, Xiaoqing Xi, Jinfeng Cai, Chen Zhang, Xuefei Wang

The Texas Heart Institute Journal

BACKGROUND: Previous studies have established a positive correlation between serum uric acid to creatinine (SUA/Cr) ratio and cardiovascular disease, but the relationship between SUA/Cr ratio and the prognosis of heart failure (HF) remains unknown. This study investigated the potential of SUA/Cr ratio as a prognostic predictor for patients with HF.

METHODS: This single-center prospective cohort study enrolled 2,122 patients with HF between March 2013 and June 2017. All patients were divided into 3 groups according to SUA/Cr ratio tertiles and were followed up with until December 31, 2022. The association between SUA/Cr ratio and the prognosis of HF was assessed …


Coronary Artery Bypass Grafting In A Patient With Multivessel Disease And Dextrocardia With Situs Inversus Totalis, Rohit Shahani, Adham Ahmed, Frank M Rosell, Alexander Iribarne Jan 2024

Coronary Artery Bypass Grafting In A Patient With Multivessel Disease And Dextrocardia With Situs Inversus Totalis, Rohit Shahani, Adham Ahmed, Frank M Rosell, Alexander Iribarne

The Texas Heart Institute Journal

Dextrocardia with situs inversus totalis is a rare hereditary condition characterized by reversed orientation of the major thoracic and abdominal organs. Though dextrocardia itself is not believed to increase the risk of coronary artery disease, the workup and surgical management of patients with this condition may be technically challenging to heart team clinicians. This report describes the case management of a high-risk 56-year-old man with dextrocardia who presented with multivessel coronary artery disease.


Mitral Valve Regurgitation In Klippel-Feil Syndrome With Related Thoracic Deformity, Yuki Endo, Yoshiei Shimamura, Hiroshi Niinami Jan 2024

Mitral Valve Regurgitation In Klippel-Feil Syndrome With Related Thoracic Deformity, Yuki Endo, Yoshiei Shimamura, Hiroshi Niinami

The Texas Heart Institute Journal

Klippel-Feil syndrome, characterized by congenital fusion of any 2 or more cervical vertebrae, is a rare disorder in which skeletal and other organ system-related abnormalities have been reported. This article reports a case of mitral valve regurgitation in a patient with Klippel-Feil syndrome and related thoracic deformity who underwent mitral valvuloplasty. Postoperatively, the mitral valve regurgitation disappeared, and there has been no recurrence for 3 years. This case highlights mitral valvuloplasty via median sternotomy as an excellent treatment for mitral valve regurgitation in a patient with thoracic deformity related to Klippel-Feil syndrome.


Effect Of Acute Care Discharge Delays On Inpatient Rehabilitation Facility (Irf) Utilization, Eric Garrard Jan 2024

Effect Of Acute Care Discharge Delays On Inpatient Rehabilitation Facility (Irf) Utilization, Eric Garrard

Student Dissertations

Discharge delays present hospitals with challenges in managing costs for Medicare admissions. Meanwhile, Inpatient Rehabilitation Facilities (IRF) are subject to strict pre-admission requirements that can complicate efficient transitions of care for patients with intensive rehabilitation needs. The purpose of this retrospective quantitative correlational study was to examine any relationship between acute care discharge delays and IRF utilization. This study investigated whether length of stay (LOS) and Medicare Advantage prior authorization requirements impact IRF referrals by reviewing 3,747 medical records of acute stroke patients aged 65 years and older at a regionally integrated healthcare system over a 3-year period (2020- 2022). …


Improving Nutrition Screening Practice In The Hospitalized Heart Failure Patient Population, Amanda J. Bourgeois Jan 2024

Improving Nutrition Screening Practice In The Hospitalized Heart Failure Patient Population, Amanda J. Bourgeois

DNP Projects

Background: Heart Failure is a disease known to affect nearly 6.5 million adults in the United States. Characterized by recurrent hospitalizations, heart failure significantly contributes to morbidity, mortality, and healthcare costs in the United States and worldwide. Because malnutrition is prevalent in the heart failure population, healthcare providers must perform nutritional assessments on admission to intervene in the case of malnutrition, prevent deterioration, and improve patient prognosis. Without intervention and early identification of malnutrition, heart failure hospitalizations will remain a significant problem.

Purpose: The purpose of this study is to evaluate the effect of an evidence-based educational program for cardiac …


The 10 Commandments For Minimally Invasive Removal Of Nonmalignant Intracardiac Tumors, Danny Ramzy, Nicholas Ray Jan 2024

The 10 Commandments For Minimally Invasive Removal Of Nonmalignant Intracardiac Tumors, Danny Ramzy, Nicholas Ray

Journal Articles

No abstract provided.


A Frequent Diagnostic Pitfall: Dermatological Clinical Features And Pathological Results In Diagnosing Pagetoid Squamous Cell Carcinoma In Situ (Case Series), Sheng-Kai Wang, Jia-Wei Cai, Yu Zhang, Ya-Jing Lin, Yi-Hui Yang Jan 2024

A Frequent Diagnostic Pitfall: Dermatological Clinical Features And Pathological Results In Diagnosing Pagetoid Squamous Cell Carcinoma In Situ (Case Series), Sheng-Kai Wang, Jia-Wei Cai, Yu Zhang, Ya-Jing Lin, Yi-Hui Yang

Journal Articles

Squamous cell carcinoma (SCC) in situ can occur on any skin or mucus surface and is more commonly found in elderly patients on areas of skin that have been sunburnt. Most previous case reports are from dermatologists, with few published reports from pathologists. In this study, three patients underwent pathological routine and auxiliary immunohistochemical (IHC) examination and were ultimately diagnosed with pagetoid SCC in situ - a different diagnosis from the initial clinical assessment. All three patients received a complete resection of the skin mass. After follow-up, as of June 2023, the patients had no tumour recurrence or metastasis. Pagetoid …


Unveiling The Complex World Of Extracellular Vesicles: Novel Characterization Techniques And Manufacturing Considerations, James J Lai, John J Hill, Casey Y Huang, Gino C Lee, Karol W Mai, Maggie Y Shen, Simon K Wang Jan 2024

Unveiling The Complex World Of Extracellular Vesicles: Novel Characterization Techniques And Manufacturing Considerations, James J Lai, John J Hill, Casey Y Huang, Gino C Lee, Karol W Mai, Maggie Y Shen, Simon K Wang

Journal Articles

Extracellular vesicles (EVs) function as potent mediators of intercellular communication for many in vivo processes, contributing to both health and disease related conditions. Given their biological origins and diverse functionality from correspondingly unique "cargo" compositions, both endogenous and modified EVs are garnering attention as promising therapeutic modalities and vehicles for targeted therapeutic delivery applications. Their diversity in composition, however, has revealed a significant need for more comprehensive analytical-based characterization methods, and manufacturing processes that are consistent and scalable. In this review, we explore the dynamic landscape of EV research and development efforts, ranging from novel isolation approaches, to their analytical …


Addressing Disparity: A Waiting Room Intervention For Preeclampsia Prevention In African Americans, Morgan Semana Jan 2024

Addressing Disparity: A Waiting Room Intervention For Preeclampsia Prevention In African Americans, Morgan Semana

Nursing | Senior Theses

Maternal mortality is a pressing, global concern that particularly affects African American women in the United States. African American women face disproportionately a high maternal mortality rate (MMR), with rates more than double that of white women. Preeclampsia emerges as the leading cause of maternal mortality in African American women, driving the need for targeted interventions. To address this issue, a proposed research study aims to investigate the impact of a nurse-led, waiting room, preeclampsia and aspirin effectiveness educational intervention on the knowledge and preeclampsia rates among African American women. The study draws upon existing evidence that supports the use …


Retrospective Analysis For Incidence Of Takotsubo Cardiomyopathy Compared Against Insurance Coverage Type, Kevyn Niu, Iftekhar Baig Jan 2024

Retrospective Analysis For Incidence Of Takotsubo Cardiomyopathy Compared Against Insurance Coverage Type, Kevyn Niu, Iftekhar Baig

West Florida Division GME Research Day 2024

No abstract provided.


Cardiac Neuroendocrine Function: A New Opportunity For Targeted Chronic Therapies, Jacob Keesee, Rami Khouzam Jan 2024

Cardiac Neuroendocrine Function: A New Opportunity For Targeted Chronic Therapies, Jacob Keesee, Rami Khouzam

South Atlantic Division GME Research Day 2024

No abstract provided.


Management Considerations In A Case Of Sepsis Induced Takotsubo Cardiomyopathy In A Post-Operative Patient., Avraham Fox, Rachel Groening, Carsten Z. Steinmetz, Callaham A. Brock, Saptarshi Biswas Jan 2024

Management Considerations In A Case Of Sepsis Induced Takotsubo Cardiomyopathy In A Post-Operative Patient., Avraham Fox, Rachel Groening, Carsten Z. Steinmetz, Callaham A. Brock, Saptarshi Biswas

South Atlantic Division GME Research Day 2024

No abstract provided.


Congenital Atrial Septal Defect Presenting With Tamponade Physiology And An Associated Viral Illness, Angel G. Juarez, Gabriela Jhon, Rami N. Khouzam, Randall Goodroe, Russell F. Stahl, Mohamed Faris Jan 2024

Congenital Atrial Septal Defect Presenting With Tamponade Physiology And An Associated Viral Illness, Angel G. Juarez, Gabriela Jhon, Rami N. Khouzam, Randall Goodroe, Russell F. Stahl, Mohamed Faris

South Atlantic Division GME Research Day 2024

No abstract provided.


Noonan Syndrome And Late Onset Eisenmenger Syndrome, Kimberly Solana Mathurin, Payton Williams, Amethyst Wilder Jan 2024

Noonan Syndrome And Late Onset Eisenmenger Syndrome, Kimberly Solana Mathurin, Payton Williams, Amethyst Wilder

South Atlantic Division GME Research Day 2024

No abstract provided.


Analysis Of Temporal Artery Biopsy By Provider Across A Large Multi-State Healthcare Network, Karling Gravenstein, Mikalah Maury, Priya Arya, Robert Liebman Jan 2024

Analysis Of Temporal Artery Biopsy By Provider Across A Large Multi-State Healthcare Network, Karling Gravenstein, Mikalah Maury, Priya Arya, Robert Liebman

South Atlantic Division GME Research Day 2024

No abstract provided.


Stemi Alert Notification System At Hca Florida Orange Park Hospital: A Quality Improvement Project, Jomel Jacinto, Pranav Bommineni, Steven Goodfriend, Mubbasher Syed Jan 2024

Stemi Alert Notification System At Hca Florida Orange Park Hospital: A Quality Improvement Project, Jomel Jacinto, Pranav Bommineni, Steven Goodfriend, Mubbasher Syed

South Atlantic Division GME Research Day 2024

No abstract provided.


Subacute Defibrillator Lead Associated Right Ventricular Perforation In A Young Individual With Non-Ischemic Cardiomyopathy: A Unique Clinical Case, Jackson V. Littlejohn, Aditya Sharma, Marisha R. Sharma, Kamran Rizvi Jan 2024

Subacute Defibrillator Lead Associated Right Ventricular Perforation In A Young Individual With Non-Ischemic Cardiomyopathy: A Unique Clinical Case, Jackson V. Littlejohn, Aditya Sharma, Marisha R. Sharma, Kamran Rizvi

North Texas GME Research Forum 2024

Pacemaker-lead associated complications are often documented in elderly populations with ischemic heart disease. Acute perforations within 24 hours of implantation are the most common, and immediate life-threatening complications are most likely to occur during an acute perforation. Subacute perforations between 1 day and 30 days after implantation are less common and carry a lower risk of life-threatening complications. Here, we present a unique case of subacute right ventricular perforation in a young individual with non-ischemic cardiomyopathy, challenging the conventional understanding of such an occurrence. Further adding to the intrigue of our case, the patient had recurrent hospital visits both before …


Etanercept-Induced Iga Vasculitis, Marshall Hall, Christian Scheufele, Christopher Wong, Michael Carletti, Stephen E. Weis Jan 2024

Etanercept-Induced Iga Vasculitis, Marshall Hall, Christian Scheufele, Christopher Wong, Michael Carletti, Stephen E. Weis

North Texas GME Research Forum 2024

Introduction: IgA vasculitis, formerly known as Henoch-Schoenlein purpura, is a subtype of leukocytoclastic vasculitis (LCV) and approximately 90% are seen in the pediatric population. In the adult population, it is more frequently associated with a more severe clinical course. Causes of IgA vasculitis may be idiopathic or may be secondary to infections or medications. Etanercept is a tumor necrosis factor-alpha fusion protein that has been rarely associated with LCV. Case presentation: A 59-year-old female with a 2-year history of red-to-violaceous purpuric papules on the bilateral lower extremities. She noted that after etanercept administration her lesions would get redder and would …