Deborah Heart and Lung Center

Innovation has been the cornerstone of progress in the field of percutaneous coronary intervention (PCI) since its inception. Refinements in procedural technique and interventional tools have improved patient outcomes and overall safety. Despite this progress, however, the health risks posed to operators and staff remain undeniably high. Robotic PCI (R-PCI) offers a new era in coronary revascularization poised to address this dilemma. To date, R-PCI procedures have been widely performed in clinical practice for over a decade and multiple novel endovascular robotic systems are currently under development. This review serves as an up-to-date understanding of R-PCI, focusing on the origins, clinical evidence, current state, and future targets of robotic therapy.

Nurses in all specialties have been called upon to take action to address global climate change, climate justice, and health. The American Nurses Association (2023) has specifically tasked nursing professional organizations to (a) educate members on climate change-related illnesses and negative impacts on treatment, (b) collaborate with grassroots organizations for environmental justice efforts, (c) support policies that promote climate mitigation and adaptation, (d) maintain familiarity with climate justice frameworks, and (e) collectively amplify the voice of nursing to strengthen its impact on climate policy. The purpose of this white paper is to enlighten members of the Oncology Nursing Society and oncology nurses at large on the increasing impact of climate change across the cancer control continuum and the pivotal role of the oncology nurse in education, research, clinical practice, and advocacy. Climate change refers to long-term shifts in temperature and weather patterns that are occurring because of global warming (United Nations, n.d.). Climate change is an often-overlooked social determinant of (or contributor to) health that exacerbates poor health, increases healthcare costs, disproportionately affects some communities, and has a synergistic effect with other social determinants of health (Ragavan et al., 2020). Climate change affects all aspects of the cancer control continuum and impacts some populations disproportionately. Events such as wildfires and floods, exacerbated by climate change, can heighten individuals' exposure to cancer-causing substances, thereby increasing their susceptibility to the disease; reducing such exposure can reduce risks for cancer and positively impact the environment. Air pollution, extended droughts, heat waves, ultraviolet radiation, extreme weather events, and food supply disruptions also impact cancer etiology. Extreme weather events disrupt preventive care, cancer detection, and screening efforts, and create workforce shortages that can lead to suboptimal care. Disruptions in the supply chain and scheduled healthcare visits impact patient care continuity. Additionally, climate-related extreme weather events have an impact on overall survival and disrupt end-of-life care, underscoring the pervasive impact of climate change on cancer care across the continuum. Oncology nurses are strategically positioned to contribute to multifaceted solutions, including obtaining and offering education to fellow healthcare providers, students, patients, community members, and policymakers. Oncology nurse scientists are equipped to spearhead the generation of pertinent new knowledge, and nurses in clinical care can play a crucial role in assisting their healthcare system to become carbon net neutral. Oncology nurses must answer the call to actively engage in climate and health advocacy efforts within their own healthcare systems and in the communities where they live, work, and play. Several resources for education and action are shared.

Background Obesity is a major risk factor for cardiovascular disease, with differential impact across populations. This descriptive epidemiologic study outlines trends and disparities in obesity-related cardiovascular mortality in the US population between 1999 and 2020. Methods and Results The Multiple Cause of Death database was used to identify adults with primary cardiovascular death and obesity recorded as a contributing cause of death. Cardiovascular deaths were grouped into ischemic heart disease, heart failure, hypertensive disease, cerebrovascular disease, and other. Absolute, crude, and age-adjusted mortality rates (AAMRs) were calculated by racial group, considering temporal trends and variation by sex, age, and residence (urban versus rural). Analysis of 281 135 obesity-related cardiovascular deaths demonstrated a 3-fold increase in AAMRs from 1999 to 2020 (2.2-6.6 per 100 000 population). Black individuals had the highest AAMRs. American Indian or Alaska Native individuals had the greatest temporal increase in AAMRs (+415%). Ischemic heart disease was the most common primary cause of death. The second most common cause of death was hypertensive disease, which was most common in the Black racial group (31%). Among Black individuals, women had higher AAMRs than men; across all other racial groups, men had a greater proportion of obesity-related cardiovascular mortality cases and higher AAMRs. Black individuals had greater AAMRs in urban compared with rural settings; the reverse was observed for all other races. Conclusions Obesity-related cardiovascular mortality is increasing with differential trends by race, sex, and place of residence.