Long-Term Outcomes of Magnetic Sphincter Augmentation: A Comparative Study to Nissen Fundoplication.

Background: Magnetic sphincter augmentation (MSA) demonstrates improvement in gastroesophageal reflux disease (GERD) across multiple short-term studies. Long-term, single-arm studies show durable outcomes, but there is limited comparative data to Nissen fundoplication (NF).

Methods: We performed a retrospective propensity-matched cohort study of patients with GERD undergoing MSA or NF between 2012 and 2018.

Physical and psychological health consequences of intimate partner violence among married primary school teachers in Delta South Senatorial Zone of Delta State, Nigeria: Implication for marital stability.

Background: Intimate Partner Violence (IPV) is a serious health issue among couples which is recorded more among married partners. Dishearteningly, IPV among couples who are teachers is underreported due to shame, thereby increasing the prevalence of IPV in the area of the study.

Objectives: The study examined physical and psychological health consequences of IPV on married primary school teachers.

Thirty- and 90-Day Morbidity and Mortality by Clavien-Dindo after Surgery for Antireflux and Hiatal Hernia.

Background: The historic morbidity and mortality rates of antireflux and hiatal hernia operation are reported as 3% to 21% and 0.2% to 0.5%, respectively.

DOCK2 Deficiency Causes Defects in Antiviral T-Cell Responses and Impaired Control of Herpes Simplex Virus Infection.

The expanding number of rare immunodeficiency syndromes offers an opportunity to understand key genes that support immune defense against infectious diseases. However, analysis of these in patients is complicated by their treatments and comorbid infections, requiring the use of mouse models for detailed investigations. We developed a mouse model of DOCK2 immunodeficiency and herein demonstrate that these mice have delayed clearance of herpes simplex virus type 1 (HSV-1) infections.

DOCK2-deficiency causes defects in anti-viral T cell responses and poor control of herpes simplex virus infection.

The expanding number of rare immunodeficiency syndromes offers an opportunity to understand key genes that support immune defence against infectious diseases. However, patients with these diseases are by definition rare. In addition, any analysis is complicated by treatments and co-morbid infections requiring the use of mouse models for detailed investigations.

Effect of Intrapleural Fibrinolytic Therapy vs Surgery for Complicated Pleural Infections: A Randomized Clinical Trial.

Importance: There is a paucity of high-quality prospective randomized clinical trials comparing intrapleural fibrinolytic therapy (IPFT) with surgical decortication in patients with complicated pleural infections.

Objective: To assess the feasibility, safety, and efficacy of an algorithm comparing tissue plasminogen activator plus deoxyribonuclease therapy with surgical decortication in patients with complicated pleural infections.

Design, Setting, And Participants: This parallel pilot randomized clinical trial was performed at a single urban community-based center from March 1, 2019, to December 31, 2021, with follow-up for 90 days.

The Novel Conduit: Challenges of Esophagectomy After Bariatric Surgery.

Metabolic surgery has been on the rise over the last 2 decades. As more literature has been being published regarding its efficacy in treating metabolic syndrome as well as advancements in surgical training and safety rise with it, metabolic surgery will in no doubt continue to increase in prevalence. Concomitantly, the prevalence of esophageal cancer is increasing.

The Nissen-Hill Hybrid Repair: Experience With the First 500.

Introduction: A new repair for gastroesophageal reflux and hiatal hernia, the Nissen-Hill hybrid repair, was developed to combine the relative strengths of its component repairs with the aim of improved durability. In several small series, it has been shown to be safe, effective, and durable for paraesophageal hernia, Barrett esophagus, and gastroesophageal reflux disease. This study represents our experience with the first 500 consecutive repairs for all indications.

Comparing Initial Surgery versus Fibrinolytics for Pleural Space Infections: A Retrospective Multicenter Cohort Study.

When drainage of complicated pleural space infections alone fails, there exists two strategies in surgery and dual agent-intrapleural fibrinolytic therapy; however, studies comparing these two management strategies are limited. To determine the outcomes of surgery versus fibrinolytic therapy as the primary management for complicated pleural space infections (CPSI). A retrospective review of adults with a CPSI managed with surgery or fibrinolytics between 1/2015 and 3/2018 within a multicenter, multistate hospital system was performed.

Changes in Distensibility Index During an Incremental POEM Myotomy.

Background: A longer myotomy for the treatment of achalasia is associated with worse gastroesophageal reflux disease despite palliating dysphagia. Recently, clinical outcomes have been correlated to the distensibility of the distal esophagus, which is measured intra-operatively using an endoscopic functional luminal image probe (EndoFLIP). We aimed to determine the minimum per oral endoscopic myotomy (POEM) length to allow for adequate distensibility index (DI).

Persistent N2 After Induction Is Not a Contraindication to Surgery for Lung Cancer.

Background: Surgical management for potentially resectable stage IIIA-N2 non-small cell lung cancer (NSCLC) is controversial. For some, persistent N2 disease after induction therapy is a contraindication to resection. We examined outcomes of a well-selected surgical cohort of postinduction IIIA-N2 NSCLC patients with persistent N2 disease.

Atypical B cells are part of an alternative lineage of B cells that participates in responses to vaccination and infection in humans.

The diversity of circulating human B cells is unknown. We use single-cell RNA sequencing (RNA-seq) to examine the diversity of both antigen-specific and total B cells in healthy subjects and malaria-exposed individuals. This reveals two B cell lineages: a classical lineage of activated and resting memory B cells and an alternative lineage, which includes previously described atypical B cells.

Ineffective esophageal motility is not a contraindication to total fundoplication.

Introduction: Ineffective esophageal motility (IEM) is a physiologic diagnosis and is a component of the Chicago Classification. It has a strong association with gastroesophageal reflux and may be found during work-up for anti-reflux surgery. IEM implies a higher risk of post-op dysphagia if a total fundoplication is done.

Surgical Management of Non-Small Cell Lung Cancer Invading the Fissure: Less Is More?

Background: When a resectable lung cancer that invades across the fissure into an adjacent lobe is encountered, options include a bilobectomy on the right or a pneumonectomy on the left vs a parenchymal-sparing resection combined with a lobectomy. Although parenchymal-sparing combinations are technically possible, the available literature reporting on the related oncologic outcomes is limited. We sought to examine the influence of resection extent on overall survival and recurrence patterns in this scenario.

Not Following the Rules in Guideline Care for Lung Cancer Diagnosis and Staging Has Negative Impact.

Background: Recent studies have identified poor adherence to recommended guidelines in diagnosing and staging patients with non-small cell lung cancer (NSCLC), and this practice has been associated with numerous negative downstream effects. However, these reports consist predominantly of large administrative databases with inherent limitations. We aimed to describe guideline-inconsistent care and identify any associated factors within the Swedish Cancer Institute health care system.

Salvage Lung Resections After Definitive Chemoradiotherapy: A Safe and Effective Oncologic Option.

Background: Patients with locally advanced, non-small cell lung cancer treated with definitive chemoradiotherapy alone often demonstrate persistent or recurrent disease. In the absence of systemic progression, salvage lung resection after definitive chemoradiotherapy has been used as a treatment option. Given the paucity of data, we sought to evaluate the safety and efficacy of salvage pulmonary resections occurring greater than 90 days after definitive chemoradiotherapy.

Electronic Medical Record Inaccuracies: Multicenter Analysis of Challenges with Modified Lung Cancer Screening Criteria.

The National Comprehensive Cancer Network expanded their lung cancer screening (LCS) criteria to comprise one additional clinical risk factor, including chronic obstructive pulmonary disease (COPD). The electronic medical record (EMR) is a source of clinical information that could identify high-risk populations for LCS, including a diagnosis of COPD; however, an unsubstantiated COPD diagnosis in the EMR may lead to inappropriate LCS referrals. We aimed to detect the prevalence of unsubstantiated COPD diagnosis in the EMR for LCS referrals, to determine the efficacy of utilizing the EMR as an accurate population-based eligibility screening "trigger" using modified clinical criteria.

Malaria exposure drives both cognate and bystander human B cells to adopt an atypical phenotype.

Atypical memory B cells (aMBCs) are found in elevated numbers in individuals exposed to malaria. A key question is whether malaria induces aMBCs as a result of exposure to Ag, or non-Ag-specific mechanisms. We identified Plasmodium and bystander tetanus toxoid (TT) specific B cells in individuals from areas of previous and persistent exposure to malaria using tetramers.

B-cell memory in malaria: Myths and realities.

B-cell and antibody responses to Plasmodium spp., the parasite that causes malaria, are critical for control of parasitemia and associated immunopathology. Antibodies also provide protection to reinfection.

Staging System for Neuroendocrine Tumors of the Lung Needs to Incorporate Histologic Grade.

Background: Neuroendocrine tumors of the lung are staged with the American Joint Committee on Cancer (AJCC) TNM system for non-small cell lung cancer. However neuroendocrine tumors have a distinct clinical behavior with grade providing critical prognostic information. We aim to determine components of a tumor-specific staging system.

Use of a report card to evaluate outcomes of achalasia surgery: beyond the Eckardt score.

Background: Achalasia outcome is primarily defined using the Eckardt score with failure recognized as > 3. However, patients experience many changes after myotomy including new onset GERD, swallowing difficulties, and potential need for additional treatment. We aim to devise a comprehensive assessment tool to demonstrate the extent of patient-reported outcomes, objective changes, and need for re-interventions following myotomy.

Sublobar Resection in the Treatment of Peripheral Typical Carcinoid Tumors of the Lung.

Background: The role of sublobar resection in the treatment of pulmonary typical carcinoids is controversial. This study aims to compare long-term outcomes between sublobar and lobar resections in patients with peripheral typical carcinoid.

Methods: We retrospectively compared consecutive patients who underwent curative sublobar resection with patients who underwent lobectomy for cT1-3 N0 M0 peripheral pulmonary typical carcinoid in eight centers between 2000 and 2015.

Does Treatment of the Hiatus Influence the Outcomes of Magnetic Sphincter Augmentation for Chronic GERD?

Background: Hiatal dissection, restoration of esophageal intra-abdominal length, and crural closure are key components of successful antireflux surgery. The necessity of addressing these components prior to magnetic sphincter augmentation (MSA) has been questioned. We aimed to compare outcomes of MSA between groups with differing hiatal dissection and closure.

Large Cell Neuroendocrine Tumor Size >3 cm Negatively Impacts Long-Term Outcomes After R0 Resection.

Background: Minimal knowledge exists regarding the outcome, prognosis and optimal treatment strategy for patients with pulmonary large cell neuroendocrine carcinomas (LCNEC) due to their rarity. We aimed to identify factors affecting survival and recurrence after resection to inform current treatment strategies.

Methods: We retrospectively reviewed 72 patients who had undergone a curative resection for LCNEC in 8 centers between 2000 and 2015.