Diffusion weighted imaging to predict longer term response in Crohn's disease patients commencing biological therapy: Results from the MOTILITY Trial.

Objectives: Predicting longer term response to biological therapy for small bowel Crohn's disease (SBCD) is an unmet clinical need. Diffusion-weighted MR imaging (DWI) may indicate disease activity, but its predictive ability, if any, is unknown. We investigated the prognostic value of DWI for one year response or remission (RoR) in SBCD patients commencing biologic therapy, including incremental value over C-reactive protein (CRP) and faecal calprotectin (FC).

Multidisciplinary Teamwork in Management of Dislodged Prosthetic Aortic Valve Leaflet.

Mechanical valve leaflets have the potential to detach and migrate to unintended locations, leading to life- and limb-threatening situations. We report a unique case of a dislodged mechanical aortic valve leaflet in the right iliac artery bifurcation after a redo mitral valve replacement. This was promptly recognized by input from a multidisciplinary team, allowing immediate correction of the aortic valve insufficiency followed by staged retrieval of the dislodged leaflet to avoid vascular complications.

Enhancing lung transplantation with ECMO: a comprehensive review of mechanisms, outcomes, and future considerations.

Background: Lung transplantation (LTx) is a critical intervention for patients with end-stage lung disease. However, challenges such as donor organ scarcity and post-transplant complications significantly affect its success. Recent advancements in Extracorporeal Membrane Oxygenation (ECMO) have shown promise in improving the outcomes and expanding eligibility for LTx.

Effective Management of Acute Pulmonary Embolism and Deep Vein Thrombosis: Insights From a Case Series on Procedure Benefits.

Pulmonary thromboembolectomy is an essential intervention for managing acute pulmonary embolism (PE), with various treatment approaches including systemic thrombolysis, open surgical embolectomy, and percutaneous mechanical thrombectomy. Multimodal approaches are crucial for improving outcomes in massive and submassive PE cases, with integration across disciplines such as vascular surgery and interventional radiology enhancing comprehensive care. This manuscript will discuss a case series featuring two patients diagnosed with acute PE.

International expert guidance for defining and monitoring small bowel strictures in Crohn's disease on intestinal ultrasound: a consensus statement.

Background: Diagnostic imaging using CT enterography, magnetic resonance enterography, and intestinal ultrasound are important tools in evaluating stricturing Crohn's disease. Definitions of strictures have been developed for CT enterography and magnetic resonance enterography. However, expert recommendations for definitions and treatment response of strictures on intestinal ultrasound are not available.

SBTD: Secured Brain Tumor Detection in IoMT Enabled Smart Healthcare.

Brain tumors are fatal and severely disrupt brain function as they advance. Timely detection and precise monitoring are crucial for improving patient outcomes and survival. A smart healthcare system leveraging the Internet of Medical Things (IoMT) revolutionizes patient care by offering streamlined remote healthcare, especially for individuals with acute medical conditions like brain tumors.

Heparin resistance management during cardiac surgery: a literature review and future directions.

Introduction: Heparin, a commonly used anticoagulant in cardiac surgery, binds to antithrombin III (ATIII) to prevent clot formation. However, heparin resistance (HR) can complicate surgical procedures, leading to increased thromboembolic risks and bleeding complications. Proper diagnosis and management of HR are essential for optimizing surgical outcomes.

An Optimization Tool to Formulate Diets within a Supplementary Nutrition Program for Children.

Background: In large supplementary feeding programs for children, it is challenging to create and sustain contextual, acceptable, nutritionally complete, and diverse supplemental foods. For example, the Indian Supplementary Nutrition Program (SNP) supplements the dietary intake of children, pregnant and lactating women, and severely acutely malnourished (SAM) children by offering dry take home rations (THRs) or hot cooked meals (HCMs) across India, but an optimization tool is necessary to create local contextual recipes for acceptable and nutritionally adequate products.

Objectives: This study aimed to create a linear programming (LP) model to optimize diverse food provisions for a SNP to meet its program guidelines, using locally available foods, within budgetary allocations.

Global Perfusion Practice Survey: Readiness of On-Call and Emergency Operation Rooms.

Introduction: Perfusion safety in cardiac surgery is vital, and this survey explores perfusion practices, perspectives, and challenges related to it. Specifically, it examines the readiness of on-call and emergency operation rooms for perfusion-related procedures during urgent situations. The aim is to identify gaps and enhance perfusion safety protocols, ultimately improving patient care.

Influence of diffusion weighted imaging and contrast enhanced T1 sequences on the diagnostic accuracy of magnetic resonance enterography for Crohn's disease.

Objectives: To evaluate the additional diagnostic benefit of diffusion weighted imaging (DWI) and contrast enhanced (CE) images during MR enterography (MRE) of Crohn's disease.

Methods: Datasets from 73 patients (mean age 32; 40 male) (28 new-diagnosis, 45 relapsed) were read independently by two radiologists selected from a pool of 13. Radiologists interpreted datasets using three sequential sequence blocks: (1) T2 weighted and steady state free precession gradient echo (SSFP) images alone (T2^); (2) T2 weighted and SSFP images with DWI (T2 + DWI^) and; (3) T2 weighted images, SSFP, DWI and post-contrast enhanced (CE) T1 images (T2 + DWI + CE^), documenting presence, location, and activity of small bowel disease.

COMPARISON OF ABDOMINAL EXERCISES AND NEUROMUSCULAR ELECTRICAL STIMULATION ON DIASTASIS RECTI ABDOMINIS MUSCLE IN POSTNATAL FEMALES WITH CAESAREAN SECTION.

The separation of the two rectus abdominis muscles along the linea alba is termed diastasis of recti abdominis muscles (DRAM). DRAM is a common health problem in people that are both pregnant and postpartum. With a 100% frequency at gestational week 35, it is extremely frequent during pregnancy.

Systematic review: Defining, diagnosing and monitoring small bowel strictures in Crohn's disease on intestinal ultrasound.

Background: Stricturing Crohn's disease (CD) occurs most commonly in the terminal ileum and poses a clinical problem. Cross-sectional imaging modalities such as intestinal ultrasound (IUS), computed tomography enterography (CTE), and magnetic resonance enterography (MRE) allow for assessment of the entire bowel wall and associated peri-enteric findings. Radiologic definitions of strictures have been developed for CTE and MRE; their reliability and responsiveness are being evaluated in index development programs.

Inflammatory Myofibroblastic Tumor With Rapid Recurrence and Distant Metastasis: Report of a Rare Case.

Inflammatory myofibroblastic tumors (IMTs) are rare spindle cell tumors clinically, morphologically, and genetically heterogeneous, mimicking many other reactive and neoplastic lesions and creating great diagnostic problems. Although it is generally characterized by oncogene-derived proliferation of myofibroblasts in a background of polyclonal inflammatory cell infiltrates, morphological variations do occur requiring immunohistochemistry and molecular genetics to confirm the diagnosis. It encompasses a wide age range, and locations, mostly said to be of intermediate grade having a low risk of recurrence and metastasis.

Diagnostic performance of sonographic activity scores for adult terminal ileal Crohn's disease compared to magnetic resonance and histological reference standards: experience from the METRIC trial.

Objectives: The simple ultrasound activity score for Crohn's disease (SUS-CD) and bowel ultrasound score (BUSS) are promising intestinal ultrasound (IUS) indices of CD, but studied mainly in small settings with few sonographers. We compared SUS-CD and BUSS against histological and magnetic resonance enterography (MRE) reference standards in a post hoc analysis of a prospective multicentre, multireader trial.

Methods: Participants recruited to the METRIC trial (ISRCTN03982913) were studied, including those with available terminal ileal (TI) biopsies.

Management of acute aortic services during the COVID-19 pandemic: a retrospective cohort study from the Middle East.

Unlabelled: COVID-19 created a challenging situation for cardiac surgery and associated acute care programs around the world. While non-urgent cases might be postponed, operating on life-threatening conditions, including type A aortic dissection (TAAD), must be sustained despite the ongoing pandemic. Therefore, the authors investigated the impact of the COVID-19 pandemic on their urgent aortic program.

Management of Patients With Tricuspid Valve Endocarditis and Ongoing Intravenous Drug Abuse: Less Is More.

Right-sided infective endocarditis in patients with intravenous drug abuse portends a worse prognosis. Data on optimal management strategy in this situation are scarce. We describe outcomes of 2 different treatment strategies, including a patient treated conservatively with favorable intermediate-term results and another who was treated surgically and developed recurrent endocarditis.

Hybrid repair of type II thoracoabdominal aortic aneurysm using modified branch-first technique.

The hybrid modified branch-first technique has extended the feasibility of open thoracoabdominal aortic aneurysm (TAAA) repair in otherwise hostile aortic anatomy that is not entirely amenable for extent II open TAAA conventional repair or total endovascular repair. The modified branch-first open TAAA technique has been developed successfully at our center and has been used to treat extent III TAAAs with successful outcomes. By combining the modified technique with endovascular thoracic aortic repair, we have been able to successfully extend its use to more extensive extent II TAAAs.

The Effects of GCSF Primary Prophylaxis on Survival Outcomes and Toxicity in Patients with Advanced Non-Small Cell Lung Cancer on First-Line Chemoimmunotherapy: A Sub-Analysis of the Spinnaker Study.

GCSF prophylaxis is recommended in patients on chemotherapy with a >20% risk of febrile neutropenia and is to be considered if there is an intermediate risk of 10−20%. GCSF has been suggested as a possible adjunct to immunotherapy due to increased peripheral neutrophil recruitment and PD-L1 expression on neutrophils with GCSF use and greater tumour volume decrease with higher tumour GCSF expression. However, its potential to increase neutrophil counts and, thus, NLR values, could subsequently confer poorer prognoses on patients with advanced NSCLC.

Polyvascular Disease in the Gulf Region: Concealed Marker of Poor Outcomes in Acute Coronary Syndrome.

Polyvascular disease (PolyVD) is the presence of atherosclerosis in multiple vascular territories and is associated with an increased risk of major adverse cardiac and cerebrovascular events (MACCE). Our study aims to draw attention to the prevalence and outcomes of PolyVD in patients presenting with acute coronary syndrome (ACS) in the Gulf region. Highlighting the disease burden of PolyVD in our population will lead to more vigilant surveillance, better clinical outcomes, and improved quality of life.