Deprescribing electronic case reviews for older veterans at risk for falls: Effects on drug burden and falls.

Background: Falls are the most common medication-related safety event in older adults. Deprescribing fall risk-increasing drugs (FRIDs) may mitigate fall risk. This study assesses the effects of an innovative deprescribing program in reducing FRID burden and falls-related acute visits over 1 year.

Laser-assisted permanent greenfield filter removal with ileocaval stent reconstruction following filter thrombosis, a case report.

Emerging literature supports removal of chronic indwelling IVC filters when they are contributing to complications for a patient and are no longer indicated. We present an interesting case of an elderly patient who had a history of DVT and underwent spinal surgery, which required cessation of his anticoagulation and placement of an IVC filter pre-operatively. Approximately 15 years later the patient presented to our institution with chronic occlusion of his IVC at the level of his filter which had never been removed, with bilateral lower extremity DVT and symptoms of phlegmasia cerulea dolens.

Don't look back in anger: A cross-sectional and dyadic examination of the Dark Triad, anger, and aggression in athletes.

Objectives: The Dark Triad (psychopathy, Machiavellianism, and narcissism) has been linked to anti-social behaviour in sport, and while anti-social behaviour often involves aggression and violence, no research to date has examined the relationship between the Dark Triad and anger and aggression in athletes. The current two-sample study sought to address this gap.

Design: Multi-sample cross-sectional design.

Cross-study safety analysis of risk factors in CAR T cell clinical trials: An FDA database pilot project.

The Chimeric Antigen Receptor (CAR) T Cell Safety Database Project explored the use of cross-study safety data to identify risk factors associated with severe cytokine release syndrome (sCRS) and severe neurological toxicities (sNTX) after CAR T cell administration. Sponsors voluntarily submitted data for 1,926 subjects from 17 phases 1 and 2 studies (six acute lymphocytic leukemia [ALL], five non-Hodgkin's lymphoma [NHL], and six multiple myeloma [MM] studies). Subjects with ALL had a higher risk for developing sCRS and sNTX compared with subjects with NHL or MM.

Resident involvement in cataract surgery at the Veterans Health Administration: complications, case complexity, and the role of experience.

Purpose: To characterize intraoperative complications, case complexity, and changes in complication rates with surgical experience for cataract surgeries involving residents at the Veterans Health Administration (VHA).

Setting: All VHA facilities where cataract surgery was performed.

Design: Multicenter, retrospective cohort study.

Naloxone Dispensing in Patients at Risk for Opioid Overdose After Total Knee Arthroplasty Within the Veterans Health Administration.

Background: Naloxone prescribing among patients undergoing surgery is not well described. This cohort study was designed to examine patients' risk factors for opioid overdose and their association with naloxone prescribing among veterans undergoing total knee arthroplasty (TKA) after a systemwide Overdose Education and Naloxone Distribution (OEND) initiative.

Methods: A retrospective analysis of Veterans Health Administration (VHA) records was performed and consisted of 38,011 veterans undergoing primary TKA from 2013 to 2016.

FDA Approval Summary: Idecabtagene Vicleucel for Relapsed or Refractory Multiple Myeloma.

In March 2021, the FDA approved idecabtagene vicleucel, a chimeric antigen receptor T-cell therapy targeting the B-cell maturation antigen (BCMA), for adult patients with relapsed/refractory multiple myeloma (RRMM) after ≥4 lines of therapy including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 mAb. Approval was based on overall response rate (ORR), complete response (CR) rate, and duration of response (DOR) in 100 adult patients with RRMM treated with idecabtagene vicleucel in a single-arm trial. Patients received a single infusion of idecabtagene vicleucel, preceded by lymphodepleting chemotherapy with cyclophosphamide and fludarabine.

Use and Toxicity of Checkpoint Inhibitors for Solid Tumor Treatment in a Veteran Population.

Background: New immunotherapy agents have provided additional options for the treatment of a variety of malignancies, including the programmed death 1 (PD-1) protein inhibitors nivolumab and pembrolizumab. Initial dosing was based on patient weight, but subsequent studies supported fixed dosing, thereby prompting a change in US Food and Drug Administration-approved dosing. Depending on patient weight, one dosing strategy may be more cost-effective than another; thereby, a combination of dosing strategies may be beneficial for institutions.

Role of memantine in the prophylactic treatment of episodic migraine: A systematic review.

Objective: The purpose of this systematic review is to assess the efficacy and safety of memantine for the prophylactic treatment of episodic migraine.

Background: Migraine is a prevalent chronic disease with significant costs to the health care system. Although various prophylactic treatment options are available, these medications have limitations based on efficacy, potential side effects, and patient preference.

N95 respirator reuse, decontamination methods, and microbial burden: A randomized controlled trial.

Purpose: To evaluate the effectiveness and ease of N95 respirator decontamination methods in a clinic setting and to identify the extent of microbial colonization on respirators associated with reuse.

Methods: In a prospective fashion, N95 respirators (n = 15) were randomized to a decontamination process (time, dry heat, or ultraviolet C light [UVC]) in outpatient clinics. Each respirator was re-used up to 5 separate clinic sessions.

Balloon assisted stent deployment in the cephalic arch (BASCA).

Cephalic arch stenosis causes repeated dysfunction and failure of arteriovenous access. Outcomes following balloon angioplasty alone in this location are unsatisfactory. Stent grafts have very good patency rates in this location.

Effects of Acetaminophen, NSAIDs, Gabapentinoids, and Their Combinations on Postoperative Pulmonary Complications After Total Hip or Knee Arthroplasty.

Objective: Multimodal analgesia has gained popularity in total hip arthroplasty (THA) and total knee arthroplasty (TKA), but large multicenter studies evaluating specific analgesic combinations are lacking.

Design: A retrospective study using the Premier Healthcare Database (2009-2014).

Subjects: Adults who underwent elective primary THA or TKA.

Impact of prophylactic oseltamivir on INR in patients on stable warfarin therapy.

Influenza prophylaxis with oseltamivir is recommended for exposed high-risk patients. Patients with many comorbidities have an increased likelihood of co-administration of oseltamivir and warfarin. Evidence of a drug interaction is conflicting in the literature and is limited to a 5-day treatment course.

Description of Pharmacist Recommendations in the Caring for Older Adults and Caregivers at Home (COACH) Program.

To describe recommendations made by geriatric clinical pharmacists within an innovative care model focusing on patients with dementia living at home. Retrospective chart review. Outpatients in a tertiary care Veterans Affairs health care system.

Dose-Dependent Association of Gabapentinoids with Pulmonary Complications After Total Hip and Knee Arthroplasties.

Background: Gabapentinoids are commonly prescribed in perioperative multimodal analgesia protocols. Despite widespread use, the optimal dose to reduce opioid consumption while minimizing risks is unknown. We assessed dose-dependent effects of gabapentinoids on opioid consumption and postoperative pulmonary complications following total hip or knee arthroplasty (THA or TKA).

A rare case of bleeding duodenal varices from superior mesenteric vein obstruction -treated with transhepatic recanalization and stent placement.

Ectopic varices are complex and highly variable entities that are not fully understood. Duodenal varices from pancreatitis have rarely been reported. Ectopic varices have much higher bleeding rates than the more common gastro-esophageal varices, and are associated with higher mortality.

Use of a Fully Automated Internet-Based Cognitive Behavior Therapy Intervention in a Community Population of Adults With Depression Symptoms: Randomized Controlled Trial.

Background: Although internet-based cognitive behavior therapy (iCBT) interventions can reduce depression symptoms, large differences in their effectiveness exist.

Objective: The aim of this study was to evaluate the effectiveness of an iCBT intervention called Thrive, which was designed to enhance engagement when delivered as a fully automated, stand-alone intervention to a rural community population of adults with depression symptoms.

Methods: Using no diagnostic or treatment exclusions, 343 adults with depression symptoms were recruited from communities using an open-access website and randomized 1:1 to the Thrive intervention group or the control group.

Porous silver-coated pNIPAM--AAc hydrogel nanocapsules.

This paper describes the preparation and characterization of a new type of core-shell nanoparticle in which the structure consists of a hydrogel core encapsulated within a porous silver shell. The thermo-responsive hydrogel cores were prepared by surfactant-free emulsion polymerization of a selected mixture of -isopropylacrylamide (NIPAM) and acrylic acid (AAc). The hydrogel cores were then encased within either a porous or complete silver shell for which the localized surface plasmon resonance (LSPR) extends from visible to near-infrared (NIR) wavelengths (i.

Trends in Chronic Opioid Use Around Inpatient Surgery Within the Veterans Health Administration.

This study assesses outcomes of veterans who have undergone inpatient surgery since the Veterans Health Administration’s opioid safety initiative was initiated.