Utilization of immediate extubation in a multidisciplinary pathway for pediatric liver transplantation associated with improved postoperative outcomes.

Background: Immediate extubation is becoming more common in liver transplantation. However, limited data exist on how to identify pediatric patients with potential for successful immediate extubation and how this intervention may affect recovery.

Methods: This retrospective review evaluated patients who underwent liver transplantation from 2015 to 2021 at Children's Healthcare of Atlanta.

Trends in sedation-analgesia practices in pediatric liver transplant patients admitted postoperatively to the pediatric intensive care unit: An analysis of data from the pediatric health information system (PHIS) database.

Background: Children admitted to the pediatric intensive care unit (PICU), after liver transplantation, frequently require analgesia and sedation in the immediate postoperative period. Our objective was to assess trends and variations in sedation and analgesia used in this cohort.

Methods: Multicenter retrospective cohort study using the Pediatric Health Information System from 2012 to 2022.

Intralesional cryotherapy with triamcinolone and onabotulinumtoxinA injections for umbilical keloid: A case report.

Introduction: Keloid scars are therapeutically challenging and although many treatment options exist, there are no specific guidelines, and few reports have discussed keloids in the umbilical region.

Methods: Here, we present a successful treatment of a 31-year-old female with a history of a recurrent keloid in the umbilical region. The keloid was treated using intralesional cryotherapy followed by intralesional onabotulinumtoxinA and triamcinolone acetonide injections.

Femoral nerve neuromonitoring for lateral lumbar interbody fusion surgery.

Background Context: The transpsoas lateral lumbar interbody fusion (LLIF) technique is an effective alternative to traditional anterior and posterior approaches to the lumbar spine; however, nerve injuries are the most reported postoperative complication. Commonly used strategies to avoid nerve injury (eg, limiting retraction duration) have not been effective in detecting or preventing femoral nerve injuries.

Purpose: To evaluate the efficacy of emerging intraoperative femoral nerve monitoring techniques and the importance of employing prompt surgical countermeasures when degraded femoral nerve function is detected.

Optimizing the Therapeutic Window of Targeted Drugs in Oncology: Potency-Guided First-in-Human Studies.

Many targeted therapies are administered at or near the maximum tolerated dose (MTD). With the advent of precision medicine, a larger therapeutic window is expected. Therefore, dose optimization will require a new approach to early clinical trial design.

Improved resolution of mixed STR profiles using a fully automated differential cell lysis/DNA extraction method.

Sexual assault evidence often contains sperm cells, which are typically separated from nonsperm cells using manual differential lysis procedures. The goal of this study was to evaluate the automated QIAGEN QIAcube for this purpose and to compare it to manual QIAGEN and manual organic differential methods using DNA yields STR profile data for assessment. DNA yields were determined by qPCR, followed by multiplex STR amplification, CE analysis, and mixture interpretation.

PKC induces release of a functional ectodomain of the guidance cue semaphorin6A.

Semaphorins (Semas) are a family of secreted and transmembrane proteins that play critical roles in development. Interestingly, several vertebrate transmembrane Sema classes are capable of producing functional soluble ectodomains. However, little is known of soluble Sema6 ectodomains in the nervous system.

Does Metformin Have an Effect on Stent Patency Rates.

Background: Metformin is the most commonly used drug for type 2 diabetes. Research has shown that metformin also has a protective effect on endothelium by decreasing endothelial vascular reactivity. We hypothesize that metformin will decrease restenosis/reintervention rates in patients receiving lower extremity non-drug-eluting stents (nDESs) in the superficial femoral artery(SFA) and/or popliteal artery.

Randomized phase 2 trial of a coordinated breast cancer follow-up care program.

Background: Previous research has demonstrated that cancer survivors often fail to receive recommended care and also undergo unnecessary care; this reduces care quality and increases costs.

Methods: This phase 2 trial randomized 100 stage 0 to IIIa breast cancer patients who had primary care providers within a large Massachusetts-based hospital network (with accessible online records) to either coordinated follow-up care (CC), which entailed a tailored survivorship care plan (SCP) and patient navigator calls every 3 months, or standard care (SC), which did not include an SCP or patient navigation, for 1 year after the completion of their last chemotherapy, surgery, or radiation treatment. The primary endpoint was the frequency of redundant examinations (>1 breast/chest wall examination per patient within any 30-day period in the absence of a new breast or chest wall complaint) over the year of follow-up.

New Minimally Invasive Technique for Direct Pars Interarticularis Osteosynthesis Using Cortical Screws and Spinous-Process Modular Link.

Study Design: Case report.

Objective: To report a case of direct pars osteosynthesis using computed topography (CT) navigation, image guided cortically placed screws with curvilinear subspinous modular link.

Summary Of Background Data: Spondylolysis fracture is commonly encountered in athletes who subject their spines to repetitive hyperextension stress.

Quantifying Anesthesia Exposure in Growing Rod Treatment for Early Onset Scoliosis.

Background: Growing rod (GR) treatment for early-onset scoliosis requires repeated anesthesia exposure (AE). At a minimum, GR treatment requires AE for diagnostic imaging, index GR surgery, periodic lengthenings, and final fusion. Adjunct procedures and complication-related procedures also increase AE.

Mexiletine Prevents Recurrent Torsades de Pointes in Acquired Long QT Syndrome Refractory to Conventional Measures.

Objectives: The purpose of this study was to examine the role of mexiletine, a late sodium current (I) blocker, in acute termination of torsades de pointes (TdP) refractory to conventional therapy in acquired long QT syndromes (LQTS).

Background: Long QT interval can predispose to TdP and is therefore associated with significant mortality. Currently, there is no available pharmacotherapy to target directly the ionic basis of most LQTS for the acute termination of TdP.

Motor evoked potentials for femoral nerve protection in transpsoas lateral access surgery of the spine.

Detecting potential intraoperative injuries to the femoral nerve should be the main goal of neuromonitoring of lateral lumber interbody fusion (LLIF) procedures. We propose a theory and technique to utilize motor evoked potentials (MEPs) to protect the femoral nerve (a peripheral nerve), which is at risk in LLIF procedures. MEPs have been advocated and widely used for monitoring spinal cord function during surgical correction of spinal deformity and surgery of the cervical and thoracic spine, but have had limited acceptance for use in lumbar procedures.

What makes a top research medical school? A call for a new model to evaluate academic physicians and medical school performance.

Since the publication of the Flexner Report in 1910, the medical education enterprise has undergone many changes to ensure that medical schools meet a minimum standard for the curricula and clinical training they offer students. Although the efforts of the licensing and accrediting bodies have raised the quality of medical education, the educational processes that produce the physicians who provide the best patient care and conduct the best biomedical research have not been identified. Comparative analyses are powerful tools to understand the differences between institutions, but they are challenging to carry out.

Targeting CD137 enhances the efficacy of cetuximab.

Treatment with cetuximab, an EGFR-targeting IgG1 mAb, results in beneficial, yet limited, clinical improvement for patients with head and neck (HN) cancer as well as colorectal cancer (CRC) patients with WT KRAS tumors. Antibody-dependent cell-mediated cytotoxicity (ADCC) by NK cells contributes to the efficacy of cetuximab. The costimulatory molecule CD137 (4-1BB) is expressed following NK and memory T cell activation.

Electrical failure of an ICD lead due to a presumed insulation defect only diagnosed by a maximum output shock.

A 55-year-old male patient presented after a single shock caused by oversensing of isolated nonphysiologic signals on both the distal HV and pace-sense channels. No other abnormalities were found. He subsequently returned complaining of device "vibration" and his St.

Relationship between routine multi-detector cardiac computed tomographic angiography prior to reoperative cardiac surgery, length of stay, and hospital charges.

While multi-detector cardiac computed tomography angiography (MDCCTA) prior to reoperative cardiac surgery (RCS) has been associated with improved clinical outcomes, its impact on hospital charges and length of stay remains unclear. We studied 364 patients undergoing RCS at Washington Hospital Center between 2004 and 2008, including 137 clinically referred for MDCCTA. Baseline demographics, procedural data, and perioperative outcomes were recorded at the time of the procedure.

Malignant osseous tumors of the pediatric spine.

In the pediatric population, malignant osseous tumors of the spine include osteosarcoma, Ewing sarcoma, lymphoma, and metastatic neuroblastoma. Although these tumors are rare, prompt diagnosis and recognition are critical to the overall prognosis. Improved understanding of the natural history of spine deformity, combined with advances in imaging, surgical technology, radiation therapy, and chemotherapeutic regimens, has improved survival rates and decreased rates of local recurrence-especially recurrence of low-grade lesions.

Acute posttraumatic catastrophic failure of a second-generation, highly cross-linked ultra-high-molecular-weight polyethylene patellar component.

A 74-year-old man underwent total knee arthroplasty in 1996 and subsequent revision total knee arthroplasty for aseptic loosening in 2005. During revision, an all-polyethylene, 7-mm, second-generation, highly cross-linked ultra-high-molecular-weight polyethylene patellar component (Durasul; Zimmer, Warsaw, Indiana) was used. The patient recovered well, but he presented with severe acute pain after a popping feeling was detected during a game of golf in postoperative year 4.

Combination strategies to enhance antitumor ADCC.

The clinical efficacy of monoclonal antibodies as cancer therapeutics is largely dependent upon their ability to target the tumor and induce a functional antitumor immune response. This two-step process of ADCC utilizes the response of innate immune cells to provide antitumor cytotoxicity triggered by the interaction of the Fc portion of the antibody with the Fc receptor on the immune cell. Immunotherapeutics that target NK cells, γδ T cells, macrophages and dendritic cells can, by augmenting the function of the immune response, enhance the antitumor activity of the antibodies.

Stimulation of natural killer cells with a CD137-specific antibody enhances trastuzumab efficacy in xenotransplant models of breast cancer.

Trastuzumab, a monoclonal antibody targeting human epidermal growth factor receptor 2 (HER2; also known as HER-2/neu), is indicated for the treatment of women with either early stage or metastatic HER2(+) breast cancer. It kills tumor cells by several mechanisms, including antibody-dependent cellular cytotoxicity (ADCC). Strategies that enhance the activity of ADCC effectors, including NK cells, may improve the efficacy of trastuzumab.