Use of Cell-Free DNA Testing to Diagnose Infective Endocarditis in a Patient With Negative Blood Cultures.

Infective endocarditis (IE) is associated with significant morbidity and mortality. Its diagnosis can be especially challenging, as can the identification of a causative pathogen, which, in turn, is crucial for appropriate management. Here, we present a rare case of Streptococcus intermedius endocarditis complicated by lung and cerebral abscess in which clinicians employed cell-free deoxyribonucleic acid (cfDNA) testing to confirm the diagnosis, establish a causative pathogen, and determine appropriate antibiotic therapy.

Evaluation of forces applied to tissues during robotic-assisted surgical tasks using a novel force feedback technology.

Background: The absence of force feedback (FFB) is considered a technical limitation in robotic-assisted surgery (RAS). This pre-clinical study aims to evaluate the forces applied to tissues using a novel integrated FFB technology, which allows surgeons to sense forces exerted at the instrument tips.

Methods: Twenty-eight surgeons with varying experience levels employed FFB instruments to perform three robotic-assisted surgical tasks, including retraction, dissection, and suturing, on inanimate or ex-vivo models, while the instrument sensors recorded and conveyed the applied forces to the surgeon hand controllers of the robotic system.

'Was my kidney biopsy worth it?'-A qualitative phenomenological study of patient experiences and perceived barriers to kidney biopsy.

Background: Kidney biopsy is an important investigation in nephrology and facilitates the diagnosis of many conditions. It is an invasive procedure with the risk of significant complications, which limits its usage. There is minimal literature on how patients experience a kidney biopsy.

Decisional Conflict Among Patients Newly Diagnosed With Clinical T1 Renal Masses: A Prospective Study.

Purpose: Because multiple management options exist for clinical T1 renal masses, patients may experience a state of uncertainty about the course of action to pursue (ie, decisional conflict). To better support patients, we examined patient, clinical, and decision-making factors associated with decisional conflict among patients newly diagnosed with clinical T1 renal masses suspicious for kidney cancer.

Materials And Methods: From a prospective clinical trial, participants completed the Decisional Conflict Scale (DCS), scored 0 to 100 with < 25 associated with implementing decisions, at 2 time points during the initial decision-making period.

Capnocytophaga sputigena Tonsillitis in a Patient With Acute Myeloid Leukemia.

is a gram-negative facultatively anaerobic, capnophilic bacterium typically residing in the human oropharyngeal flora. This opportunistic pathogen can cause a wide range of infections, from bacteremia to septic abortion. However, it is exceedingly rare for a patient to present with tonsillitis due to .

Detection of Testicular Metastasis from Renal Cell Carcinoma on PSMA-PET Scan.

The use of prostate-specific membrane antigen-positron emission tomography (PSMA-PET) is becoming more widespread for the diagnosis and management of prostate cancer. Here we report a case of oligometastatic renal cell carcinoma (RCC) to the testes diagnosed incidentally on PSMA-PET imaging. This case demonstrates the potential for diagnosis of nonprostate disease with PSMA-PET imaging, as well as the promising nature of PSMA-PET for the diagnosis and surveillance of RCC.

The Heart of the Matter: Immune Checkpoint Inhibitors and Immune-Related Adverse Events on the Cardiovascular System.

Cancer remains a prominent global cause of mortality, second only to cardiovascular disease. The past decades have witnessed substantial advancements in anti-cancer therapies, resulting in improved outcomes. Among these advancements, immunotherapy has emerged as a promising breakthrough, leveraging the immune system to target and eliminate cancer cells.

A Rare Case of a Morel-Lavallée Lesion Complicated by Pseudomonas aeruginosa Infection: Diagnostic Challenges and Therapeutic Considerations.

Morel-Lavallée lesions are uncommon soft tissue injuries resulting from trauma, characterized by the separation of subcutaneous tissue from the underlying fascia. Soft tissue infections with are rare and most typically associated with hospital-acquired infections and burn wounds. This case report is regarding a 57-year-old man following a motorcycle accident who presented with a unique occurrence of an MLL complicated by infection.

A Review of Omadacycline for Potential Utility in the Military Health System for the Treatment of Wound Infections.

Introduction: Combat-related wound infections complicate the recovery of wounded military personnel, contributing to overall morbidity and mortality. Wound infections in combat settings present unique challenges because of the size and depth of the wounds, the need to administer emergency care in the field, and the need for subsequent treatment in military facilities. Given the increase in multidrug-resistant pathogens, a novel, broad-spectrum antibiotic is desired across this continuum of care when the standard of care fails.

A Rare Case of Herpes Simplex Virus and Cytomegalovirus Dual Infection Inducing Unremitting Ulcerative Colitis.

Ulcerative colitis (UC) is a subtype of inflammatory bowel disease that results in inflammation and ulceration in the lining of the large intestine. Patients with UC are frequently prescribed immunosuppressive medications to treat their symptoms, resulting in an increased risk of reactivation of many latent viruses, including herpes simplex virus (HSV) and cytomegalovirus (CMV). However, it is rare for a patient to present with simultaneous reactivation of both viruses.

Amidine-Based Cationic Conjugated Oligoelectrolytes with Antimicrobial Activity against Biofilms.

is an opportunistic Gram-negative bacterium that can cause high-morbidity infections. Due to its robust, flexible genome and ability to form biofilms, it can evade and rapidly develop resistance to antibiotics. Cationic conjugated oligoelectrolytes (COEs) have emerged as a promising class of antimicrobials.

Improving Staff Workflow in Urology Procedure Clinic Using the Model for Improvement.

Objective: To maximize procedure volume and minimize workflow inefficiency in our urological procedure clinic, we hypothesized that for staff (nurses/medical assistants) and patient teams, team workflow duration (TWD) (the time required to complete team duties for a single appointment) could be reduced by 50% with a targeted workflow intervention developed using the Model for Improvement and Plan-Do-Study-Act cycles. Workflow inefficiency leads to wasted time and workplace dissatisfaction, resulting in lost revenue due to low procedure volume and high staff turnover.

Methods: A baseline time study was performed to measure TWD for clinical teams, including the front desk, physician, staff, and patient teams.

Practice of immediate sequential bilateral cataract surgery (ISBCS): A teaching hospital experience in United Kingdom.

Background / Objectives: Utilisation of ISBCS has been encouraged since COVID-19 in line with the RCOphth recommendations. This study aims to share experience from a UK teaching hospital on ISBCS and to evaluate pre-, intra- and post-operative outcomes from the ISBCS cohort.

Methods: Of 3402 cataract surgeries performed between July 2020 and July 2021 (1 year since the reopening of the cataract service from COVID-19), 208 eyes of 104 patients (6.

Correction to "An Iterative Approach Guides Discovery of the FabI Inhibitor Fabimycin, a Late-Stage Antibiotic Candidate with Efficacy against Drug-Resistant Gram-Negative Infections".

[This corrects the article DOI: 10.1021/acscentsci.2c00598.

An Iterative Approach Guides Discovery of the FabI Inhibitor Fabimycin, a Late-Stage Antibiotic Candidate with Efficacy against Drug-Resistant Gram-Negative Infections.

Genomic studies and experiments with permeability-deficient strains have revealed a variety of biological targets that can be engaged to kill Gram-negative bacteria. However, the formidable outer membrane and promiscuous efflux pumps of these pathogens prevent many candidate antibiotics from reaching these targets. One such promising target is the enzyme FabI, which catalyzes the rate-determining step in bacterial fatty acid biosynthesis.

Effect of Corneal Cross-linking versus Standard Care on Keratoconus Progression in Young Patients: The KERALINK Randomized Controlled Trial.

Purpose: To examine the efficacy and safety of corneal cross-linking (CXL) for stabilization of progressive keratoconus.

Design: Observer-masked, randomized, controlled, parallel-group superiority trial.

Participants: Sixty participants 10 to 16 years of age with progressive keratoconus, one eye of each deemed the study eye.

Overall Survival of Biopsy-confirmed T1B and T2A Kidney Cancers Managed With Observation: Prognostic Value of Tumor Histology.

Introduction: The natural history of T1b (4-7 cm) or T2a (> 7-10 cm) kidney cancers managed with observation is not well-understood. The aim of our study was to determine if the addition of histologic subtype to a predictive model of overall survival (OS) that includes covariates for competing risks in observed, biopsy-proven, T1b and T2a renal cell carcinomas (RCCs) improves the model's performance.

Materials And Methods: We queried the National Cancer Database for patients with biopsy-proven stage T1b or T2a RCC and managed nonoperatively between 2004 and 2015.

Implementation of Postoperative Standard Opioid Prescribing Schedules Reduces Opioid Prescriptions Without Change in Patient-reported Pain Outcomes.

Objective: To implement Standard Opioid Prescribing Schedules (SOPS) based on opioid use following urologic surgeries and to evaluate how evidence-based prescribing schedules affect opioid use and patient reported outcomes.

Methods: Patients who underwent urologic surgeries within 6 procedure subtypes at UNC Health during the 2 study time periods ("pre-SOPS": 7/2017-1/2018, "post-SOPS": 7/2018-1/2019) were invited to complete a survey analyzing postoperative opioid usage, storage and disposal, and patient reported outcomes (including pain interference using a validated questionnaire). A pharmacy database provided medication prescribing data and patient demographics.

Improving the precision of search strategies for guideline surveillance.

Introduction And Aim: NICE guideline surveillance determines whether previously published guidelines need updating. The surveillance process must balance time constraints with methodological rigor. It includes a rapid review to identify new evidence to contradict, reinforce or clarify guideline recommendations.

NICE update NICE public health guidance update.

This article covers recently published National Institute for Health and Care Excellence (NICE) guidance relevant to public health and a review of evidence published since we released the NICE guidance on unintentional injury prevention in under 15 year olds. The article features some of this evidence that was found to reinforce published recommendations on safety in the home and on the roads, indicating the guidance remains up to date and relevant. In addition, it importantly highlights that there is great opportunity to prevent future unintentional injury through integrated and coordinated, evidence and intelligence-informed approaches.

A randomised, controlled, observer-masked trial of corneal cross-linking for progressive keratoconus in children: the KERALINK protocol.

Introduction: The KERALINK trial tests the hypothesis that corneal cross-linking (CXL) treatment reduces the progression of keratoconus in comparison to standard care in patients under 17 years old. KERALINK is a randomised controlled, observer-masked, multicentre trial in progressive keratoconus comparing epithelium-off CXL with standard care, including spectacles or contact lenses as necessary for best-corrected acuity.

Methods And Analysis: A total of 30 participants will be randomised per group.

Comparison of the Harms, Advantages, and Costs Associated With Alternative Guidelines for the Evaluation of Hematuria.

Importance: Existing recommendations for the diagnostic testing of hematuria range from uniform evaluation of varying intensity to patient-level risk stratification. Concerns have been raised about not only the costs and advantages of computed tomography (CT) scans but also the potential harms of CT radiation exposure.

Objective: To compare the advantages, harms, and costs associated with 5 guidelines for hematuria evaluation.

Epidemiology of the Frequency, Etiology, Direction, and Severity (FEDS) system for classifying glenohumeral instability.

Hypothesis: The purpose of this multicenter epidemiologic study was to determine the distribution of patients within the Frequency, Etiology, Direction, and Severity (FEDS) classification system to determine which categories are of clinical importance.

Methods: Shoulder instability patients were identified using International Classification of Diseases, Ninth Revision coding data from 3 separate institutions from 2005-2010. Data were collected retrospectively.