Clinical Outcomes of Early Phenotype-Desirable Antimicrobial Therapy for Enterobacterales Bacteremia.

Importance: Initiating effective therapy early is associated with improved survival among patients hospitalized with gram-negative bloodstream infections; furthermore, providing early phenotype-desirable antimicrobial therapy (PDAT; defined as receipt of a β-lactam antibiotic with the narrowest spectrum of activity to effectively treat the pathogen's phenotype) is crucial for antimicrobial stewardship. However, the timing of targeted therapy among patients hospitalized with gram-negative bloodstream infections is not well understood.

Objective: To compare the clinical outcomes between patients who were hospitalized with Enterobacterales bloodstream infections receiving early vs delayed PDAT.

Incidence and variability in receipt of phenotype-desirable antimicrobial therapy for Enterobacterales bloodstream infections among hospitalized United States patients.

Background: Using a large, geographically diverse, hospital-based database in the United States (Premier PINC AI Healthcare Database), we aimed to describe the proportion and characteristics of patients receiving phenotype-desirable antimicrobial therapy (PDAT) among those hospitalized with Enterobacterales bloodstream infections.

Methods: Adult patients with an admission between January 1, 2017 and June 30, 2022 with ≥1 blood culture positive for , , , or and receiving an empiric antibiotic therapy on blood culture collection (BCC) Days 0 or 1 were included. Receiving PDAT (defined as receipt of any antimicrobial categorized as "desirable" for the respective phenotype) on BCC Days 0-2 was defined as receiving early PDAT.

Treatment patterns, healthcare resource use, and costs associated with uncomplicated urinary tract infection among female patients in the United States.

Background: We evaluated associations between antibiotic prescription and healthcare resource use and costs (Part A), and between antibiotic switching and healthcare resource use, costs, and uncomplicated urinary tract infection recurrence (Part B) in female patients with uncomplicated urinary tract infection in the United States.

Methods: This retrospective cohort study of linked Optum and Premier Healthcare Database data included female patients ≥12 years old with an uncomplicated urinary tract infection diagnosis (index date), who were prescribed antibiotics during an outpatient/emergency department visit between January 1, 2013 and December 31, 2018. In Part A, patients were stratified by antibiotic prescription appropriateness: appropriate and optimal (compliant with Infectious Diseases Society of America 2011 guidelines for drug class/treatment duration) versus inappropriate/suboptimal (inappropriate drug class/treatment duration per Infectious Diseases Society of America 2011 guidelines, and/or treatment failure).

In-Hospital Mortality Among Hospitalized Coronavirus Disease 2019 Patients in the United States: How Did It Change in 2021?

In this retrospective observational study in a US national sample of 501 671 adults hospitalized with coronavirus disease 2019, adjusted in-hospital mortality decreased from 12% in February 2021 to 9% in April 2021. However, adjusted in-hospital mortality increased to 16% in September and October 2021. Adjusted intensive care unit admission fluctuated between 20% and 27% in 2021.

Healthcare Resource Utilization of Patients With COVID-19 Visiting US Hospitals.

Objectives: Severe cases of COVID-19 have overwhelmed hospital systems across the nation. This study aimed to describe the healthcare resource utilization of patients with COVID-19 from hospital visit to 30 days after discharge for inpatients and hospital-based outpatients in the United States.

Methods: A retrospective cohort study was conducted using Premier Healthcare Database COVID-19 Special Release, a large geographically diverse all-payer hospital administrative database.

ANTI-REFLUX PROCEDURES AFTER ROUX-EN-Y GASTRIC BYPASS.

Background: Roux-en-Y gastric bypass (RYGB) has been the choice of bariatric procedure for patients with symptomatic reflux - and is known to be effective in reducing the need for anti-reflux medication postoperatively. However, a small number of RYGB patients can still develop severe reflux symptoms that require a surgical intervention.

Aim: To examine and describe the patient population that requires an anti-reflux procedure after RYGB evaluating demographics, characteristics, symptoms and diagnosis.

Is Coronavirus Disease 2019 (COVID-19) Less Deadly Now? Trends in In-Hospital Mortality Among Hospitalized COVID-19 Patients in the United States.

After an initial decline from April through June 2020 (from 22.2% to 11.9%), adjusted in-hospital mortality in coronavirus disease 2019 (COVID-19) inpatients peaked twice and was significantly higher than June 2020 for subsequent months except in July and October 2020.

To oversew or not to oversew in robotic sleeve gastrectomy: a case against oversewing the staple line.

Background: The benefits of oversewing the staple lines during laparoscopic sleeve gastrectomy have been controversial. No study examined the benefit of oversewing the staple lines in robotic sleeve gastrectomy (RSG). This retrospective study aims to examine the difference in immediate postoperative complications, readmissions, reoperations, and emergency room visits between RSG patients with and without oversewn staple lines at a single, large-volume, bariatric center.

Effect of Obesogenic Medication on Weight- and Fitness-Change Outcomes: Evidence from the Look AHEAD Study.

Objective: This study evaluates whether obesogenic medications may decrease the effectiveness of lifestyle interventions. The authors of this study hypothesized that participants who took obesogenic medications would be less responsive to the intervention in the Look AHEAD trial.

Methods: In the trial, 5,145 participants with overweight or obesity, aged 45 to 76 years with type 2 diabetes, were randomly assigned to an intervention (vs.

Preoperative Exposure to Low-Calorie Sweeteners and Bariatric Surgery Outcomes.

Purpose: Low-calorie (LCSs) may be negatively associated with weight and metabolic health. We hypothesized that LCS exposure may hinder the effectiveness of bariatric procedures. The aim of this study was to examine the association between preoperative LCS use and weight loss/comorbidity remission following sleeve gastrectomy and gastric bypass.

Impact of Weight Status on the Cardiopulmonary Fitness Outcome of a School-Based Physical Activity Program.

Background: The effectiveness of school-based physical activity interventions for improving cardiopulmonary fitness (CPF) of overweight and obese children is not well established. In this study, we evaluated whether overweight and obese children had similar changes in body mass index (BMI) and CPF as normal weight children after participating in a program for one academic year.

Methods: Using purposive sampling at the school level, we selected 16 program and 7 control schools in a large metropolitan area in the Southeast during the 2015-2016 academic year.

The Associations between Childhood Obesity, Academic Performance, and Perception of Teachers: From Kindergarten to Fifth Grade.

Obesity is weakly associated with negative academic achievement among school-aged children. The purpose of this study is to demonstrate the relationships between reading/mathematics scores (objective) and teachers' perception of learning ability (subjective) and childhood obesity-from kindergarten to fifth grade. This study examined a longitudinal study of a nationally representative sample of 18,174 children who were enrolled in kindergarten in 2010 in the United States (ECLS-K:2011).

Cardiopexy at the Time of Sleeve Gastrectomy as a Preventive Measure for Reflux.

Background: One of the most significant concerns after laparoscopic sleeve gastrectomy (LSG) is the new-onset or worsening of gastroesophageal reflux disease (GERD). Some patients with LSG undergo a conversion to Roux-en-Y gastric bypass (RYGB) because of severe GERD. Cardiopexy at the time of LSG may help prevent GERD.

Feasibility and safety of robot-assisted bariatric conversions and revisions.

Background: Conversions and revisions after bariatric procedures are inevitable and associated with longer operative time and higher complication rates. Because robot-assisted procedures allow better dissection, robotic conversions and revisions may be more beneficial to the patients than laparoscopic ones.

Objectives: This study aimed to compare the feasibility and safety of robot-assisted conversions and revisions to laparoscopic procedures.

Short-term results of long biliopancreatic limb Roux-en-Y gastric bypass-is it superior?

Objectives: To compare the short-term safety and effectiveness of long biliopancreatic limb Roux-en-Y gastric bypass (RYGB) to that of regular RYGB.

Setting: Academic hospital, United States.

Methods: A retrospective chart review was performed on 89 consecutive patients who underwent RYGB between February 4, 2014 and March 12, 2015.

A comparison of surgical pulmonary embolectomy and catheter-directed lysis for life-threatening pulmonary emboli.

Objectives: Patients with life-threatening pulmonary emboli (PE) have traditionally been treated with anticoagulation alone, yet emerging data suggest that more aggressive therapy may improve short-term outcomes. The purpose of this study was to compare postoperative outcomes between catheter-directed thrombolysis (CDL) and surgical pulmonary embolectomy (SPE) in the treatment of life-threatening PE.

Methods: A retrospective single-centre observational study was conducted for patients who underwent SPE or CDL at a single US academic centre.

Late Adiposity Rebound and the Probability of Developing and Reversing Childhood Obesity.

Objective: To evaluate the associations between late adiposity rebound (at or after 7.0 years of age) and the probability of developing and reversing obesity during elementary school years.

Study Design: Using nationally representative cohorts from Early Childhood Longitudinal Studies, Kindergarten Class of 1998-1999 and 2010-2011, weighted extended Cox hazard models were used to assess the probability of developing and reversing obesity (cut-offs for extended models were 6 and 12 months after kindergarten entry, respectively).

Conversions of Roux-en-Y gastric bypass to duodenal switch (SADI-S and BPD-DS) for weight regain.

Background: Duodenal switch is a choice of conversion when patients fail to lose or regain weight after Roux-en-Y gastric bypass (RYGB). This study aims to evaluate the effectiveness and safety of duodenal switch as a secondary operation for patients who presented with insufficient weight loss or weight regain after a RYGB.

Methods: A retrospective chart review was performed on 15 patients who underwent a conversion of RYGB to single anastomosis duodeno-ileal bypass with sleeve (SADI-S) or biliopancreatic diversion with duodenal switch (BPD-DS) due to weight regain between December 31, 2013 and October 31, 2018.

Safety and short-term effectiveness of endoscopic sleeve gastroplasty using overstitch: preliminary report from a multicenter study.

Background: Endoscopic sleeve gastroplasty (ESG) is an option for patients with Class I and II obesity or patients who refuse to undergo a laparoscopic bariatric surgery. The aims of this study are as follows: (1) to demonstrate a short-term outcome after primary ESG and (2) to compare the effectiveness of weight loss between Class I and Class II obesity patients.

Methods: Patients undergoing ESG at four bariatric centers in Brazil between April 1, 2017 and December 31, 2018 were prospectively enrolled in the study (BMI 30.

Pathologic findings of the removed stomach during sleeve gastrectomy.

Background: Laparoscopic sleeve gastrectomy (LSG) is the preferred surgical intervention to treat morbid obesity. Despite the rising popularity of LSG, little is known on the histopathologic findings of the resected partial stomach specimens. Our study aims to identify prevalent pathologic findings of the removed stomach and explore the association between patient characteristics and abnormal findings.