Acute management of massive pulmonary embolism in pregnancy.

Key Content: •Massive pulmonary embolism (PE) during pregnancy or the postpartum period is a rare but potentially lethal event.•Physiological changes in the coagulation system during pregnancy and puerperium would lead to a hypercoagulable state.•Diagnosis of PE in pregnancy remains a challenge due to physiological changes in pregnancy.

Consistent direction despite wavering policy: reductions in resident physician extended duration shifts over 20 years.

We examined data from 17,498 physicians-in-training who reported on 92,662 months of work over a 20 year study interval that included three major revisions to work hour limits. Extended duration shifts (≥24 hours; EDS) are much less common than they used to be. On average, first-year resident physicians (PGY1s) currently work a total of 4 EDS per year and 3 EDS per month during months in which any EDS are worked.

Comparison of mitral valve repair versus replacement for mitral valve regurgitation.

Background: Mitral regurgitation (MR) is a prevalent valvular abnormality categorized as primary or secondary based on aetiology. Surgical intervention, particularly mitral valve repair, is often preferred over replacement due to its association with better outcomes. However, the benefits of repair versus replacement, especially in secondary MR, remain debated.

Optimum diagnostic pathway and pathologic confirmation rate of early stage lung cancer: Results from the VIOLET randomised controlled trial.

Background: Pathologic confirmation of lung cancer influences treatment selection for suspected early-stage lung cancer. High pre-treatment tissue confirmation rates are recommended. We sought to define management and outcomes of patients undergoing surgery for primary lung cancer in a UK multi-centre clinical trial.

Data-driven cluster analysis identifies distinct types of metabolic dysfunction-associated steatotic liver disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) exhibits considerable variability in clinical outcomes. Identifying specific phenotypic profiles within MASLD is essential for developing targeted therapeutic strategies. Here we investigated the heterogeneity of MASLD using partitioning around medoids clustering based on six simple clinical variables in a cohort of 1,389 individuals living with obesity.