Identifying Quality Improvement Targets After Pediatric Gastrostomy Tube Insertion: A NSQIP-Pediatric Pilot Study.

Background: Gastrostomy tube (GT) placement is one of the most common procedures performed by pediatric surgeons; however, no current national clinical data registry exists to assess GT-specific care processes and morbidity. The American College of Surgeons (ACS) National Surgical Quality Improvement Program-Pediatric (NSQIPPed) GT Pilot was created to provide participants with these data. This study aims to analyze these data to identify variability in perioperative practices and post-operative morbidity in pediatric GT operations and to provide targets for future quality improvement (QI) interventions.

Left Common Iliac Artery Aneurysm Rupture to an Iliac Vein with a Venous Anomaly: A Case Report.

Ruptured iliac artery aneurysms are serious conditions with high mortality, occasionally perforating into the venous system. A 73-year-old male presented with left leg edema and a pulsatile left lower abdominal mass. Computed tomography revealed a ruptured left common iliac artery aneurysm with perforation into the left common iliac vein.

Perforating pharyngeal injury caused by minor blunt trauma to the neck: A case report.

Background: Pharyngeal perforation has been documented as a consequence of substantial external force applied to the neck. Such trauma is frequently accompanied by additional organ injury and cervical fracture. In this report, we present an exceptionally rare instance in which minor blunt trauma to the neck resulted in pharyngeal injury without concomitant damage to other organs.

Undiagnosed mirror syndrome with maternal hypoxemia onset during an emergency cesarean section: A case report.

Rationale: Mirror syndrome is a rare pregnancy condition in which maternal edema is associated with fetal hydrops. Because of its rarity and overlapping symptoms, this condition is often misdiagnosed as another pregnancy complication.

Patient Concerns: A 28-year-old pregnant Japanese woman presented with sudden 7.

Comparative Analysis of Indices for Social Determinants of Health in Pediatric Surgical Populations.

Importance: Conclusions vary substantially among studies examining associations between area-based social determinants of health (SDOH) and pediatric health disparities based on the selected patient population and SDOH index. Most national studies use zip codes, which encompass a wide distribution of communities, limiting the generalizability of findings.

Objectives: To characterize the distributions of composite SDOH indices for pediatric surgical patients within a national sample of academic children's hospitals and to assess SDOH index precision in classifying patients at similar levels of disadvantage.

Complex Multimorbidity and Trajectories of Functional Disabilities in the Last Three Years of Life: A Prospective Cohort Study of Older Adults in Japan.

We sought to understand the impact of multimorbidity (MM) on the trajectories of functional decline in the last three years of life among older people in Japan. We used nationwide longitudinal cohort data with 6-year follow-up and analyzed 3731 functionally independent residents aged 65 years and older. The primary outcome was the five trajectory groups of functional disability in the last three years of life, defined by group-based trajectory modeling (GBTM).

Safety of Breastfeeding During Favipiravir Therapy: A Case Study.

Introduction: Favipiravir is a known anti-influenza agent that has been used globally, especially during the coronavirus disease 2019 (COVID-19) pandemic. This drug has been important for treating influenza and other emerging infectious diseases, although it was ultimately proven to be ineffective for COVID-19. Currently, no studies have reported the human-milk transfer of favipiravir at doses of 1,600-3,600 mg/day in the treatment of diseases, including COVID-19.

Usefulness of the Slope of the Preload Recruitable Stroke Work Relationship for the Prediction of Rehospitalization After Transcatheter Mitral Edge-to-Edge Repair.

Background: Among patients with functional mitral regurgitation (FMR), responders to transcatheter mitral edge-to-edge repair (TEER) remain unclear. We investigated whether the slope of the preload recruitable stroke work relationship (M; calculated as stroke work / [EDV - k × EDV + {1 - k} × LV wall], where EDV is end-diastolic volume, k is a constant, and LV wall is the volume of the left ventricular wall) could predict rehospitalization in FMR patients after TEER.

Methods And Results: Mwas calculated for 24 FMR patients using echocardiography.

Investigating novel bacteriophage endolysins as potential antimicrobial agents.

Unlabelled: As antibiotic resistance has become a major global threat, the World Health Organization (WHO) has urgently called for alternative strategies for control of bacterial infections. Endolysin, a phage-encoded protein, can degrade bacterial peptidoglycan (PG) and disrupt bacterial growth. According to the WHO, there are only three endolysin products currently in clinical phase development.

Cost-Effectiveness of Nonoperative Management vs Upfront Laparoscopic Appendectomy for Pediatric Uncomplicated Appendicitis Over 1 Year.

Background: Non-operative management (NOM) with antibiotics alone for pediatric uncomplicated appendicitis is accepted to be safe and effective. However, the relative cost-effectiveness of this approach compared to appendectomy remains unknown. We aimed to evaluate the cost-effectiveness of non-operative versus operative management for pediatric uncomplicated acute appendicitis.

Vascular Access Stenosis Caused by Membranous Structure in Patients on Hemodialysis.

Purpose: A membranous structure (MS) may be seen on ultrasound at a site of vascular access (VA) stenosis in patients on hemodialysis. It can also be encountered during percutaneous transluminal angioplasty (PTA) and be impassable from one side but easily passed from the other. This study aimed to examine the characteristics of MS cases and how to treat them.

Impact of irrigation flow rates on lesion size and safety of ablation catheters: an ex vivo porcine heart study.

Radiofrequency (RF) catheter ablation is a well-established therapeutic approach for treating arrhythmias, where lesion size and safety are critical for efficacy. This study explored the impact of varying irrigation flow rates on lesion characteristics using the TactiFlex™ SE Ablation Catheter (TF) in an ex vivo porcine heart model, focusing on the size and safety outcomes associated with low versus standard flow rates. Myocardial slabs from porcine hearts were subjected to ablation using two types of irrigated catheters.

Voltage-Guided and Non-Voltage-Guided Superior Vena Cava Isolation in Patients With Atrial Fibrillation.

Background: In addition to the pulmonary vein, the superior vena cava (SVC) is an important focus of atrial fibrillation (AF). However, SVC isolation may cause serious complications, and appropriate settings and techniques for SVC isolation are lacking.

Methods: This study enrolled 86 consecutive patients with AF who underwent SVC isolation.

Evaluating a virtual facilitation workshop with antimicrobial stewardship teams within a cluster randomized stepped-wedge trial.

Background: Antimicrobial stewardship programs (ASP) often function naturally as facilitators within clinical hospital settings, by working with individuals and teams to reduce unnecessary antibiotics. Within implementation science, facilitation has been studied and evaluated as an implementation strategy that can accelerate and improve fidelity to implementation efforts. This study describes a novel, virtual facilitation strategy developed and served as an intervention within the optimizing perioperative antibiotics for children trial (OPERATIC trial).

ACTH stimulation and oral salt loading tests detect biochemical outcome early after primary aldosteronism surgery.

Background: In primary aldosteronism (PA), the biochemical outcomes of the Primary Aldosteronism Surgical Outcome study are used to assess aldosterone hypersecretion 6-12 months after surgery. However, few studies have investigated whether the outcomes can be predicted in the early postoperative period. In this retrospective study, we evaluated whether the adrenocorticotropin stimulation test (AST) and oral salt loading test (OST) performed immediately after surgery could predict biochemical outcomes 1 year after surgery.

Usefulness of bilateral cerebral regional oxygen saturation measurements in determining selective cerebral perfusion flow rate in a pediatric patient with aortic arch stenosis: a case report.

Background: We report a pediatric case where bilateral regional oxygen saturation (rSO) measurements were useful in determining the selective cerebral perfusion (SCP) flow rate.

Case Presentation: A 9-year-old Japanese boy, 128 cm tall and weighing 25.6 kg, was scheduled for aortic arch reconstruction due to a 90-100 mmHg pressure gradient.

Twice-Yearly Depemokimab in Severe Asthma with an Eosinophilic Phenotype.

Background: Depemokimab is an ultra-long-acting biologic therapy with enhanced binding affinity for interleukin-5 that may enable effective 6-month dosing intervals.

Methods: In these phase 3A, randomized, placebo-controlled replicate trials, we evaluated the efficacy and safety of depemokimab in patients with severe asthma and an eosinophilic phenotype characterized by a high eosinophil count (≥300 cells per microliter in the previous 12 months or ≥150 cells per microliter at screening) and a history of exacerbations despite the receipt of medium- or high-dose inhaled glucocorticoids. Patients were randomly assigned in a 2:1 ratio to receive either depemokimab (at a dose of 100 mg subcutaneously) or placebo at weeks 0 and 26, plus standard care.