LI-RADS US Surveillance Version 2024 for Surveillance of Hepatocellular Carcinoma: An Update to the American College of Radiology US LI-RADS.

In 2017, the American College of Radiology introduced the US Liver Imaging Reporting and Data System (LI-RADS) as a framework for US surveillance of patients at risk for developing hepatocellular carcinoma. This has aided in the standardization of technique, clinical reporting, patient management, data collection, and research. Emerging evidence has helped inform changes to the algorithm, now released as LI-RADS US Surveillance version 2024.

Inborn errors of immunity reveal molecular requirements for generation and maintenance of human CD4 IL-9-expressing cells.

Background: CD4 T cells play essential roles in adaptive immunity. Distinct CD4 T-cell subsets-T1, T2, T17, T22, T follicular helper, and regulatory T cells-have been identified, and their contributions to host defense and immune regulation are increasingly well defined. IL-9-producing T9 cells were first described in 2008 and appear to play both protective and pathogenic roles in human immunity.

Midterm survival, clinical, and hemodynamic outcomes of a novel mechanical mitral valve prosthesis.

Objective: To evaluate the midterm survival, clinical, and hemodynamic outcomes of the On-X mechanical mitral valve, based on the 5-year results of the Prospective Randomized On-X Anticoagulation Clinical Trial (PROACT).

Method: PROACT Mitral was a multicenter study evaluating 401 patients who underwent mitral valve replacement (MVR) with either Standard or Conform-X On-X mitral valves, comparing low-dose and standard-dose warfarin. Here we report prespecified secondary outcomes of survival, New York Heart Association (NYHA) functional classification, and valve hemodynamics as assessed by core lab-adjudicated echocardiography at 1, 3, and 5 years in the pooled population.

Eosinophilic esophagitis drives tissue fibroblast regenerative programs toward pathologic dysfunction.

Background: Pathologic tissue remodeling with scarring and tissue rigidity has been demonstrated in inflammatory, autoimmune, and allergic diseases. Eosinophilic esophagitis (EoE) is an allergic disease that is diagnosed and managed by repeated biopsy procurement, allowing an understanding of tissue fibroblast dysfunction. While EoE-associated tissue remodeling causes clinical dysphagia, food impactions, esophageal rigidity, and strictures, molecular mechanisms driving these complications remain under investigation.

Bridging from research evidence to treatment decisions: The case of treatment based on predicted mandibular growth.

Introduction: Norms for mandibular growth are well-established, but they have large variances, and no research has been conducted on how practitioners use them in clinical judgment to guide the treatment of individual patients.

Methods: Co-Pog projections of mandibular growth were combined from the Burlington and Michigan growth studies following statistical adjustments. Cervical measures were also evaluated.

Development of and recovery from acute kidney injury after cardiac surgery: Randomized phase 2 trial of the hepatocyte growth factor mimetic ANG-3777.

Objectives: To investigate the safety and efficacy of ANG-3777, a hepatocyte growth factor mimetic, in mitigating the risk of acute kidney injury (AKI) in patients undergoing cardiac surgery with cardiopulmonary bypass.

Methods: In this double-blind placebo-controlled study (Guard Against Renal Damage [GUARD]), patients were randomized to receive intravenous ANG-3777 2 mg/kg or placebo once daily for 4 days. The primary end point was severity of AKI, measured by mean area under the concentration-time curve on percent increase in serum creatinine from days 2 to 6.

Diversity in the US Academic Microsurgery Pathway.

Although the representation of women and ethnic minority students in the US medical schools has recently increased, discrepancies in representation among plastic surgery residents and faculty continue. The state of sex and ethnic diversity in academic microsurgery remains minimally investigated. We aimed to evaluate the sex, race, and ethnicity demographics among academic microsurgeons and identify underrepresentation along the leadership pathway.

Accuracy of dental implant placement with CAD-CAM 3D printed and conventional thermoplastic surgical pilot guides: A clinical comparative trial.

Statement Of Problem: Dental implant placement is routinely guided by using 2-dimensional radiographs and thermoplastic surgical guides (CTGs), which may lack accuracy. Three-dimensionally (3D) printed surgical guides (3DGs) have been recommended to improve accuracy. However, they require additional training on specific technology.

A multicenter analysis of aortic root replacement: Non-native chest increases risk of postoperative mortality.

Objective: Re-do root replacement poses a significant technical challenge, increasing the potential risk of morbidity and mortality. This multi-institution study compared the outcomes of aortic root replacement stratified by chest surgery and aortic root history.

Methods: A retrospective review by the Western Aortic Collaborative was performed of 3 different aortic centers for patients who underwent nonemergency root replacement from 2017 to 2023 with exclusion of patients who underwent more than hemiarch replacement or presented with acute or hyperacute aortic dissection.

Microcomputed tomography assessment of microleakage and void formation under ceramic adhesive precoated orthodontic brackets.

Introduction: This study aimed to evaluate microleakage, voids, and gaps in ceramic adhesive precoated (APC) brackets using microcomputed tomography and investigate their correlation with bond strength.

Methods: A total of 52 human premolars were included in this study. The teeth were randomly divided into 4 groups of 13 teeth each.

The use and implementation of omalizumab as food allergy treatment: Consensus-based guidance and Work Group Report of the Adverse Reactions to Foods Committee of the American Academy of Allergy, Asthma & Immunology.

Omalizumab was recently approved by the US Food and Drug Administration for treatment of any single food allergy or multiple food allergies in children aged 1 year and older and adults. There is currently no formal guidance regarding recommended best practices for omalizumab use in food allergy, including patient selection, anticipated goals and outcomes of therapy, procedure for monitoring patients who elect to start omalizumab therapy, and ways in which omalizumab can be incorporated into the landscape of food allergy management and daily clinical practice. This work group report was developed by the food allergy therapies subcommittee of the Adverse Reactions to Foods Committee within the American Academy of Allergy, Asthma & Immunology.

A Narrative Review of Key Studies in Medical Education in 2023: Applying the Current Literature to Educational Practice and Scholarship.

Pediatric clinician educators face the challenge of juggling clinical practice with teaching responsibilities. The balancing act is even more challenging when one considers the need to stay current with evidence from clinical and medical education literature. In this narrative review of 2023 medical education literature, the Academic Pediatric Association Education Committee's Top Articles team summarizes high-yield articles that possess the potential to significantly influence pediatric clinician educator teaching and practice.

Hospital readmissions reduction program penalizes safety net hospital clinicians.

Objective: The Hospital Readmissions Reduction Program (HRRP), started under the Patient Protection and Affordable Care Act and administered by the Centers for Medicare and Medicaid Services, was created with the intention to improve healthcare quality and costs. However, research on disparities in healthcare demonstrates the HRRP's protocolized risk-adjustment calculations neglect social factors, which consequently harms disadvantaged patient populations and unfairly contributes to clinician and hospital penalties.

Methods: A PRISMA literature review was conducted using PubMed and Cochrane Library to explore the inclusion of social factors such as socioeconomic status on risk-adjustment calculations, and their relation to healthcare disparities, penalties, and outcomes.

Conversion of a failing fixed implant prosthesis into an implant-retained overdenture: A clinical report.

Implants supporting a fixed prosthesis may fail leaving unfavorable implant distribution for a fixed prosthesis. This clinical report illustrates a treatment option for converting a failing fixed prosthesis into a mandibular complete overdenture by using a portion of the existing fixed implant prosthesis. The use of a resilient liner to retain a converted mandibular overdenture framework provided satisfactory results in the first year of clinical use.

Interventional Oncology Meets Immuno-oncology: Combination Therapies for Hepatocellular Carcinoma.

The management of hepatocellular carcinoma (HCC) is undergoing transformational changes due to the emergence of various novel immunotherapies and their combination with image-guided locoregional therapies. In this setting, immunotherapy is expected to become one of the standards of care in both neoadjuvant and adjuvant settings across all disease stages of HCC. Currently, more than 50 ongoing prospective clinical trials are investigating various end points for the combination of immunotherapy with both percutaneous and catheter-directed therapies.

Updated review of omalizumab to treat uncontrolled pediatric allergic asthma.

Asthma has been increasingly recognized as a heterogeneous disease; however, many patients with asthma have allergic asthma (AA). Inhaled corticosteroids and other inhalers have been integral in treating many symptoms of asthma, but these medications do not completely address the disease's underlying mechanism. Pediatric asthma imposes a substantial burden on patients and the health care system.

Lower Risk of Death and Kidney Failure Associated with Higher Target (vs Below-Target) Doses of RAS Inhibitors in Octogenarians with HFrEF.

Background: Renin-angiotensin system (RAS) inhibitors at higher target doses reduce the risk of death in patients with heart failure with reduced ejection fraction (HFrEF). Less is known about their effectiveness in octogenarians, the examination of which was the objective of this study.

Methods: Of the 32,964 veterans ≥ 80 years with HFrEF (ejection fraction ≤ 40%) receiving RAS inhibitors, 6655 received them at target doses.

Addressing health disparities in food allergy: A Position Statement of the AAAAI Prior Authorization Task Force.

Self-reported food allergies (FAs) affect approximately 8% of the US pediatric and approximately 10% of the adult population, which reflects potentially disproportionate increases among ethnically and racially minoritized groups. Multiple gaps and unmet needs exist regarding FA disparities. There is reported evidence of disparities in FA outcomes, and the FA burden may also be disproportionate in low-income families.

The Association Between Accelerated Biological Aging and Cardiovascular Outcomes in Older Adults with Hypertension.

Background: Current hypertension treatments rely on chronological age, which may not reflect individual differences in aging and its impact on cardiovascular health. This study aimed to determine whether biological age can predict adverse outcomes in older adults with hypertension, independent of traditional risk factors including chronological age.

Methods: An analysis of a prospective cohort was conducted using data from the Health and Retirement Study, a longitudinal survey of older adults in the United States.