Symptomatic Improvement in Adults and Adolescents with Eosinophilic Esophagitis Requires Higher Systemic Dupilumab Exposure than Histologic Response.

Introduction: We assessed potential mechanisms behind the requirement for more frequent dupilumab dosing in eosinophilic esophagitis (EoE) compared with other approved indications.

Methods: Results for the phase 3 LIBERTY EoE TREET study co-primary endpoints (proportion of patients achieving a peak intraepithelial eosinophil count of ≤6 eosinophils per high-power field and absolute change from baseline in Dysphagia Symptom Questionnaire total score) were pooled in exposure-response analyses.

Results: A steep initial relationship then plateau was observed between higher dupilumab steady state trough concentrations (Ctrough) and decreased eosinophilic infiltration at Week 24, while a graded exposure-response relationship was observed for symptomatic improvement at Week 24.

In-Hospital Outcomes Associated With Initial Fibrinolysis Versus Primary Percutaneous Coronary Intervention Among Patients Residing in Rural Areas Presenting With ST-Segment Elevation Myocardial Infarction.

Fibrinolysis is more commonly used to manage ST-segment elevation myocardial infarction (STEMI) in rural versus urban areas. However, little is known about the outcomes associated with this treatment strategy in rural individuals. We sought to compare in-hospital outcomes associated with the use of fibrinolysis versus primary percutaneous coronary intervention (PCI) among patients residing in rural areas presenting with STEMI.

Curriculum innovation: Interactive educational workshop improves neurology resident knowledge of multiple sclerosis.

Introduction: Establishing a solid resident knowledge of multiple sclerosis (MS) during neurology residency is crucial for independent clinical practice. We created a case-based and interactive educational workshop on MS with the aim of improving neurology resident clinical and theoretical knowledge of various aspects of MS diagnosis and care.

Methods: MS neurologists from the University of North Carolina (UNC) School of Medicine designed a 4-hour in-person case-based interactive educational workshop for all neurology residents.

Use of epigenetically modified bacteriophage and dual beta-lactams to treat a Mycobacterium abscessus sternal wound infection.

Nontuberculous mycobacterium (NTM) infections are challenging to manage and are frequently non-responsive to aggressive but poorly-tolerated antibiotic therapies. Immunosuppressed lung transplant patients are susceptible to NTM infections and poor patient outcomes are common. Bacteriophages present an alternative treatment option and are associated with favorable clinical outcomes.

Sex and Gender Health Education Tenets: An Essential Paradigm for Inclusivity in Dentistry.

Sex and gender are essential components of person-centered care. This article presents and discusses four important tenets regarding sex and gender health that should be incorporated into dental education and oral health care to foster inclusivity and improve care for all patients, including a sex and gender-diverse patient population.

Missed Opportunities for Early De-Escalation of Antipseudomonal Beta-Lactam Antimicrobial Therapy in Enterobacterales Bloodstream Infection.

Antipseudomonal β-lactams (APBL) are commonly used for empirical therapy of Gram-negative bloodstream infections (BSI). This retrospective cohort study examines risk factors for prolonged APBL use (≥48 h) in patients with Enterobacterales BSI and compares 28-day mortality between early de-escalation of APBL and prolonged APBL therapy. Adult patients admitted to two community hospitals in South Carolina with Enterobacterales BSI from January 2010 to June 2015 were included in this study.

A Decade Long Analysis of Healthcare Disparities and Uterine Artery Embolization: An Exploration of Social Determinants of Health.

Purpose: To determine the extent that social determinants of health have on uterine artery embolization (UAE) utilization for treatment of symptomatic uterine fibroids.

Methods: In this IRB-exempt study, data from the 2011-2020 National Inpatient Sample was used to identify patients with ICD-9 and -10 codes of uterine fibroids who underwent UAE. Data collected included: patient's demographics (race/ethnicity, income, insurance status) and procedure location (geographic region, hospital setting).

Noise-Induced Hearing Loss in Orthopaedic Surgery: A Review Article.

There are many sources of noise production in the operating room, including conversations among the surgical team, background music, electric monitors and alarms, surgical power tools, surgical instrument clattering and hammering, and suction devices. These sources introduce occupational hazards by producing damaging noise levels that exceed noise exposure level guidelines set by the National Institute of Occupational Safety and Health and the Health and Safety Executive. Noise-induced hearing loss affects up to 50% of orthopaedic staff, but few preventative measures are regularly followed in the orthopaedic setting.

Centralized Colorectal Cancer Screening Outreach in Federally Qualified Health Centers: A Randomized Clinical Trial.

Importance: Colorectal cancer (CRC) screening is effective but remains underused in federally qualified health centers (FQHCs).

Objective: To assess the effectiveness of a centralized CRC screening outreach intervention involving mailed fecal immunochemical testing (FIT) outreach and patient navigation to colonoscopy after abnormal results of FIT.

Design, Setting, And Participants: A pragmatic randomized clinical trial was conducted, using intention-to-treat analysis.

Disparities in Breast Cancer Treatment and Reconstruction Among Native Hawaiian and Pacific Islander Women: Systematic Review and Meta-Analysis.

Background: Native Hawaiian and Pacific Islander (NHPI) women experience significant disparities in breast cancer treatment and outcomes, including lower rates of postmastectomy reconstruction, higher refusal rates of radiation therapy, and delays in surgical care. These disparities contribute to poorer survival and increased complications compared to other racial/ethnic groups. This systematic review and meta-analysis aim to quantify these disparities and assess their impact on breast cancer outcomes in NHPI women.