Revitalizing Innovation: Addressing the Effects of the Downturn in Venture Capital for Cardiovascular Devices.

Venture capital (VC) plays a critical role in driving advancements in medical device innovations through its investment in early-stage companies. However, a concerning trend has emerged over the past decade: a decline in interest from VC funds toward investing in medical devices. Particularly alarming is the more than 50% decrease in investment in early-stage medical device development over the span of 2 decades.

Percutaneous hallux fusion with calcaneus bone autograft: a retrospective cohort study of clinical and radiographic outcomes.

Background: In the case of end-stage hallux rigidus, first metatarsophalangeal (MTP) joint arthrodesis is the gold-standard and is traditionally performed via an open approach. However, complications such as nonunion have been reported to be as high as 30%. Recently, there have been reports demonstrating a percutaneous approach to be effective and safe.

The efficacy of revascularization in ischemic cardiomyopathy.

Ischemic cardiomyopathy (ICM) is characterized by myocardial dysfunction due to myocardial ischemia, associated with the presence of significant coronary artery disease (CAD). We provide a comprehensive review of the current evidence for coronary revascularization in ICM, including consideration of the different modalities of coronary artery bypass grafting and percutaneous coronary intervention. In addition to a contemporary assessment of the literature, we aim to provide real-world insights and perspectives to guide clinical decision-making in this heterogeneous and complex patient population.

Immediate postpartum contraceptive implant placement and breastfeeding success in postpartum people at risk for low milk supply: A randomized non-inferiority trial.

Objectives: Our goal was to measure the impact of postpartum contraceptive implant insertion timing on breastfeeding success and duration in a population at high-risk for low milk supply.

Study Design: We conducted a three-armed randomized non-inferiority study of postpartum people who plan to breastfeed and have known risk factors for low milk supply. Participants were randomized to one of three groups for the timing of implant placement: within 30 minutes of placental delivery, 24-72 hours postpartum, or 6+ weeks postpartum.

Five Year Outcomes in Low-Risk Patients Undergoing Surgery in the PARTNER 3 Trial.

Background: Surgery remains an important treatment for low-risk patients with severe symptomatic aortic stenosis (AS). We evaluated 5-year outcomes in low-risk patients undergoing isolated surgical aortic valve replacement (SAVR) or SAVR with concomitant procedures within the randomized PARTNER 3 trial.

Methods: In the PARTNER 3 trial, 454 patients underwent surgery for severe, symptomatic, tri-leaflet AS and were followed for 5 years.

Novel Use of EndoFLIP to Characterize Kock Pouch Stricture Before and After Endoscopic Intervention.

Stricture formation is a common complication after restorative proctocolectomy and Kock pouch surgery. Endoluminal functional lumen imaging probe (EndoFLIP) is a balloon catheter device that uses impedance planimetry to provide luminal pressure and dimension measurements. This case describes the first use of EndoFLIP to quantify the distensibility and diameter of a Kock pouch stricture before and after endoscopic balloon dilation and needle knife stricturotomy.

Long-Term Outcomes of Early Surgery vs Endoscopy First in Chronic Pancreatitis: Follow-Up Analysis of the ESCAPE Randomized Clinical Trial.

Importance: Patients with painful chronic pancreatitis and a dilated pancreatic duct can be treated by early surgery or an endoscopy-first approach.

Objective: To compare long-term clinical outcomes of early surgery vs an endoscopy-first approach using follow-up data from the ESCAPE randomized clinical trial.

Design, Setting, And Participants: Between April 2011 and September 2018, 88 patients with painful chronic pancreatitis were randomly assigned to early surgery or an endoscopy-first approach in 30 hospitals in the Netherlands collaborating in the Dutch Pancreatitis Study Group as part of the ESCAPE randomized clinical trial.

Endoscopy for Altered Anatomy in Inflammatory Bowel Disease.

A significant proportion of patients with Crohn's disease or ulcerative colitis will ultimately necessitate surgical interventions, despite advances in diagnosis, medical therapy, and endoscopic interventions. These surgeries lead to substantial alterations in bowel anatomy. The present review aims to emphasize the key role of conducting a comprehensive endoscopic evaluation of both anatomic landmarks and endoscopic features for accurate clinical interpretation, thereby impacting decisions regarding medical or endoscopic interventions.

Therapeutic advances in neuroinfectious diseases.

There have been several major advances in therapeutic options for the treatment of neurological infections over the past two decades. These advances encompass both the development of new antimicrobial therapies and the repurposing of existing agents for new indications. In addition, advances in our understanding of the host immune response have allowed for the development of new immunomodulatory strategies in the treatment of neurological infections.

Lower Perceived Social Support During Hospitalization by Close Family Members may have Significant Associations with Psychological Distress 1 Month After Cardiac Arrest.

Background: The perception of having poor social support is associated with worse symptoms of psychological distress in close family members of critically ill patients, yet this has never been tested after cardiac arrest.

Methods: Close family members of consecutive patients with cardiac arrest hospitalized at an academic tertiary care center participated in a prospective study. The validated Multidimensional Scale of Perceived Social Support (MSPSS) cued to index hospitalization was administered before discharge.

Efficacy and Safety of Risankizumab in the Treatment of Crohn's Disease of the Pouch.

Risankizumab has shown efficacy in the treatment of moderate-to-severe Crohn's disease (CD). The use of risankizumab in the treatment of CD of the pouch has not been previously reported. Here, we have 10 patients with biologics exposed CD of the pouch treated with risankizumab.

Risk factors and clinical outcomes associated with multiple as opposed to single pathogens detected on the gastrointestinal disease polymerase chain reaction assay.

Background: The use of gastrointestinal disease multiplex polymerase chain reaction (GI PCR) testing has become common for suspected gastrointestinal infection. Patients often test positive for multiple pathogens simultaneously through GI PCR, although the clinical significance of this is uncertain.

Methods: This retrospective cohort study investigated risk factors and clinical outcomes associated with detection of multiple (as opposed to single) pathogens on GI PCR.

Outcomes after right-sided colon surgery in Crohn's disease versus cancer.

Background: Surgery for Crohn's disease (CD) is considered to have more complications due to the underlying inflammation, immunosuppression, and malnutrition. We sought to study the outcomes of right-sided colonic resection in patients with CD and patients with cancer at a high-volume tertiary center utilizing a standardized perioperative protocol.

Methods: This is a retrospective study of outcomes for all patients with CD or patients undergoing ileocolic resection or right hemicolectomy with ileocolic anastomosis at a single institution from 2013 to 2022.

External Validation of the Recalibrated HEART Score for Evaluation of Possible Acute Coronary Syndrome.

A single high-sensitivity troponin-T (hs-TnT) measurement may be sufficient to risk-stratify emergency department (ED) patients with possible acute coronary syndrome (ACS) using the recalibrated History, Electrocardiogram, Age, Risk Factors, Troponin (rHEART) score. We sought to validate this approach in a multiethnic population of United States patients and investigate gender-specific differences in performance. We conducted a secondary analysis of a prospective cohort study of adult ED patients with possible ACS at a single, urban, academic hospital.