Clinical and Biomarker Determinants for Recurrent Stroke in Patients With Atrial Fibrillation: A Systematic Review and Meta-Analysis.

Background And Objectives: Despite effective secondary prevention, including oral anticoagulant (OAC) therapy, the risk of recurrent stroke (RS) in patients with atrial fibrillation (AF) remains substantial with an annualized risk of 3.2%-6.5% per year.

Estimating the public economic gains in Taiwan from in vitro fertilization (IVF) subsidy changes implemented in 2021.

Study Question: What is the governmental fiscal impact of a new assisted reproduction subsidy scheme based on projected lifetime net taxes attributed to resulting live births in Taiwan?

Summary Answer: We estimate that the new fertility reimbursement scheme has generated favorable lifetime fiscal gains for the Taiwanese government, resulting in a return on investment (ROI) of NT$5.6 for every NT$1.0 spent based on those families receiving public subsidies for fertility care under the new scheme.

Animal-assisted intervention services across UK intensive care units: A national service evaluation.

Background: Animal-assisted interventions (AAI) can provide psychological support to critical care patients during their intensive care unit (ICU) admission. However, there are currently no data on AAI services across UK ICUs. The current study therefore aims to (i) determine how many ICUs in the UK offer services, (ii) characterise available services and (iii) explore and review local documentation for service oversight.

A complex and severe encephalitis associated with four co-existing neuronal cell-surface autoantibodies.

Many forms of autoimmune encephalitis are mediated by neuronal cell-surface directed autoantibodies. The co-occurrence of four neuronal cell-surface antibodies in a single patient is exceptionally rare. We report a patient who had a severe encephalitis associated with antibodies to NMDA, Glycine, GABA and GABA receptors.

An analysis of e-scooter-related trauma in Ireland: an update.

Aims: Electronic (E)-scooters have become increasingly common in Ireland. Our group was the first to publish an analysis of injuries related to these devices in Ireland in 2021. Since then, the use of e-scooters has increased significantly.

Validating performance status and activities of daily living assessment tools for Chinese palliative care in a cancer setting: A cross-cultural psychometric study.

Objective: National approaches to the routine assessment of palliative care patients improve patient outcomes. However, validated tools and a national methodology for this are lacking in Mainland China. The Australian Palliative Care Outcomes Collaboration (PCOC) model is a well-established national program aimed at improving the quality of palliative care based on point-of-care outcomes assessment.

Coccidiomycosis: ankle septic arthritis with an extended incubation period requiring aggressive multidisciplinary surgical intervention.

Coccidiomycosis is a regional disease with global importance, with both an expanding endemic area and population, as well as increasing travel. Although unusual, it should be considered in patients with a travel history to endemic areas, even when immunocompetent and outside the usual incubation period. We present a case of isolated ankle septic arthritis which required an aggressive multidisciplinary surgical approach as well as antibiotic therapy.

Peripheral Venous Pressure And NT-proBNP Phenotypes as Surrogates for Invasive Fontan Haemodynamics in Adults.

We hypothesized that phenotyping patients using a combination of resting peripheral venous pressure (PVP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) would predict invasive Fontan haemodynamics. Accordingly, 35 adults with a history of Fontan palliation were categorized into 3 groups according to PVP and NT-proBNP values: normal, ↑NT-proBNP (≥300 pg/dL) or ↑PVP (≥15 mm Hg), and ↑PVP+↑NT-proBNP. Those in the normal values group universally had normal resting pulmonary artery wedge and Fontan pressures, with a single patient having abnormal exercise values; conversely, all patients in the ↑PVP+↑NT-proBNP group had increased resting Fontan or pulmonary artery wedge pressures, with those in the ↑NT-proBNP or ↑PVP group constituting an intermediate group.

Commencement of Atorvastatin and Ezetimibe Immediately in Patients Presenting with Acute Coronary Syndrome.

Lipids are implicated in the development of coronary atherosclerosis. Achieving a significant reduction in lipid levels remains a crucial aspect of secondary prevention following an acute coronary syndrome event. Novel lipid-lowering therapies now provide clinicians with a variety of therapeutic strategies to choose from and tailor to individual patient needs.

Heart failure after left atrial appendage occlusion: Insights from the LAAOS III randomized trial.

Aims: The left atrial appendage (LAA) produces natriuretic peptides and its removal or occlusion might increase the risk of heart failure (HF). We aimed to investigate the incidence of HF after LAA occlusion or removal (LAAO) in the Left Atrial Appendage Occlusion Study (LAAOS III).

Methods And Results: Patients (n = 4811) with atrial fibrillation (AF) and a CHADS-VASc score ≥2, who were having cardiac surgery for another indication, were randomized to undergo surgical LAAO or not.

Comprehensive consent in urology using decision aids, leaflets, videos and newer technologies: empowering patient choice and shared decision-making.

In this paper, we explore the usage of decision aids, patient information leaflets (PILs), videos, social media and modern technology to empower patients and enable shared decision-making (SDM). It explores the role of enhanced consent processes in urology. A re-evaluation of the conventional consent process is required towards more patient-centred care and SDM, which prioritises patient education and understanding of their medical conditions and treatment pathways.

Differentiating Separate Primary Lung Adenocarcinomas From Intrapulmonary Metastases With Emphasis on Pathological and Molecular Considerations: Recommendations From the International Association for the Study of Lung Cancer Pathology Committee.

Introduction: With the implementation of low-dose computed tomography screening, multiple pulmonary tumor nodules are diagnosed with increasing frequency and the selection of surgical treatments versus systemic therapies has become challenging on a daily basis in clinical practice. In the presence of multiple carcinomas, especially adenocarcinomas, pathologically determined to be of pulmonary origin, the distinction between separate primary lung carcinomas (SPLCs) and intrapulmonary metastases (IPMs) is important for staging, management, and prognostication.

Methods: We systemically reviewed various means that aid in the differentiation between SPLCs and IPMs explored by histopathologic evaluation and molecular profiling, the latter includes DNA microsatellite analysis, array comparative genomic hybridization, TP53 and oncogenic driver mutation testing and, more recently, with promising effectiveness, next-generation sequencing comprising small- or large-scale multi-gene panels.

Ectopic Thymoma in the Thorax With Associated Myasthenia Gravis.

A 52-year-old man presented with a one-year history of episodic unilateral facial numbness, jaw weakness, ptosis, and hoarseness. Brain imaging was unremarkable and an 11.5cm right lower thoracic mass was discovered on chest x-ray, which was further evaluated by CT and MRI radiology.

Pilot study on the in-vitro effect of radiation therapy on bending stiffness of intramedullary photodynamic implants.

Photodynamic implants are an increasingly popular minimally invasive option for the surgical treatment of metastatic bone disease. Following surgery, adjuvant radiation therapy (RT) is frequently administered to achieve better disease control and improve patient quality of life, but the role of RT in implant failures associated with photodynamic implants remains unclear. The aim of this study is to determine if the therapeutic RT range of 10-50 Gy affects the biomechanical properties of photodynamic implants.

Detection of Real-Time Changes in Direction of COVID-19 Transmission Using National- and State-Level Epidemic Trends Based on R Estimates - United States Overall and New Mexico, April-October 2024.

Public health practitioners rely on timely surveillance data for planning and decision-making; however, surveillance data are often subject to delays. Epidemic trend categories, based on time-varying effective reproductive number (R) estimates that use nowcasting methods, can mitigate reporting lags in surveillance data and detect changes in community transmission before reporting is completed. CDC analyzed the performance of epidemic trend categories for COVID-19 during summer 2024 in the United States and at the state level in New Mexico.

Evaluating family-centred care at BC Children's Hospital: Healthcare providers' perspectives.

Background: Family-centred care (FCC) emphasizes a partnership approach to care between healthcare providers (HCPs), patients, and families. FCC provides significant benefits to both children and families; however, challenges exist in implementing FCC into practice. This study aimed to explore HCPs' FCC behaviours in multidisciplinary specialty clinics at a tertiary pediatric health care center in Canada.

Incidence of diabetes mellitus following hospitalisation for COVID-19 in the United Kingdom: A prospective observational study.

Background: People hospitalised for coronavirus disease 2019 (COVID-19) have elevated incidence of diabetes. However, it is unclear whether this is due to shared risk factors, confounding or stress hyperglycaemia in response to acute illness.

Methods: We analysed a multicentre prospective cohort study (PHOSP-COVID) of people ≥18 years discharged from NHS hospitals across the United Kingdom following COVID-19.

Relapse-free survival with adjuvant dabrafenib/trametinib therapy after relapse on a prior adjuvant CPI in BRAF V600-mutated stage III/IV melanoma.

Background: In BRAF-mutated high-risk melanoma, targeted therapy (BRAF/MEK inhibitors) and checkpoint inhibitor (CPI) immunotherapy have durable benefits as first-line (1L) adjuvant therapy. Based on differing action mechanisms of BRAF/MEK inhibitors and CPI immunotherapies, there is interest in evaluating the activity of 2L adjuvant targeted therapy in decreasing the risk of subsequent recurrence after repeat resection following relapse on/after 1L adjuvant CPI.

Patients And Methods: This was a retrospective review of BRAF V600-mutated resected stage III/IV melanoma patients in the United States, Australia, and The Netherlands who received 1L adjuvant CPI immunotherapy, relapsed locoregionally/distantly, were again resected to no evidence of disease, and received dabrafenib/trametinib (dab/tram) as 2L adjuvant therapy.