pHoenix score: development and validation of a novel approach to decrease the number of inconclusive GERD diagnoses.

Background: The Johnson-DeMeester composite score (DMS) is the historical gold standard for diagnosing gastroesophageal reflux disease (GERD). The Lyon Consensus outlines criteria for diagnosing GERD by pH monitoring, defining normal acid exposure time (AET) as < 4% and pathological as > 6%, presenting diagnostic uncertainty from 4 to 6%. We aimed to (i) calculate the proportion of borderline studies defined by total AET alone that are reclassified as normal or pathological by the DMS, (ii) determine the importance of supine AET for reclassification, and (iii) propose a new classification system using a composite score that considers positional changes.

Adverse outcomes with left atrial appendage occlusion device implantation in chronic and end stage kidney disease: A systemic review and meta-analysis.

Background: Chronic kidney disease (CKD) and end stage renal disease (ESRD) are associated with increased risk of bleeding events, including hemorrhagic stroke, and periprocedural and gastrointestinal bleeding among patients with atrial fibrillation who are on anticoagulation. Safety of percutaneous left atrial appendage occlusion (LAAO) among this patient population has been uncertain with studies showing contradictory results.

Methods: PubMed and Google Scholar databases were queried for studies comparing outcomes among patients with and without significant CKD, and with and without ESRD who underwent LAAO device implantation.

Evaluating endotracheal tube length in very and extremely preterm infants.

Objective: Our study objective was to evaluate changes in ETT tube depth throughout the initial intubation course in very and extremely preterm infants in order to evaluate the risk of outgrowing an endotracheal tube (ETT).

Methods: This was a retrospective cohort study of preterm infants born at <32 weeks of gestation who were admitted to the NICU between 2012 and 2021 and required intubation for mechanical ventilation. Infants who were intubated only for surfactant administration and those with airway malformations were excluded.

Endoscopic assessment of failed fundoplications differs between endoscopists.

Background: Despite excellent long-term outcomes, a small proportion of patients who undergo fundoplication with hiatal hernia repair (laparoscopic antireflux surgery [ARS]) for treatment of gastroesophageal reflux disease (GERD) may require reoperation. Esophagogastroduodenoscopy (EGD) assessment in patients presenting with symptom recurrence plays a critical role in surgical planning of redo-ARS by confirming failure of the fundoplication and revealing the pattern of failure. We aimed to compare the findings documented by external endoscopists (i.

Why Opportunities for Tenure Matter for Minoritized Faculty in Academic Medicine.

Academic medicine continues to characterize the experiences of Black and other minoritized faculty in medicine to enhance their careers and promote their advancement. An issue of discussion is tenure and its role in the advancement and retention of this group. Tenure is a sign of national presence, command of an area of study, and can demonstrate support from the institution in terms of permanent employment, eligibility to apply for awards, sit or vote on certain committees or qualify for certain leadership opportunities.

Two brothers with human papillomavirus-positive oropharyngeal squamous cell carcinoma of the tonsil: A case report.

Oropharyngeal squamous cell carcinoma is a distinct subtype of head and neck cancer that has become increasingly linked to human papillomavirus over the last four decades. Described is the case of two brothers diagnosed with human papillomavirus-positive oropharyngeal squamous cell carcinoma 6 years apart. The first brother, R.

The impact of health disparities on peripheral vascular access outcomes in hospitalized patients: an observational study.

Background: Placement of peripheral intravenous catheters (PIVC) is a routine procedure in hospital settings. The primary objective is to explore the relationship between healthcare inequities and PIVC outcomes.

Methods: This study was a multicenter, observational analysis of adults with PIVC access established in the emergency department requiring inpatient admission between January 1st, 2021, and January 31st, 2023, in metro Detroit, Michigan, United States.

Racial/Ethnic, Sex, and Economic Disparities in the Utilization and Outcomes of Intracoronary Imaging.

Background: Intracoronary imaging-guided percutaneous coronary intervention (PCI) is associated with improved outcomes compared with angiography-guided PCI. Data on racial/ethnic, sex, and economic disparities in the utilization and outcomes of intracoronary imaging in the United States are scarce.

Methods: We analyzed the National Inpatient Sample (2016-2020) to examine racial/ethnic, sex, and economic differences in the utilization of intracoronary imaging among patients who underwent PCI.

Economic Disparities in Utilization and Outcomes of Structural Heart Disease Interventions in the United States.

Background: Disparities in access to care cause negative health consequences for underserved populations. Economic disparities in structural heart disease (SHD) interventions are not well characterized.

Objectives: The objective of this study was to evaluate economic disparities in the utilization and outcomes of SHD interventions in the United States.