Which is the better polyp detection metric: adenomas per colonoscopy or adenoma detection rate? A simulation modeling study.

We compared the ability of adenoma detection rate (ADR) and adenoma per colonoscopy (APC) to assess endoscopist detection, using statistical principles and simulations. We simulated a population of endoscopists and patients to compare the ability of ADR versus APC for capturing true endoscopist ability (TEA). We compared these rates with and without adjustment for patient and exam factors using multivariable models, and adjustment for imprecision due to low volume using empirical Bayes (shrinkage).

Integration of Palliative Care into Heart Failure Care: Consensus-Based Recommendations from the Heart Failure Society of America.

Heart failure (HF) is characterized by significant symptoms, compromised quality of life, frequent hospital admissions, and high mortality rates; palliative care (PC) is, therefore, highly relevant for patients with HF and their clinicians. Multiple guidelines and consensus statements recommend the provision of PC alongside HF management. However, few resources exist to guide the integration of PC into HF care, for both primary PC (provided by HF clinicians in the course of HF care) and specialty PC (provided by PC specialists).

Comprehensive Assessment of Lifetime Cigarette Smoking and Its Association with Health-Related Quality of Life among Older US Adults-A Cross-sectional Study.

Background: Cigarette smoking is an established risk factor for lower health-related quality of life (HRQOL). Studies to date have not used comprehensive measures of tobacco exposures across the life course. We examined the association between a lifetime cigarette smoke exposure index (LCSEI) and HRQOL among older US adults.

Comparison of Cochet-Bonnet, Dental Floss, and Cotton Wisp With Applications to Corneal Sensation Testing.

Purpose: The measurement of corneal sensation can be useful in the diagnosis of corneal neuropathies. Although the Cochet-Bonnet esthesiometer (CB) is the gold standard, cotton wisp (CW) and dental floss are commonly used in clinical practice.

Methods: We assessed the steady-state force of thick dental floss (tkDF), thin dental floss (tnDF), and CW compared with that of CB.

Patient Satisfaction Is Nearly 90% After Total Knee Arthroplasty; We Are Better Than We Were.

Background: Total knee arthroplasty (TKA) is frequently performed to reduce pain and improve quality of life. Patient satisfaction following TKA is commonly reported at 80%. However, given recent advancements in perioperative management, implants, and operative techniques, new assessments on patient satisfaction are warranted.

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.

Prehospital Trauma Compendium: Fluid Resuscitation in Trauma - a Position Statement and Resource Document of NAEMSP.

Fluid resuscitation choices in prehospital trauma care are limited, with most Emergency Medical Services (EMS) agencies only having access to crystalloids. Which solution to use, how much to administer, and judging the individual risks and benefits of giving or withholding fluids remains an area of uncertainty. To address the role of crystalloid fluids in prehospital trauma care, we reviewed the available relevant literature and developed recommendations to guide clinical care.

Implementation of Electronic Medical Record Interventions to Maximize Opioid Disposal after Surgery in Routine Clinical Practice.

Background: Despite guideline directed opioid prescribing after surgery, many patients retain excess opioids. Leftover pills increase the risk for misuse, diversion, and dependency. It is unclear whether interventions applied in routine clinical practice can increase excess opioid disposal rates.

Dual Access Rapid Trap for Augmentation of Guide Catheter Support in the Left Coronary System.

Coaxial trapping of guide extension catheters within a coronary artery allows for maximal support in delivering equipment; however, use of this technique within the left main coronary artery has been avoided due to concerns surrounding hemodynamic instability and vessel injury. We describe our initial experience with impromptu coaxial trapping of guide extension catheters within the left main coronary artery using the dual access rapid trap (DART) technique. Coaxial trapping of guide extension catheters within the left main coronary artery using DART enabled successful equipment delivery across balloon-uncrossable lesions.

An Inflammatory Myofibroblastic Tumor With a Novel ALK Mutation Leading to Acquired Resistance to Tyrosine Kinase Inhibitors.

Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm that can locally recur and potentially metastasize. Approximately 50% of IMTs harbor rearrangements in the gene encoding anaplastic lymphoma kinase (ALK), a receptor tyrosine kinase that can be therapeutically targeted with tyrosine kinase inhibitors (TKIs). With successful application of TKI in ALK-positive nonsmall cell carcinoma (NSCLC), ALK inhibitors are often first-line treatments for patients with unresectable or metastatic IMTs.