Update on HIV Chemoprevention.

Despite rapid advances in the field of HIV prevention and treatment, unacceptably high global HIV incidence rates highlight the ongoing need for effective HIV prevention interventions for populations at risk for HIV acquisition. This article provides an updated review of the current data surrounding HIV prevention strategies, including treatment as prevention (TasP), preexposure prophylaxis (PrEP), and postexposure prophylaxis (PEP), as well as advances in sexually transmitted infection biomedical prevention. This review provides an overview of the multiple PrEP modalities that are available globally, such as oral PrEP, injectable cabotegravir, and the dapivirine vaginal ring, and describes their respective clinical trials, efficacies, and regulatory approvals.

Desensitization With Imlifidase for HLA-Incompatible Deceased Donor Kidney Transplantation: A Delphi International Expert Consensus.

Highly sensitized (HS) patients in need of kidney transplantation (KTx) typically spend a longer time waiting for compatible kidneys, are unlikely to receive an organ offer, and are at increased risk of antibody-mediated rejection (AMR). Desensitization using imlifidase, which is more rapid and removes total body immunoglobulin G (IgG) to a greater extent than other methods, enables transplantation to occur between HLA-incompatible (HLAi) donor-recipient pairs and allows patients to have greater access to KTx. However, when the project was launched there was limited data and clinical experience with desensitization in general and with imlifidase specifically.

Use of optimal fluoroscopic angulation to facilitate effective pulsed field ablation in a patient with atrial fibrillation.

The circular-shaped PulseSelect™ PFA catheter has demonstrated comparable efficacy to traditional thermal catheter ablation in achieving pulmonary vein isolation (PVI), while preventing thermally mediated complications. However, this catheter does not have any objective parameters to confirm real-time tissue-catheter contact. We report a case in which PVI was achieved through PFA using optimal biplane fluoroscopic angulations which were more useful for accurately assessing and adjusting the position and rotation of the circular catheter electrodes than the conventional fluoroscopic angulations.

Office-Based Endoscopic Urological Procedures Under Local Anesthesia: Prospective Evaluation of Feasibility, Pain, and Patient Preference.

Several diagnostic and therapeutic endoscopic urological procedures, such as stent placement, ureteroscopy, and bladder stone lithotripsy, can be performed in a hospital, an ambulatory surgery center, in the office with IV sedation, or in the office using only topical anesthesia. The potential benefits of performing procedures in the office setting using topical anesthesia include efficiency and cost reduction. The potential harms are failure to achieve the desired outcome and patient pain.

Systematic Review: Effectiveness of Carbon Dioxide Lasers for Treatment of Adult Laryngeal Hemangioma.

Importance: Adult laryngeal hemangiomas are rare and may cause symptoms such as dysphonia, dysphagia, and dyspnea. Carbon dioxide (CO2) lasers offer an alternative approach to managing this rare condition.

Objective: The objective of this study is to evaluate the effectiveness of CO2 lasers in treating adult hemangioma and to identify potential side effects associated with this treatment modality.

Gastric Microbiota Associated with Gastric Precancerous Lesions in -Negative Patients.

Studies on the gastric microbiota associated with gastric precancerous lesions remain limited. This study aimed to profile the gastric mucosal microbiota in patients with -negative precancerous lesions. Gastric mucosal samples were obtained from 67 -negative patients, including those with chronic gastritis (CG), intestinal metaplasia (IM), and dysplasia.

Prevalence of FGFR2b Protein Overexpression in Advanced Gastric Cancers During Prescreening for the Phase III FORTITUDE-101 Trial.

Purpose: Fibroblast growth factor receptor 2 isoform IIIb (FGFR2b) protein overexpression is an emerging biomarker in gastric cancer and gastroesophageal junction cancer (GC). We assessed FGFR2b protein overexpression prevalence in nearly 3,800 tumor samples as part of the prescreening process for a global phase III study in patients with newly diagnosed advanced or metastatic GC.

Methods: As of June 28, 2024, 3,782 tumor samples from prescreened patients from 37 countries for the phase III FORTITUDE-101 trial (ClinicalTrials.

Development and Pilot Implementation of a Theory-Based Cognitive Rehabilitation Protocol for Adults With Chronic Cognitive Complaints After Mild Traumatic Brain Injury.

Purpose: The aim of this study was to describe the development of and pilot feasibility outcomes for a strategy-based, brief, intensive cognitive rehabilitation intervention delivered to U.S. service members and veterans with mild traumatic brain injury in a recently completed 3-year pragmatic clinical trial: Symptom-Targeted Approach to Rehabilitation for Concussion (STAR-C).

Lipid Deposition in Skeletal Muscle Tissues and Its Correlation with Intra-Abdominal Fat: A Pilot Investigation in Type 2 Diabetes Mellitus.

This study evaluated metabolites and lipid composition in the calf muscles of Type 2 diabetes mellitus (T2DM) patients and age-matched healthy controls using multi-dimensional MR spectroscopic imaging. We also explored the association between muscle metabolites, lipids, and intra-abdominal fat in T2DM. Participants included 12 T2DM patients (60.

Cerebrovascular Accidents After Orthotopic Liver Transplantation in Patients with Hepatopulmonary Syndrome: A Case Series.

Hepatopulmonary syndrome (HPS), defined by the presence of pulmonary vascular dilatations that cause right-to-left transpulmonary shunting of venous blood with a consequential increase in the alveolar-arterial oxygen gradient, is a relatively frequent complication of chronic liver disease. While orthotopic liver transplantation (OLT) is indicated and often curative in HPS patients with end-stage liver disease (ESLD), little is known about the peri- and post-operative-period risks of CVA in OLT recipients with HPS. : We report a case series of five non-consecutive OLT recipients with HPS who developed ischemic and/or hemorrhagic CVAs during or shortly after OLT, raising concern that the risks of neurological complications remain increased even after OLT.

GV1001, hTERT Peptide Fragment, Prevents Doxorubicin-Induced Endothelial-to-Mesenchymal Transition in Human Endothelial Cells and Atherosclerosis in Mice.

Doxorubicin is a highly effective anticancer agent, but its clinical use is restricted by severe side effects, including atherosclerosis and cardiomyopathy. These complications are partly attributed to doxorubicin's ability to induce endothelial-to-mesenchymal transition (EndMT) in vascular endothelial cells, a critical process in the initiation and progression of atherosclerosis and cardiomyopathy. GV1001, a multifunctional peptide with anti-inflammatory, anti-cancer, antioxidant, and anti-Alzheimer's properties, has demonstrated inhibition of EndMT.

Electroacupuncture may protect pulmonary dysplasia in offspring with perinatal nicotine exposure by altering maternal gut microbiota and metabolites.

Background: Perinatal nicotine exposure (PNE) induces pulmonary dysplasia in offspring and it increases the risk of respiratory diseases both in offspring and across generations. The maternal gut microbiota and its metabolites, such as short-chain fatty acids (SCFAs), can regulate fetal lung development and are susceptible to nicotine exposure. Therefore, modulation of PNE-induced changes in maternal gut microbiota and SCFAs may prevent the occurrence of pulmonary dysplasia in offspring.

Prevalence, Diagnosis, and Management of Stress Urinary Incontinence in Women: A Collaborative Review.

Background And Objective: Stress urinary incontinence (SUI), defined as any involuntary leakage of urine associated with physical activity, remains underdiagnosed and undertreated. This review aims to provide an updated overview of the prevalence, diagnosis, and treatment of SUI in women, drawing upon recent evidence-based literature and clinical guidelines.

Methods: A systematic search of the MEDLINE database was conducted to identify only the most up-to-date and relevant studies published up to February 26, 2024, including the reference ESTER systematic review.

Limited Utility of Routine Surveillance Ultrasound in Differentiated Thyroid Cancer Patients With Undetectable Postoperative Thyroglobulin Levels.

Background: Neck ultrasound (US) and serum thyroglobulin (Tg) measurements are mainstays of long-term differentiated thyroid cancer (DTC) surveillance. Given the high sensitivity of serum Tg, we aimed to assess the utility of neck US in DTC patients who underwent total thyroidectomy and have undetectable serum Tg.

Methods: We performed a retrospective cohort analysis of DTC patients who underwent a total thyroidectomy at our institution (2010-2023) and received US-guided fine needle aspiration (FNA) during their surveillance.

Medical School Curriculum Evaluation to Improve Health Equity Education.

Following the birth of Black Lives Matter, USA medical students advocated for greater commitment to health equity from their schools. In response to such concerns, in 2015, the Yale School of Medicine formed a committee for diversity, inclusion, and social justice and a committee on lesbian, gay, bisexual, transgender, queer, questioning, and intersex affairs. Based on their efforts, our Educational Policy and Curriculum Committee commissioned a student-faculty-led task force to survey the curriculum and make recommendations toward the creation of a health equity curriculum.

Evaluation of disparities in hospitalisation outcomes for deaf and hard of hearing patients with COVID-19: a multistate analysis of statewide inpatient databases from Florida, Maryland, New York and Washington.

Objective: Investigate whether deaf or hard of hearing (D/HH) patients with COVID-19 exhibited different hospitalisation outcomes compared with hearing patients with COVID-19.

Design: Cohort study SETTING: Statewide Inpatient Databases for Florida, Maryland, New York and Washington, for the year 2020.

Participants: Records of patients aged 18-64 years with COVID-19 PRIMARY OUTCOMES AND MEASURES: Differences in in-hospital death, 90-day readmission, length of stay, hospitalisation cost, hospitalisation cost per day, intensive care unit (ICU) or coronary care unit (CCU) utilisation and ventilation use were evaluated.

Factors Associated with Corneal Hysteresis in an Elderly White Population: The Thessaloniki Eye Study.

Prcis: In 801 participants, corneal hysteresis (CH) was positively associated with female gender and central corneal thickness, and negatively with age and axial length. Diabetes showed no significant association with CH in the adjusted models.

Purpose: To provide values of corneal hysteresis (CH) in an elderly, healthy Greek population and to investigate its association with demographic, ocular, and systemic factors.

Age-stratified trends and outcomes of inpatient cholecystectomy for acute cholecystitis in the United States.

Background: The elderly population in the United States is rapidly expanding. Older patients over age 65 with acute cholecystitis may face greater perioperative risk compared to younger patients undergoing urgent laparoscopic cholecystectomy. We aimed to characterize trends in utilization and outcomes of inpatient cholecystectomy across the United States stratified by age.

Chronic Kidney Disease-Mineral Bone Disorder (CKD-MBD) in Pediatric Kidney Transplant Recipients.

Kidney transplantation remains the gold standard treatment for end-stage kidney disease (ESKD), effectively alleviating numerous comorbidities and offering a substantial survival advantage over long-term dialysis. Despite advancements in immunosuppressive regimens and improvements in graft and patient survival rates, extended patient longevity brings an accumulating burden and complexity of bone disease in this population, which often goes underrecognized. The present study reviews the pathophysiology of CKD-MBD in pediatric KTR, focusing on the progression of bone disease before and after transplantation.

Navigating Limited Resources-Outpatient Pediatric Cholecystectomies at Rural Hospitals.

Background: Rural facilities that provide pediatric surgical services are a critical resource to local communities. Our aim was to characterize differences in outpatient pediatric cholecystectomy outcomes performed at rural and urban hospitals with the hypothesis that rural hospitals would have similar outcomes.

Methods: The Nationwide Ambulatory Surgery Sample (NASS), which contains ambulatory surgery encounters at hospital-owned facilities, was used to perform a retrospective cohort analysis of pediatric patients age 18-years and younger who had a cholecystectomy (n = 15,449) between 2016 and 2018.

Generalizable, sequence-invariant deep learning image reconstruction for subspace-constrained quantitative MRI.

Purpose: To develop a deep subspace learning network that can function across different pulse sequences.

Methods: A contrast-invariant component-by-component (CBC) network structure was developed and compared against previously reported spatiotemporal multicomponent (MC) structure for reconstructing MR Multitasking images. A total of 130, 167, and 16 subjects were imaged using T, T-T, and T-T- -fat fraction (FF) mapping sequences, respectively.

Pregnancy Complications and Long-Term Atherosclerotic Cardiovascular Disease Risk.

Purpose Of Review: Discuss the relationship between pregnancy complications and long-term atherosclerotic cardiovascular disease (ASCVD) risk.

Recent Findings: A large body of research confirms an association between pregnancy complications and increased short and long-term ASCVD risk and seeks to understand mechanisms for these associations. Social determinants of health continue to have a critical impact on the prevalence of adverse pregnancy outcomes (APOs) and long term ASCVD risk.