1,578 results match your criteria: "Department of Medicine Lahey Hospital & Medical Center Burlington MA USA.[Affiliation]"

Objective: Chat-based artificial intelligence programs like ChatGPT are reimagining how patients seek information. This study aims to evaluate the quality and accuracy of ChatGPT-generated answers to common patient questions about lung cancer surgery.

Methods: A 30-question survey of patient questions about lung cancer surgery was posed to ChatGPT in July 2023.

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Article Synopsis
  • Current methods to predict sudden cardiac death (SCD) in children with hypertrophic cardiomyopathy (HCM) are insufficient, although late gadolinium enhancement (LGE) in CMR imaging has shown a link to SCD in adults.
  • This study aimed to assess the significance of LGE in HCM patients under 21 years, utilizing data from various international centers between 2015 and 2022.
  • Results indicated that 32.9% of the 700 patients had LGE, and those with LGE were more likely to experience SCD or related events, emphasizing the potential role of LGE in clinical assessments for younger patients with HCM.
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Racial disparity in peripheral nerve block usage in breast reconstruction: A nationwide analysis.

J Plast Reconstr Aesthet Surg

November 2024

Division of Plastic & Reconstructive Surgery, Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA, United States. Electronic address:

Peripheral nerve block (PNB) usage in plastic surgery is associated with reduction in post-operative opioid consumption and pain demonstrating benefits in breast reconstruction (BR). This retrospective study explored whether racial-ethnic disparities exist with PNB use for postoperative analgesia in patients undergoing BR. Using the American College of Surgeons National Surgical Quality Improvement Program database, women who underwent BR from 2012-2021 and received "regional" in addition to general anesthesia were included in the study.

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Background: Recent data are inconclusive regarding the risk of arrhythmias among young cannabis users. Furthermore, many young adults use both cannabis and tobacco, which could add a residual confounding effect on outcomes. So, we studied young men who have cannabis use disorder (CUD) excluding tobacco use disorder (TUD) to understand their independent association with atrial fibrillation (AF) and related outcomes.

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Background: Gender-affirming hormone therapy (GAHT) is common among transgender individuals, but its impact on lipid profile and cardiovascular health is not well studied.

Objectives: The authors performed a systematic review and meta-analysis of existing literature to assess the impact of GAHT on lipid profiles and metabolic cardiovascular risk factors in transgender individuals.

Methods: Online databases including MEDLINE/PubMed, Embase, and Cochrane Central registry were searched to find studies on lipid profile changes in women who are transgender, also referred to as transfeminine (TF), and men who are transgender, also referred to as transmasculine (TM) before and after GAHT.

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More than a decade has passed since researchers in the Early Lung Cancer Action Project and the National Lung Screening Trial demonstrated the ability to save lives of high-risk individuals from lung cancer through regular screening by low dose computed tomography scan. The emergence of the most recent findings in the Dutch-Belgian lung-cancer screening trial (Nederlands-Leuvens Longkanker Screenings Onderzoek [NELSON]) further strengthens and expands on this evidence. These studies demonstrate the benefit of integrating lung cancer screening into clinical practice, yet lung cancer continues to lead cancer mortality rates in the United States.

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Cardiomyopathies in Pregnancy: Trends and Clinical Outcomes in Delivery Hospitalizations in the United States (2005-2020).

Curr Probl Cardiol

December 2024

Inova Schar Heart and Vascular, Inova Fairfax Medical Campus, Falls Church, Virginia, USA. Electronic address:

Article Synopsis
  • Cardiomyopathy (CDM) during pregnancy significantly impacts maternal health, with serious risks leading to morbidity and mortality.
  • Analysis of delivery hospitalizations from 2005-2020 showed that peripartum cardiomyopathy (PPCM) represented the majority of cases, followed closely by dilated cardiomyopathy (DCM), while hypertrophic (HCM) and restrictive cardiomyopathy (RCM) were less common.
  • PPCM was linked to the highest in-hospital mortality and adverse events, though its prevalence has decreased over time, while DCM and HCM rates have increased, highlighting a need for more research in this area.
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Interactions between food and oral anticoagulants (OACs), particularly vitamin K antagonists such as warfarin, are widely recognized and may also be clinically relevant for direct OACs. Pharmacokinetic and pharmacodynamic interactions with food or herbs can lead to anticoagulation potentiation, increased risk of bleeding, or reduced drug efficacy, all compromising patient safety. We conducted a systematic search for randomized controlled trials (RCTs) on PubMed for assessments of interactions between OACs and various ingestants.

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Article Synopsis
  • The study aimed to assess how multiple attempts at emergency airway intubation in the emergency department (ED) increase the risk of complications.
  • An analysis of data from a multicenter registry showed that out of 15,079 intubation cases, complications occurred in 14% of patients, with hypoxia being the most common major issue.
  • The results indicated that the odds of major complications significantly increased with each additional intubation attempt, emphasizing the need for effective airway management strategies.
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GLP-1 single, dual, and triple receptor agonists for treating type 2 diabetes and obesity: a narrative review.

EClinicalMedicine

September 2024

Massachusetts General Hospital, MGH Weight Center, Department of Medicine-Division of Endocrinology-Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Boston, MA, USA.

Unlabelled: Obesity and type 2 diabetes mellitus (T2DM) present major global health challenges, with an increasing prevalence worldwide. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as a pivotal treatment option for both conditions, demonstrating efficacy in blood glucose management, weight reduction, cardiovascular disease prevention, and kidney health improvement. GLP-1, an incretin hormone, plays a crucial role in glucose metabolism and appetite regulation, influencing insulin secretion, insulin sensitivity, and gastric emptying.

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Background: Rotator cuff calcific tendinitis is a common cause of shoulder discomfort. Ultrasound-guided barbotage consists of needle aspiration and a subsequent lavage of calcium deposits in the shoulder. While barbotage has proven benefit, other options have also shown similar symptom improvement.

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Protein Intake and High Uric Acid Stone Risk.

Kidney Med

September 2024

Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.

Article Synopsis
  • A retrospective study analyzed metabolic differences between pure and impure uric acid kidney stone formers using data from patients at Yale Urology and Nephrology Clinics between 1996 and 2021.
  • Among 722 uric acid stone formers (16.8% of the total), pure stone formers were generally older, heavier, and had a higher incidence of chronic kidney disease.
  • The study found that pure uric acid stone formers had lower urinary pH and citrate levels, along with higher protein intake markers, indicating that adjusting protein consumption might help lower the risk of stone formation, especially in those with kidney issues.
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The Discover In-Hospital Cardiac Arrest (Discover IHCA) Study: An Investigation of Hospital Practices After In-Hospital Cardiac Arrest.

Crit Care Explor

September 2024

Bronx Center for Critical Care Outcomes and Resuscitation Research, Division of Critical Care Medicine, Montefiore Medical Center, Bronx, NY.

Importance: In-hospital cardiac arrest (IHCA) is a significant public health burden. Rates of return of spontaneous circulation (ROSC) have been improving, but the best way to care for patients after the initial resuscitation remains poorly understood, and improvements in survival to discharge are stagnant. Existing North American cardiac arrest databases lack comprehensive data on the post-resuscitation period, and we do not know current post-IHCA practice patterns.

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Purpose Of Review: Mechanical chest compression devices are increasingly deployed during cardiopulmonary resuscitation. We discuss the data supporting the use of mechanical chest compression devices during cardiac arrest and provide an opinion about the future of the technology.

Recent Findings: Multiple randomized trials investigating the use of mechanical chest compression devices for out-of-hospital cardiac arrest have not demonstrated improved outcomes.

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Article Synopsis
  • The SEQUOIA-HCM trial examines the effectiveness of aficamten, a new cardiac myosin inhibitor, in improving exercise capacity in adults suffering from symptomatic obstructive hypertrophic cardiomyopathy (HCM).
  • The study involves a double-blind, placebo-controlled design, with participants recruited from 101 sites across 14 countries, focusing on those with objectively measured exertional intolerance.
  • The main goal is to assess changes in integrated exercise performance after 24 weeks of treatment using a combination of peak oxygen uptake and ventilation efficiency, along with monitoring clinical health outcomes.
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Real-World Prescription Data for Intrathecal Drug Delivery: A Retrospective Analysis in 32,784 Patients.

Neuromodulation

September 2024

Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Beth Israel Lahey Health, Boston, MA, USA.

Objectives: Currently, there are three monotherapy drugs approved by the United States Food and Drug Administration (FDA) for use in intrathecal drug delivery systems (IDDS): morphine, ziconotide, and baclofen. In practice, use includes alternate drugs, drug combinations, and drug concentrations. There is a paucity of real-world data examining prescription patterns for IDDS.

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Mortality, perioperative complications and surgical timelines in hip fracture patients: Comparison of the Spanish with the non-Spanish Cohort of the HIP ATTACK-1 trial.

Injury

November 2024

Population Health Research Institute, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Background: Hip fractures carry a substantial risk of complications and death. This study aimed to report the 90-day incidence of mortality, major perioperative complications and in-hospital timelines after a hip fracture in the Spanish HIP ATTACK-1 trial cohort, comparing with the non-Spanish cohort.

Methods: Prospective cohort study of Spanish patients nested in the HIP ATTACK-1 trial.

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Effect of Aficamten on Health Status Outcomes in Obstructive Hypertrophic Cardiomyopathy: Results From SEQUOIA-HCM.

J Am Coll Cardiol

November 2024

University of Missouri-Kansas City's Healthcare Institute for Innovations in Quality, Kansas City, Missouri, USA; Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA.

Background: A primary goal in treating obstructive hypertrophic cardiomyopathy (oHCM) is to improve patients' health status: their symptoms, function, and quality of life. The health status benefits of aficamten, a novel cardiac myosin inhibitor, have not been comprehensively described.

Objectives: This study sought to determine the effect of aficamten on patient-reported health status, including symptoms of fatigue, shortness of breath, chest pain, physical and social limitations, and quality of life.

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Background: Obstructive hypertrophic cardiomyopathy (oHCM) is characterized by left ventricular (LV) hypertrophy, LV outflow tract obstruction, and left atrial dilation, which can be associated with progressive heart failure, atrial fibrillation, and stroke. Aficamten is a next-in-class cardiac myosin inhibitor that reduces outflow tract obstruction by modulating cardiac contractility, with the potential to reverse pathological remodeling and, in turn, reduce cardiovascular events.

Objectives: This study sought to investigate the effect of aficamten on cardiac remodeling compared with placebo using cardiovascular magnetic resonance (CMR) and its association with key clinical endpoints in the SEQUOIA-HCM (Safety, Efficacy, and Quantitative Understanding of Obstruction Impact of Aficamten in HCM) CMR substudy.

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Background: Aficamten, a next-in-class cardiac myosin inhibitor, improved peak oxygen uptake (pVO) and lowered resting and Valsalva left ventricular outflow (LVOT) gradients in adults with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) in SEQUOIA-HCM (Phase 3 Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Placebo in Adults With Symptomatic oHCM), a phase 3, multicenter, randomized, double-blinded, placebo-controlled study.

Objectives: The authors sought to evaluate the effect of aficamten on echocardiographic measures of cardiac structure and function in SEQUOIA-HCM.

Methods: Serial echocardiograms were performed over 28 weeks in patients randomized to receive placebo or aficamten in up to 4 individually titrated escalating doses (5-20 mg daily) over 24 weeks based on Valsalva LVOT gradients and left ventricular ejection fraction (LVEF).

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Article Synopsis
  • The study analyzed the role of biomarkers NT-proBNP and hs-cTnI in managing obstructive hypertrophic cardiomyopathy (oHCM) and how they relate to treatment effects of aficamten.
  • Baseline levels of NT-proBNP correlated with the left ventricular outflow tract gradient (LVOT-G) and diastolic function, while hs-cTnI correlated with left ventricular thickness.
  • After 8 weeks of aficamten treatment, NT-proBNP decreased by 79% and hs-cTnI by 41%, with these reductions linked to improvements in heart function, health status, and exercise capacity, suggesting that these biomarkers are useful for tracking treatment response.
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Article Synopsis
  • Direct oral anticoagulants are commonly used for preventing strokes in patients with atrial fibrillation and flutter, but concerns about bleeding limit their use; milvexian is a new drug that might work as well with less bleeding risk.
  • The LIBREXIA AF trial is a large global study comparing milvexian to apixaban, enrolling 15,500 participants to assess if milvexian can prevent strokes without increasing bleeding events significantly.
  • The results from this study aim to clarify the efficacy and safety of milvexian compared to apixaban over a projected 4-year follow-up period.
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GLP-1 Receptor Agonists Among Patients With Overweight or Obesity, Diabetes, and HFpEF on SGLT2 Inhibitors.

JACC Heart Fail

November 2024

Department of Cardiovascular Medicine, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, Massachusetts, USA. Electronic address:

Article Synopsis
  • - The study explores the additional benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RA) for patients with obesity, type 2 diabetes, and heart failure with preserved ejection fraction (HFpEF) who are already on sodium-glucose cotransporter 2 inhibitors (SGLT2i).
  • - Researchers analyzed data from over 7,000 patients and found that those taking both GLP-1 RA and SGLT2i had significantly lower risks of heart failure exacerbations and other health issues compared to those on SGLT2i alone.
  • - While the combination therapy showed many benefits, it also had an increased risk of diabetic retinopathy, indicating the need for
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