Increasing Serious Illness Conversations in Patients at High Risk of One-Year Mortality Using Improvement Science: A Quality Improvement Study.

Serious illness conversation (SIC) in an important skillset for clinicians. A review of mortality meetings from an urban academic hospital highlighted the need for early engagement in SICs and advance care planning (ACP) to align medical treatments with patient-centered outcomes. The aim of this study was to increase SICs and their documentation in patients with low one-year survival probability identified by updated Charlson Comorbidity Index (CCI) scores.

Neurobiological Mechanisms Underlying Psychological Dysfunction After Brain Injuries.

Despite the presentation of similar psychological symptoms, psychological dysfunction secondary to brain injury exhibits markedly lower treatment efficacy compared to injury-independent psychological dysfunction. This gap remains evident, despite extensive research efforts. This review integrates clinical and preclinical evidence to provide a comprehensive overview of the neurobiological mechanisms underlying neuropsychological disorders, focusing on the role of key brain regions in emotional regulation across various forms of brain injuries.

Comparative effectiveness of antipsychotic treatment strategies for relapse prevention in first-episode schizophrenia in Finland: a population-based cohort study.

Background: The best pharmacological treatment practices for relapse prevention in patients with first-episode schizophrenia are unclear. We aimed to assess different treatment strategies used before and after the first relapse, and their associations with subsequent relapse risk.

Methods: In this population-based cohort study, we enrolled individuals (aged ≤45 years) with first-episode schizophrenia who were hospitalised and subsequently relapsed between 1996 and 2014 from the nationwide Finnish Hospital Discharge Register.

Predictors of failure of percutaneous endoscopic gastrostomy tube placement: a retrospective study in a tertiary care center in the USA.

Background /aims: Percutaneous endoscopic gastrostomy (PEG) tube placement is a common procedure used to initiate enteral feeding. To our knowledge, there are no previous studies that analyze predictors of PEG failure. This study aims to identify risk factors for failure of inpatient PEG placement.

Olanzapine/Samidorphan Effects on Weight Gain: An Individual Patient Data Meta-Analysis of Phase 2 and 3 Randomized Double-Blind Studies.

To evaluate weight change with a combination of olanzapine and samidorphan (OLZ/SAM) versus olanzapine by pooling data across clinical studies. This study was an individual patient data (IPD) meta-analysis of clinical trial data. EMBASE, MEDLINE, and PsycInfo were searched for randomized clinical trials (≥12 weeks) in adults with schizophrenia or bipolar I disorder in which weight change from baseline was the primary or secondary end point.

Implementation of a Digital Health Technology Platform Improves Neurosurgical Resident Communication Skills.

Introduction: Surgical residency lacks standardized curricula for teaching interpersonal and communication skills. We evaluated the utility of a digital health communication platform, Playback Health, that generates audiovisual recordings of patient-provider interactions as a tool for junior neurosurgical resident education.

Methods: Junior (postgraduate year (PGY)-2 and PGY-3) neurosurgical residents rated their comfort working with five attending neurosurgeons (one of whom implemented Playback Health) across 10 categories, grouped into three overarching domains encompassing knowledge base, technical skills, and interpersonal skills on a 10-point Likert scale.

Pros and Cons of Inpatient SGLT2i Use for Hyperglycemia and Heart Failure.

Sodium-glucose cotransporter 2 inhibitors (SGLT2is), originally approved by the US Food and Drug Administration for glycemic control in type 2 diabetes mellitus (DM2), have shown substantial cardiovascular and renal benefits, leading to their expanded use in managing heart failure (HF) and chronic kidney disease in the outpatient setting. Despite these benefits, their use for inpatient hyperglycemia management is not universally endorsed due to safety concerns and inadequate data. However, emerging evidence suggests potential advantages of initiating SGLT2i treatment for patients during hospitalization in the setting of HF.

The Effects of Osteopathic Manipulative Treatment on Arrhythmias: A Double-blind Randomized Controlled Trial in Patients with Cardiac Implantable Electronic Devices.

This double-blind randomized controlled trial investigated the effects of osteopathic manipulative treatment (OMT) on cardiac arrhythmias in patients with cardiac implantable electronic devices (CIEDs). Participants (n = 41) with CIEDs were randomly assigned to either the OMT group or the control group (light touch/sham) and received a one-time intervention. No significant change in arrhythmia burden was found in the 1 month following intervention ( = .

Stroke Mimics at 30 Years: Where We Have Been, Where We Are Now, and Where We Are Going.

Stroke mimics and chameleons remain a major challenge to the clinician and clinical investigator. Misdiagnosis of stroke can result in significant harm to our patients, as well as unnecessary financial costs to the health care systems internationally. The approach to stroke mimics and chameleons has evolved over time with the development of clinical scales and technology.

Risk Factors for the Development of Neurological Deficits in Metastatic Spinal Disease: An International, Multicenter Delphi Study.

Study Design: Delphi study.

Objective: The objective of this study was to identify risk factors associated with the development and/or progression of neurological deficits in patients with metastatic spinal disease.

Methods: A three-round Delphi study was conducted between January-May 2023 including AO Spine members, comprising mainly neurosurgeons and orthopedic surgeons.

Defining Spine Cancer Pain Syndromes: A Systematic Review and Proposed Terminology.

Study Design: Systematic Review.

Objectives: Formalized terminology for pain experienced by spine cancer patients is lacking. The common descriptors of spine cancer pain as mechanical or non-mechanical is not exhaustive.

Role of Posterior Carbon Fiber Implants in Spine Tumor Surgery.

Study Design: Narrative Review.

Objective: The management of spinal tumors requires a multi-disciplinary approach including surgery, radiation, and systemic therapy. Surgical approaches typically require posterior segmental instrumentation to maintain long-term spinal stability.

Recurrent Sinonasal Squamous Cell Carcinoma: Current Insights and Treatment Advances.

Squamous cell carcinoma is the most common malignancy affecting the sinonasal tract. Local recurrence is the main pattern of treatment failure, affecting nearly half of patients treated for primary sinonasal squamous cell carcinoma (SNSCC). Due to disease rarity and heterogeneity of practices, there are limited guidelines for how to diagnose and care for these patients.

Multiomics dissection of human RAG deficiency reveals distinctive patterns of immune dysregulation but a common inflammatory signature.

Human recombination-activating gene (RAG) deficiency can manifest with distinct clinical and immunological phenotypes. By applying a multiomics approach to a large group of -mutated patients, we aimed at characterizing the immunopathology associated with each phenotype. Although defective T and B cell development is common to all phenotypes, patients with hypomorphic variants can generate T and B cells with signatures of immune dysregulation and produce autoantibodies to a broad range of self-antigens, including type I interferons.

Generative Artificial Intelligence: Applications in Scientific Writing and Data Analysis in Wound Healing Research.

Generative artificial intelligence (AI) models are a new technological development with vast research use cases among medical subspecialties. These powerful large language models offer a wide range of possibilities in wound care, from personalized patient support to optimized treatment plans and improved scientific writing. They can also assist in efficiently navigating the literature and selecting and summarizing articles, enabling researchers to focus on impactful studies relevant to wound care management and enhancing response quality through prompt-learning iterations.

The Difficulties of Treating Complement-3-Mediated Glomerulopathy.

Background: C3 glomerulopathy (C3G) is a rare disease affecting the complement alternative pathway, categorized into dense deposit disease and C3 glomerulonephritis. Dense deposit disease predominantly affects younger individuals, while C3 glomerulonephritis tends to manifest in older populations. The diseases are characterized by dysregulation of the complement alternative pathway, leading to the deposition of complement components in the glomeruli and subsequent renal dysfunction.

The Role of Empiric Antifungal Therapy in Patients With Perforated Peptic Ulcer: An Updated Systematic Review and Meta-Analysis.

Fungal growth is common in intraoperative cultures of patients with perforated peptic ulcer (PPU) leading to the common use of empiric antifungal therapy, with current evidence not clearly supporting this practice. The goal of this updated systematic review and meta-analysis was to synthesize the effect of empiric antifungals in patients with PPU. Eligible studies were identified through a comprehensive literature search in the MEDLINE (PubMed) and EMBASE databases, following the PRISMA 2020 statement.

Deep sequencing-derived Metagenome Assembled Genomes from the gut microbiome of liver transplant patients.

Recurrence of metabolic dysfunction-associated steatotic liver disease (MASLD) after liver transplantation (LT) is a continuing concern. The role of gut microbiome dysbiosis in MASLD initiation and progression has been well established. However, there is a lack of comprehensive gut microbiome shotgun sequence data for patients experiencing MASLD recurrence after LT.

Observational study of venous leg ulcer treated with a native collagen-alginate dressing and the impact on wound-related quality of life.

Background: Venous leg ulcers (VLUs) are associated with various physical and social adverse effects for patients but also contribute to a significant socioeconomic burden.

Purpose: To examine the clinical performance and safety of a collagen-alginate dressing in combination with standard wound care in non-healing VLUs.

Methods: In an observational, explorative, single-center study, VLUs of 60 patients were covered with a collagen-alginate dressing.

Connectome imaging to facilitate preservation of the frontal aslant tract.

Supplementary motor area (SMA) syndrome is characterized by contralateral akinesia and mutism, and frequently occurs following resection of tumors involving the superior frontal gyrus. The frontal aslant tract (FAT), involved in functional connectivity of the supplementary area and other related large-scale brain networks, is implicated in the pathogenesis of, and recovery from, SMA syndrome. However, intraoperative neuromonitoring of the FAT is inconsistent and poorly reproducible, leading to a high rate of postoperative SMA syndrome.