Treatment Selection for the High-risk Patient with Stage I Non-Small Cell Lung Cancer: Sublobar Resection, Stereotactic Ablative Radiotherapy or Image-guided Thermal Ablation?

Objective: A significant proportion of patients with stage I non-small cell lung cancer (NSCLC) are considered at high risk for complications or mortality after lobectomy. The American Association for Thoracic Surgery (AATS) previously published an expert consensus document detailing important considerations in determining who is at high risk. The current objective was to evaluate treatment options and important factors to consider during treatment selection for these high-risk patients.

Systematic Review of Image-guided Thermal Ablation for Treatment of High-Risk Patients with Stage I Non-Small Cell Lung Cancer.

Image-guided thermal ablation (IGTA) applied to pulmonary pathology is an alternative to surgery in high-risk patients with stage I non-small cell lung cancer (NSCLC). Its application to lung neoplasm was first introduced in 2001 and has been implemented to treat metastatic disease to the lung or in select medically inoperable patients with peripheral stage I NSCLC. IGTA may also be an alternative to treat stage I NSCLC in non-operable patients with interstitial lung disease in whom a radiation modality is deemed too high risk.

The Importance of Pulmonary Nodule Features in the Selection of Treatment for the High-risk Patient with Stage I Non-Small Cell Lung Cancer.

Objective: The American Association for Thoracic Surgery (AATS) Clinical Practice Standards Committee (CPSC) previously published important considerations in determining who is at high risk for complications or mortality after lobectomy. Sublobar resection, stereotactic ablative radiotherapy, or image-guided thermal ablation is typically considered when the risks associated with lobectomy are high. The current objective was to evaluate important lung-nodule-related factors to consider during treatment selection for high-risk patients with stage I non-small cell lung cancer (NSCLC).

Augmented reality for epilepsy surgery: Examining usability and efficacy in presurgical planning.

Objective: The aim of this paper was to visualize 3-dimensional (3-D) brain and electrode placement data for epilepsy surgery within an augmented reality (AR) environment using a wearable headset, with the ultimate goal of enhancing presurgical planning for epilepsy surgery and understanding the efficiency and utility of such a program in a clinical setting. The evaluation process for surgical intervention in epilepsy cases involves a series of extensive tests, including EEG, MRI, PET, SPECT, and fMRI. A second phase of assessment incorporates the placement of depth electrodes within the brain to record seizure activity.

Hand and Glove Sanitizing in Sterile Compounding, Part 1.

Selecting an appropriate sanitizer (i.e., "rub") for application to hands and gloves before and, if necessary, during sterile compounding is as important as is its consistent and judicious use.

Latarjet Procedure for Patients with Pre-Existing Seizure Disorders Versus Controls: A Systematic Review & Meta-Analysis.

Background: The purpose of this study was to systematically review the literature to ascertain the clinical outcomes of the Latarjet procedure in patients with seizure disorders (SD) versus controls.

Methods: Two independent reviewers performed a literature search using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using PubMed, Embase and Scopus databases. Only studies reporting on outcomes of the Latarjet procedure comparing patients with pre-existing SDs, or those comparing such patients versus controls were considered for inclusion.

Late Diagnostic Clues in Rapidly Progressing Probable Heidenhain Variant of Creutzfeldt-Jakob Disease.

Presenting symptoms of sporadic Creutzfeldt-Jakob disease (sCJD) are variable, and as imaging and EEG may be normal in the early to middle stages of the disease process, serial testing is vital when there is clinical suspicion for sCJD. We present a case of probable Heidenhain variant of sCJD (HvCJD) with notable rapid progression. A 72-year-old woman presented with neurological decline following new-onset visual changes.

Deceased Donor Infectious Diseases Testing and Antimicrobial Use: Surveys of Organ Procurement Organizations and Transplant Professionals.

Background: Donor screening and antimicrobial management processes are inconsistent across organ procurement organizations (OPOs) and transplant centers. As part of a Controversies Conference addressing the evaluation and management of infectious diseases (ID) in deceased donors sponsored by the American Society of Transplantation (AST), two online pre-meeting surveys were developed to inform conference proceedings and assess current practices and opinions on donor screening and antimicrobial management.

Methods: Survey 1 addressed the current state of deceased donor ID testing, culture data communication, antimicrobial utilization, and involvement of transplant ID during donor management and was distributed to all 56 United States OPOs.

Sotorasib for the treatment of locally advanced/metastatic non-small cell lung cancer.

Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation is prognostic of poor survival for patients with non-small cell lung cancer (NSCLC). KRAS G12C mutations occur in 13% of NSCLC cases and despite the frequency of this mutation, advances in drug development against KRAS have historically been impeded due to the extremely high affinity of KRAS for guanosine triphosphate (GTP) and the lack of a binding pocket on the surface of KRAS that is suitable for drug binding. Sotorasib, a first-in-class, highly selective KRAS G12C inhibitor overcomes this issue by irreversibly binding in the switch-II pocket.

Utility of the TG/HDL-C Ratio in Estimating Pediatric Cardiometabolic Risk in a Community Hospital.

: The evaluation of metabolic syndrome (MetS) is critical among children and adolescents as it can predict cardiovascular disease in adulthood. The TG/HDL-C ratio has the best predictive accuracy among the different lipid ratios. This study aims to evaluate the prevalence and factors associated with a high TG/HDL-C ratio and the predictive accuracy for pediatric MetS.

Temporal trends and disparities in atherosclerosis-associated cerebrovascular disease mortality in the United States, 1999-2020.

Background: Cerebrovascular disease (CEVD) accounts for the second leading cause of death worldwide. Despite recent advancements in treatment strategies, the prevalence and cost associated with CEVD are rising. Atherosclerosis significantly contributes to CEVD risk by restricting cerebral blood flow, leading to ischemic stroke.

Plasma Protein Biomarkers of Spirometry Measures of Impaired Lung Function.

Background: Impaired pulmonary function carries significant risks for lung, cardiovascular, and metabolic disorders.

Research Question: Can circulating protein biomarkers of pulmonary function provide insight into the pathophysiologic features of lung function impairment and links to comorbidities?.

Study Design And Methods: We analyzed plasma levels of 2,922 proteins in 32,493 UK Biobank participants (53% female; mean [SD] age, 57 [8] years) to investigate their associations with spirometry measures of lung function (FEV, FVC, FEV to FVC ratio), and with obstructive (n = 4,713) and restrictive (n = 3,886) spirometry patterns.

Association between burnout and workplace climate in transplant clinical pharmacists.

Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Lung Nodules and Masses in Non-HIV Immunocompromised Patients: A Clinical Imaging Algorithmic Approach.

Topic Importance: The incidence of pulmonary nodules and masses in non-HIV immunocompromised patients has significantly increased due to advancements in hematopoietic stem cell transplantation (HSCT) and solid organ transplantation (SOT) and the widespread use of chemotherapy and immunosuppressive therapies. Differentiating between infectious and noninfectious causes is critical for appropriate diagnosis and management, especially because radiologic and clinical presentations can be nonspecific.

Review Findings: This review provides a practical framework for evaluating pulmonary nodules and masses in non-HIV immunocompromised patients, incorporating clinical, immunologic, and radiologic features.

Sexual and Gender Diverse Healthcare Navigation Model: A Community-Participatory Delphi Adaptation of the Transitional Care Model for Sexual and Gender Diverse Individuals.

Health care transitions, movements between providers or settings, can lead to poor outcomes, higher resource utilization, and even higher costs. Health care transitions can be complex experiences for sexual and gender diverse (SGD) individuals, especially when there is a need for ongoing health care (e.g.

Imaging findings associated with costoclavicular intervention during lead extraction.

Background: Binding sites in the costoclavicular space are commonly encountered during transvenous lead extraction. Severe adhesions may warrant use of more aggressive rotational cutting tools or surgical intervention. It is not known whether preprocedural multidetector computed tomography (MDCT) can provide information about the likelihood that a patient will require costoclavicular intervention.

Multicentre analysis of severe perioperative adverse events in children undergoing surgery who were infected with SARS-CoV-2: a propensity score-adjusted analysis.

Background: The incidence of severe adverse events in children with SARS-CoV-2 undergoing anaesthesia has not been well established. We examined the relationship between SARS-CoV-2 infection and severe perioperative adverse events in children.

Methods: This multicentre (21 North American institutions), retrospective cohort study included children <18 years old, with American Society of Anesthesiologists physical status (ASA PS) of 1-4 and non-severe SARS-CoV-2, who underwent general anaesthesia between April 1, 2020, and March 31, 2021.

Feasibility of Obtaining Patient-Reported Outcome Measures in a High-Volume Multidisciplinary Surgical Limb Salvage Center.

Background: Completion of patient-reported outcome measures (PROMs) is labor-intensive but paramount in improving patient-centered care, allowing for advancement of techniques and scrutinization of outcomes. We report the feasibility of PROM collection and reporting for patients seen in a high-volume, multidisciplinary, tertiary limb salvage center to determine pain and functionality outcomes.

Methods: The center received grant funding resources for large-scale PROM collection.

Bone block options for treating glenoid bone loss and glenohumeral instability: A systematic review.

Background: To systematically review the literature assessing glenoid bone loss restoration by different bone block options and compare their dimensions.

Methods: Systematic examination of articles in PubMed and EMBASE databases was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to find studies of bone grafts for treating anterior glenohumeral instability. Statistical analyses were conducted via Review Manager, and a -value of <0.