Interobserver reliability and accuracy of the visual assessment of interventricular septal flattening in pulmonary hypertension.

Background: Interventricular septal (IVS) flattening is a key echocardiographic feature of pulmonary hypertension (PH) that is associated with worse outcomes. The accuracy and interobserver reliability of visual and quantitative measures of IVS in PH patients are poorly described.

Methods: This single-center, retrospective analysis included 173 PH patients.

Simple and Epididymal-Sparing Orchiectomy for Surgical Castration in Stage IV Prostate Cancer.

Androgen deprivation therapy, the mainstay of treatment for patients with advanced prostate cancer, can be either medical or surgical. Surgery has cost benefits compared to medical treatment. In this study, we evaluated the use of simple and epididymal-sparing orchiectomy in 2 different practice settings for the treatment of metastatic prostate cancer.

Clinical safety and efficacy of microwave ablation for small renal masses.

Purpose: CT-guided MWA is a safe and effective tool that should be utilized in the treatment of small renal masses (SRMs). We aim to clarify the utility of CT-guided MWA by examining patient outcomes such as recurrence, treatment success, changes in renal function, and complications.

Methods: A retrospective review of consecutive patients with SRMs who underwent same day renal mass biopsy (RMB) and CT-guided MWA between 2015 and 2022 was performed.

Polypharmacy in chronic kidney disease: Health outcomes & pharmacy-based strategies to mitigate inappropriate polypharmacy.

The rising prevalence of comorbidities in an increasingly aging population has sparked a reciprocal rise in polypharmacy. Patients with chronic kidney disease (CKD) have a greater burden of polypharmacy due to the comorbidities and complications associated with their disease. Polypharmacy in CKD patients has been linked to myriad direct and indirect costs for patients and the society at large.

Successful Treatment of Cutaneous Leishmaniasis With Cryotherapy.

Leishmaniasis, a protozoal infection, is a growing health concern with 1.5 million new cases reported annually resulting in a wide spectrum of disease and clinical presentations. The disease is endemic in 98 countries with increasing prevalence in non-endemic areas.

Pelvic Organ Preservation in Non-muscle-invasive Bladder Cancer: Less Is More.

Radical cystectomy (RC) is a treatment option for high-risk non-muscle-invasive bladder cancer (NMIBC) but is associated with high morbidity and a negative impact on quality of life. Reproductive or pelvic organ-sparing cystectomy (ROSC) techniques have emerged as a potential strategy to mitigate some potential effects of standard RC. Here we discuss current knowledge regarding oncological, functional, and sexual function outcomes associated with ROSC and their applicability in NMIBC.

Radical cystectomy and women's sexual health - can we do better?

Purpose Of Review: Female sexual function after radical cystectomy is a crucial, but historically overlooked component of bladder cancer survivorship. This review focuses on recent studies, which have investigated pelvic health and sexual function after radical cystectomy. We discuss modifiable factors, which may contribute to decreased sexual function after radical cystectomy and techniques, which may lead to improved outcomes.

Transition to Practice: Implementing Healthy Work Environment Standards through Nurse Resident-Led Evidence-based Practice Change in Transcatheter Aortic Valve Replacement Care on a Cardiac Telemetry Unit.

Implementing healthy work environment standards helps to improve the care environment for nurses and patients. These standards were used as a framework during a nurse resident-led evidence-based practice project. The transcatheter aortic valve replacement team collaborated with the nurse residents throughout the evidence-based practice project to design a fast-track patient selection checklist and give input into a care protocol for their cardiac telemetry unit.

Implementing Evidence-Based Motivational Interviewing Strategies in the Care of Patients with Heart Failure.

Motivational interviewing (MI) has positive effects on heart failure patient outcomes related to self-care. MI can be effectively used by the interprofessional team in the hospital and clinic settings, and it can be effective even in brief patient interactions. The spirit of MI uses collaboration, evocation, and honoring the patient's autonomy.

Prevention of Pressure Injury in Patients Hospitalized with Heart Failure.

Hospital-acquired pressure injuries are problematic within organizations. The Centers for Medicare and Medicaid Services counts hospital-acquired pressure injuries as a patient safety event and encourages hospitals to reduce or eliminate them in part by reducing payments to the hospital. Individuals who are admitted to hospitals with acute heart failure are usually elderly with comorbidities that increase their risk of developing a pressure injury.

Educating Bachelor of Science in Nursing Students in Leadership Strategies Needed for Care Management and Disease Management for the Heart Failure Patient Population.

During Bachelor of Science in Nursing (BSN) program education, student nurses are introduced to topics such as patient care across health care settings, health promotion, research, safety and quality, technology, and leadership in the health care system. As one of the most common diseases in the population, heart failure (HF) is covered throughout the BSN curriculum. There are various educational strategies used by nursing schools to ensure BSN students possess the necessary leadership skills and are prepared for providing HF patient care in care management settings.

Role of Telemedicine in Improving Guideline-Directed Medical Treatment for Patients with Heart Failure During a Pandemic.

Guideline-directed medical treatment (GDMT) is the mainstay of treatment for patients with heart failure (HF). Despite compelling evidence, patient and provider adherence to these guidelines remains low. This is mostly due to the complexity of the GDMT regimen and the competing comorbid conditions.

Bombesin-drug conjugates in targeted therapy for small cell lung cancer.

Small cell lung cancer (SCLC) is a aggressive form of primary lung neoplasm that often presents in elderly smokers. While stage I SCLC can be managed with surgery, extensive-stage disease is managed with chemotherapy using etoposide and cisplatin among other agents, and often complemented by radiation therapy to the chest and cranium. Recent advances in pharmacological research have yielded novel antibody and peptide-conjugated adjunctive chemotherapy, of which bombesin and bombesin receptors have played an important role due to their overexpression in SCLC and other lung cancers.

Use of Handheld Ultrasound to Estimate Right Atrial Pressure in a Pulmonary Hypertension Clinic.

Point-of-care ultrasonography is an invaluable asset for inpatient decision-making. Whether handheld ultrasound can be used in the outpatient management of pulmonary hypertension is unknown. We investigated whether a handheld ultrasound estimate of right atrial pressure correlates with B-type natriuretic peptide (BNP) and clinical outcome over time in outpatients with pulmonary hypertension.

Acute effect of inhaled iloprost on exercise dynamic hyperinflation in COPD patients: A randomized crossover study.

Background And Objective: We tested whether the prostacyclin analog inhaled iloprost modulates dead space, dynamic hyperinflation (DH), and systemic inflammation/oxidative stress during maximal exercise in subjects with chronic obstructive pulmonary disease (COPD) who were not selected based on pulmonary hypertension (PH).

Methods: Twenty-four COPD patients with moderate-severe obstruction (age 59 ± 7 years, FEV 53 ± 13% predicted) participated in a randomized, double-blind, placebo-controlled crossover trial. Each subject received a single nebulized dose of 5.

A1C Reduction in Patients Who Declined Pharmacist-Led Diabetes Management Services.

Introduction: The purpose of this research is to assess the mean change in A1C associated with patients who declined a pharmacy-led diabetes management program and to evaluate effects of predictor variables on the odds of achieving improved A1C in these patients.

Study Design: Retrospective, single-center, single-group, cohort study.

Methods: Patients 18 years or older with uncontrolled type 2 diabetes (defined as A1C ≥ 9%) who declined pharmacy-led diabetes management services were included in the study.

Phase II Trial of Neoadjuvant Systemic Chemotherapy Followed by Extirpative Surgery in Patients with High Grade Upper Tract Urothelial Carcinoma.

Purpose: Data supporting neoadjuvant chemotherapy of high grade upper tract urothelial carcinoma are scant. In this multi-institution, prospective, phase II trial we investigated pathological complete responses after neoadjuvant chemotherapy of high grade upper tract urothelial carcinoma.

Materials And Methods: Patients with high grade upper tract urothelial carcinoma in whom nephroureterectomy was planned were assigned to 4 neoadjuvant chemotherapy cycles of accelerated methotrexate, vinblastine, doxorubicin and cisplatin in those with baseline creatinine clearance greater than 50 ml per minute or gemcitabine and carboplatin in those with creatinine clearance 30 to 50 ml per minute or less.

A Prospective, Single-Arm, Multicenter Trial of Catheter-Directed Mechanical Thrombectomy for Intermediate-Risk Acute Pulmonary Embolism: The FLARE Study.

Objectives: The aim of this study was to evaluate the safety and effectiveness of percutaneous mechanical thrombectomy using the FlowTriever System (Inari Medical, Irvine, California) in a prospective trial of patients with acute intermediate-risk pulmonary embolism (PE).

Background: Catheter-directed thrombolysis has been shown to improve right ventricular (RV) function in patients with PE. However, catheter-directed thrombolysis increases bleeding risk and many patients with PE have relative and absolute contraindications to thrombolysis.

Evidence-based Strategies for Advanced Heart Failure.

Heart failure is a complex disease that interacts with other organ systems, such as the lungs, kidneys, and the liver, in a complex manner. The stages of heart failure often define the acuity and onset of disease symptoms and progression as well as treatment measures, in addition to the patient's functional class. As the neurohormonal and compensatory mechanisms become resistant and fail guideline-directed medical therapy, more advanced therapies are required.