Novel streamlined technique for left atrial appendage closure using a radiofrequency wire-based large access system.

Introduction: Transseptal puncture (TSP) to allow for large delivery sheath left atrial (LA) access remains a challenging aspect of LA appendage closure (LAAC) in patients with prior history of TSP, thick or lipomatous septum, atrial septal aneurysms, or other complex cardiac anatomies. This study investigates the use of the VersaCross large access (VLA) system (Baylis Medical/Boston Scientific) to improve procedural efficiency of LAAC compared to the standard needle workflow.

Methods And Results: Fifty LAAC procedures using WATCHMAN FLX between November 2021 and September 2022 were retrospectively analyzed comparing the VLA workflow (n = 25) to the standard needle workflow (n = 25).

AGENT ORANGE-INDUCED Anaplastic Large-Cell Lymphoma (ALCL) with Cutaneous Involvement.

Anaplastic large-cell lymphoma (ALCL) is a CD30 + lymphoproliferative disorder that may manifest with skin involvement. We present a rare case of Agent Orange-induced ALCL with cutaneous involvement of the hand, surgical excision, and follow-up treatment.

Strength, Endocrine, and Body Composition Alterations across Four Blocks of Training in an Elite 400 m Sprinter.

The ability to produce force rapidly has the potential to directly influence sprinting performance through changes in stride length and stride frequency. This ability is commonly referred to as the rate of force development (RFD). For this reason, many elite sprinters follow a combined program consisting of resistance training and sprint training.

Changes in Maximal Strength and Home Run Performance in NCAA Division I Baseball Players Across 3 Competitive Seasons: A Descriptive Study.

The purpose of this longitudinal, descriptive study was to observe changes in maximal strength measured via isometric clean grip mid-thigh pull and home runs (total and home runs per game) across three years of training and three competitive seasons for four National Collegiate Athletic Association (NCAA) Division 1 baseball players. A one-way repeated measures analysis of variance (ANOVA) was performed, revealing significant univariate effects of time for peak force (PF) ( = 0.003) and peak force allometrically scaled (PFa) ( = 0.

Clinical efficacy and safety of mucosal incision-assisted biopsy for the diagnosis of upper gastrointestinal subepithelial tumors: A systematic review and meta-analysis.

Background: Endoscopic ultrasound-guided fine-needle aspiration and biopsy (EUS-FNA/FNB) has been traditionally used for making a tissue diagnosis. Several newer techniques are emerging as a viable alternative to EUS-FNA/FNB, including mucosal incision-assisted biopsy (MIAB), with a view to increasing the diagnostic yield for upper gastrointestinal (GI) subepithelial tumors (SETs). We conducted a systematic review and meta-analysis to describe the overall diagnostic yield of MIAB for upper GI SETs.

Urine Drug Test Interpretation: An Educational Program's Impact on Resident Knowledge and Comfort Level.

Introduction: Following the release of the Centers for Disease Control and Prevention guidelines in 2016, institutions are encouraged to have controlled substance agreements that require the use of drug screens for appropriate opioid prescribing. Correct evaluation of urine drug tests (UDTs) is essential for appropriate chronic prescribing of controlled substances. Anticipating the increase in use of these tests, our institution developed and implemented an educational program to improve knowledge of and comfort level with UDT interpretation.

A Review of Mentoring in Academic Medicine.

Many believe that mentoring is essential for new and developing faculty physicians to achieve their professional and personal goals, yet there are both positive and potential negative aspects of mentoring. Research reports on the process have few quantifiable objective outcomes, use mostly single-center study populations, lack controls and use mostly qualitative techniques. Absence of a standardized definition of mentorship has allowed widespread application of the term to other forms of protégé support.

Local extinction and unintentional rewilding of bighorn sheep (Ovis canadensis) on a desert island.

Bighorn sheep (Ovis canadensis) were not known to live on Tiburón Island, the largest island in the Gulf of California and Mexico, prior to the surprisingly successful introduction of 20 individuals as a conservation measure in 1975. Today, a stable island population of ∼500 sheep supports limited big game hunting and restocking of depleted areas on the Mexican mainland. We discovered fossil dung morphologically similar to that of bighorn sheep in a dung mat deposit from Mojet Cave, in the mountains of Tiburón Island.

MicroRNAs regulatory networks in myeloid lineage development and differentiation: regulators of the regulators.

MicroRNAs (miRNAs) are abundant small molecules of ≈ 22 nucleotides that reprogram gene expression by targeting mRNA degradation and translation disruption. An emerging concept implicates miRNA coupling with transcription factors in myeloid-based development of dendritic cells, monocytes and granulocytes, as well as function as mature cells and contributors to host defense and inflammation. Here, we review this new and important interactive circuitry and how it contributes to reprogramming cell phenotypic responses associated with mature immune competency.

The Del Rio project: a case for community-campus partnership.

Context: Interdisciplinary teams of graduate health professions students and faculty were provided with experiential learning opportunities while assisting a small rural community address critical health-related issues.

Project Objectives: To establish an effective partnership with community leaders and area residents to assist in determining the feasibility of a new primary care clinic and to remediate a water borne disease threat. To create interdisciplinary clinical learning experiences and to develop future longitudinal learning opportunities, emphasizing primary prevention.

Avoiding Overmedication of Elderly Patients.

Overmedication is the use of drugs that are not clinically indicated and are given in an inappropriate or overly aggressive manner even when nonpharmacologic alternatives are more suitable. This is an extension of polypharmacy and is caused when age-related changes in pharmacokinetics, pharmaco-dynamics, and potential drug interactions are ignored, when inappropriate drugs are used, or when a drug is prescribed for the wrong diagnosis in elderly individuals. Overmedication can cause adverse drug reactions, increased drug costs, and noncompliance with therapeutic regimens.