A Phase II Trial of Onapristone and Fulvestrant for Patients With ER+ and HER2- Metastatic Breast Cancer.

Background: The SMILE study is a multi-institutional phase II clinical trial to determine the efficacy and safety of an antiprogestin, onapristone, in combination with fulvestrant as second-line therapy for patients with ER+, PgR+/-, HER2- metastatic breast cancer. This study was terminated early and herein, we report patient characteristics, and outcomes.

Methods: Eligibility criteria included disease progression on ≥2 lines of prior therapy, ECOG performance status ≤ 2, measurable disease per RECIST 1.

Naloxone coprescribing best practice advisory for patients at high risk for opioid-related adverse events.

Objective: To implement an electronic health record best practice advisory (BPA) to promote coprescribing of naloxone to patients at high risk of serious opioid-related adverse events (ORADEs).

Design: This pre-post quasi-experimental study evaluated 9 months of opioid and naloxone prescription data before and after BPA implementation.

Setting: The Froedtert & the Medical College of Wisconsin enterprise is comprised of 45 ambulatory clinics and 10 hospitals, including the only adult Level 1 trauma center in eastern Wisconsin.

PI3K signaling and lysyl oxidase is critical to corneal stroma fibrosis following mustard gas injury.

Sulfur mustard gas (SM), an alkylating and vesicating agent, has been used frequently in many wars and conflicts. SM exposure to the eye results in several corneal abnormalities including scar/fibrosis formation. However, molecular mechanism for SM induced corneal fibrosis development is poorly understood.

Adaptation of meaning-centered psychotherapy for healthcare providers to buffer work-induced distress and improve wellbeing.

Healthcare providers (HCPs) face high rates of distress, experienced as burnout, moral distress, compassion fatigue, and grief. HCPs are also experiencing a crisis in meaning whereby distress is associated with disconnection from meaning in work and, in turn, a lack of meaning in work can further perpetuate distress for HCPs. Although scalable systems-level solutions are needed to tackle multidimensional HCP distress, it is also necessary to address HCP suffering at individual, team, and institutional levels.

Characterizing Nodal Gamma-Delta T-Cell Lymphoma: Clinicopathological and Molecular Insights.

Peripheral T-cell lymphomas with gamma-delta phenotype (GDTCL) are rare lymphoid malignancies. Beyond the well-recognized entities of extranodal lymphomas with gamma-delta phenotype as defined by the fifth edition of the World Health Organization Classification of Hematolymphoid Tumors and 2022 International Consensus Classification, there is a group of poorly defined gamma-delta T-cell lymphomas with predominantly nodal presentation, termed as nodal GDTCL (nGDTCL). In this study, we present a series of 12 cases of Epstein-Barr virus-negative nGDTCL, highlighting the clinical, histopathological, and molecular features of this rare entity.

An Analytical Approach that Combines Knowledge from Germline and Somatic Mutations Enhances Tumor Genomic Reanalyses in Precision Oncology.

Expanded analysis of tumor genomics data enables current and future patients to gain more benefits, such as improving diagnosis, prognosis, and therapeutics. Here, we report tumor genomic data from 1146 cases accompanied by simultaneous expert analysis from patients visiting our oncological clinic. We developed an analytical approach that leverages combined germline and cancer genetics knowledge to evaluate opportunities, challenges, and yield of potentially medically relevant data.

Cambridge risk score, new hyperglycemia, and complications in surgical patients without diabetes.

Aims: Our study examined the association between the Cambridge Risk Score (CRS), new hyperglycemia (NH), and complications in patients undergoing elective surgery.

Methods: In this retrospective cross-sectional study, adult surgical patients, without diabetes, with NH (blood glucose ≥140 mg/dL) were identified, and the CRS was calculated. We used univariate regression models to evaluate the relationship between CRS and NH with 30-day readmission, length of stay (LOS), and complications.

Measurable Residual Disease in Mantle Cell Lymphoma: The Unbearable Lightness of Being Undetectable.

Purpose Of Review: This paper evaluates the benefits and limitations of detecting measurable residual disease (MRD) in mantle cell lymphoma (MCL) and assesses its prognostic value. It also aims to highlight the importance of detecting low MRD levels post-treatment and their application in clinical practice.

Recent Findings: Recent studies show that MRD levels predict relapse and survival outcomes in hematologic neoplasms, including MCL.

Development and validation of an artificial intelligence system for surgical case length prediction.

Background: Accurate case length estimation is a vital part of optimizing operating room use; however, significant inaccuracies exist with current solutions. The purpose of this study was to develop and validate an artificial intelligence system for improved surgical case length prediction by applying natural language processing and machine-learning methods.

Methods: All inpatient elective surgical cases longer than 30 minutes completed between 2017 and 2023 at a single, quaternary care hospital were considered.

International cross-sectional survey on current and updated definitions of intra-abdominal hypertension and abdominal compartment syndrome.

Background: The Abdominal Compartment Society (WSACS) established consensus definitions and recommendations for the management of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in 2006, and they were last updated in 2013. The WSACS conducted an international survey between 2022 and 2023 to seek the agreement of healthcare practitioners (HCPs) worldwide on current and new candidate statements that may be used for future guidelines.

Methods: A self-administered, online cross-sectional survey was conducted under the auspices of the WSACS to assess the level of agreement among HCPs over current and new candidate statements.

Advancing personalized healthcare: leveraging explainable AI for BPPV risk assessment.

Background: Benign Paroxysmal Positional Vertigo (BPPV) is a common vestibular disorder significantly impacting older adults, characterized by brief episodes of vertigo triggered by head movements. Accurate and timely diagnosis of BPPV can be challenging due to its overlapping symptoms with other conditions. Machine learning (ML) offers a promising approach to enhance diagnostic accuracy and efficiency.

Cephalosporins for Outpatient Pyelonephritis in the Emergency Department: COPY-ED Study.

Study Objective: The primary objective of our study was to compare the effectiveness of oral cephalosporins versus fluroquinolones and trimethoprim/sulfamethoxazole (TMP-SMX) for the treatment of pyelonephritis in patients discharged home from the emergency department (ED).

Methods: This was a multicenter, retrospective, observational cohort study of 11 geographically diverse US EDs. Patients aged ≥18 years diagnosed with pyelonephritis and discharged home from the ED between January 1, 2021 and October 31, 2023 were included.

The LAVA Study: A Prospective, Multicenter, Single-Arm Study of a Liquid Embolic System for Treatment of Peripheral Arterial Hemorrhage.

Purpose: To present the results of the Liquid Embolization of Arterial Hemorrhages in Peripheral Vasculature (LAVA) study evaluating safety and effectiveness of Lava Liquid Embolic System, an ethylene vinyl alcohol (EVOH), for peripheral arterial hemorrhage (PAH).

Materials And Methods: LAVA was a pivotal, prospective, multicenter, single-group, centrally adjudicated study of adults with active PAH. Patients received EVOH at 1 of 2 viscosities, administered by experienced physicians.

Utility of iron concentration two to four hours post ingestion in predicting toxicity.

Introduction: Iron products are widely available over the counter and have the potential to cause serious toxicity. Iron concentrations can be used to prognosticate and guide treatment during acute ingestions. Traditionally, a concentration of 350 μg/dL with symptoms, or 500 μg/dL without symptoms, is considered toxic and will likely need treatment to prevent decompensation.

Prospective, multi-site evaluation of the Cepheid Xpert Xpress CoV-2 test on nasal and nasopharyngeal swabs.

Unlabelled: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues its largely aseasonal spread with millions of cases per year. Highly sensitive, point-of-care testing is critical for rapid detection of coronavirus disease 2019 (COVID-19) cases and initiation of antiviral therapy to avert adverse health outcomes and reduce onward transmission of the virus. While hundreds of COVID-19 diagnostics received emergency use authorization from the FDA during the pandemic, significantly fewer have navigated the course to FDA clearance or approval.

Antibiotic Prophylaxis and Spinal Infection After Gunshot Wounds to the Spine: A Retrospective Study.

Introduction: Spinal and paraspinal infections (SPIs) are a potential complication following traumatic spinal column injury, and we sought to determine the association of antibiotic prophylaxis on SPI development following a spinal gunshot wound (GSW).

Methods: A single-center retrospective cohort study was performed on adults who sustained a GSW to the spinal column over 11 y. Patients were excluded if they died within 24 h or had a mechanism other than GSW.