Seamless Navigation of Bispecific Therapies: Optimizing Management and Outpatient Access With a Focus on Coordination.

Bispecific antibodies (BsAbs) have emerged as crucial therapeutic agents for patients with relapsed/refractory diffuse large B-cell lymphoma, multiple myeloma, and most recently, lung cancer. These therapies have demonstrated remarkable efficacy in clinical trials; however, multidisciplinary collaboration is essential to ensure optimal patient outcomes amid the operational complexities associated with BsAb therapy. As BsAbs are being prepared for broader adoption, clinicians and treatment centers must navigate operational challenges, including financial considerations, patient selection, caregiver involvement, and transitions of care.

An Effective Protocol for Perioperative Venous Thromboembolism Prophylaxis in DIEP Flap Breast Reconstruction: A Single Institution Retrospective Review.

Background: Deep inferior epigastric artery perforator (DIEP) free flap breast reconstruction is one of the most highly used procedures for autologous breast reconstruction. Many venous thromboembolism (VTE) risk assessment models have been proposed in breast reconstructive surgery, including the widely used Caprini score. However, a paucity of data suggests an effective standardized VTE protocol.

Screening for Comorbidity of Sleep Disorders in Career Firefighters.

Background: The purpose of this study was to assess the prevalence and sequelae of insomnia, obstructive sleep apnea (OSA), and comorbid OSA and insomnia (COMISA).

Method: In the morning, after a shift end, Midwest career firefighters ( N = 89) in a midsized city completed an electronic battery of questionnaire to screen for OSA, daytime sleepiness, insomnia, presleep arousal, nightmares, mental and physical health symptoms, and a one-night sleep diary.

Results: Prevalence of firefighters exceeding screening thresholds: OSA: 54%; insomnia: 30%; COMISA: 17%; four or more nightmares per month: 15%.

Pandemics Interlaced: The Impact of the COVID-19 Pandemic on the Wellbeing of Sober Living Home Residents.

Objectives: This study aimed to discover how the COVID-19 pandemic altered the implementation of the social model of recovery in sober living homes (SLHs). Researchers analyzed associations between residents' feelings of interconnectedness, social service utilization, and relapse predictors throughout the pandemic. This study provides an understanding of how the COVID-19 pandemic impacted treatment of substance use disorder (SUD).

Treatment of Angiosarcoma of the Head and Neck: A Systematic Review.

Primary cutaneous angiosarcoma (cAS) of the head and neck is a rare sarcoma with a poor prognosis and limited treatment options. We conducted a systematic review of treatments used for head and neck cAS and determined the treatment modalities that offer the longest mean overall survival (OS). Forty publications totaling 1295 patients were included.

Building the Worksite Wellness Foundation Infrastructure: A Critical Component of the WorkWell KS Strategic Framework.

Objective: Workplace health programs can be ineffective, and changes are likely to be temporary without first establishing a wellness infrastructure. This study sought to determine whether attending a WorkWell KS Building the Worksite Wellness Foundation (Foundation) workshop enabled worksites to develop this infrastructure.

Methods: Survey data were collected from worksites before attending a workshop and approximately 1 year later.

Role Clarity and Interprofessional Colleagues in Psychological Safety: A Faculty Reflection.

Psychological safety in high-fidelity simulation-based experiences ensures that learners feel safe with new experiences in the service of learning. This article is a faculty reflection on breaches in the psychological safety among nursing students in 2 independent, high-fidelity simulation-based experience studies that were conducted in 2019. Demonstrated breaches in psychological safety included fear and anxiety in the sole provider role in multiple-patient simulations and incivility directed toward nursing students in a primary nurse role in interprofessional simulations.

High Rate of Emergency Department Care in Youth With Abdominal Pain-Associated Functional Gastrointestinal Disorders.

Objectives: The primary objective was to describe patterns of care delivery locations in youth with abdominal pain-associated functional gastrointestinal disorders (AP-FGID) and assess for differences in patterns of care delivery by sex and race. A secondary objective was to describe cost variability within the emergency department (ED).

Methods: Data were obtained using a large, single-vendor database that extracts and deidentifies data from the electronic health record across the outpatient, ED, and inpatient continuum of care.

The Effect of Preprocedural Anxiety on General Anesthesia Management: A Case Report.

Preoperative anxiety occurs in many surgical patients and yet there are no clear recommendations on how to provide the best evidence-based care to these patients during a general anesthetic. The following case report describes a complex case of a 35-year-old female who presented for imaging under general anesthesia with high preoperative anxiety. She displayed fluctuations in hemodynamics, an increased induction dose of propofol, and vasopressor support throughout the intraoperative phase of care.

Longitudinal Relationship Between Tibiofemoral Contact Stress at Baseline and Worsening of Knee Pain Over 84 Months in the Multicenter Osteoarthritis Study.

Objective: The aim of the study was to determine whether tibiofemoral contact stress predicts risk for worsening knee pain over 84 ms in adults aged 50-79 yrs with or at elevated risk for knee osteoarthritis.

Design: Baseline tibiofemoral contact stress was estimated using discrete element analysis. Other baseline measures included weight, height, hip-knee-ankle alignment, Kellgren-Lawrence grade, and Western Ontario and McMaster Universities Osteoarthritis Index pain subscale.

ABCs of Pain: A Functional Scale Measuring Perioperative Pain in Total Hip Arthroplasty Patients.

Introduction: Functional pain assessments are critical in total hip arthroplasty. This pilot study investigated a novel functional pain scale-the Activity-Based Checks of Pain (ABCs)-and its correlations with the 0 to 10 numeric rating scale (NRS) and outpatient milligram of morphine equivalents (MMEs) prescribed and needed in the first 2 weeks after total hip arthroplasty.

Methods: ABCs and NRS were collected at the baseline, inpatient, and 2-week follow-up.

Translating Sexual Dysfunction: Does Language Impact Clinical Discussion of Painful Sex?

Objectives: Dyspareunia and sexual dysfunction are estimated to affect up to 22% and 43% of women, respectively. There is concern that these statistics do not depict the true prevalence and that these conditions are frequently undiagnosed and untreated. By 2060, Latinos will make up 30% of the total population in the United States.

Massive Iatrogenic Pediatric Ketamine Overdose With Serial Levels and Minimal Morbidity.

Ketamine is a dissociative anesthetic commonly used for procedural sedation owing to its perceived favorable safety profile. Despite its frequent use, overdoses of ketamine are rarely reported, and no cases with serum levels of ketamine or its metabolite have previously been reported. We report a case of an iatrogenic pediatric ketamine 20 mg/kg intramuscular overdose with serial ketamine and norketamine levels that resulted in minimal toxicity.

Chyle Leak Following Autologous Breast Reconstruction: A Rare Complication of a Deep Inferior Epigastric Artery Perforator Flap.

Background: While complications of deep inferior epigastric artery perforator flaps are known and well documented, a thorough literature review revealed no other reports of a patient developing a chyle leak following the use of the internal mammary vessels for recipient vessels in autologous breast reconstruction.

Case: A 55-year-old woman underwent free autologous breast reconstruction. She developed a chyle leak during the postoperative period.

Intrathecal Baclofen Injection to Avoid Withdrawal in a Multiple Sclerosis Patient Undergoing Lumbar Spine Surgery: A Case Report.

Spasticity of spinal or cerebral origin is frequently treated with baclofen. Treatment interruption initially results in rebound spasticity; life-threatening withdrawal symptoms may follow. Severe rebound spasticity of leg muscles occurred in a multiple sclerosis patient after a 10-hour long perioperative pause of oral baclofen intake.

Decision-Making Data: Expectations for Reproducibility of Lifting on Separate Days.

Purpose: The purpose of this study was to explore the difference in maximal lifting capability between 2 modes of lifting (traditional crate and XRTS Lever Arm) over multiple days. The differences in absolute strength values were compared with existing criteria for sincere effort during distraction-based lifting. In addition, rate of perceived exertion (RPE) is presented for the 2 modes of lifting on each day.

Impact of Polypharmacy on Seniors' Self-Perceived Health Status.

Objectives: Polypharmacy is common among older patients and is linked to increased risk of adverse health outcomes. This study aimed to explore the association of polypharmacy and self-perceived health status (SPHS) among geriatric patients.

Methods: This cross-sectional analysis of longitudinal observational research used national survey data from 2005-2008.

Concussion management plans' compliance with NCAA requirements: Preliminary evidence suggesting possible improvement.

This study examined the extent to which concussion management plans at National Collegiate Athletic Association (NCAA) member schools were in line with NCAA Concussion Policy and best practice recommendations in absence of any process to ensure compliance. Most schools' concussion management plans were in compliance with 3 (60%) or 4 (25.6%) of the NCAA's 4 required components.