Left Ventricular Energetics in Patients Receiving Veno-Arterial Extracorporeal Membrane Oxygenation for Extracorporeal Cardiopulmonary Resuscitation.

Introduction: The haemodynamic effects veno-arterial extracorporeal membrane oxygenation (VA-ECMO) remain inadequately understood. We investigated invasive left ventricular (LV) haemodynamics in patients who underwent treatment with an intensive care strategy involving extracorporeal cardiopulmonary resuscitation (ECPR).

Methods: We conducted invasive haemodynamic assessments on 15 patients who underwent ECPR and achieved return of spontaneous circulation.

Readability of Online Pediatric Orthopaedic Trauma Patient Education Materials.

Introduction: The importance of web resources for educating orthopaedic trauma patients is well recognized. Yet these resources often exceed the sixth-grade reading level and are too complex for most patients to understand. This study examines the readability of the American Academy of Orthopaedic Surgeons' (AAOS) pediatric trauma-related educational content compared with similar materials from the Pediatric Orthopaedic Society of North America (POSNA).

Fully covered self-expandable metal stents versus multiple plastic stents for the treatment of post-orthotopic liver transplant anastomotic biliary strictures: An updated systematic review and meta-analysis of randomized controlled trials.

Background And Aims: The most common adverse event (AE) of orthotopic liver transplantation (OLT) is anastomotic biliary stricture (ABS). Management varies widely between centers, and it is not clear whether a combination of endoscopic dilation of the stenosis followed by multiple plastic stents (MPS) or placement of a fully covered self-expandable metal stent (fcSEMS) is better for the management of post-OLT ABS. This systematic review and meta-analysis aimed to compare the efficacy, safety, and cost of fcSEMS versus MPS in the treatment of post-OLT ABS.

If it is a solid tumor target, then it may be a hematologic cancer target: Bridging the great divide.

Tumor-agnostic US Food and Drug Administration approvals are transforming oncology. They include larotrectinib/entrectinib/repotrectinib (NTRK fusions), selpercatinib (RET fusions), dabrafenib/trametinib (BRAF mutations), pembrolizumab/dostarlimab (microsatellite instability), pembrolizumab (high tumor mutational burden), and trastuzumab deruxtecan (HER2 3+ expression) (all solid cancers). Pemigatinib is approved for FGFR1-rearranged myeloid/lymphoid neoplasms.

Effect of Hemolysis on Routine Blood Gas and Whole Blood Analytes.

Background: Hemolysis is a major pre-analytical concern for many laboratory analytes; however, instruments utilized for whole blood chemistries and blood gas measurements lack the ability to detect and measure the degree of hemolysis. This study evaluated the effect of hemolysis on 13 routine whole blood and blood gas analytes and compared visual assessments of hemolysis to measured hemolysis (H-index).

Methods: Remnant whole blood samples (n = 85) were split into 2 portions and aspirated through a syringe one or more times.

The RISE (Resilience in Stressful Events) Peer Support Program: Creating a Virtuous Cycle of Healthcare Leadership Support for Staff Resilience and Well-Being.

Healthcare leaders are responsible for creating an environment where their staff can maintain their resilience and well-being. However, there is a crisis of burnout among healthcare workers. The resulting increased turnover, diminished morale and performance, safety risks, and decreased worker engagement produces a vicious cycle of burnout.

Clinical Course of Isolated Recurrent, Persistent Complex Perianal Fistulas Without Luminal Crohn's Disease: A Multicenter Case Series of 24 Patients.

Background: Isolated complex perianal fistulas, without luminal evidence of inflammatory bowel disease in the gastrointestinal tract, pose diagnostic and treatment dilemmas for gastroenterologists and colorectal surgeons. For patients who develop recurrent complex fistulas, a presumptive diagnosis of Crohn's disease may be made. It is unclear whether these cases of isolated perianal disease in the absence of luminal inflammation truly represent isolated severe cryptoglandular fistulas or rather an early presentation of Crohn's disease.

Ketogenic diet therapy for the treatment of pediatric epilepsy.

In 1921, the classic ketogenic diet was created at the Mayo Clinic in Rochester, Minnesota to treat epilepsy in children and adults. Over a century later, it is a widely used, standard-of-care therapy for typically treatment-resistant epilepsy worldwide. There are currently five versions of ketogenic diet therapy that can be started either in or out of the hospital setting.

Electronic evaluation of infection risk from room environment and prior room occupants: the transmission from room environment events (TREE) measure.

Over a 2-year period, we identified Transmission from Room Environment Events (TREE) across the Johns Hopkins Health System, where the subsequent room occupant developed the same organism with the same antimicrobial susceptibilities as the patient who had previously occupied that room. Overall, the TREE rate was 50/100,000 inpatient days.

Impact of anterior cruciate ligament tears on player efficiency ratings and salary in National Basketball Association over the past 20 years: a retrospective case control study.

Objectives: Players in the National Basketball Association (NBA) are at high risk for ACL tears which are detrimental to their career due to the months of rehabilitation. The authors hypothesize that after anterior crucial ligament (ACL) injury, older players will be less likely to return to the NBA, players that do return will have a lower performance efficiency rating (PER), and the decrease in PER will be associated with a lower salary.

Methods: This case-control study utilized the publicly available database maintained by the NBA, professional basketball players from 2002 to 2022 who suffered an ACL tear were identified.

Bridging the Gap: Subspecialty Telemedicine Consultations at a Level III Neonatal Intensive Care Unit.

Many neonatal intensive care units (NICUs) lack access to subspecialist consultants and may transfer patients requiring subspecialty care to referral facilities or seek informal consultation. The objective of this work was to evaluate the feasibility, acceptability, and impact of extending pediatric subspecialty services from a children's hospital to a level III NICU via teleconsultation and describe processes, facilitators, and challenges. Monitored consultations for 1 year and surveyed clinicians regarding feasibility, perceived benefits, and challenges.

Alterations in Mitochondrial Function in Pulmonary Vascular Diseases.

Alterations of mitochondrial bioenergetics and arginine metabolism are universally present and mechanistically linked to pulmonary arterial hypertension (PAH), but there is little knowledge of arginine metabolism and mitochondrial functions across the different pulmonary hypertension (PH) groups. We hypothesize that abnormalities in mitochondrial functions are present across all PH groups and associated with clinical phenotypes. We test the hypothesis in PH patients and healthy controls from the Pulmonary Vascular Disease Phenomics Program cohort, who had comprehensive clinical phenotyping and follow-up for at least 4 years for death or transplant status.

The Impact of Traveling Fellowships: Perspectives from Rothman-Ranawat Travel Fellows.

Background: Traveling fellowships, such as the Hip Society Rothman-Ranawat fellowship, offer orthopaedic surgeons the opportunity to enhance their skills, conduct research, and gain mentorship at top orthopaedic centers. This study aimed to assess the impact of the Hip Society Rothman-Ranawat traveling fellowship on an adult reconstruction surgeon's career.

Methods: A non-incentivized online survey was distributed to the 40 past recipients of the Hip Society Rothman-Ranawat traveling fellowship spanning from 2013 to 2023.

Left Anterior Descending Nonculprit Lesions and Clinical Outcomes in Patients With ST-Segment Elevation Myocardial Infarction.

Background: In the COMPLETE (Complete vs Culprit-Only Revascularization to Treat Multi-Vessel Disease After Early PCI for STEMI) trial, complete revascularization in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD) reduced important outcomes compared with culprit-only percutaneous coronary intervention. Whether clinical outcomes in STEMI patients with MVD are influenced by the presence of a left anterior descending (LAD) nonculprit lesion (NCL) remains unknown.

Objectives: This study sought to compare: 1) cardiovascular outcomes among patients with an NCL in the proximal/mid-LAD to patients with an NCL in other locations; and 2) the benefit of NCL revascularization in patients with and without a proximal/mid-LAD NCL.

Survey of Latin American ketogenic diet centers: Challenges and success for "La Terapia Cetogénica".

Objective: Despite growing recognition of the efficacy of ketogenic diet therapies (KDT) in reducing seizure frequency and improving the quality of life for individuals with epilepsy, several factors hinder their widespread adoption across Latin America. Specific challenges in the region have been discussed but not formally studied. Currently, no data exist on the availability and operation of KDT teams in the region.