Large Free-Floating Left Atrial Ball Thrombus With Intermittent Mitral Valve Occlusion.

An 83-year-old man with known history of atrial fibrillation presented for preoperative evaluation for elective left nephrectomy for cancer. Transthoracic echocardiogram revealed a large, free-floating, left atrial mass. Further profiling with transesophageal echocardiogram showed a free-floating mass intermittently obstructing the mitral valve.

Diabetes Mellitus Is Not a Risk Factor for Difficult Intubation Among Critically Ill Adults: A Secondary Analysis of Multicenter Trials.

Objectives: Diabetes mellitus has been associated with greater difficulty of tracheal intubation in the operating room. This relationship has not been examined for tracheal intubation of critically ill adults. We examined whether diabetes mellitus was independently associated with the time from induction of anesthesia to intubation of the trachea among critically ill adults.

Diabetic Kidney Disease.

Diabetic kidney disease is a leading cause of kidney failure worldwide and is easily detectable with screening examination. Diabetes causes hyperfiltration and activation of the renin-angiotensin aldosterone system by hemodynamic changes within the nephron, which perpetuates damaging physiology. Diagnosis is often clinical after detection of heavy proteinuria in a patient with diabetes,but can be confirmed by observation of histologic stages on kidney biopsy.

Processes of obstetrical care and outcomes among Ontario physicians versus non-physicians: a population-based study.

Objective: We compared processes of antepartum, intrapartum and postpartum care and obstetrical outcomes between physicians and non-physicians.

Design: This is a population-based retrospective matched cohort study.

Setting: The study was conducted in Ontario, Canada.

GLP-1 Receptor Agonist in Nonobese Patients with Type 2 Diabetes Mellitus and Heart Failure with Preserved Ejection Fraction.

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) promote weight loss and improve heart failure-related symptoms, quality of life, and functional capacity in patients with obesity and heart failure with preserved ejection fraction (HFpEF). However, their clinical effectiveness in nonobese patients with diabetes and HFpEF is understudied.

Methods: The TriNetX research network was used to identify adult patients (≥18 years) with type 2 diabetes mellitus (T2DM), heart failure with preserved ejection fraction (left ventricular ejection fraction ≥45%), elevated brain natriuretic peptide (≥ 150 pg/mL) or N-terminal pro-B-type natriuretic peptide(≥ 450 pg/mL) and a body mass index (BMI) <30 kg/m2 on or before August 31, 2022.

Health-Related Quality of Life Across the Spectrum of Bladder Cancer: A Current Review.

Purpose Of Review: The purpose of this review is to highlight the health-related quality of life (HRQOL) burden of bladder cancer due to the disease itself and its treatments.

Recent Findings: Large database studies have provided evidence that patients with bladder cancer have worse HRQOL than the general population. While transurethral resections and intravesical therapy are known to cause urinary symptoms, a large impact on HRQOL otherwise has not been demonstrated.

Evaluation of the Incidence of Nocardia Infection in Solid Organ Transplant Recipients on Trimethoprim-Sulfamethoxazole for Opportunistic Infection Prophylaxis.

Background: Trimethoprim-sulfamethoxazole (TMP-SMX) is the preferred prophylactic agent for pneumonia (PJP) and toxoplasmosis after solid organ transplant (SOT). Compared with other agents, it has additional activity against species.

Objective: The purpose of this study was to evaluate the incidence of infection in SOT patients receiving TMP-SMX or an alternative agent for opportunistic infection (OI) prophylaxis.

Association between higher glucose levels and reduced survival in patients with non-small cell lung cancer treated with immune checkpoint inhibitors.

Background: Obesity and hypercholesterolemia have been associated with better responses to ICIs in NSCLC, while type 2 diabetes (T2D) has been associated with a worse response. However, the association between glucose levels and outcomes remains unknown. This study investigated the impact of mean baseline glucose levels, T2D, dyslipidemia, and obesity on overall survival (OS) in NSCLC patients undergoing ICI therapy.

Multi-Institutional Evaluation and Training of Breast Density Classification AI Algorithm Using ACR Connect and AI-LAB.

Objective: To demonstrate and test the capabilities of the ACR Connect and AI-LAB software platform by implementing multi-institutional artificial intelligence (AI) training and validation for breast density classification.

Methods: In this proof-of-concept study, six US-based hospitals installed Connect and AI-LAB. A breast density algorithm was trained and tested on retrospective mammograms.

Utilization Fraction of Ambulatory Hand Procedures: Cost-Reduction Through Surgical Instrument Tray Optimization.

Background: Our objective is to evaluate the utilization fraction (UF) of surgical instruments during a commonly performed ambulatory hand surgery case as an avenue for cost reduction, increased operating room efficiency, and systems quality improvement.

Methods: The total number of instruments opened at the start of the case was recorded followed by instruments being divided into those used and not used during the procedure. Total sterile processing costs were estimated at $1.

Associations of SGLT2i with Cardiorenal Outcomes Among Diabetics with Prostate Cancer on Hormone Therapy.

Purpose: Studies have reported associations between prostate cancer, type II diabetes mellitus (T2DM), and cardiovascular disease in the context of treatment with hormone therapy (HT). This study aimed to assess the role of Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) in preventing adverse cardiovascular and renal outcomes in diabetics with prostate cancer.

Methods: Patients ≥ 18 years of age with T2DM and prostate cancer who received HT between August 1, 2013, and August 31, 2021, were identified using the TriNetX research network.

Consensus Considerations and Good Practice Points for Use of Continuous Glucose Monitoring Systems in Hospital Settings.

Continuous glucose monitoring (CGM) systems provide frequent glucose measurements in interstitial fluid and have been used widely in ambulatory settings for diabetes management. During the coronavirus disease 2019 (COVID-19) pandemic, regulators in the U.S.

Outcomes of down-titration in patients with severe scalp alopecia areata initially treated with baricitinib 4-mg: Week 152 data from BRAVE-AA2.

Background: Baricitinib, an oral selective Janus kinase inhibitor, is approved to treat adults with severe alopecia areata (AA).

Objective: To report the week 152 efficacy results from the phase 3 trial BRAVE-AA2 down-titration substudy.

Methods: BRAVE-AA2 enrolled 546 adults with severe AA (Severity of Alopecia Tool [SALT] score ≥50).

Particulate Matter 2.5 Pollution Impact on Comorbid Cancer and Cardiovascular Disease Mortality in the U.S.

Background: Evidence regarding the effect of long-term exposure to particulate matter (PM) 2.5 and comorbid cancer and cardiovascular disease (CVD) mortality is limited.

Objectives: In this study, the author report the association between long-term exposure to PM 2.

The learning curve for robotic living donor right hepatectomy: Analysis of outcomes in 2 specialized centers.

Robotic surgery is an emerging minimally invasive option for living donor hepatectomy. Currently, there are no studies on the learning curve of robotic donor hepatectomy. Thus, we evaluated the learning curve for robotic donor right hepatectomy.

Quality of Life and Psychosocial Outcomes Among Children With Cleft Differences.

Introduction Velopharyngeal insufficiency (VPI) and craniofacial differences can lead to diminished speech and swallowing function resulting in communication and social challenges throughout childhood. To monitor changes in patients' psychosocial health and velopharyngeal function, the Pediatric Symptom Checklist (PSC) and Velopharyngeal Insufficiency Effects on Life Outcomes (VELO) survey tools can be utilized. This study aimed to investigate the relationship between VPI quality-of-life outcomes and psychosocial disturbances through a comparative analysis of PSC and VELO parental surveys among children followed by a craniofacial team.

Association Between Neuromuscular Blocking Agents and Outcomes of Emergency Tracheal Intubation: A Secondary Analysis of Randomized Trials.

Study Objective: To examine the association between the neuromuscular blocking agent received (succinylcholine versus rocuronium) and the incidences of successful intubation on the first attempt and severe complications during tracheal intubation of critically ill adults in an emergency department (ED) or ICU.

Methods: We performed a secondary analysis of data from 2 multicenter randomized trials in critically ill adults undergoing tracheal intubation in an ED or ICU. Using a generalized linear mixed-effects model with prespecified baseline covariates, we examined the association between the neuromuscular blocking agent received (succinylcholine versus rocuronium) and the incidences of successful intubation on the first attempt (primary outcome) and severe complications during tracheal intubation (secondary outcome).

Access to a Patient Portal is Associated with a Higher Rate of Diabetic Eye Examination Completion.

Purpose: To evaluate factors associated with a higher completion rate of annual diabetic eye examinations.

Methods: This retrospective, cross-sectional study included patients diagnosed with diabetes mellitus (DM) who were aged 18-75 years and receiving primary care in a suburban integrated delivery network (IDN). Patient demographic, sociomedical, biometric characteristics, and Healthcare Effectiveness Data and Information Set (HEDIS) measures within the Comprehensive Diabetes Care bundle were extracted from the electronic health record (EHR) and analyzed by using multivariate logistic regression to assess factors associated with completion of an eye exam (retinal) performed during the study year.

Does ultrasound guidance decrease femoral access site complications in neurointerventional procedures? A retrospective cohort study.

Background: Ultrasound has been increasingly used to guide femoral arterial access for neuroendovascular procedures. Its effect on the safety outcomes has yet to be established.

Purpose: The purpose is to determine the effect of ultrasound-guided punctures on femoral access site complications (ASC), and to identify other potential predictors of ASC.

Long-Term Clinical Outcomes Following the WATCHMAN Device Use in Medicare Beneficiaries.

Background: Long-term outcomes following left atrial appendage occlusion outside clinical trials and small registries are largely unknown. Collecting these data was a condition of US market authorization of the WATCHMAN device. The aim of this analysis was to evaluate the rates of stroke, bleeding, and death among Medicare beneficiaries following left atrial appendage occlusion implantation during initial commercial availability of the WATCHMAN left atrial appendage occlusion device overall and in important subgroups.