Cardiac Magnetic Resonance Imaging in Diagnostics and Cardiovascular Risk Assessment.

Cardiac magnetic resonance (CMR) allows for analysis of cardiac function and myocardial tissue characterization. Increased left ventricular mass (LVM) is an independent predictor of cardiovascular events; however, the diagnosis of left ventricular hypertrophy and its prognostic value strongly depend on the LVM indexation method. Evaluation of the quantity and distribution of late gadolinium enhancement assists in clinical decisions on diagnosis, cardiovascular assessment, and interventions, including the placement of cardiac implantable electronic devices and the choice of an optimal procedural approach.

Clinical Utility of an Alzheimer's Disease Blood Test Among Cognitively Impaired Patients: Results from the Quality Improvement PrecivityAD2 (QUIP II) Clinician Survey Study.

: The objective of this study was to assess clinical decision-making associated with the use of a multi-analyte blood biomarker (BBM) test among patients presenting with signs or symptoms of mild cognitive impairment or dementia. : The Quality Improvement PrecivityAD2 (QUIP II) Clinician Survey (NCT06025877) study evaluated the clinical utility of the PrecivityAD2™ blood test in a prospective, single cohort of 203 patients presenting with symptoms of Alzheimer's disease (AD) or other causes of cognitive decline across 12 memory specialists. The PrecivityAD2 blood test (C2N Diagnostics, St.

Type 1 Diabetes Mellitus and Thromboembolism in Pregnancy.

Objective The impact of type 1 DM (T1DM) on thromboembolism in pregnancy is uncertain. We hypothesized that T1DM is associated with higher rates of thrombotic events during pregnancy and the postpartum period. Study Design This is a retrospective cohort study utilizing the National Inpatient Sample database from HCUP/AHRQ for 2017-2019.

The Evidence-Based Medicine Management of Endometriosis Should Be Updated for the Limitations of Trial Evidence, the Multivariability of Decisions, Collective Experience, Heuristics, and Bayesian Thinking.

: The diagnosis and treatment of endometriosis should be based on the best available evidence. Emphasising the risk of bias, the pyramid of evidence has the double-blind, randomised controlled trial and its meta-analyses on top. After the grading of all evidence by a group of experts, clinical guidelines are formulated using well-defined rules.

Efficacy of Amniotic Suspension Allografts in the Treatment of Knee Osteoarthritis: A Systematic Review.

Knee osteoarthritis significantly impacts mobility and quality of life. This condition is a leading cause of disability in aging populations, with total knee replacement commonly sought in advanced cases. Traditional nonoperative management strategies, including anti-inflammatories, corticosteroid injections, and hyaluronic acid, often provide limited relief, especially in severe cases.

What Gastroenterologists Should Know About Microplastics and Nanoplastics.

Global production and widespread use of plastics are increasing dramatically. With current limited recycling and recovery options, microplastics and nanoplastics (MNPs) persist in the natural environment. Due to their ubiquity, human exposure to MNPs is inevitable.

Leveraging Saliva for Insights into Head and Neck Cancer.

Head and neck cancer (HNC) represents a heterogeneous group of malignancies with increasing global incidence and notable mortality. Early detection is essential for improving survival rates and minimizing recurrence; however, existing diagnostic methods are often invasive and complex. There is a need for noninvasive and more effective approaches for early detection and real-time monitoring of HNC.

Standardized Clinical Infectious Diseases Pharmacy Care Delivery and Antimicrobial Stewardship Program Management Within a Large, Integrated Healthcare System.

Purpose: Infectious Diseases (ID) pharmacy expertise is crucial for the success of antimicrobial stewardship (AMS) efforts. As health systems expand due to mergers and acquisitions, ID pharmacy teams strive to deliver consistent care across the enterprise. This report describes the fusion of multiple AMS practice models during the integration of health systems to optimize and standardize care delivery.

In-stent restenosis.

Endovascular arterial recanalization has become the mainstay therapy for peripheral arterial occlusive disease. Although immediate technical success is achieved in greater than 90% of cases, longer-term results continue to vary based on the clinical presentation, and the treated target lesion. In the current era, sustained patency can be expected following intervention in the carotid, coronary, renal, and iliac arteries.

Adjunctive Middle Meningeal Artery Embolization for Subdural Hematoma.

Background: Subacute and chronic subdural hematomas are common and frequently recur after surgical evacuation. The effect of adjunctive middle meningeal artery embolization on the risk of reoperation remains unclear.

Methods: In a prospective, multicenter, interventional, adaptive-design trial, we randomly assigned patients with symptomatic subacute or chronic subdural hematoma with an indication for surgical evacuation to undergo middle meningeal artery embolization plus surgery (treatment group) or surgery alone (control group).

Treatment of cerebral radiation necrosis using hyperbaric oxygen therapy in a child: illustrative case.

Background: Cerebral radiation necrosis (RN) is an uncommon sequela that occurs in up to 25% of irradiated patients. This can occur 6 months to several years after therapy and create symptoms of headaches, focal neurological deficits, seizures, or behavioral changes. Management can involve corticosteroids, antiplatelet drugs, surgery, and hyperbaric oxygen therapy (HBOT).

Abdominoperineal Resection for T4 Low Rectal Cancer After Neoadjuvant Therapy-Are the Outcomes Acceptable?

Introduction: There is no clear consensus on using the response MRI as opposed to the pretreatment MRI for surgical planning in cT4 low rectal cancer. The objective of this study is to determine the safety of using response MRI in surgical planning for T4 rectal cancer.

Methods: This study is a retrospective review of a prospectively maintained database of abdominoperineal resections conducted at a single tertiary cancer center.

Development and validation of clinical criteria to identify familial chylomicronemia syndrome (FCS) in North America.

Background: Familial chylomicronemia syndrome (FCS) is an ultrarare inherited disorder. Genetic testing is not always feasible or conclusive. European clinicians developed a "FCS score" to differentiate between FCS and multifactorial chylomicronemia syndrome (MCS), a more common condition with overlapping features.

Tailored resection for persistent extramural vascular invasion in locally advanced rectal cancers.

Background: Extramural vascular invasion (EMVI) is a bad prognostic feature in rectal cancer and cancers that remain EMVI positive after neoadjuvant therapy are at high risk for having involved circumferential resection margins. Conventional total mesorectal excision (TME) resections are inadequate in such cases and often lead to positive margins.

Methods: We propose a technique for the surgical management of locally advanced tumours with persistent EMVI after neoadjuvant therapy.

Molecular Tumor Testing on Colorectal Adenocarcinoma Specimens in a Large Community-Based Healthcare System.

Purpose: This study aimed to describe the adherence of National Comprehensive Cancer Network guidelines to perform genetic screening for all colorectal cancer (CRC) specimens with molecular tumor testing, eg, immunohistochemical (IHC) testing, in a large community-based healthcare setting. The study also identified trends involving characteristics of CRC, individual reporting physician, and physician location and examined the potential impact of these trends on the performance of molecular tumor testing.

Methods: This was a retrospective, multi-center study using a centralized pathology database to assess molecular testing on CRC specimens.

Distinguishing hypertensive cardiomyopathy from cardiac amyloidosis in hypertensive patients with heart failure: a CMR study with histological confirmation.

Purpose: Differentiation of the cause of left ventricular hypertrophy (LVH) is challenging in cases with co-existing hypertension. CMR offers assessment of diffuse myocardial abnormalities via T1 mapping with extracellular volume fraction (ECV) and macroscopic fibrosis via late gadolinium enhancement imaging (LGE). The goal of the study was to understand if CMR parameters can differentiate hypertensive cardiomyopathy (HC) from cardiac amyloidosis (CA) in patients with hypertension and heart failure, using endomyocardial biopsy (EMB) as the gold standard.

Heidenhain Variant of Creutzfeldt-Jakob Disease: A Case Report.

Creutzfeldt-Jakob disease (CJD) is a rare, rapidly progressive, fatal neurodegenerative disorder caused by an accumulation of protein-containing particles called prions in the central nervous system. The Heidenhain variant (HvCJD) is a rare subtype of CJD that presents with predominantly visual symptoms at onset. The patient presented in this case had several weeks of visual symptoms prior to hospital admission.

Obstetric Cardiac Arrest: A Case Report.

Cardiac arrest during pregnancy does not occur infrequently and is influenced by obstetric and non-obstetric factors. The patient described in this case report is a pregnant woman who suffered a leg injury that required urgent surgical repair. Moments prior to that procedure, the fetus experienced extreme bradycardia on fetal heart tone monitoring.

Delayed abdominal aortic aneurysm sac rupture after open repair.

Open surgical repair of abdominal aortic aneurysm (AAA) is often regarded as a near-permanent operation with little long-term complications. Reported herein is a case of delayed rupture of an enlarging AAA sac after open repair requiring re-exploration in a patient presenting with flank pain and ipsilateral hydronephrosis. The natural history of a large, excluded aneurysm sac after open AAA repair, hypothesized etiology for this rare occurrence, and proposed diagnostic and therapeutic algorithm are described.

Impact of post-hepatectomy biliary leaks on long-term survival in different liver tumors: A single institute experience.

Backgrounds/aims: A postoperative biliary leak is one of the most morbid complications occurring after a liver resection, the long-term impact of which remains unknown.

Methods: Retrospective analysis of consecutive liver resections performed from 1 January 2011 to 31 December 2021. Primary endpoint of disease-free survival (DFS) was compared between patients with and without a bile leak, stratifying for tumor type.