Out of Hospital Bystander CPR Rates in Baltimore City, Maryland, 2020-2022, Compared to State and National Rates: A Preliminary Report.

This preliminary study was a rapid retrospective analysis of out-of-hospital cardiac arrest (OHCA) cases from Baltimore City between January 2020 and December 2022, using data from the Cardiac Arrest Registry to Enhance Survival. Of the 1,282 cases in 2022, 27.4% received bystander CPR compared to 40.

Prognostic relevance of exercise pulmonary hypertension: results of the multicentre PEX-NET Clinical Research Collaboration.

Background: Exercise pulmonary hypertension (PH) was defined by a mean pulmonary arterial pressure (mPAP)/cardiac output (CO) slope >3 mmHg·min·L between rest and exercise in the 2022 European Society of Cardiology/European Respiratory Society PH guidelines. However, large, multicentre studies on the prognostic relevance of exercise haemodynamics and its added value to resting haemodynamics are missing.

Patients And Methods: The PEX-NET (Pulmonary Haemodynamics during Exercise Network) registry enrolled patients who underwent clinically indicated right heart catheterisations both at rest and ergometer exercise from 23 PH centres worldwide.

CDC's Core Elements to promote diagnostic excellence.

Nearly a decade after the National Academy of Medicine released the "Improving Diagnosis in Health Care" report, diagnostic errors remain common, often leading to physical, psychological, emotional, and financial harm. Despite a robust body of research on potential solutions and next steps, the translation of these efforts to patient care has been limited. Improvement initiatives are still narrowly focused on selective themes such as diagnostic stewardship, preventing overdiagnosis, and enhancing clinical reasoning without comprehensively addressing vulnerable systems and processes surrounding diagnosis.

Thirty years of surveillance of depleted uranium-exposed Gulf War veterans demonstrate continued effects to bone health.

During the spring of 2024, 33 members of a group of Gulf War I veterans wounded in depleted uranium (DU) friendly-fire incidents were seen at the Baltimore VA Medical Center for surveillance related to their combat exposure. The cohort was assessed with a protocol which includes exposure monitoring for total and isotopic uranium (U) concentrations in urine and a comprehensive assessment of health outcomes including measures of bone metabolism and bone mineral density (BMD). An audiometry examination of the cohort was added to assess for acoustic trauma and toxic metal effects in this surveillance episode marking over 30 years since this exposure event.

Predicting deep infection in pilon and tibial plateau fractures: a secondary analysis of the VANCO and OXYGEN trials.

Objectives: To develop and validate a prediction model for a deep surgical site infection (SSI) after fixation of a tibial plateau or pilon fracture.

Design: Pooled data from 2 randomized trials (VANCO and OXYGEN).

Setting: Fifty-two US trauma centers.

Use of Epinephrine in Cardiac Arrest: Advances and Future Challenges.

Epinephrine is the most common medication used in cardiac arrest. Although the medication has been a mainstay of treatment over the last century, the utility and efficacy of epinephrine has been re-evaluated in recent years. This study aims to evaluate the literature describing the efficacy, timing, and dosing of epinephrine use in cardiac arrest.

Identification of Functional Immune Biomarkers in Breast Cancer Patients.

Cancer immunotherapy has emerged as an effective, personalized treatment for certain patients, particularly for those with hematological malignancies. However, its efficacy in breast cancer has been marginal-perhaps due to cold, immune-excluded, or immune-desert tumors. Natural killer T (NKT) cells play a critical role in cancer immune surveillance and are reduced in cancer patients.

Targeted Therapy of Antibody-Induced Autoimmune Arthritis Using Peptide-Guided Nanoparticles.

Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation of the joints and it affects over 18 million people worldwide. Despite the availability of a variety of potent drugs for RA, over 30-40 percent of patients fail to achieve adequate remission, and many patients suffer from systemic adverse effects. Thus, there is an urgent need for a joint-targeted drug delivery system.

Using a Failing Human Ventricular Cardiomyocyte Model to Re-Evaluate Ca Cycling, Voltage Dependence, and Spark Characteristics.

Previous studies have observed alterations in excitation-contraction (EC) coupling during end-stage heart failure that include action potential and calcium (Ca) transient prolongation and a reduction of the Ca transient amplitude. Underlying these phenomena are the downregulation of potassium (K) currents, downregulation of the sarcoplasmic reticulum Ca ATPase (SERCA), increase Ca sensitivity of the ryanodine receptor, and the upregulation of the sodium-calcium (Na-Ca) exchanger. However, in human heart failure (HF), debate continues about the relative contributions of the changes in calcium handling vs.

Amplifying School Mental Health Literacy Through Neuroscience Education.

Children and adolescents face a wide variety of developmental changes and environmental challenges, and it is estimated that at least one in five children aged 3-17 will experience behavioral or mental health issues. This period of life coincides with major changes in brain structure and function that have profound long-term consequences for learning, decision-making (including risk taking), and emotional processing. For example, continued development of the prefrontal cortex in adolescence is a sensitive period during which individuals are particularly susceptible to risky behaviors, environmental stressors, and substance use.

Multiple sclerosis disease-modifying therapy use in the department of veteran affairs and Medicare: A comparative analysis.

Background: High-cost disease-modifying therapies (DMT) for multiple sclerosis (MS) have created affordability challenges for people with MS (PwMS) and payers. The Department of Veterans Affairs (VA) is the largest integrated healthcare system in the US and uses a variety of approaches to manage utilization and cost of MS DMT. The objective of this paper is to compare national utilization trends in the VA to the US Medicare program, another large federal public healthcare program.

Gain-of-Function and Loss-of-Function Mutations in the RyR2-Expressing Gene Are Responsible for the CPVT1-Related Arrhythmogenic Activities in the Heart.

Mutations in the ryanodine receptor (RyR2) gene have been linked to arrhythmia and possibly sudden cardiac death (SCD) during acute emotional stress, physical activities, or catecholamine perfusion. The most prevalent disorder is catecholaminergic polymorphic ventricular tachycardia (CPVT1). Four primary mechanisms have been proposed to describe CPVT1 with a RyR2 mutation: (a) gain-of-function, (b) destabilization of binding proteins, (c) store-overload-induced Ca release (SOICR), and (d) loss of function.

Information Sharing to Enhance Early Childhood Services.

Purpose: The purpose of this study was to investigate stakeholder willingness to share information among various social service providers, and to determine perceived barriers to accessing these services in our state.

Description: The Maryland Family Network and the Maryland Chapter, American Academy of Pediatrics partnered to collect information on family information sharing preferences and barriers to services. We received 22 Survey Monkey responses and had 41 focus group participants aged 25 to 44 years and all regions of the state were represented.

The utility of surgical drains in adult and pediatric posterior spinal fusion: systematic review and meta-analysis.

Surgical drains are utilized in spinal surgery to reduce the incidence of epidural hematomas (EDHs) and to facilitate optimal wound healing. Despite their widespread use, there is a paucity of data to support their utility. The goal of this systematic review and meta-analysis is to compare the effect of using drains versus no drains on postoperative outcomes in adult and pediatric patients undergoing posterior spinal fusions for deformity or degenerative conditions.

Primary Care and Public Health - Both Essential for National Health Security and Population Health.

The COVID-19 pandemic was a stress test that revealed critical weaknesses in the foundation of the US health care delivery system, which left unresolved will ultimately lead to catastrophic population health consequences. Primary care and public health are the most fragile and important parts of that foundation. Collapse of either of these disciplines would lead to cascading failures harming the health of individuals and the health security of the nation.

Tele-Ultrasound in the Wilderness: A Tutorial Experience for Medical Students.

Introduction: Providers can evaluate patients who sustain trauma during outdoor activities by using the extended focused assessment with sonography for trauma (FAST) and the limited knee ultrasound. Remote tele-mentored ultrasound (RTMUS) can help minimally trained providers in the wilderness if they have difficulty obtaining a view or have questions about the interpretation of an image. The goal of our study was to determine the feasibility of using RTMUS to teach the FAST exam and knee ultrasound exam to ultrasound-naive medical students during a wilderness medicine outdoor activity.

Factors associated with breast lymphedema after adjuvant radiation therapy in women undergoing breast conservation therapy.

Purpose: Breast lymphedema after post-lumpectomy radiation therapy (RT) is poorly defined and difficult to treat. The aim of this study was to define the incidence of breast lymphedema and identify factors associated with the risk of developing breast lymphedema (BL) in women undergoing breast-conserving therapy.

Methods: A retrospective cohort study of patients with early-stage breast cancer who underwent breast-conserving surgery (lumpectomy) followed by RT between January 1, 2014 and July 31, 2019 at a single institution.

Non-intensive care unit feasibility for ambulatory veno-venous extracorporeal membrane oxygenation patients.

Introduction: Veno-venous extracorporeal membrane oxygenation has increasingly been utilized to support patients in respiratory failure as a bridge to recovery or lung transplantation. As patients progress from cannulation to recovery or transplantation, it has been shown that physical therapy and ambulation are possible and beneficial for patient outcomes.

Methods: We sought to evaluate the feasibility of managing these ambulatory VV-ECMO patients in a non-ICU setting by conducting a single-center, retrospective cohort study to characterize the daily data collection (i.

Accuracy of Financial Disclosures by Scientific Presenters/Authors at the ASNR 2024 annual meeting.

Physician-industry financial relationships can drive research and innovation, improving patient care and outcomes, but potentially raise ethical concerns if not disclosed appropriately. This study shows high rates of non-disclosures by authors/presenters at the ASNR 2024 annual meeting, despite strict requirements. 86.