Role of B7-H3 in predicting response to neoadjuvant chemotherapy in muscle-invasive bladder cancer.

Background: Neoadjuvant platinum-based chemotherapy offers a modest survival advantage in muscle-invasive bladder cancer (MIBC) for patients with pathologic response. B7-H3 (), an immune checkpoint overexpressed in various cancers, including urothelial-cell carcinoma (UCC), has been associated with chemoresistance and poor oncologic outcomes. We aimed to explore if B7H3 expression on bladder biopsy samples was a predictive biomarker for pathologic response to neoadjuvant platinum-based chemotherapy.

CT/MRI LI-RADS 2024 Update: Treatment Response Assessment.

With the rising incidence of hepatocellular carcinoma, there has been increasing use of local-regional therapy (LRT) to downstage or bridge to transplant, for definitive treatment, and for palliation. The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) Treatment Response Assessment (TRA) algorithm provides guidance for step-by-step tumor assessment after LRT and standardized reporting. Current evidence suggests that the algorithm performs well in the assessment of tumor response to arterial embolic and loco-ablative therapies and fair when assessing response to radiation-based therapies, with limited data to validate the latter.

Burden of Hyperlipidemia, Cardiovascular Mortality, and COVID-19: A Retrospective-Cohort Analysis of US Data.

Background: Hyperlipidemia is a major cardiovascular disease (CVD) risk factor, but limited data on its mortality trends in CVD over time. We assessed annual hyperlipidemia-related CVD mortality trends in the United States, including the COVID-19 pandemic's impact.

Methods And Results: Mortality data were obtained from CDC repository between 1999 and 2020 among patients ≥15 years old, using ICD-10 codes hyperlipidemia (E78.

Endoscopy in Special Situations in Inflammatory Bowel Disease: Acute Colitis, Pregnancy, and Pediatrics.

Endoscopy for a hospitalized patient with acute severe ulcerative colitis should be limited to flexible sigmoidoscopy. If, during pregnancy, inflammatory bowel disease (IBD) is active or if a new diagnosis of IBD is suspected, endoscopy may be needed to guide medical decision-making. The determination to proceed with endoscopy during pregnancy is nuanced and requires the ability to discern appropriate indications, knowledge regarding safety of bowel preparation and anesthesia.

It's Current: NAEC Provides Us With the Recipe to Build a Better Epilepsy Center.

The National Association of Epilepsy Centers (NAEC) recently published their updated guidelines for specialized epilepsy centers. The first NAEC guidelines provided basic expectations for in-patient care, with the goal of makingan accurate diagnosis and choose the best intervention- medical or surgical. With the 2001 report, the emphasis was for epilepsy centers to be able to provide comprehensive diagnostic and treatment services.

Blood Pressure and Heart Rate Response to Orthostasis in Somali Americans.

Purpose: Cardiovascular health disparities are present in African Americans, but it remains unknown whether this phenomenon affect Somali Americans. Study of Somali Americans is warranted due to distinct genetic and cultural differences from African Americans of western African ancestry. Orthostatic hemodynamic responses have implications for cardiovascular risk, especially among African American females.

Impact of Dermoscopy Training on Diagnostic Accuracy, and Its Association With Biopsy and Referral Patterns Among Primary Care Providers: A Retrospective and Prospective Educational Intervention Study.

Background: Proper diagnosis in primary care is crucial due to the large number of skin cancer diagnoses each year and its associated growing economic burden. Understanding how primary care providers can be best trained in dermoscopy is instrumental in helping primary care providers differentiate benign and malignant cutaneous lesions so that appropriate action can be taken (eg, biopsy/referral to dermatology or reassurance).

Objective: To assess the success of concise dermoscopy training among primary care providers.

Peripheral Endothelial Dysfunction Is Associated With Incident Major Depressive Disorder.

Background: A subset of individuals with major depressive disorder (MDD) have a high burden of cardiovascular risk factors and cerebral small-vessel disease, implicating vascular disease in the development of depression. Cross-sectional studies demonstrate a link between endothelial dysfunction and MDD, but the prospective association between peripheral endothelial dysfunction (PED) and an incident diagnosis of MDD is unknown.

Methods And Results: Patients undergoing a baseline assessment of cardiovascular risk were evaluated for PED using reactive hyperemia-peripheral arterial tonometry (≤1.

Considerations regarding safety with pulsed field ablation for atrial fibrillation.

The introduction of pulsed field ablation (PFA) in electrophysiology marks a significant advancement, promising efficacy comparable to thermal ablation methods while potentially providing safety advantages. Despite a generally favorable safety profile in human trials and postmarket registries, cautious evaluation of PFA's safety is essential. This review provides a comprehensive overview of key safety considerations as we discuss a myriad of considerations ranging from thermal effects, gaseous microbubble formation, muscle contractions, and proarrhythmia to procedural techniques.

Discrepancy Between Patient vs Provider Assessment of Erection Quality.

Objective: To characterize the discrepancy between patients' and providers' assessments of erection rigidity and its association with patient characteristics and penile ultrasound parameters.

Methods: Patients presenting for penile Doppler ultrasound between July 2022 and October 2023 were reviewed retrospectively. After intracavernosal injection, patients and providers independently rated erection rigidity from 1 to 10 prior to ultrasound.

The Dunning‒Kruger effect in resident predicted and actual performance on the American Board of Emergency Medicine in-training examination.

Objectives: The Dunning-Kruger effect (DKE) is a cognitive bias wherein individuals who are unskilled overestimate their abilities, while those who are skilled tend to underestimate their capabilities. The purpose of this investigation is to determine if the DKE exists among American Board of Emergency Medicine (ABEM) in-training examination (ITE) participants.

Methods: This is a prospective, cross-sectional survey of residents in Accreditation Council for Graduate Medical Education (ACGME)-accredited emergency medicine (EM) residency programs.

Patient, facility, and environmental factors associated with obesity treatment in US Veterans.

Background: Identifying patient-, facility-, and environment-level factors that influence the initiation and retention of comprehensive lifestyle management interventions (CLMI) for urban and rural Veterans could improve obesity treatment and reach at Veterans Affairs (VA) facilities.

Aims: This study identified factors at these various levels that predicted treatment engagement, retention, and weight management among urban and rural Veterans.

Methods: A retrospective cohort study of 631,325 Veterans was designed using VA databases to identify Veterans with class II and III obesity during 2015-2017.

Microscopic characteristics of peri- and postmortem fracture surfaces.

This study investigated if microscopic surface features captured with a scanning electron microscope (SEM) effectively discriminate fracture timing. We hypothesized that microscopic fracture characteristics, including delamination, osteon pullout, and microcracks, may vary as bone elasticity decreases, elucidating perimortem and postmortem events more reliably than macroscopic analyses. Thirty-seven unembalmed, defleshed human femoral shafts from males (n=18) and females (n=2) aged 33-81 years were fractured at experimentally simulated postmortem intervals (PMIs) ranging from 1 to 60 warm weather days (250-40,600 ADH).

Clinical characteristics and outcomes in middle-aged Fontan patients.

Background: Middle-aged Fontan patients are underrepresented in contemporary studies. The purpose of this study was to describe the clinical characteristics and outcomes in middle-aged patients with Fontan palliation.

Methods: All adults with Fontan palliation were divided into 'middle-aged' group (>40 years of age at baseline encounter), and 'young adult' group.

Promise and Peril of a Genotype-First Approach to Mendelian Cardiovascular Disease.

Precision medicine, which among other aspects includes an individual's genomic data in diagnosis and management, has become the standard-of-care for Mendelian cardiovascular disease (CVD). However, early identification and management of asymptomatic patients with potentially lethal and manageable Mendelian CVD through screening, which is the promise of precision health, remains an unsolved challenge. The reduced costs of genomic sequencing have enabled the creation of biobanks containing in-depth genetic and health information, which have facilitated the understanding of genetic variation, penetrance, and expressivity, moving us closer to the genotype-first screening of asymptomatic individuals for Mendelian CVD.

Transcranial doppler (TCD) in predicting outcomes following successful mechanical thrombectomy of large vessel occlusions in anterior circulation: a systematic review and meta-analysis.

Background: Transcranial Doppler (TCD) is a non-invasive, bedside tool that allows for real-time monitoring of the patient's hemodynamic status following mechanical thrombectomy (MT). This systematic review and meta-analysis aims to evaluate the predictive value of TCD parameters following successful MT (Thrombolysis in Cerebral Infarction 2b-3).

Methods: In July 2024, we searched PubMed, Embase, and Scopus, to identify observational studies in which TCD parameters were measured within 48 hours of MT.