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Respiratory Syncytial Virus Disease Burden and Nirsevimab Effectiveness in Young Children From 2023-2024.

JAMA Pediatr

December 2024

Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.

Importance: During the 2023-2024 respiratory syncytial virus (RSV) season in the United States, 2 new RSV prevention products were recommended to protect infants in their first RSV season: nirsevimab and Pfizer's maternal RSV vaccine. Postlicensure studies are needed to assess prevention product impact and effectiveness.

Objective: To compare the epidemiology and disease burden of medically attended RSV-associated acute respiratory illness (ARI) among children younger than 5 years during the 2023-2024 RSV season with 3 prepandemic RSV seasons (2017-2020), estimate nirsevimab effectiveness against medically attended RSV-associated ARI, and compare nirsevimab binding site mutations among circulating RSV in infants with and without nirsevimab receipt.

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Beyond pathology: Patient experiences of laparoscopy for persistent pelvic pain with no identifiable cause found.

Aust N Z J Obstet Gynaecol

December 2024

Department of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia.

Article Synopsis
  • Laparoscopy is commonly used to investigate pelvic pain, but many patients end up with no clear diagnosis, leading to unmet expectations and emotional distress.
  • A study involving interviews with 15 patients revealed themes such as the desire for diagnosis, hope as a coping mechanism, and challenges with communication and mental health post-procedure.
  • The findings stress the need for effective pre- and postoperative counseling from clinicians to better prepare patients for the possibility of inconclusive results and to address their mental health concerns.
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Objective: To provide an overview of the literature on the impact of the coronavirus disease 2019 (COVID-19) pandemic on healthcare disparities in various groups, in relation to social determinants of health (SDOH) and longstanding social disparities.

Design: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians (ACEP) addressed the impact of health disparities in disaster planning and response. A workgroup composed of seven physicians with academic and deployment disaster medicine experience was formed.

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Background: We explore the association between hypoglycaemia fear (FH) and glycaemia during and after exercise sessions in a large sample of physically active youth with type 1 diabetes (T1D).

Methods: We used data from the Type 1 Diabetes Exercise Initiative Paediatric (T1DEXIP) Study. Youth self-reported on FH using the Hypoglycaemia Fear Survey-Child (HFS-C).

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Psychosocial well-being and diabetes distress in the transition to motherhood among women with type 1 or type 2 diabetes.

Sex Reprod Healthc

December 2024

School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Australia; Department of Psychiatry, School of Clinical Sciences, Monash University, Australia.

Objective: To investigate the associations between psychological well-being, measured with the Postnatal Well-being in Transition (PostTrans) Questionnaire, and diabetes distress among mothers with type 1 or type 2 diabetes.

Method: Eighty-two postnatal women completed a cross-sectional survey. The survey included the Diabetes Distress Scale, and the PostTrans Questionnaire to assess the psychosocial well-being of women transitioning to motherhood.

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This article reviews the psychological distress experienced by NICU families, including anxiety, postpartum depression (PPD), and post-traumatic stress disorder (PTSD), in addition to providing recommendations for clinicians at the individual, institutional, and national level. Currently, mental health screenings, specialized evaluations, and treatment options are not routinely offered to NICU families and are frequently under-utilized when offered. Here we provide expert opinion recommendations to address challenges in supporting universal screening, offering bedside interventions, including trained mental health professionals in care plans, updating neonatology training competencies, and advocating for policies that support the mental health of NICU families.

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Article Synopsis
  • Immunotherapy has enhanced survival rates for patients with advanced clear cell renal cell carcinoma (ccRCC), but many patients still develop resistance to treatment.
  • A study examined tumor samples from patients with both treatment-naïve and treatment-exposed ccRCC, revealing that tumors exposed to immunotherapy contained more immune cells (like CD8+ T cells and neutrophils) and showed significant changes in cellular markers.
  • Key findings included increased expression of COL4A1 and ITGAV in the stroma of treated tumors, suggesting a need for further investigation into how these changes impact the tumor immune environment and potential new therapies.
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Spatial transcriptomics (ST) is a powerful tool for understanding tissue biology and disease mechanisms. However, the advanced data analysis and programming skills required can hinder researchers from realizing of the full potential of ST. To address this, we developed spatialGE, a web application that simplifies the analysis of ST data.

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Seasons of Kawasaki Disease during the COVID-19 pandemic.

Cardiol Young

December 2024

Labatt Family Heart Centre, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, ON, Canada.

The incidence of Kawasaki Disease has a peak in the winter months with a trough in late summer/early fall. Environmental/exposure factors have been associated with a time-varying incidence. These factors were altered during the COVID-19 pandemic.

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Background: Although clinical overlap between Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) has been evident, information regarding those presenting with shock has been limited. We sought to determine associations with shock within and between diagnosis groups.

Methods: The International KD Registry enrolled contemporaneous patients with either KD or MIS-C from 39 sites in 7 countries from January 1, 2020, to January 1, 2023.

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Article Synopsis
  • Patients with decompensated cirrhosis face higher COVID-19 risks, and the study analyzed outcomes based on demographics using SECURE-Liver and COVID-Hep databases.
  • In North America, Black patients showed higher rates of hospitalization, ICU admission, and death compared to White patients, while Hispanic patients fared better. In Europe, White patients had more comorbidities but lower hospitalization rates than non-White patients.
  • After adjusting for confounders, many disparities in COVID-19 outcomes became statistically insignificant, indicating that other health conditions might contribute to the increased risks rather than demographics alone.
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Introduction: Rheumatic heart disease (RHD) results from chronic inflammation and fibrosis of heart valves following untreated rheumatic fever, yet its immunopathology, particularly involving T helper 17 (Th17) cells and their cytokines, is not fully understood. Th17 cells are prominent drivers of inflammation and have been linked to various autoimmune diseases, suggesting their potential role in RHD-related valve damage. This study examines Th17-associated cytokines-interleukin (IL)-17, IL-6, IL-23, and IL-21-in RHD.

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Midterm survival, clinical, and hemodynamic outcomes of a novel mechanical mitral valve prosthesis.

J Thorac Cardiovasc Surg

November 2024

Division of Cardiothoracic Surgery, Mount Sinai Saint Luke's, New York, NY.

Objective: To evaluate the midterm survival, clinical, and hemodynamic outcomes of the On-X mechanical mitral valve, based on the 5-year results of the Prospective Randomized On-X Anticoagulation Clinical Trial (PROACT).

Method: PROACT Mitral was a multicenter study evaluating 401 patients who underwent mitral valve replacement (MVR) with either Standard or Conform-X On-X mitral valves, comparing low-dose and standard-dose warfarin. Here we report prespecified secondary outcomes of survival, New York Heart Association (NYHA) functional classification, and valve hemodynamics as assessed by core lab-adjudicated echocardiography at 1, 3, and 5 years in the pooled population.

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Purpose: We sent surveys to a large number of radiation oncologists with active thoracic cancer practices and applied the Delphi method over 3 rounds to generate consensus dose-volume histogram metrics. We used these results to create consensus-based organs-at-risk dose constraints and target goal templates for practical implementation.

Methods And Materials: In this institutional review board-approved study, data were collected using REDCap electronic data capture on a secure server.

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Longitudinal biomonitoring of mycotoxin exposure during pregnancy in the Yale Pregnancy Outcome Prediction Study.

Environ Int

December 2024

Department of Food Chemistry and Toxicology, Faculty of Chemistry, University of Vienna, Währinger Straße 38, 1090 Vienna, Austria; Exposome Austria, Research Infrastructure and National EIRENE Node, Austria. Electronic address:

Article Synopsis
  • Mycotoxins, which are harmful fungal toxins, can negatively affect pregnant women and their babies, but there's limited information about their exposure in the US, particularly among pregnant women.
  • This study analyzed mycotoxin exposure in a group of 50 women during pregnancy by testing samples of their serum and urine at various stages using advanced liquid chromatography techniques.
  • Results indicated the presence of several mycotoxins, with notable detection rates for ochratoxin A and deoxynivalenol, showing some women exceeded recommended daily intake levels for these toxins.
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Background: Atriofascicular fibers (AFFs) are rare accessory pathways that have higher rates of recurrence after ablation because of either failure to identify AFF (M) potentials or mechanical termination with contact.

Objective: We aimed to evaluate whether electroanatomic mapping (EAM) using multielectrode, high-density nonlinear catheters can reliably localize AFF potentials and determine a site for ablation without causing mechanical termination.

Methods: Seven patients underwent electrophysiology studies (EPS) and EAM using high-density, multielectrode catheters for antidromic tachycardia using AFFs.

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Autoimmune neutropenia (AIN) refers to the immune-mediated destruction of neutrophils. It is a rare condition with an estimated prevalence of less than 1 case per 100,000 per year. Typical treatment involves supportive care with granulocyte colony-stimulating factor (G-CSF) and management of secondary infections with antibiotics.

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Immunotherapy has changed the treatment landscape of cancer in the past decade. Amongst various forms of immunotherapy, manipulating the T cell has shown promise in past few years. T cell manipulation can be done by CAR-T cell therapy or bispecific antibodies.

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Article Synopsis
  • Sleep plays a vital role in health and well-being, with many people experiencing sleep deprivation and chronic insomnia, leading to serious health issues.
  • Understanding sleep architecture and hygiene is essential for maintaining physiological functions and overall homeostasis.
  • The course targets certified registered nurse anesthetists, providing insights into the relationship between sleep and health, risk factors for chronic sleep deprivation, and treatment options like propofol-induced sleep.
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A Simple Clinical Predictive Model for Arthroscopic Mobility of Osteochondritis Dissecans Lesions of the Knee.

Am J Sports Med

December 2024

Emory Sports Performance and Research Center(SPARC), Flowery Branch, Georgia; Emory Sports Medicine Center, Atlanta, Georgia; Emory Sports Medicine Center, Atlanta, Georgia, USA; Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia.

Background: Osteochondritis dissecans (OCD) of the knee is a focal idiopathic alteration of subchondral bone and/or its precursor with risk for instability and disruption of adjacent cartilage. Treatment options focused on preventing premature osteoarthritis vary depending on multiple patient and lesion characteristics, including lesion mobility.

Purpose: To differentiate lesion mobility before arthroscopy using a multivariable model that includes patient demographic characteristics and physical examination findings.

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Background: Cardiac papillary fibroelastomas (CPFs) are benign endocardial tumours with embolic potential. This article is a systematic review to identify the clinical profile, diagnosis, tumour characteristics, and treatment modalities in patients with CPF presenting with stroke or transient ischemic attack (TIA).

Methods: This systematic review was conducted using the PubMed and Embase databases, including case reports and/or series and observational studies (for a search period of up until April 2022).

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