Percutaneous Lapidus Bunionectomy: A New, Less Invasive Method for a 100 Year Old Surgery.

Lapidus is a common procedure in our armamentarium for the treatment of hallux valgus deformity. This study presents to the reader that it can be performed percutaneously. It is a technically difficult procedure to perform that requires didactic and cadaveric percutaneous training.

How to Start an Invasive Cardiopulmonary Exercise Testing Program: A Comprehensive and Practical Guide.

Invasive cardiopulmonary exercise testing (iCPET) is increasingly recognized as a critical diagnostic tool for assessing exercise intolerance and dyspnea. The manuscript highlights the iCPET program's diagnostic precision in identifying various cardiopulmonary disorders, offering insights into tailored treatment strategies. This guide aims to assist institutions in establishing their iCPET programs, addressing both the technical and administrative facets essential for success.

Association Between Race and Comorbid Conditions Among Older Adults with Dementia.

Dementia is estimated to affect over 150 million individuals by 2050. Individuals with dementia commonly suffer from other comorbid conditions which can affect quality of life and result in increased health care expenditures. We conducted this study to determine the frequency of comorbid conditions between representative samples of non-Hispanic Black and White US adults aged ≥65 with dementia.

Minimally Invasive Alternatives for the Treatment of Lesser Toe Deformities.

Toe deformities are often correct with a simple proximal interphalangeal joint fusion whatever if the joint is mobile or rigid. Percutaneous technique allows a different approach of the deformity. Fusion is no more the only solution.

Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD): Update on Prevalence, Risk Factors, Pathogenesis, and Therapy.

Purpose Of Review: Rheumatoid arthritis is frequently complicated by interstitial lung disease (RA-ILD), an underappreciated contributor to excess morbidity and mortality. The true prevalence of RA-ILD is difficult to define given the variability in diagnostic criteria used. The lack of standardized screening methods, an incomplete understanding of disease pathogenesis, and dearth of validated biomarkers have limited the development of controlled clinical trials for this disease.

Alternative techniques for cardiopulmonary resuscitation in extreme environments - A scoping review.

Background: Cardiopulmonary resuscitation (CPR) is essential for saving lives during cardiac arrest, but performing CPR in extreme environments poses unique challenges. In scenarios ranging from hypogravity or microgravity to confined spaces like aeroplanes and underwater scenarios, traditional CPR techniques may be inadequate. This scoping review aims to identify alternative chest compression techniques, synthesise current knowledge, and pinpoint research gaps in resuscitation for cardiac arrest in extreme conditions.

Better Care, Same Cost - Reducing Unplanned Care for Multi-visit Patients: A Payer-Provider Model.

Importance: Many interventions implemented for multi-visit patients (MVP) have been developed to address patient-centric needs of these individuals and reduce unplanned care for ambulatory-sensitive conditions. More rigorous research is needed to better understand the impact of these interventions on changes in care utilization including unplanned care.

Objective: To evaluate the impact of the Enhanced Care Program (ECP), a payer-provider collaborative model, on unplanned care use and cost of care.

Long-Term Safety of Facilitated Subcutaneous Immunoglobulin 10% Treatment in US Clinical Practice in Patients with Primary Immunodeficiency Diseases: Results from a Post-Authorization Safety Study.

Facilitated subcutaneous immunoglobulin (fSCIG) 10% is an immunoglobulin replacement therapy that utilizes recombinant human hyaluronidase (rHuPH20) to enhance immunoglobulin dispersion and absorption, allowing for longer treatment intervals similar to intravenous immunoglobulin (up to once monthly). fSCIG 10% is indicated in the USA for treating adults and children aged ≥ 2 years with primary immunodeficiency diseases (PIDs). This prospective, non-interventional, open-label, multicenter, post-authorization safety study (NCT02593188) was conducted in the USA from November 2015 to October 2021 to assess the long-term safety of fSCIG 10% in routine clinical practice.

Cardioneuroablation for the treatment of reflex syncope and functional bradyarrhythmias: A Scientific Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS) and the Latin American Heart Rhythm Society (LAHRS).

Cardioneuroablation has emerged as a potential alternative to cardiac pacing in selected cases with vasovagal reflex syncope, extrinsic vagally induced sinus bradycardia-arrest or atrioventricular block. The technique was first introduced decades ago, and its use has risen over the past decade. However, as with any intervention, proper patient selection and technique are a prerequisite for a safe and effective use of cardioneuroablation therapy.

Best anticoagulation strategy with and without appendage occlusion for stroke-prophylaxis in postablation atrial fibrillation patients with cardiac amyloidosis.

Introduction: Both atrial fibrillation (AF) and amyloidosis increase stroke risk. We evaluated the best anticoagulation strategy in AF patients with coexistent amyloidosis.

Methods: Consecutive AF patients with concomitant amyloidosis were divided into two groups based on the postablation stroke-prophylaxis approach; group 1: left atrial appendage occlusion (LAAO) in eligible patients and group 2: oral anticoagulation (OAC).

A clinical antiracism curriculum for third-year medical students to bring antiracist principles to the bedside.

As medical educators, we have a responsibility to ensure our trainees are exposed to curricula dedicated to Diversity, Equity, and Inclusion (DEI), as illustrated by the Association of American Medical Colleges' recently released DEI Competencies Across the Curriculum. We designed and implemented a curriculum, Social Justice Rounds (SJR), that incorporates teaching on these topics directly into inpatient clinical work. SJR are brief team-based discussions facilitated by Pediatric Hospital Medicine faculty that focus on racism in medicine and other forms of discrimination experienced by patients and the effect it has on their interaction with the healthcare system.

Reconstruction of Urethral Sphincter With Polyacrylamide Hydrogel.

Importance: Urethral bulking is an alternative to synthetic midurethral sling for the treatment of stress urinary incontinence (SUI) in women. Urethral bulking agents, which are injected in the submucosal tissues of the proximal urethra/bladder neck, have demonstrated less adverse effects with similar satisfaction rates but lower subjective and objective cure rates when compared with midurethral sling. Cystoscopic Reconstruction of External Sphincter Technique (CREST) is a novel technique, which reinforces the natural closure mechanism of the external urinary sphincter (EUS).

Acute Kidney Injury Resulting From Hemoglobinuria After Pulsed-Field Ablation in Atrial Fibrillation: Is it Preventable?

Background: High-voltage pulses can cause hemolysis.

Objectives: The authors evaluated the occurrence of hemoglobinuria after pulsed-field ablation (PFA) and its impact on renal function in patients with atrial fibrillation (AF).

Methods: A consecutive series of patients with AF undergoing PFA were included in this analysis.

Disturbed atrial metabolism, shear stress, and cardiac load contribute to atrial fibrillation after ablation: AXAFA biomolecule study.

Aims: Different disease processes can combine to cause atrial fibrillation (AF). Their contribution to recurrent AF after ablation in patients is not known. Cardiovascular processes associated with recurrent AF after AF ablation were determined by quantifying biomolecules related to inflammation, metabolism, proliferation, fibrosis, shear stress, atrial pressure, and others in the AXAFA biomolecule study.

Defining Minimum Treatment Parameters of Ablative Radiation Therapy in Patients With Hepatocellular Carcinoma: An Expert Consensus.

Purpose: External beam radiation therapy (EBRT) is a highly effective treatment in select patients with hepatocellular carcinoma (HCC). However, the Barcelona Clinic Liver Cancer system does not recommend the use of EBRT in HCC due to a lack of sufficient evidence and intends to perform an individual patient level meta-analysis of ablative EBRT in this population. However, there are many types of EBRT described in the literature with no formal definition of what constitutes "ablative.

Cell-free DNA levels associate with COPD exacerbations and mortality.

The Question Addressed By The Study: Good biological indicators capable of predicting chronic obstructive pulmonary disease (COPD) phenotypes and clinical trajectories are lacking. Because nuclear and mitochondrial genomes are damaged and released by cigarette smoke exposure, plasma cell-free mitochondrial and nuclear DNA (cf-mtDNA and cf-nDNA) levels could potentially integrate disease physiology and clinical phenotypes in COPD. This study aimed to determine whether plasma cf-mtDNA and cf-nDNA levels are associated with COPD disease severity, exacerbations, and mortality risk.