Timing of Aortic Valve Intervention in the Management of Aortic Stenosis.

Aortic stenosis (AS) affects about 12% of people aged ≥75 years. Accumulating evidence on the prognostic importance of cardiac damage in patients with asymptomatic and less than severe AS supports the proposition of advancing aortic valve replacement (AVR) to earlier disease stages. Potential benefits of earlier treatment, including prevention of cardiac damage progression and reduced cardiovascular hospitalizations, need to be balanced against the earlier procedural risk and subsequent lifetime management after AVR.

The Influence of Perspective on Perception: Assessing Residue Across Planes of Videofluoroscopy.

Objectives: (1) To determine whether perception of pharyngeal residue severity differs by view plane on videofluoroscopy. (2) To explore whether the Bolus Clearance Ratio (BCR) can be reliably applied in the anterior-posterior (AP) plane. (3) To investigate the relationship between perception of residue severity and BCR measures across view planes.

Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis.

Background: For patients with asymptomatic severe aortic stenosis and preserved left ventricular ejection fraction, current guidelines recommend routine clinical surveillance every 6 to 12 months. Data from randomized trials examining whether early intervention with transcatheter aortic-valve replacement (TAVR) will improve outcomes in these patients are lacking.

Methods: At 75 centers in the United States and Canada, we randomly assigned, in a 1:1 ratio, patients with asymptomatic severe aortic stenosis to undergo early TAVR with transfemoral placement of a balloon-expandable valve or clinical surveillance.

Primary Chemoablation of Recurrent Low-Grade Intermediate-Risk Nonmuscle-Invasive Bladder Cancer With UGN-102: A Single-Arm, Open-Label, Phase 3 Trial (ENVISION).

Purpose: We evaluate the efficacy and safety of UGN-102 chemoablation for the primary treatment of patients with recurrent low-grade intermediate-risk nonmuscle-invasive bladder cancer.

Materials And Methods: ENVISION is an ongoing, multinational, single-arm, phase 3 study in patients with a biopsy-proven recurrence of untreated low-grade intermediate-risk nonmuscle-invasive bladder cancer. Patients received 6 weekly intravesical instillations of UGN-102 (mitomycin; outpatient setting) and were evaluated at 3 months.

Impact of rapid blood culture identification PCR panel on optimal antibiotic use in methicillin-susceptible bacteremia.

Unlabelled: Rapid identification of methicillin-susceptible (MSSA) bacteremia may optimize antibiotic use and clinical outcomes. The study objective was to assess the impact of the BioFire® blood culture identification (BCID) polymerase chain reaction (PCR) panel on antibiotic use and clinical outcomes in patients with MSSA bacteremia. This was a retrospective chart review of adult inpatients with MSSA bacteremia during the pre-PCR (June 2018-December 2019) and post-PCR (June 2020-December 2021) implementation periods.

An Uncommon Occurrence of Rectal Leiomyoma: A Case Report and Literature Review.

Gastrointestinal (GI) leiomyomas, particularly those located in the rectum, are extremely rare, accounting for approximately 0.1% of rectal tumors. We report the case of a middle-aged female who presented with chronic diarrhea of unknown origin.

Metastatic Small Cell Carcinoma of the Stomach.

Primary gastric small cell carcinoma (GSCC) is an extremely rare type of small cell carcinoma. Its aggressive nature with early widespread metastasis and late detection gives it a poor prognosis with overall survival of <12 months. GSCC is a type of neuroendocrine tumor, and because of its histopathological similarity to small cell lung carcinoma (SCLC), treatment regimen of GSCC includes the same chemotherapy agents as SCLC.

Exploring Innovative U.S. School Health Delivery Models: A Narrative Review.

School health services have been described as the "hidden healthcare" system because of their isolation within schools and from other healthcare providers. This isolation may inhibit innovations in school healthcare delivery. Hence, there is a need to identify and characterize various delivery models.

Scoping Review: Is Push-Dose Norepinephrine a Better Choice?

Introduction: The use of push-dose vasopressors to treat anesthesia-induced hypotension is a common evidence-based practice among anesthesiologists. In more recent years, the use of push-dose vasopressors has transitioned to the emergency department (ED) and critical care setting. There is debate on the best choice of a push-dose vasopressor, with push-dose epinephrine or phenylephrine being more commonly used.

Initiating an Insulin Safety Campaign to reduce the incidence of glycemic harm events for hospitalized adults 65 and older.

Background: During calendar years 2021 through 2023, our health system admitted 200,837 persons 18 years and older with diabetes, of which 61% (n = 123,393) were 65 years and older with orders for insulin administration. The incidence of diabetes among hospitalized persons 65 and older continues to increase in the United States, with 24 million adults 65 and older with diabetes reported in 2020. Insulin, a high-risk medication, has the potential for adverse drug events, which can cause significant harm to patients, potentially resulting in death.