Amino Acid Supplementation May Help Prevent Muscle Wasting After Orthopedic Surgery, but Additional Studies Are Warranted: A Systematic Review of Randomized Clinical Trials.

Essential amino acid (EAA) supplementation, including conditionally essential amino acid (CEAA) and branched-chain amino acids (BCAA) supplementation, has been suggested as a mechanism to optimize patient outcomes by counteracting the atrophy associated with orthopedic procedures. We sought to investigate the effect of EAA supplementation in the perioperative period on patients undergoing orthopedic and spine surgery, specifically whether it is associated with (1) reductions in postoperative muscle atrophy and (2) improved postoperative function including range of motion, strength, and mobility. We conducted a systematic review of the literature.

Identifying biomarker-driven subphenotypes of cardiogenic shock: analysis of prospective cohorts and randomized controlled trials.

Background: Cardiogenic shock (CS) is a heterogeneous clinical syndrome, making it challenging to predict patient trajectory and response to treatment. This study aims to identify biological/molecular CS subphenotypes, evaluate their association with outcome, and explore their impact on heterogeneity of treatment effect (ShockCO-OP, NCT06376318).

Methods: We used unsupervised clustering to integrate plasma biomarker data from two prospective cohorts of CS patients: CardShock (N = 205 [2010-2012, NCT01374867]) and the French and European Outcome reGistry in Intensive Care Units (FROG-ICU) (N = 228 [2011-2013, NCT01367093]) to determine the optimal number of classes.

Penile Reconstruction in Aphallia: Modification of the De Castro Technique With Large Tissue Expander.

Aphallia is an exceedingly rare congenital malformation. The condition is the result of a sporadic anatomic anomaly during fetal development in a 46, XY male patient with otherwise normal functioning testes and male sexual hormone metabolism. Neophallus reconstruction using the De Castro phalloplasty technique is currently the most accepted treatment modality for this condition.

Reshaping Our Understanding of Sensation and Pain Following Breast Reduction Surgery.

Background: This study evaluated the sensory and breast pain outcomes in inferior versus superomedial pedicle breast reduction.

Methods: Twenty patients undergoing the inferior pedicle technique were matched to 20 patients undergoing the superomedial pedicle technique based on age, BMI, and resection weight. Patients were evaluated preoperatively and postoperatively at 1, 3, 6, and 12 months.

Instagram Versus Reality: Who Are Actually Plastic Surgeons?

Background: Instagram has become one of the most powerful marketing tools available to plastic surgeons because patients have increasingly turned to online resources to find physicians. Within, we review the online presence of self-ascribed plastic surgeons in the United States to identify potential misinformation and dishonest advertising.

Methods: The Inflact database was queried for the search terms: "plastic surgeon/surgery," "plastic and reconstructive surgeon/surgery," "aesthetic surgeon/surgery," and "cosmetic surgeon/surgery.

Children and providers' perspectives on once-weekly rifapentine and isoniazid TB preventive therapy.

Background: TB preventive treatment (TPT) prevents the development of TB disease in individuals at risk of progression from infection to disease. However, implementation of TPT for children is poor in most high-burden settings. The long duration and pill burden of the 6-month once-daily isoniazid regimen (6H) pose significant barriers to completion.

Informational rescaling of PCA maps with application to genetic distance.

Principal Component Analysis (PCA) is a powerful multivariate tool allowing the projection of data in low-dimensional representations. Nevertheless, datapoint distances on these low-dimensional projections are challenging to interpret. Here, we propose a computationally simple heuristic to transform a map based on standard PCA (when the variables are asymptotically Gaussian) into an entropy-based map where distances are based on mutual information (MI).

Clinical Outcomes and Donor-specific Antibody Rebound 5 y After Kidney Transplant Enabled by Imlifidase Desensitization.

Background: Imlifidase is an IgG-cleaving endopeptidase conditionally approved in Europe for desensitization of highly sensitized patients before kidney transplantation. We present 5-y outcomes and donor-specific antibody (DSA) levels for clinical trial participants from a single site who received imlifidase for desensitization before incompatible transplantation (NCT02790437).

Methods: Imlifidase was administered up to 24 h before living or deceased donor kidney transplantation.

Visually significant ocular decompression retinopathy following laser peripheral iridotomy in a patient with primary acute angle-closure glaucoma.

Purpose: We report a single case of ocular decompression retinopathy (ODR) following neodymium-doped yttrium aluminum garnet laser peripheral iridotomy (Nd:YAG LPI) for primary acute angle-closure glaucoma associated with delayed visual recovery secondary to optic nerve head edema and macular thickening.

Observations: A 56-year-old female patient presented to the emergency department with primary acute angle-closure glaucoma. After topical and IV therapy did not improve intraocular pressure (IOP), an Nd:YAG LPI was performed.

Implications of Charge and Heteroatom Dopants on the Thermodynamics and Kinetics of Redox Reactions in Keggin-Type Polyoxometalates.

The utilization of polyoxometalate-based materials is largely dictated by their redox properties. Detailed understanding of the thermodynamic and kinetic efficiency of charge transfer is therefore essential to the development of polyoxometalate-based systems for target applications. Toward this end, we report electrochemical studies of a series of heteroatom-doped Keggin-type polyoxotungstate clusters [PWO] ( ), [VWO] ( ), [P(VW)O] ( ), and [V(VW)O] ( ) to elucidate the role of the identity and spatial location of heteroatoms and overall cluster charge on the rate constants of electron transfer and redox reaction entropies.

Cost-Effectiveness of the Self-Care Management System for Heart Failure.

Background: We recently reported that the self-care management system for heart failure (HF) decreased re-hospitalization for HF. In the present study we estimate the cost-effectiveness of this system.

Methods And Results: We retrospectively enrolled 569 consecutive patients who were admitted for HF treatment at Kitano Hospital.

The Effects of Osteopathic Manipulative Treatment on Arrhythmias: A Double-blind Randomized Controlled Trial in Patients with Cardiac Implantable Electronic Devices.

This double-blind randomized controlled trial investigated the effects of osteopathic manipulative treatment (OMT) on cardiac arrhythmias in patients with cardiac implantable electronic devices (CIEDs). Participants (n = 41) with CIEDs were randomly assigned to either the OMT group or the control group (light touch/sham) and received a one-time intervention. No significant change in arrhythmia burden was found in the 1 month following intervention ( = .

Case report of entrectinib associated fulminant myocarditis.

Background: ROS1 tyrosine kinase inhibitors are one of the primary immunotherapies for fusion-positive cancers. Tyrosine kinase inhibitors have markedly improved outcomes for advanced cancers previously with poor prognosis. Entrectinib is an example of an ROS1 inhibitor that can be used for lung adenocarcinoma.

The effect of replacing prolonged sitting with intermittent standing during a simulated workday on the subsequent night's sleep.

A bout of leisure-time physical activity improves sleep on the subsequent night. However, whether breaking up sedentary time during the workday improves sleep is unknown. The purpose of this study was to examine whether breaking up prolonged sitting by standing during the workday leads to better sleep the following night.

Anatomic total shoulder arthroplasty in the 7th decade of life demonstrates superior long-term maintenance than in older patients.

Background: Anatomic total shoulder arthroplasty (aTSA) is often delayed due to concerns about a more rapid loss of postoperative improvements in younger, more active patients. This retrospective study investigated the effects of patient age on activity-specific functional outcomes at a minimum of 10 years following aTSA.

Methods: A retrospective review of a shoulder arthroplasty database was performed.

Outcome of a Nail-plate Fixation Combination for a Distal Femur Fracture in a 99-year-old Patient.

Introduction: This report describes the use of a combination of a retrograde femoral nail and distal femur locking plate for the treatment of an open intra-articular distal femur fracture in a 99-year-old female. The purpose of this report is to highlight that nail-plate fixation constructs can be performed percutaneously and expeditiously even in extremely old patients; therefore, patient age should not be a limiting factor in choosing this construct to allow for immediate weight-bearing.

Case Report: The patient was a 99-year-old female who presented to the emergency room after a fall.

Dietary Interventions in Heart Failure With Preserved Ejection Fraction: A Scoping Review.

Patients with heart failure with preserved ejection fraction (HFpEF) are burdened by multiple diet-sensitive comorbidities, including obesity and malnutrition. Despite this, a low percentage of patients with HFpEF have been enrolled in dietary intervention trials in heart failure and few dietary interventions have been conducted in HFpEF exclusively. This scoping review will examine available evidence regarding dietary interventions in patients with HFpEF, highlight existing gaps in knowledge, and discuss emerging dietary therapies in this population.

Adult-Onset Myoclonus in a Large Urban Inpatient Setting: A Retrospective Cohort Study.

Background: Myoclonus is a hyperkinetic movement with various attributable etiologies, semiologies, and treatment outcomes. To our knowledge, few studies investigated adult-onset myoclonus in an inpatient setting.

Methods: We retrospectively reviewed charts of adult inpatients with myoclonus at New York Presbyterian Brooklyn Methodist Hospital between 2011 and 2021.

Effects of an intervention combining physical activity and components of Amygdala and Insula Retraining (AIR) on sleep and working memory among older male adults.

Background: Older individuals are at a particular risk of sleep disorders, a loss of cognitive and emotional control, and a poor quality of life. Pharmaceutical therapy for these conditions is commonplace but has not been particularly effective, and relatively little research exists for their treatment using non-pharmacological approaches. The effectiveness of Physical Activity plus selected components of Amygdala and Insula Retraining (PAAIR) was tested to improve sleep quality, depression, working memory, and emotion regulation among older males.

Cardiovascular patches applied in congenital cardiac surgery: Current materials and prospects.

Congenital Heart Defects (CHDs) are the most common congenital anomalies, affecting between 4 and 75 per 1000 live births. Cardiovascular patches (CVPs) are frequently used as part of the surgical armamentarium to reconstruct cardiovascular structures to correct CHDs in pediatric patients. This review aims to evaluate the history of cardiovascular patches, currently available options, clinical applications, and important features of these patches.

Solar elastosis correlates with high tumor mutation burden and better 5-year disease-specific survival in patients with stage II/III melanoma.

Objective: To evaluate the relation between solar elastosis and tumor mutation burden (TMB) in a large clinically annotated cohort of stage II and III melanoma patients.

Methods: Primary cutaneous melanomas from 469 AJCC (8 edition) stage II and III patients with clinical annotation including outcome at 5 years of diagnosis were histopathologically evaluated for solar elastosis. Next-generation sequencing assay MSK-IMPACT was employed to determine TMB.