Utility of Guideline-Directed Therapy on Mortality and Readmissions in Socioeconomically Disadvantaged Heart Failure Patients.

Heart failure with reduced ejection fraction (HFrEF) represents a significant public health challenge, affecting millions worldwide with high morbidity and mortality rates. Admissions due to HFrEF impose a considerable financial burden on patients and healthcare systems. Guideline-directed medical therapy (GDMT) has emerged as a proven strategy to reduce morbidity and mortality in heart failure (HF) patients.

Impact of the COVID-19 pandemic on the experiences of underrepresented-in-medicine women applicants to surgical residency.

Background: The COVID-19 pandemic brought additional challenges to the 2020-2021 application cycle. The objective of this study was to explore how such challenges altered the perceptions/motivations/concerns of applicants to surgical fields, particularly those self-identifying as women underrepresented-in-medicine (UiM).

Methods: An anonymous mixed-methods survey was electronically distributed to all medical student members of the Association of Women Surgeons between 10/1/2020-12/31/2020.

Identifying Predictors of Extended Intensive Care Unit Stay Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: An Analysis of 101 ACS NSQIP Pediatric Participating Centers.

Background: While prolonged operative time and increased levels fused have been shown to increase the risk of prolonged intensive care unit (ICU) length-of-stay (LOS), studies are limited in guiding decision-making regarding the need for intensive care postoperatively. This is especially the case among the cohort of adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF); associations between comorbidities and ICU LOS are not well-delineated.

Methods: AIS patients who underwent PSF from January 1st, 2016 to December 1st, 2016 at 101 participating centers were identified using the American College of Surgeons (ACS) National Surgical Quality Im-provement Project (NSQIP) Pediatric database.

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.

Current Treatment Paradigm and Approach to Advanced Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is one of the most common forms of primary liver cancer worldwide. Herein, we present a review article that provides a broad overview of the current landscape of HCC, including the etiology, potential risk factors, and molecular pathways that can serve as potential therapeutic targets. The risk factors tend to vary depending on the geographic distribution; hepatitis B-induced cirrhosis and HCC occur more frequently in Asia and Sub-Saharan Africa, whereas metabolic disorders are the culprits in Western Europe and the Americas.

Iloprost: Old and New Indications.

Iloprost is a synthetic long-acting prostacyclin-analog drug used to treat various vascular diseases. The Federal Drug Administration approved the drug in 2004 for pulmonary arterial hypertension, and it has since been shown to be helpful in other vascular conditions such as scleroderma and Raynaud phenomenon. The Federal Drug Administration has now approved the use of iloprost for severe frostbite.

Prenatal exposure to phthalates and phthalate replacements in relation to chorionic plate surface vasculature at delivery.

Pregnant people are ubiquitously exposed to endocrine-disrupting phthalates through consumer products and food. The placenta may be particularly vulnerable to the adverse effects of phthalates, with evidence from animal models suggesting impacts on placental development and vascularization. We translate this research to humans, examining gestational exposure to phthalates and phthalate replacements in relation to novel markers of chorionic plate surface vascularization.

Effectiveness and Safety of Pharmacologic Therapies for Migraine in the Emergency Department: A Systematic Review and Bayesian Network Meta-analysis.

Study Objective: We performed a systematic review and Bayesian network meta-analysis to determine which pharmacologic therapies are relatively more effective and safer for migraine in adult patients who present to the emergency department (ED).

Methods: We searched MEDLINE, Embase, and Web of Science from inception to February 9, 2024. Eligible studies were randomized controlled trials that enrolled adult participants presenting to ED with migraine and compared one pharmacologic therapy to another or placebo.

Moderate Aortic Stenosis With Cardiac Damage: A New Type of Severe Aortic Stenosis.

The clinical implications of severe aortic stenosis have been well established. Understanding of moderate aortic stenosis, however, continues to evolve. Athough moderate aortic stenosis may be less clinically impactful in patients with normal ventricular function, it may carry prognostic significance in those patients with a ventricle exhibiting signs of cardiac damage.

Inflammatory Breast Cancer and Transient Complete Radiographic Response to Chemoimmunotherapy: A Case Report.

Introduction: Inflammatory breast cancer is a rare and aggressive subtype, with high breast cancer mortality. Compared to noninflammatory breast cancer, even after treatment and response to standard-of-care breast cancer chemotherapy, it has a high propensity for lymph node involvement, high rates of distant metastasis, and shorter survival. The immune checkpoint inhibitor, pembrolizumab, in combination with chemotherapy is now approved for early triple negative breast cancer (TNBC) and for advanced disease if positive for the programmed cell death ligand 1 protein (PD-L1).

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.

Gastrointestinal Sequelae of COVID-19: Investigating Post-Infection Complications-A Systematic Review.

Gastrointestinal (GI) complications are significant manifestations of COVID-19 and are increasingly being recognized. These complications range from severe acute pancreatitis to colitis, adding complexity to diagnosis and management. A comprehensive database search was conducted using several databases.

New Onset of Acute and Chronic Hepatic Diseases Post-COVID-19 Infection: A Systematic Review.

The SARS-CoV-2 virus caused a pandemic in the 2020s, which affected almost every aspect of life. As the world is recovering from the effect of the coronavirus, the concept of post-COVID-19 syndrome has emerged. Multiple organ systems have been implicated, including the liver.

Evaluating the impact of multiple sclerosis on 2 year postoperative outcomes following long fusion for adult spinal deformity: a propensity score-matched analysis.

Study Design: Retrospective cohort study.

Purpose: The impact of neuromuscular disorders such as multiple sclerosis (MS) on outcomes following long segment fusion is underreported. This study evaluates the impact of MS on two-year (2Y) postoperative complications and revisions following ≥ 4-level fusion for adult spinal deformity (ASD).

Pain management in acute musculoskeletal injury: Effect of opioid nonopioid medications.

Background: The use of opioids for pain is linked to an increased risk of developing opioid use disorder, and has resulted in the emergence of the opioid crisis over the last few years.

Aim: The systematic review question is "How does the use of opioid medications in pain management, compared with non-opioid medications, affect pain intensity over the short, intermediate, and long-term in adults with acute traumatic pain?".

Methods: The protocol was prospectively registered on the International Prospective Register of Systematic Reviews: CRD42021279639.

Cross Sectional Survey of Ob/Gyn Residents' Graduated Experience With Robotic Surgery.

Study Objective: Obstetrics and gynecology (Ob/Gyn) resident experience with robotic gynecologic surgery has been evaluated at time of graduation, but no specific surgical procedures were identified to differentiate the experiences of residents at each level. This study proposes to determine which factors are correlated with more hands-on robotic surgery experience and resident satisfaction.

Design: An Investigational Review Board-approved, 15-question survey was distributed electronically.

HPV-YAP1 oncogenic alliance drives malignant transformation of fallopian tube epithelial cells.

High grade serous ovarian carcinoma (HGSOC) is the most common and aggressive ovarian malignancy. Accumulating evidence indicates that HGSOC may originate from human fallopian tube epithelial cells (FTECs), although the exact pathogen(s) and/or molecular mechanism underlying the malignant transformation of FTECs is unclear. Here we show that human papillomavirus (HPV), which could reach FTECs via retrograde menstruation or sperm-carrying, interacts with the yes-associated protein 1 (YAP1) to drive the malignant transformation of FTECs.

Mechanical thrombectomy with the InThrill device for thrombosed hemodialysis access: A single center experience.

Objective: To assess the effectiveness and safety of the InThrill Thrombectomy System in treating thrombosed arteriovenous fistulas (AVFs) and grafts (AVGs) via mechanical thrombectomy.

Methods: Institutional database was retrospectively searched to identify all thrombectomy procedures performed using the study device at our hospital for thrombosis of AVFs or AVGs. Inclusion criteria encompassed patients aged 18 and above who underwent AV access thrombectomy using the study device.

A Neuroendocrine Tumor of Unknown Primary Origin: A Case Report and Review of the Literature.

Neuroendocrine tumors (NETs) are uncommon malignancies that develop from neuroendocrine cells which most commonly occur in the GI tract, lung, and pancreas. Treatment courses for these tumors are largely dictated by the primary origin site, which can present diagnostic and therapeutic challenges in NETs of unknown primary origin. Herein, we present a case of an NET of unknown primary origin with significant liver metastases.

Trends in Active Surveillance for Men With Intermediate-Risk Prostate Cancer.

Importance: Initial management of intermediate-risk prostate cancer is evolving, with no clear recommendation for treatment. Data on utilization of active surveillance for patients with newly diagnosed intermediate-risk prostate cancer may help clarify emerging trends.

Objective: To further characterize US national trends of initial management of intermediate-risk prostate cancer.

Sleep misperception in women with myofascial temporomandibular disorder.

Study Objectives: Temporomandibular disorders (TMDs) were linked to poor sleep on the Pittsburgh Sleep Quality Index (PSQI), whereas polysomnography revealed no major sleep disturbances, implying sleep state misperception. This study investigates sleep state misperception in TMD and control participants; correlates sleep state misperception with objective short sleep duration (SSD), depression symptoms, daytime sleepiness, and orofacial pain; and compares objective SSD between the groups.

Methods: General linear models were used to compare second-night polysomnography total sleep time, sleep latency, sleep efficiency (SE), and wake after sleep onset with homologous PSQI-derived variables in 124 women with myofascial TMD and 46 age and body mass index matched controls.