Primary Versus Secondary Immune Thrombocytopenia (ITP): A Meeting Report from the 2023 McMaster ITP Summit.

The McMaster Immune Thrombocytopenia (ITP) Summit was an educational seminar from leading experts in immune thrombocytopenia and related disorders geared towards hematologists, internists, immunologists, and clinical and translational scientists. The focus of the Summit was to review the mechanisms, diagnosis and treatment of primary versus secondary ITP. Specific objectives were to describe the unique features of secondary ITP, and to review its mechanisms in the context of autoimmune disease and infection.

Heightened cholesterol 25-hydroxylase expression in aged lung during .

Introduction: Alveolar macrophages (AM) are critical effectors of the immune response and are essential for host responses to . Changes in lipid metabolism in AM can alter cellular function and biology. Impaired metabolism can contribute to excessive lipid accumulation and pro-inflammatory signaling.

Cervical spine considerations in Goldenhar syndrome: a clinical perspective.

Background: Goldenhar syndrome is a clinically heterogeneous disorder defined by a rare combination of congenital anomalies-an eye abnormality, in addition to two of the following three: ear anomalies, mandibular malformations, and vertebral defects. Notably, children with Goldenhar syndrome present with a high incidence of cervical spine malformations.

Clinical Case: In this report, we present an unusual case of a 15-year-old child with Goldenhar syndrome, who additionally presents with some clinical features of VACTERL syndrome.

Risk Stratification of Miscellaneous Uterine Mesenchymal Neoplasms: The Role of Morphology, Immunohistochemistry, and Molecular Testing.

Uterine mesenchymal tumors are a diverse group of tumors that can display a broad range of morphologic, immunohistochemical, and molecular profiles and are associated with varied clinical behaviors. In recent years, they have increasingly been classified by their underlying molecular alterations, leading to a more precise separation of diagnostic entities. As their diagnostic criteria have been refined, so too have the features that can be used to predict clinical outcomes.

Left Ventricular Dimensions and Clinical Outcomes With a Fully Magnetically Levitated Left Ventricular Assist Device.

Background: Prior analyses have suggested that a smaller left ventricular end-diastolic diameter (LVEDD) is associated with reduced survival following HeartMate 3 left ventricular assist device implantation.

Objectives: In this trial-based comprehensive analysis, the authors sought to examine clinical characteristics and association with the outcome of this specific relationship.

Methods: The authors analyzed the presence of LVEDD <55 mm among 1,921 analyzable HeartMate 3 patients within the MOMENTUM 3 (Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3) trial portfolio, on endpoints of overall survival and adverse events at 2 years.

Human AI collaboration for unsupervised categorization of live surgical feedback.

Formative verbal feedback during live surgery is essential for adjusting trainee behavior and accelerating skill acquisition. Despite its importance, understanding optimal feedback is challenging due to the difficulty of capturing and categorizing feedback at scale. We propose a Human-AI Collaborative Refinement Process that uses unsupervised machine learning (Topic Modeling) with human refinement to discover feedback categories from surgical transcripts.

Novel Cardiac CT Method for Identifying the Atrioventricular Conduction Axis via Anatomical Landmarks.

Background: Understanding the conduction axis location aids in avoiding iatrogenic damage and guiding targeted heart rhythm therapy.

Objective: Cardiac structures visible with clinical imaging have been demonstrated to correlate with variability in the conduction system course. We aimed to standardize and assess the reproducibility of predicting the location of the atrioventricular conduction axis by cardiac computed tomographic.

Safety of prolonged bilateral antegrade cerebral perfusion in aortic arch surgery with moderate hypothermia.

Objectives: This study investigates the impact of bilateral antegrade cerebral perfusion time on outcomes in aortic arch surgery.

Methods: In total, 961 patients underwent either hemi arch (n = 385) or total arch replacement (n = 576) with bilateral antegrade cerebral perfusion and moderate hypothermia management between 2006 and 2020 across 2 aortic centers. Antegrade cerebral perfusion time was categorized into 4 groups (≤30 min: n = 169, 30-60min: n = 298, 60-90min: n = 261, >90min: n = 233).

Cost and Inpatient Burden of Mandible Fracture Management: A 14-Year Analysis.

Objective: To evaluate characteristics associated with increased cost and length of hospitalization of mandible fracture management.

Study Design: Retrospective chart review.

Methods: Demographics, injury mechanism, associated injuries, treatment information, and associated costs were collected for all patients treated for mandible fracture treated at a single institution over a 14-year period.

Trends in Urology Residency Applications: Results from The Society of Academic Urologists Program Director Survey from 2022 to 2024.

Objectives: To provide a cross-sectional view of the current opinions surrounding the urology match by analyzing data from the annual Society of Academic Urologists Program Director Surveys conducted between 2022 and 2024.

Methods: Data collected through surveys distributed to all urology program directors consisting of questions covering program demographics, applicant selection criteria, preference signals, virtual interviews, and other relevant topics.

Results: 89, 90, and 89 program directors participated in the surveys for the years 2022, 2023, and 2024, respectively.

Five Year Outcomes in Low-Risk Patients Undergoing Surgery in the PARTNER 3 Trial.

Background: Surgery remains an important treatment for low-risk patients with severe symptomatic aortic stenosis (AS). We evaluated 5-year outcomes in low-risk patients undergoing isolated surgical aortic valve replacement (SAVR) or SAVR with concomitant procedures within the randomized PARTNER 3 trial.

Methods: In the PARTNER 3 trial, 454 patients underwent surgery for severe, symptomatic, tri-leaflet AS and were followed for 5 years.

A large-scale proteomics resource of circulating extracellular vesicles for biomarker discovery in pancreatic cancer.

Pancreatic cancer has the worst prognosis of all common tumors. Earlier cancer diagnosis could increase survival rates and better assessment of metastatic disease could improve patient care. As such, there is an urgent need to develop biomarkers to diagnose this deadly malignancy.

De novo variants disrupt an LDB1-regulated transcriptional network in congenital ventriculomegaly.

Congenital hydrocephalus (CH), characterized by cerebral ventriculomegaly (CV), is among the most common and least understood pediatric neurosurgical disorders. We have identified in the largest-assembled CV cohort (>2,697 parent-proband trios) an exome-wide significant enrichment of protein-altering de novo variants (DNVs) in LDB1 (p = 1.11 x 10-15).

Vitamin D in patients with low tumor-burden indolent non-Hodgkin lymphoma treated with rituximab therapy (ILyAD): a randomized, phase 3 clinical trial.

Background: There is a significant association between low vitamin D levels at diagnosis of indolent B-cell lymphomas and inferior overall survival (OS). To determine whether supplemental vitamin D improves event-free survival (EFS) in these patients, we conducted a comparative double-blind study of vitamin D vs. placebo.

Phase I study of intratumoral injection of talimogene laherparepvec for the treatment of advanced pancreatic cancer.

Background: Pancreatic ductal adenocarcinoma (PDAC) presents a redoubtable challenge due to late-stage diagnosis and limited treatment options, necessitating innovative therapeutic strategies.

Methods: Here, we report our results investigating the safety and efficacy of talimogene laherparepvec (T-VEC), an FDA-approved oncolytic herpes simplex virus type 1, in patients with advanced PDAC. Nine patients with treatment-refractory advanced PDAC received escalating doses of T-VEC via endoscopic injection.

Radiofrequency Ablation of Toxic Thyroid Nodules: An Early Experience of a Single Institution in the United States.

Objective: The field of endocrine surgery has been expanding its minimally invasive techniques to treat a wide range of thyroid pathologies. Radiofrequency ablation (RFA) is one targeted thermal therapy that has been identified as safe and effective for the treatment of benign pathologies as an alternative to surgery. We have employed RFA at our institution and are reporting our experience with this techniques safety, efficacy, and considerations in the treatment of toxic adenomas and multinodular goiters.

How cardiac computed tomography angiography and positron emission tomography play complementary roles in a Practice's business model.

Cardiovascular imaging is fundamental and crucial for providing accurate diagnosis and guiding treatment. There are unique clinical benefits and uses of Cardiac CT as well as cardiac PET. There have been advances in cardiac PET as well as Cardiac CT which have led to novel applications.

Transdifferentiation of Secretory Carcinoma to Metaplastic Carcinoma at Metastatic Site.

Secretory carcinoma is a rare breast tumor driven by fusion. It has characteristic morphologic features and identification of these tumors is critical as these patients may benefit from TRK inhibitors. Morphologic shift upon treatment has not been reported in secretory carcinoma or other -driven tumors.

Addressing pain in people living with cystic fibrosis: Cystic fibrosis foundation evidence-informed guidelines.

Even as many outcomes for people living with cystic fibrosis (PLwCF) improve, individuals still experience extensive symptom burdens. From birth, many PLwCF experience both pain as a symptom of their CF disease and procedural pain, posing detriments to health, functioning, and quality of life. Despite its prevalence and impact, there is no CF-specific guidance for the assessment and management of pain.