Antiviral Stewardship in Transplantation.

Though antimicrobial stewardship programs (ASPs) are required for hospitals, the involvement of transplant recipients in programmatic interventions, protocols, and metrics has historically been limited. Though there is a growing interest in studying stewardship practices in transplant patients, optimal practices have not been clearly established. A component of ASPs, antiviral stewardship (AVS), specifically targeting cytomegalovirus (CMV), has been more recently described.

Trident Sign: The Key Magnetic Resonance Imaging Finding Distinguishing Spinal Cord Sarcoidosis From Multiple Sclerosis and Seropositive Neuromyelitis Optica Spectrum Disorder.

Spinal cord sarcoidosis, an uncommon manifestation of neurosarcoidosis, presents diagnostic and therapeutic challenges because the condition is rare and has diverse clinical manifestations that can mimic other conditions such as multiple sclerosis and neuromyelitis optica spectrum disorder. A middle-aged African American female with a history of idiopathic intracranial hypertension and hydrocephalus with ventriculoperitoneal shunt presented with progressive, predominantly left-sided gait instability, weakness, and paresthesia. Cerebrospinal fluid showed lymphocytosis, red blood cells, elevated oligoclonal bands, and elevated kappa free light chains, concerning for multiple sclerosis.

I'm Getting a Migraine: A Comparative Evaluation of Patient and Clinician Interpretations of Migraine Symptoms.

Patients and providers vary in how they describe common otolaryngology-related complaints. These differences can lead to miscommunication and frustration that may affect patient outcomes and satisfaction. The aim of this cross-sectional survey-based study was to explore the differences in migraine symptom selection by otolaryngology patients and clinicians.

MedVantage: A Primary Care Model for Populations With High Social and Medical Needs.

Despite the substantial expenditures on health care in the United States, persistent underperformance in health system metrics necessitates innovative approaches to address complex patient needs. The MedVantage Clinic in New Orleans, Louisiana, offers a regionally tailored, value-based primary care model targeting patients with high social and medical needs. This study provides an evaluation of the efficacy of the MedVantage Clinic in improving the cost of care and service utilization for this population.

The Acquisition of Cardiovascular Adaptation to Aerobic Exercise: When Does It Begin and How Does It Evolve Depending on Intrinsic and Extrinsic Factors?

The acquisition and evolution of cardiovascular (CV) adaptation to physical activity or exercise training are critical in enhancing cardiorespiratory fitness (CRF) and reducing CV disease (CVD) risk. CV adaptations to exercise occur through structural, functional, and molecular changes that enhance cardiac efficiency. These adaptations, such as increased stroke volume, improved blood pressure regulation, and enhanced endothelial function, collectively reduce CVD morbidity and mortality.

Serial secretoneurin measurement and risk of ventricular arrhythmias and death in patients with left ventricular systolic dysfunction.

Background: Secretoneurin, a member of the granin protein family, is associated with the risk of mortality in patients with acute and chronic heart failure. Secretoneurin may play an important role in cardiomyocyte calcium handling, suggesting that it may influence cardiac arrhythmia risk. We hypothesized that baseline and serial measurements of circulating secretoneurin are associated with the risk of incident ventricular tachyarrhythmias (VA) and death, and that serial measurement would provide prognostic information beyond baseline values.

Acute Kidney Injury in Patients with Cirrhosis and Chronic Kidney Disease: Results from the HRS-HARMONY Consortium.

Background: Chronic kidney disease (CKD) frequency is increasing in patients with cirrhosis and these individuals often experience acute kidney injury (AKI). Direct comparisons of outcomes between AKI-only vs. AKI on CKD (AoCKD) among patients with cirrhosis are not well described.

Interdisciplinary perspectives on the co-management of metabolic dysfunction-associated steatotic liver disease and coronary artery disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as a public health threat as it affects approximately 38% of the adult population worldwide, with its prevalence rising in step with that of obesity and type 2 diabetes. Beyond the implications of MASLD for liver health, it is also associated with cardiovascular and vascular dysfunction. Although the many shared risk factors and common metabolic milieu might indicate that cardiovascular disease and MASLD are discrete outcomes from common systemic pathogeneses, a growing body of evidence has identified a potential causal relationship between MASLD and coronary artery disease, which is the leading cause of morbidity and mortality in people with MASLD and all-cause mortality worldwide.

Information sharing and seeking about nutrition-related complementary and alternative medicines in online forums for people affected by cancer: A content analysis of discussion threads.

Background: Online forums are a key source of information about complementary and alternative medicine (CAM) for people affected by cancer, especially when information needs are not met in healthcare settings. This study therefore investigated nutrition-related CAM information seeking and sharing in online forums for people affected by cancer.

Methods: This study was conducted in a major online platform that hosts over 10 forums for people affected by cancer and has more than 10,000 registered users.

Platelet FcγRIIa as a Marker of Cardiovascular Risk After Myocardial Infarction.

Background: A previous single-center study of patients with myocardial infarction (MI) showed that platelet FcγRIIa (pFCG) can distinguish patients at higher and lower risk of subsequent MI, stroke, and death.

Objectives: The authors performed an 800-patient 25-center study to validate the prognostic implications of pFCG.

Methods: Patients with type 1 MI (ST-segment elevation and non-ST-segment elevation) were enrolled in a prospective noninterventional trial during their index hospitalization.

Fast vs slow rubidium-82 infusion profiles and test-retest precision of myocardial perfusion using contemporary 3D cardiac analog positron emission tomography-computed tomography imaging.

Background: On legacy 2D positron emission tomography (PET) systems utilizing a 50 mL/min Rb-82 profile, test-retest precision of quantitative perfusion is ∼10%. It is unclear whether Rb-82 infusion rate significantly impacts quantitative perfusion and/or image quality on modern analog 3D PET-CT systems. We aimed to determine whether the Rb-82 infusion profile significantly impacts test-retest precision of quantitative perfusion, perfusion metrics, and/or image quality on a modern analog 3D PET-CT scanner.