NephroCheck as a Predictor of Acute Kidney Injury Following Coronary Artery Bypass Graft Surgery.

Background Cardiac surgery-associated acute kidney injury (CSA-AKI) remains a significant complication following coronary artery bypass grafting (CABG), affecting 22%-30% of patients. This study evaluates the efficacy of NephroCheck, a biomarker-based test measuring insulin-like growth factor-binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases-2 (TIMP2), in predicting postoperative AKI. Methods In this retrospective observational cohort study, 21 patients undergoing isolated CABG were analyzed.

Posterior interosseous artery distal ulna graft for management of radius nonunion: Technique and case report.

Distal radius fracture nonunion can result in significant deformity, loss of function, and chronic pain. Presented here is a case of distal radius nonunion that was surgically reconstructed with a pedicled distal ulna bone graft based on the periosteal branches of the posterior interosseus artery (PIA). This technique has limited prior utilization for adult distal radius nonunion treatment but offers an effective option for surgical reconstruction of distal radius nonunion with preservation of the radiocarpal joint, utilizing a less invasive surgery that also reduces hospitalization stay.

Stability of diluted chlorhexidine for skin testing in drug allergy evaluations.

Background: Chlorhexidine gluconate (CHX), a common cause of perioperative anaphylaxis, is frequently used for skin testing in allergy evaluations. Although CHX's maximal nonirritating concentrations are known, the stability of its dilutions for skin testing remains unexplored, particularly when sterile water for injection (SWFI) or normal saline (NS) are used as diluents.

Objective: Our aim was to evaluate the stability and precipitation of CHX when diluted with SWFI or NS for drug allergy skin testing.

Efficacy, safety, and target engagement of dazukibart, an IFNβ specific monoclonal antibody, in adults with dermatomyositis: a multicentre, double-blind, randomised, placebo-controlled, phase 2 trial.

Background: Dermatomyositis is a chronic autoimmune disease with distinctive cutaneous eruptions and muscle weakness, and the pathophysiology is characterised by type I interferon (IFN) dysregulation. This study aims to assess the efficacy, safety, and target engagement of dazukibart, a potent, selective, humanised IgG1 neutralising monoclonal antibody directed against IFNβ, in adults with moderate-to-severe dermatomyositis.

Methods: This multicentre, double-blind, randomised, placebo-controlled, phase 2 trial was conducted at 25 university-based hospitals and outpatient sites in Germany, Hungary, Poland, Spain, and the USA.

The Dermatologic Oral Examination: Navigating the Oral Dermatoses Map.

Traditionally, dermatological education emphasizes hair, skin and nails in its curriculum. There is a practice gap with regard to knowledge of normal oral mucosa variants, performance of the oral examination, and competence in diagnosing and treating oral mucosal disorders. The oral mucosa falls within the purview of dermatology.

Improving Sternal Closure Outcomes in Cardiac Surgery: Polyethylene Suture Tapes vs. Steel Wires.

Steel wires are often inadequate for sternal closure for patients at high risk of sternal complications. This study compares a novel sternal closure system to conventional steel wires to assess its potential to reduce sternal complication rates and improve clinical outcomes. A retrospective study was conducted on 300 consecutive patients undergoing cardiac surgery via median sternotomy.

Distribution of Airway Findings in ANCA-Associated Vasculitis: A 20-Year Observational Analysis.

Pulmonary involvement is commonly observed in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), presenting with manifestations such as diffuse alveolar hemorrhage, inflammatory infiltrates, pulmonary nodules, and tracheobronchial disease. We aimed to identify distinct subgroups of tracheobronchial disease patterns in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) using latent class analysis (LCA), and to evaluate their clinical characteristics and outcomes. We conducted a retrospective cohort study using electronic medical records of patients aged >18 years diagnosed with AAV and tracheobronchial disease between 1 January 2002 and 6 September 2022.

Application of core functions and forms in complex health intervention research: a scoping review protocol.

Introduction: The ability of healthcare, community and public health systems to effectively implement and disseminate research innovations depends on contextual factors at multiple interconnected levels of influence (eg, the innovation, individual, provider/implementor, organisation and health system). Recently, there has been an increase in the development of complex interventions designed to target multiple levels, designed for or adapted to the context in which they are delivered. Two concepts from complex systems thinking have been increasingly used to operationalise such interventions-core functions (theory and evidence-driven purposes of interventions) and forms (adaptable activities that perform each core function).

Amyloidosis and Heart Transplantation in a New Era.

Background: The prognosis in patients with advanced cardiac amyloidosis (CA) remains poor.

Objectives: We sought to describe survival post heart transplantation (HT) in amyloid compared with non-amyloid recipients, highlight waitlist times within the new allocation system across three Organ Procurement and Transplantation Network (OPTN) regions, and describe multiorgan transplantation (MOT) in hereditary amyloidosis.

Methods: This is a retrospective review of end-stage CA patients who underwent HT at Mayo Clinic from January 2007 to December 2020.

Sex-specific differences in mortality and neurocardiac interactions in the Kv1.1 knockout mouse model of sudden unexpected death in epilepsy (SUDEP).

Sudden unexpected death in epilepsy (SUDEP) is a devastating complication of epilepsy with possible sex-specific risk factors, although the exact relationship between sex and SUDEP remains unclear. To investigate this, we studied Kcna1 knockout (Kcna1) mice, which lack voltage-gated Kv1.1 channel subunits and are widely used as a SUDEP model that mirrors key features in humans.

Pain and Perception: Exploring Psychedelics as Novel Therapeutic Agents in Chronic Pain Management.

Purpose Of Review: Chronic pain affects approximately 1.5 billion people worldwide, representing the leading cause of disability and a significant financial burden on healthcare systems. Conventional treatments, such as opioids and non-steroidal anti-inflammatory drugs, are frequently linked to adverse effects, including dependency and gastrointestinal issues, and often offer limited long-term relief.

Differentiation between renal cell carcinoma metastases to the pancreas and pancreatic neuroendocrine tumors in patients with renal cell carcinoma on CT or MRI.

Purpose: To determine whether renal cell carcinoma metastases (RCC-Mets) to the pancreas can be differentiated from pancreatic neuroendocrine tumors (PNETs) in patients with RCC on CT or MRI at presentation.

Methods: This retrospective study included patients with biopsy-proven RCC-Mets (n = 102) or PNETs (n = 32) at diagnosis or after nephrectomy for RCC. Inter-observer agreement (Cohen kappa) was assessed in 95 patients with independent reads by two radiologists, with discrepancies resolved by consensus for final analysis.

Development and Validation of Emoji Response Scales for Assessing Patient-Reported Outcomes.

Purpose: Emoji are digital images or icons used to express an idea or emotion in electronic communication. The purpose of this study was to develop and evaluate the psychometric properties of two patient-reported scales that incorporate emoji.

Methods: The Emoji Response Scale developed for this study has two parts: the Emoji-Ordinal and Emoji-Mood scales.

Autogene cevumeran with or without atezolizumab in advanced solid tumors: a phase 1 trial.

Effective targeting of somatic cancer mutations to enhance the efficacy of cancer immunotherapy requires an individualized approach. Autogene cevumeran is a uridine messenger RNA lipoplex-based individualized neoantigen-specific immunotherapy designed from tumor-specific somatic mutation data obtained from tumor tissue of each individual patient to stimulate T cell responses against up to 20 neoantigens. This ongoing phase 1 study evaluated autogene cevumeran as monotherapy (n = 30) and in combination with atezolizumab (n = 183) in pretreated patients with advanced solid tumors.

Prostate Cancer Risk Prediction Model Using Clinical and Magnetic Resonance Imaging-Related Findings: Impact of Combining Lesions' Locations and Apparent Diffusion Coefficient Values.

Objectives: The aims of the study are to develop a prostate cancer risk prediction model that combines clinical and magnetic resonance imaging (MRI)-related findings and to assess the impact of adding Prostate Imaging-Reporting and Data System (PI-RADS) ≥3 lesions-level findings on its diagnostic performance.

Methods: This 3-center retrospective study included prostate MRI examinations performed with clinical suspicion of clinically significant prostate cancer (csPCa) between 2018 and 2022. Pathological diagnosis within 1 year after the MRI was used to diagnose csPCa.

Crossing Boundaries: Utilizing Left-sided Impella for Right Ventricular Mechanical Support and Intraoperative Transesophageal Echocardiogram Considerations.

Objective: Right ventricular failure is a leading cause of mortality among patients with various etiologies of cardiogenic shock. This case series outlines an innovative approach to directly unloading the right ventricle with the Impella LD or 5.5 without crossing the tricuspid valve in cases requiring tricuspid valve repair or replacement.

A Guide to Pediatric Antibiotic Allergy Testing: A Report from the United States Drug Allergy Registry.

Pediatric antibiotic labels are common, and unnecessary antibiotic avoidance is associated with negative personal and public health outcomes; as a result, there is an increasing emphasis on the importance of pediatric antibiotic allergy evaluations. Different testing strategies have been advised, including skin testing and challenge testing with varied doses and duration. Established consensus testing protocols are lacking.

Association of Smokeless Tobacco Use With Perioperative Complications and Revision Surgery After Anterior Cruciate Ligament Reconstruction.

Background: Tobacco use is a known modifiable risk factor for postoperative complications and revision surgery after anterior cruciate ligament reconstruction (ACLR). Previous studies focus on tobacco as a broad categorization of traditional smoking, smokeless tobacco, and other forms of nicotine use. It is unclear if differences in the type of nicotine used lead to similar adverse outcomes after ACLR.

Unintentional exposure to leuprolide acetate during early pregnancy with a huge intramural myoma.

Leuprolide acetate is commonly used to reduce the size of myomas before surgery. Initially, it stimulates pituitary gonadotropin secretion, followed by sustained suppression of gonadal function. However, the impact on pregnancy outcomes from inadvertent exposure remains unclear.

Updated Geriatrics Competencies for Graduating Medical Students: Training Physicians to Provide Age-Friendly Care.

Purpose: Medical student education in geriatrics is a critical need for every doctor-in-training as the population ages, with fewer than 7,000 geriatricians, and older patients, who now approach 20% of the U.S. population, having unique health care needs.

Color Fundus Photography and Deep Learning Applications in Alzheimer Disease.

Objective: To report the development and performance of 2 distinct deep learning models trained exclusively on retinal color fundus photographs to classify Alzheimer disease (AD).

Patients And Methods: Two independent datasets (UK Biobank and our tertiary academic institution) of good-quality retinal photographs derived from patients with AD and controls were used to build 2 deep learning models, between April 1, 2021, and January 30, 2024. ADVAS is a U-Net-based architecture that uses retinal vessel segmentation.

Challenges in Breast Pathology: A Review of the Most Common Problems Encountered in a Subspecialty Consult Service Over 1 Year-Retrospective Review of 553 Specimens.

. To identify the most common reasons for consultation to a large specialty breast pathology service at a major institution. To provide insight into the overall challenges in practicing breast pathology.