Defensive Medicine in an Emergency Department: The Overuse of High-Sensitivity Cardiac Troponin I Testing.

Introduction: Cardiac troponin I is routinely measured in patients with suspected acute coronary syndrome. However, when a high-sensitivity cardiac troponin I (hs-cTnI) test is ordered without a clear clinical indication, unexpectedly elevated levels can lead to unnecessary diagnostic workups and inappropriate management. This study aimed to investigate physicians' rationale for performing hs-cTnI tests in an emergency department (ED).

A taxonomy of the factors contributing to the overtreatment of cancer patients at the end of life. What is the problem? Why does it happen? How can it be addressed?

Many patients with cancer approaching the end of life (EOL) continue to receive treatments that are unlikely to provide meaningful clinical benefit, potentially causing more harm than good. This is called overtreatment at the EOL. Overtreatment harms patients by causing side-effects, increasing health care costs, delaying important discussions about and preparation for EOL care, and occasionally accelerating death.

De-escalation of surgical and radiation treatment in elderly luminal breast cancer patients, single institution report and review of the evidence.

Background: De-intensification of anti-cancer therapy without significantly affecting outcomes is an important goal. Omission of axillary surgery or breast radiation is considered a reasonable option in elderly patients with early-stage breast cancer and good prognostic factors. Data on avoidance of both axillary surgery and radiation therapy (RT) is scarce and inconclusive.

Cell-free DNA Levels in Herpes Zoster: A Cross-sectional Longitudinal Study.

This study investigates serum cell-free DNA fluctuations in patients with herpes zoster or post-herpetic neuralgia, offering insight into the tissue damage and inflammatory dynamics associated with these conditions. A single-centre combined cross-sectional and longitudinal study was conducted with 59 patients to assess cell-free DNA levels in herpes zoster and post-herpetic neuralgia. Cell-free DNA was extracted from blood samples of patients with herpes zoster or post-herpetic neuralgia and compared with healthy controls.

ESAIC focused guidelines for the management of the failing epidural during labour epidural analgesia.

Background: Labour epidural analgesia reportedly fails in up to 10 to 25% of cases. A joint taskforce of European Society of Anaesthesiology and Intensive Care (ESAIC) experts was created to develop this focused guideline on the management of failing epidural analgesia in a previously well functioning epidural catheter.

Design: Six clinical questions were defined using a PICO (Population/Intervention/Comparison/Outcome) strategy to conduct a systematic literature search.

Post-Relapse Outcomes of Older Patients With NPM1-Mutated AML Are Favorable With Allo Transplant in Second Remission.

Molecular assessment of measurable residual disease (MRD) in NPM1-mutated AML patients is a powerful prognostic tool to identify the risk of relapse. There is limited data regarding MRD-guided decisions against alloSCT in elderly patients and FLT3-ITD co-mutation. We describe the outcome of NPM1-mutated AML patients in whom alloSCT was deferred based on ELN 2017 risk and MRD response.

Life cycle and morphogenetic differentiation in heteromorphic cell types of a cosmopolitan marine microalga.

Gephyrocapsa huxleyi is a prevalent, bloom-forming phytoplankton species in the oceans. It exhibits a complex haplodiplontic life cycle, featuring a diploid-calcified phase, a haploid phase and a third 'decoupled' phase produced during viral infection. Decoupled cells display a haploid-like phenotype, but are diploid.

Assessing and upgrading the cleanliness of the emergency department brief title: upgrading the emergency room's cleanliness.

Objective: To upgrade cleaning and disinfection of patient rooms in a crowded emergency department (ED).

Setting: Tertiary referral hospital.

Design: Prospective, 3-component, before-and-after intervention study.

CPX-351 +/- gemtuzumab ozogamicin as induction therapy for adult patients with newly diagnosed, favourable-intermediate risk, FLT3-ITD negative, AML: A pilot study.

This pilot study evaluated CPX-351 in adults with newly diagnosed, favourable-intermediate risk, FLT3-ITD-negative AML. Twenty patients received CPX-351 for induction, with six also receiving gemtuzumab ozogamicin (GO). The complete response rate was 95%, with 42% achieving flow-based minimal residual disease (MRD) negativity post-induction.

Acute pyelonephritis in adults. Should we adopt the pediatric guidelines?

Purpose: There are no guidelines, what recommend pro or against cystography for identification of VUR for adults who suffer from first episode of pyelonephritis. The aim of this study was to look at incidence of VUR in adults with first episode of pyelonephritis, and to highlight recommendations for possible reflux investigation in these patients.

Methods: We have performed retrospective review of all patients who admitted at our department over the last decade with the working diagnosis of acute pyelonephritis.

Long-term outcome of pediatric acute severe colitis: A prospective 5-year follow-up of the PRASCO trial.

Objectives: The PRASCO trial reported the short-term superiority of an antibiotic cocktail plus intravenous corticosteroids (IVCS) over IVCS alone in children with acute severe colitis (ASC). Here, we report the extension of the PRASCO trial and the long-term outcomes of the antibiotic cocktail in ASC.

Methods: This prospective follow-up of the PRASCO trial documented disease outcomes and treatments annually through 5 years.

Hedonic Responses to Meal Ingestion in Patients With Functional Dyspepsia and Postprandial Symptoms.

Introduction: It is not clear whether patients with postprandial symptoms enjoy the meal.

Methods: Prospective trial in patients with postprandial distress syndrome and healthy controls, comparing their responses with stepwise ingestion of a comfort meal.

Results: Healthy individuals (N = 18) enjoyed the meal and experienced digestive well-being.

From supportive care to trauma: training integrative practitioners in the treatment of acute stress disorder.

Objective: The present conflict in Israel has led to a surge in cases of acute stress disorder (ASD). The study examined a training program for integrative medicine (IM) providers working in supportive and palliative care settings, teaching clinical skills for treating ASD.

Methods: A 10-h online training program, designed by supportive care trained IM and mental health professionals was attended by a group of 32 IM providers.

Management and clinical-outcome of juxta-articular osteoid osteoma lesions.

Introduction: Osteoid osteoma (OO) is a benign intra-osseous lesion. The lesion is painful and usually diagnosed by x-ray, computed tomography (CT) or magnetic resonance imaging (MRI). When the lesion is juxta-articular or intra-capsular, the symptoms may present differently than the typical OO lesion and make diagnosis more challenging.

[EFFECTIVENESS OF SERIAL C-REACTIVE PROTEIN (CRP) MEASUREMENTS IN HOSPITALIZED PATIENTS WITH BLOOD STREAM INFECTION].

Background: C-reactive protein (CRP) is increasingly being used as an inflammatory marker in sepsis. Its main use is for diagnosis, less for prognosis, while it is increasingly used for serial monitoring of response to treatment - with little evidence to support this practice.

Objectives: Assessment of the effectiveness of serial measurements of CRP in the management of patients with blood stream infection (BSI).

Association between body mass index and clinical outcomes in patients with acute myocardial infarction and reduced systolic function: Analysis of PARADISE-MI trial data.

Aims: The relationship between body mass index (BMI) and clinical outcomes in patients with cardiovascular disease, including acute heart failure (AHF) and acute myocardial infarction (AMI), remains debated. This study investigates the association between BMI and clinical outcomes within the PARADISE-MI cohort, while also evaluating the impact of angiotensin receptor-neprilysin inhibitor (ARNI) versus angiotensin-converting enzyme inhibitor (ACE-I) treatment on this relationship.

Methods And Results: The analysis included 5589 patients from the PARADISE-MI study with available baseline BMI data.

[The Evolution of Medical Practice].

The Evolution of Medical Practice: Book Review.

Publication bias in studies on biologic therapy for children with inflammatory bowel disease.

Objective: The utilization of biologic drugs in children with inflammatory bowel disease (IBD) surged following the publications of positive results in randomized controlled trials and real-world studies. We aimed to explore the extent of publication bias associated with these findings.

Methods: Two reviewers assessed all abstracts evaluating the efficacy or safety of biologics presented at the annual European Society for Pediatric Gastroenterology Hepatology and Nutrition and North American Society for Pediatric Gastroenterology conferences from 2015 to 2019.

Left Ventricular and Atrial Function Analysis Following Transcatheter Edge-to-Edge Mitral Valve Repair.

Conventional echocardiography used to assess volumes of the left ventricle (LV) and left atrium (LA) along with mitral regurgitation grade is routine in studies before and after transcatheter edge-to-edge mitral valve repair (Mitral TEER). Previous studies focus on LV parameter changes and comparison of the functions before and a few months following Mitral TEER implantation, as well as LA reverse remodeling, by assessing LV volumes. However, less is known regarding LA strain changes in the early phase after the procedure.

Efficacy of 1% Povidone-Iodine in the Treatment of Anterior Blepharitis-Randomized Single-Center Controlled Trial.

Anterior blepharitis (AB) is a chronic eyelid inflammation with no definitive cure. To assess the safety and efficacy of a 1% povidone-iodine (PVI) ophthalmic solution lid scrub compared to formulated eyelid wipes in treating AB. A prospective, randomized, controlled, observer-masked, paired-eye trial.

Coming out of the Integrative Oncology Comfort Zone: Addressing Healthcare Providers' Wartime-Related Concerns.

Study Objective: To assess the impact of a personalized integrative medicine (IM) intervention on healthcare providers (HCPs) expressing war-related emotional/spiritual and physical concerns.

Methods: Physicians, nurses, para-medical and other HCPs from 5 hospital departments in northern Israel underwent IM treatments provided by IM-trained practitioners working in integrative oncology (IO) care settings. The two main HCP-reported concerns were scored (from 0 to 6) before and following the intervention using the Measure Yourself Concerns and Wellbeing questionnaire.