Clinicopathological significance of androgen receptor expression and tumor infiltrating lymphocytes in triple-negative breast cancer: a retrospective cohort study.

Background: Triple-negative breast cancer (TNBC) is a serious disease with limited treatment options. We explored the significance of androgen receptor (AR) expression and tumor-infiltrating lymphocytes (TILs) in predicting neoadjuvant chemotherapy (NAC) resistance in TNBC, hypothesizing that AR/TIL classification using pretreatment biopsies can identify NAC-resistant subgroups and improve the understanding of apocrine differentiation.

Methods: This retrospective study included 156 consecutive patients with TNBC treated with NAC.

Impact of intravascular ultrasound on limb events in endovascular therapy for patients with peripheral arterial disease: insights from the TOMA-CODE registry.

Intravascular ultrasound (IVUS) has become a standard procedure for performing coronary intervention, but its impact on peripheral endovascular therapy (EVT) remains unclear. To assess the usefulness of IVUS during EVT, this study analyzed over 2000 consecutive patients from the TOkyo-taMA peripheral vascular intervention research COmraDE (TOMA-CODE) registry with peripheral arterial disease (PAD) in Japan. The primary outcome was chronic limb events (a composite of clinically driven target lesion revascularization (cTLR) and major amputation) during a two-year follow-up period.

Neuroblastoma Masquerading as Constipation: Reducing Diagnostic Error With the Pediatric Abdominal Point-of-Care Ultrasound Survey.

Abdominal pain is a common pediatric complaint in the emergency department and other clinical settings. While most causes are benign, dangerous and time-sensitive conditions may be present. Point-of-care ultrasound (POCUS) is a diagnostic modality that can help more thoroughly explore the differential diagnosis at a relatively low cost, without exposure to ionizing radiation, and in a timely manner.

On-Table Virtual Reality to Reduce Anxiety/Distress during Radiation Treatments: A Pilot Randomized Trial.

We report the first randomized trial of a virtual reality (VR) headset used on-table during external beam radiation therapy (RT) treatments to reduce anxiety/distress during receipt of RT. A small pilot study was conducted among 10 patients, with VR randomized to start in the first week ("immediate VR") versus the second week ("delayed VR") of treatment. All patients (100%) in the immediate VR group had declines in measured distress scores after their first radiation treatment, compared to only 1 patient (16.

Optimizing the Appropriate Mode of the Pulse-modulated Holmium Laser in a Pop-dusting Benchtop Model.

Objective: To investigate the effectiveness of different holmium:yttrium-aluminum-garnet (Ho:YAG) laser modes for lithotripsy in the "dusting era" and identify the optimal laser mode for producing stone fragments measuring ≤0.5mm.

Methods: We used plaster of Paris-made artificial stones crushed into 2-3 mm pieces, weighing 1 g in total.

Transvaginal ovarian drilling for polycystic ovary syndrome prior to in vitro fertilization dramatically improves embryo yield, implantation, and ongoing pregnancy rates.

Purpose: To evaluate the effect of transvaginal ovarian drilling (TVOD) on IVF outcomes in subjects with clomiphene-resistant PCOS and a history of IVF failure.

Methods: Between 2008 and 2011, 19 subjects with sonographically PCOS and a history of failure to ovulate to high-dose clomiphene citrate were prospectively followed and underwent TVOD at a university hospital-based IVF program.

Results: In 15 subjects who underwent 30 fresh paired IVF cycles TVOD resulted in a significantly higher number of oocytes retrieved (7.

Discontinuation of SGLT-2i and GLP-1RA among persons with Type 2 diabetes and atherosclerotic cardiovascular disease treated in US cardiology clinics.

Background: SGLT-2i and GLP-1RA are recommended for persons with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD); for those prescribed, little is known about reasons for discontinuation.

Methods: From the COORDINATE-Diabetes randomized trial database, the frequency and reasons for discontinuation of SGLT2i or GLP-1RA were analyzed.

Results: 1045 participants were enrolled 7/2019 to 5/2022; 290 (27.

Glucocorticoid tapering pace in microscopic polyangiitis and granulomatosis with polyangiitis in Japanese real-world practice: A propensity score-matched retrospective cohort study from the J-CANVAS registry.

Objective: To assess the prevalence and outcomes among regimens of glucocorticoid tapering for microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) in real-world practice.

Methods: We retrospectively examined the Japan Collaborative Registry of ANCA-associated Vasculitis (J-CANVAS) registry, and evaluated the prevalence of glucocorticoid tapering regimens in the PEXIVAS trial. In patients with newly diagnosed MPA and GPA, we compared outcomes among standard and reduced pace regimens.

is implicated in central nervous system, orofacial and maxillofacial anomalies.

Background: Previous studies in mouse, and zebrafish embryos show strong expression in progenitor cells of neuronal and neural crest tissues suggesting its involvement in neural crest specification. However, the role of human transcription factor activator protein 2 ( in human embryonic central nervous system (CNS), orofacial and maxillofacial development is unknown.

Methods: Through a collaborative work, exome survey was performed in families with congenital CNS, orofacial and maxillofacial anomalies.

Management of adult sepsis in resource-limited settings: global expert consensus statements using a Delphi method.

Purpose: To generate consensus and provide expert clinical practice statements for the management of adult sepsis in resource-limited settings.

Methods: An international multidisciplinary Steering Committee with expertise in sepsis management and including a Delphi methodologist was convened by the Asia Pacific Sepsis Alliance (APSA). The committee selected an international panel of clinicians and researchers with expertise in sepsis management.

Association between PaCO and outcomes in patients who underwent extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest.

Aim: The optimal arterial partial pressure of carbon dioxide (PaCO) for patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) remains unknown. We aimed to investigate the association between post-resuscitation PaCO and neurological outcomes.

Methods: This retrospective cohort study analyzed data from the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan, a multicenter registry study across 36 hospitals in Japan, including patients with out-of-hospital cardiac arrest (OHCA) admitted to intensive care units (ICU) after ECPR between 2013 and 2018.

Exploring healthcare facilities' blenderized tube feeding policy trends: A survey of registered dietitian nutritionists.

Background: Recent surveys suggest that registered dietitian nutritionists (RDNs) are increasingly supportive of blenderized tube feeding (BTF). However, its actual use in clinical practice continues to lag. This disconnect may be explained by a lack of comprehensive BTF policies.

Final Results of a Multicenter Prospective Study of Stereotactic Body Radiation Therapy for Previously Untreated Solitary Primary Hepatocellular Carcinoma (The STRSPH Study).

Purpose: To report final results of a prospective study of stereotactic body radiation therapy (SBRT) in patients with previously untreated solitary primary hepatocellular carcinoma (HCC).

Methods And Materials: This prospective, single-arm, multicenter phase 2 trial recruited patients with HCC who were unsuitable for, or refused, surgery and radiofrequency ablation, with 3-year overall survival rates as the primary endpoint and survival outcomes and adverse events as secondary endpoints. The prescribed SBRT dose was 40 Gy in 5 fractions.

Natural history of dolichoectatic vertebrobasilar aneurysms: a multinational study.

Objective: Dolichoectatic vertebrobasilar aneurysms (DVBAs) are expansions of arterial tissue leading to aneurysmal formations without an obvious neck. Their natural history is poorly understood; usually patients are admitted with thromboembolic complications and/or neurological symptoms from the mass effect. There have not been international collective data, and correct timing for highly risky treatments has been under discussion.

Chronic Pectoralis Major Muscle Belly Repair and Reconstruction With Achilles Allograft Augmentation.

Case: A 60-year-old man presented with a chronic right pectoralis major muscle belly tear of the lower sternal head that was missed and previously treated with tendon repair of the sternal and clavicular heads. The tear was repaired and reconstructed with an Achilles allograft. At the 1.

Inadequate Intensification of LDL-cholesterol lowering therapy after coronary revascularization: Insights from the GOULD registry.

Background: Patients with a history of coronary revascularization are at a higher risk for subsequent cardiovascular events and all-cause mortality. Lowering LDL-cholesterol (LDL-C) levels post-revascularization significantly reduces these risks.

Methods: This analysis compared LDL-C-lowering therapies at baseline and over time among patients with and without prior coronary revascularization in the GOULD registry (a prospective multicenter cohort study).

Combined Neoadjuvant-Adjuvant Immunotherapy and Abdominoperineal Resection for a Primary Anorectal Melanoma: A Case Report.

Anorectal melanoma (ARM) is a rare entity with aggressive biological behavior and poor prognosis. Clinically, ARM presents with atypical symptoms, such as anal pain and bleeding, thus often being misdiagnosed as a benign anorectal pathology and leading to delayed diagnosis. We present a case of a 73-year-old female patient with stage I ARM, treated successfully with a combination of neoadjuvant-adjuvant immunotherapy (nivolumab, an anti-PD-1 monoclonal antibody) and abdominoperineal resection.

Prescription Medication Use and Expenditure for Atrial Fibrillation in the United States.

Objectives: To study the national trends of anticoagulants, antiarrhythmic drugs (AADs), and expenditures in the civilian noninstitutionalized atrial fibrillation (AF) population.

Methods: The Medical Expenditure Panel Survey was queried from January 2016 to December 2021 to identify adults (age ≥18 years) with a diagnosis of AF utilizing the International Classification of Diseases, Tenth Revision, Clinical Modification code I48. Prevalence of anticoagulants (AAD) and its expenditure and AF expenditure across clinical settings in the United States were estimated.

Association between in-hospital weight change and 28-day mortality in adults with gram-negative rod bacteremia.

Background: Body weight and fluid balance are critical parameters in the monitoring of patient status, as low body weight and fluid overload are associated with increased mortality in sepsis cases. While body weight reflects nutritional and fluid status, fluid balance is a major indicator of clinical stability. However, limited research has comprehensively evaluated the combined impact of in-hospital weight change and fluid balance on mortality in bacteremia patients, especially those undergoing treatment outside of ICUs.

Relationship Between Severity of Ischemia and Coronary Artery Disease for Different Stress Test Modalities in the ISCHEMIA Trial.

Background: The relationship between the extent and severity of stress-induced ischemia and the extent and severity of anatomic coronary artery disease (CAD) in patients with obstructive CAD is multifactorial and includes the intensity of stress achieved, type of testing used, presence and extent of prior infarction, collateral blood flow, plaque characteristics, microvascular disease, coronary vasomotor tone, and genetic factors. Among chronic coronary disease participants with site-determined moderate or severe ischemia, we investigated associations between ischemia severity on stress testing and the extent of CAD on coronary computed tomography angiography.

Methods: Clinically indicated stress testing included nuclear imaging, echocardiography, cardiac magnetic resonance imaging, or nonimaging exercise tolerance test.

Changes in Personal Behaviors During and After the COVID-19 Pandemic: A Nationwide Three-Year Longitudinal Study in Japan.

Few longitudinal studies have examined the impact of the COVID-19 pandemic on personal behaviors. This study investigated changes in four social behaviors among the Japanese public during and after the COVID-19 pandemic, using four-wave longitudinal data (2020-2023) from the Japan COVID-19 and Society Internet Survey (JACSIS). In total, 8622 respondents continuously participated in the surveys.

Multielectrode Radiofrequency Balloon Catheter for Paroxysmal Atrial Fibrillation: Results From the Global, Multicenter, STELLAR Study.

Introduction: The safety and efficacy of paroxysmal atrial fibrillation (PAF) ablation with the HELIOSTAR multielectrode radiofrequency (RF) balloon catheter have been demonstrated in European studies; data from elsewhere are lacking. This prospective, multicenter study conducted in the United States, Italy, and China investigated the safety and efficacy of pulmonary vein isolation (PVI) using HELIOSTAR in drug-refractory symptomatic PAF.

Methods: The primary effectiveness endpoint (PEE) was 12-month freedom from documented atrial fibrillation/atrial flutter/atrial tachycardia plus freedom from acute procedural failure, nonstudy catheter failure, repeat ablation failure, direct current cardioversion (DCCV), and Class I/III antiarrhythmic drug (AAD) failure.