Biventricular Dysfunction Due to Chronic Mitral Valve Regurgitation Caused by Aberrant Mitral Arcade.

A 53-year-old male individual with chronic severe mitral regurgitation presented with biventricular dysfunction, pulmonary hypertension, and atrial fibrillation. Echocardiography demonstrated a posterior leaflet prolapse with malcoaptation. Mitral valve repair and Maze procedure were performed, revealing absent chordae and direct connection from the anterolateral papillary muscle to the posterior leaflet, consistent with partial mitral arcade.

Impact and Durability of the Affordable Care Act Medicaid Expansion on Lung Cancer Treatment.

Background: Medicaid expansion began in 2014 after passage of the Affordable Care Act; however, the impact and durability of the effects on lung cancer treatment utilization are poorly defined. We aimed to determine whether there is a persistent difference in utilization of lung resection, lung biopsy, and nonoperative treatment of lung cancer in states participating in Medicaid expansion compared with states that are not.

Methods: A retrospective cohort study was completed analyzing the difference in utilization between Medicaid expansion states and non-expansion states in 2012-2013, 2016-2017, and 2019.

Geographic Variation in the Utilization of Services Surrounding Lung Cancer Resection.

Background: As value-based care models continue to gain emphasis, along with the need for improved profiling across the continuum of lung cancer care, a better understanding of geographic variation in utilization of services surrounding episodes of care is needed.

Methods: In this retrospective cohort study of patients undergoing lung cancer resection from 2017 to 2019, we examined geographic variation in utilization of services surrounding episodes of lung cancer resection. We utilized hierarchical logistic regression models to determine risk-adjusted utilization of services.

Complication Rate of the Nuss Procedure in Adults and Pediatric Patients: National Database Analysis.

Background: Pectus excavatum (PE) is the most common congenital chest wall defect and is characterized by the inward displacement of the sternum and costal cartilages. To date, there are limited data on adult patients undergoing the Nuss procedure for PE. This study aimed to assess the complication rate between the pediatric and adult populations and assess the trends in demographics.

Institutional Experience With Robotic Lobectomy After Neoadjuvant Immunotherapy and Chemotherapy.

Background: The real-world safety of robotic resections after neoadjuvant chemoimmunotherapy remains poorly defined in patients with non-small cell lung cancer. Due to reported increased operative challenges after neoadjuvant immunotherapy, we aim to describe our early institutional experience and outcomes after robotic resection in this clinical context.

Methods: We performed a retrospective chart review of patients with non-small cell lung cancer who underwent a robotic lobectomy, comparing patients from June 1, 2022, through October 31, 2023, who were treated with neoadjuvant chemoimmunotherapy consistent with the Checkmate-816 protocol and a control group with upfront resection.

Submitral Pseudoaneurysm Repair and Posterior Leaflet Augmentation: Reoperative Mitral Valve Repair.

A 33-year-old woman who had previously undergone mitral valve repair for native valve endocarditis presented with a submitral left ventricular pseudoaneurysm, with related mitral valve dysfunction. The operative approach to this complex pathophysiologic process is presented.

Return to Work, Sport, and Sport- Related Activity After Distal Triceps Tendon Repair: A Systematic Review.

Background: Distal triceps tendon injuries are relatively rare injuries, often occurring in highly active patients with physically demanding jobs or lifestyles. Information on return to work, sport, and activity is essential for patient education and counseling after a distal triceps tendon rupture.

Purpose: To determine the rates of return to work, sport, and sport-related activity after distal triceps tendon repair.

Resident-Driven Guideline to Reduce Iatrogenic Pneumothoraxes From Small-Bore Feeding Tubes: A Quality and Safety Improvement Project.

Small-bore feeding tubes (SBFT) in vulnerable patients carry a risk of iatrogenic pneumothorax by misplacement into the lung. This institution noted a series of iatrogenic pneumothoraxes caused by the placement of these devices. A resident-led, multidisciplinary team developed a hospital guideline through a consensus-driven process.

Depression and Distress Screening in Oncology Patients: A Descriptive Analysis.

This retrospective study aimed to describe the characteristics of cancer patients undergoing depression and distress screening at the Sidney Kimmel Cancer Center and to assess factors associated with their screening results. Data were retrieved from electronic medical records of adult Sidney Kimmel Cancer Center patients with at least one oncology encounter between January 2021 and June 2022, who underwent both depression and distress screening using the Patient Health Questionnaire-2/9 for depression and the National Comprehensive Cancer Network distress thermometer for distress during the encounter. Demographics, clinical factors, and screening results were analyzed using descriptive statistics and binary logistic regression.

Perinuclear organelle trauma at the nexus of cardiomyopathy pathogenesis arising from loss of function mutation.

Over the past 25 years, nuclear envelope (NE) perturbations have been reported in various experimental models with mutations in the gene. Although the hypothesis that NE perturbations from mutations are a fundamental feature of striated muscle damage has garnered wide acceptance, the molecular sequalae provoked by the NE damage and how they underlie disease pathogenesis such as cardiomyopathy ( cardiomyopathy) remain poorly understood. We recently shed light on one such consequence, by employing a cardiomyocyte-specific deletion in the adult heart.

Perinatal mortality trend associated with maternal obesity in United States between 2015 - 2020.

Background: Obesity is associated with an increased risk of stillbirth and neonatal death. Since the publication of A Randomized Trial of Induction Versus Expectant Management (ARRIVE) in 2018, there was an increase in 39 weeks deliveries. The objective of this study was to evaluate the trends in perinatal mortality by BMI category from 2015 to 2020.

Germline and Somatic Genomic Testing for Metastatic Prostate Cancer: ASCO Guideline.

Purpose: To evaluate evidence on germline and somatic genomic testing for patients with metastatic prostate cancer and provide recommendations.

Methods: A systematic review by a multidisciplinary panel with patient representation was conducted. The PubMed database was searched from January 2018 to May 2024.

Epidemiology of Consumer Product-Related Ocular Injuries in the Incarcerated Population.

Purpose: To characterize the epidemiology of consumer product-related ocular injury in the United States (US) incarcerated population, and identify preventable causes.

Methods: The National Electronic Injury Surveillance System (NEISS) database was queried for cases of eye injury from 2014 to 2023. Incarcerated cases were identified using the keywords "prison", "jail", "inmate", and "incarcerate".

Reoperation Rate Following Thumb Basal Joint Arthroplasty: A Minimum Follow-Up Period of 5 Years.

Purpose: Thumb basal joint arthroplasty (BJA) performed for thumb basal joint arthritis is associated with high patient satisfaction. However, complications requiring reoperation occur, with a previously reported early reoperation rate (within 2 years) of 1.5%.

Quantifying capacity of otolaryngology-head and neck surgery in Zimbabwe.

Objectives: To evaluate the otolaryngology surgical capacity in Harare, Zimbabwe by analyzing procedural volumes across four hospitals, one private and three public, from 2019 to 2022.

Methods: A retrospective review of hand-written surgical case logs was conducted at Harare Eye, Ear, Nose, and Throat Institute (HEENT), Parirenyatwa Group of Hospitals (PGH), Sally Mugabe Children's Hospital (SMCH), and Sally Mugabe Adult's Hospital (SMAH). Patient age and surgical intervention for all otolaryngology surgeries performed in the operating room from 2019 to 2022 were recorded.

Phenotypic Expansion: Fetus With Cole-Carpenter Type 2 Presenting With Novel Neonatal Lethal Skeletal Dysplasia.

We report a 28-year-old G2P0 at 24 weeks 5 days who presented for evaluation secondary to suspected skeletal dysplasia in her fetus. Fetal ultrasound imaging demonstrated foreshortened long bones by 9-10 weeks, multiple bowing deformities and fractures, 11 foreshortened paired ribs with fractures, decreased skull mineralization, frontal bossing, enlarged cavum septum pellucidi, and severe fetal growth restriction (< 2%). Findings were concerning for life limiting condition with thoracic circumference < 2.

Seizures and status epilepticus in anti-NMDA receptor encephalitis.

Background: Seizures, including status epilepticus (SE), are common in anti-NMDA receptor encephalitis (NMDARE). We aimed to describe clinical and electrographic features of patients with seizures with NMDARE, determine factors associated with SE, and describe long-term seizure outcomes.

Methods: We retrospectively identified patients with seizures in the setting of NMDARE treated at inpatient Mayo Clinic sites during the acute phase of encephalitis between October 2008 and March 2023.

Sedation Practices in Mechanically Ventilated Neurocritical Care Patients from 19 Countries: An International Cohort Study.

Background: Our objective was to characterize the impact of common initial sedation practices on invasive mechanical ventilation (IMV) duration and in-hospital outcomes in patients with acute brain injury (ABI) and to elucidate variations in practices between high-income and middle-income countries.

Methods: This was a post hoc analysis of a prospective observational data registry of neurocritically ill patients requiring IMV. The setting included 73 intensive care units (ICUs) in 18 countries, with a total of 1,450 patients with ABI requiring IMV.

Impact of Country Income Level on Outcomes in Patients with Acute Brain Injury Requiring Invasive Mechanical Ventilation: A Secondary Analysis of the ENIO Study.

Background: Invasive mechanical ventilation can present complex challenges for patients with acute brain injury (ABI) in middle-income countries (MICs). We characterized the impact of country income level on weaning strategies and outcomes in patients with ABI.

Methods: A secondary analysis was performed on a registry of critically ill patients with ABI admitted to 73 intensive care units (ICUs) in 18 countries from 2018 to 2020.

Left Bundle Branch Area Pacing Versus Right Ventricular Pacing in Patients With Atrioventricular Block: A Systematic Review and Meta-Analysis.

Background: Left bundle branch area pacing (LBBAP) is a new technique for patients with atrioventricular block (AVB) and preserved left ventricular ejection fraction (LVEF), potentially offering better cardiac function than right ventricular pacing (RVP).

Methods: We searched databases and registries for studies that compared LBBAP with RVP in patients with AVB and preserved LVEF. We extracted data on various outcomes and pooled the effect estimates using random-effects models.

The Use of Retinal Imaging Including Fundoscopy, OCT, and OCTA for Cardiovascular Risk Stratification and the Detection of Subclinical Atherosclerosis.

Purpose Of Review: Cardiovascular disease (CVD) is a leading cause of preventable morbidity and mortality globally, and retinal imaging modalities (old and new) are being explored as noninvasive tools to predict latent atherosclerosis and cardiovascular disease. This review focuses on the emerging promise of fundoscopy, optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) in CVD prognostication.

Recent Findings: High-quality studies have established the utility of vessel-based parameters and discrete conditions diagnosable via fundoscopy in subclinical atherosclerosis detection or CVD prediction.

Inpatient Multimodal Pain Regimens Do Not Impact Hospital Length of Stay or Long-term Postoperative Opioid Use Following 1 and 2-Level Lumbar Fusion.

Study Design: Retrospective cohort study.

Objective: To determine hospital length of stay (LOS) and long-term opioid consumption among patients who received inpatient multimodal analgesia following lumbar spine surgery, as opposed to those who received opioids alone.

Summary Of Background Data: Opioids have long been the historical choice for managing postoperative pain.

Modulation of Monocyte Effector Functions and Gene Expression by Human Cytomegalovirus Infection.

Monocytes are crucial players in innate immunity. The human cytomegalovirus (CMV) infection has significant impacts on monocyte effector functions and gene expression. CMV, a β-herpesvirus, disrupts key monocyte roles, including phagocytosis, antigen presentation, cytokine production, and migration, impairing their ability to combat pathogens and activate adaptive immune responses.