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.

Randomized double-blind study on safety and tolerability of TP-102 phage cocktail in patients with infected and non-infected diabetic foot ulcers.

Background: Phage therapy offers a promising alternative for treating serious infections, including diabetic foot ulcers (DFUs), through the lytic action of phages. This randomized double-blind study was conducted to evaluate the safety and tolerability of the TP-102 bacteriophage cocktail in patients with DFUs non-infected and infected with Staphylococcus aureus, Pseudomonas aeruginosa, and/or Acinetobacter baumannii.

Methods: Nineteen participants with DFUs were randomized after susceptibility testing.

Clinical outcomes by baseline metastases in patients with renal cell carcinoma treated with lenvatinib plus pembrolizumab versus sunitinib: Post hoc analysis of the CLEAR trial.

Lenvatinib plus pembrolizumab significantly improved efficacy versus sunitinib in treatment of advanced renal cell carcinoma (aRCC) in the phase 3 CLEAR study. We report results of an exploratory post hoc analysis of tumor response data based on baseline metastatic characteristics of patients who received lenvatinib plus pembrolizumab versus sunitinib, at the final overall survival analysis time point of CLEAR (cutoff: July 31, 2022). Treatment-naïve adults with aRCC were randomized to: lenvatinib (20 mg PO QD in 21-day cycles) plus pembrolizumab (n = 355; 200 mg IV Q3W); lenvatinib plus everolimus (not reported here); or sunitinib (n = 357; 50 mg PO QD; 4 weeks on/2 weeks off).

Middle ear secretions following spontaneous CSF leak repair may represent effusion rather than CSF leak.

Objective: To characterize middle ear (ME) effusion still present 2 months after repair surgery for spontaneous cerebrospinal fluid (CSF) leak via the temporal bone (TB).

Study Design: A retrospective chart review (2011-2022).

Setting: Tertiary referral academic center.

Revisional Surgery Due to Weight Regain or Insufficient Weight Loss Following One Anastomosis Gastric Bypass.

Introduction: One anastomosis gastric bypass (OAGB) is a common procedure associated with satisfactory outcomes. Revisional surgery due to weight regain or insufficient weight loss (WR/IWL) after OAGB is underreported.

Methods: A retrospective analysis of a single-bariatric surgeon database was conducted.

The personal and the national: Lessons learned in the aftermath of the October 7 attacks in Israel.

On October 7, 2023, terrorist organizations led by Hamas, launched an extensive attack on Israel. Within days following the initial attack, there was a clear need to provide psychological support to individuals who were exposed to the horrors of the October 7 attacks. Tel-Aviv Sourasky Medical Center - Ichilov, a tertiary medical center, launched an emergency mental health service to provide psychological first aid to the first-line victims of the war.

Beyond Classification: A Unique Case of Self-Resolving Cutaneous Mucinosis Associated With Streptococcal Infection in a Child.

A 3-year-old boy presented with an unusual combination of indurated skin, sclerotic plaques with lichenification, and yellowish papules. Histopathology revealed diffuse dermal mucin deposits, and laboratory tests showed a positive throat culture for Group A streptococcus and elevated serum anti-streptolysin titers. An 10-day course of oral amoxicillin was associated with near-complete resolution of all dermatological findings within 4 months.

Glucose-dependent insulinotropic polypeptide receptor signaling alleviates gut inflammation in mice.

Glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) are gut-derived peptide hormones that potentiate glucose-dependent insulin secretion. The clinical development of GIP receptor (GIPR)-GLP-1 receptor (GLP-1R) multi-agonists exemplified by tirzepatide and emerging GIPR antagonist-GLP-1R agonist therapeutics such as maritide is increasing interest in the extra-pancreatic actions of incretin therapies. Both GLP-1 and GIP modulate inflammation, with GLP-1 also acting locally to alleviate gut inflammation in part through anti-inflammatory actions on GLP-1R+ intestinal intraepithelial lymphocytes.

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.

Transcatheter Aortic Valve Implantation in Small and Very Small Aortic Valve Annuli: A Propensity-Matched Analysis Between Self-Expanding Versus Balloon-Expandable Valves.

Background: The management of Transcatheter Aortic Valve Implantation (TAVI) patients with a small aortic annulus (SAA) postures a substantial challenge, increasing the risk of patient- prosthesis mismatch (PPM) and overall mortality.

Aims: This study aimed to compare the hemodynamic and clinical outcomes of transcatheter balloon-expandable valve (BEV) versus transcatheter self-expandable valve (SEV) in SAA.

Methods: We conducted propensity score matching (PSM) of severe AS patients with SAA who underwent trans-femoral TAVR and enrolled to the Israeli TAVR registry between the years 2008 and 2023.

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.

Complement-mediated hemolytic uremic syndrome associated with postpartum hemorrhage: case series and systematic review of individual participant data.

Background: Postpartum hemorrhage is considered a risk factor for pregnancy-associated complement-mediated hemolytic uremic syndrome (CM-HUS; previously known as atypical hemolytic uremic syndrome) but has not been systematically studied.

Objectives: To systematically examine the role of postpartum hemorrhage in precipitating CM-HUS and to describe the characteristics of postpartum hemorrhage-associated CM-HUS, its prognosis and recommended management.

Methods: A systematic review of individual participant data from case series and reports in addition to a case series from our institution.

Protective eyewear in children with one eye vision loss: compliance and trends.

Purpose: Safety glasses are an important measure to prevent blindness, especially in one- eyed patients. However, patient compliance with eye protection is often limited. Unlike previous studies that described protective eyewear wearing in anophthalmic patients, this study analyzed their usage in functionally one-eyed children, having a significantly reduced visual acuity in one eye, determining common obstacles to their use.

Alterations in Response Switching in Parkinson's Disease: New Insights Into Cueing.

Switching, a critical executive function, can manifest as task switching (TS) or response switching (RS). Although TS impairments in Parkinson's disease (PD) are well-studied, RS, especially in contexts requiring adaptive behavior to external or internal cues, is less explored. This study evaluated the impact of PD on RS under exogenous and endogenous cueing.

Comparative analysis of diagnostic accuracy in adult congenital heart disease: A study of three physician groups and ChatGPT.

This research letter evaluates the diagnostic accuracy of three physician groups-pediatric cardiologists, adult congenital heart disease (ACHD) specialists, and general cardiologists-and compares it to the performance of an AI (Artificial Intelligence) LLM model. Based on eight targeted questions in adult congenital heart disease, the analysis highlights significant disparities in correct answer rates, with congenital specialists achieving the highest accuracy and the AI model - the lowest.

Impact of dopamine deficiency and REM sleep behavior disorder on cognition in early neuronal synuclein disease with hyposmia.

Objectives: To determine the impact of dopamine deficiency and isolated REM sleep behavior disorder (iRBD) on cognitive performance in early neuronal alpha-synuclein disease (NSD) with hyposmia.

Methods: Using Parkinson's Progression Markers Initiative baseline data, cognitive performance was assessed with a cognitive summary score (CSS) developed by applying regression-based internal norms derived from a robust healthy control (HC) group. Performance was examined for participants with hyposmia classified as NSD-Integrated Staging System (NSD-ISS) Stage 2, either Stage 2A (CSF alpha-synuclein seed amplification assay [SAA]+, SPECT dopamine transporter scan [DaTscan]-) or 2B (SAA+, DaTscan+).

Neonatal outcomes between trial of labor and cesarean delivery for extreme preterm infants.

Objective: To compare adverse neonatal outcomes between trial of vaginal delivery and upfront cesarean delivery for singleton infants born at 24 to 28 weeks of gestation.

Methods: This is a retrospective cohort study that was conducted at a university-affiliated tertiary medical center between 2011 and 2022, involving singleton pregnancies delivered between 24 and 27 weeks of gestation. Participants were divided into two groups based on their intended mode of delivery: a trial of labor (TOL) group and an upfront cesarean delivery (CD) group.

Relationship between prenatal ultrasound signs and genetic abnormalities for fetal malformations of cortical development.

To explore the relationship between ultrasound signs of suspected fetal malformation of cortical development (MCD) and genetic MCD.The retrospective study involved fetuses with one of the following 10 neurosonography (NSG) signs: (A) abnormal development of the Sylvian fissure; (B) delayed achievement of cortical milestones; (C) premature or aberrant appearance of sulcation; (D) irregular border of the ventricular wall or irregular shape of the ventricle; (E) abnormal shape or orientation of the sulci; (F) hemispheric asymmetry; (G) non-continuous cerebral cortex; (H) intraparenchymal echogenic nodules; (I) persistent ganglionic eminence (GE) or GE cavitation; (J) abnormal cortical lamination.95 fetuses were included in the study.

Body composition in prepubertal children with idiopathic premature adrenarche: implications for cardiometabolic health.

Background: Premature adrenarche (PA) has been reported as a potential precursor of metabolic disease. We aimed to explore the interaction between body composition and cardiometabolic health of prepubertal children with PA.

Methods: This observational study comprised of 87 children with PA (15 boys, 8.

Annotated interictal discharges in intracranial EEG sleep data and related machine learning detection scheme.

Interictal epileptiform discharges (IEDs) such as spikes and sharp waves represent pathological electrophysiological activities occurring in epilepsy patients between seizures. IEDs occur preferentially during non-rapid eye movement (NREM) sleep and are associated with impaired memory and cognition. Despite growing interest, most studies involving IED detections rely on visual annotations or employ simple amplitude threshold approaches.

Clinical Characterization and Prognostic Risk Factors of Susac Syndrome: A Retrospective Multicenter Study.

Background And Objectives: Susac syndrome (SuS) is a rare disorder characterized by encephalopathy, branch retinal artery occlusion, and sensorineural hearing loss, often accompanied by vertigo. Recent updates to diagnostic criteria and treatment guidelines have been made. This study examines clinical manifestations; disease activity; and risk factors of disability, dependency, and return to work in patients with SuS.

Factors Influencing Refractive Surgery Rejection in Israeli Patients.

Background: One of the major causes of reversible visual impairment is a refractive error, which can be corrected through refractive surgery. Data regarding the outcomes and complications of these procedures exist; however, there is a notable gap in understanding the factors leading to patient rejection, particularly in diverse populations like Israel.

Objectives: To detect clinical risk factors of patients who intend to undergo LASIK procedure and to improve the conversion rates of LASIK procedure in this population.

[Letters to Editor: The risk for clinically significant copy number variants in pregnancies with two soft markers, Geriatriophobia - a new concept in the medical world in Israel].

Letters to Editor: The risk for clinically significant copy number variants in pregnancies with two soft markers, Geriatriophobia - a new concept in the medical world in Israel.