Systematic Review of Sublobar Resection for Treatment of High-Risk Patients with Stage I Non-Small Cell Lung Cancer.

Sublobar resection offers a parenchymal-sparing surgical alternative to lobectomy and includes wedge resection and segmentectomy. Sublobar resection has been historically utilized in high-risk patients with compromised lung function; however, the technique is becoming more prevalent for normal-risk patients with peripheral lung tumors < 2 cm. In this article, we summarize the technique of sublobar resection, the importance of surgical margins and lymph node sampling, patient selection, perioperative complications, outcomes, and the impact of sublobar resection on the quality of life.

Magnitude of effect of low dose colchicine, a newly food and drug administration approved treatment for stroke prevention.

Background: As the Food and Drug Administration in June 2023 approved low dose colchicine for primary prevention of stroke and other cardiovascular events, an updated meta-analysis of stroke outcomes in randomized trials would help inform clinical practice.**** METHODS: Systematic, study-level meta-analysis of randomized clinical trials of long-term colchicine in patients with established atherosclerotic cardiovascular disease (ASCVD, preponderantly primary prevention for stroke) or following non-cardioembolic ischemic stroke/transient ischemic attack (secondary prevention). Heterogeneity was assessed with the I statistic and Cochrane's Q and potential bias assessed with the Risk of Bias 2.

Men's influence of maternal substance use before, during, and after pregnancy: A qualitative study of men with criminal-legal involvement.

Background: While the adverse effects of substance use during pregnancy are well-established, the impact men with criminal-legal involvement who use substances have on their partner's substance-using behaviors is not well characterized. We aim to understand men's experiences and perspectives about how their substance use impacts romantic partner substance use in the preconception period, before a potential or actual pregnancy.

Methods: We conducted semi-structured interviews with men residing in a transition center in the Midwestern US with a substance use disorder (SUD) who partnered with women.

Treatment Selection for the High-risk Patient with Stage I Non-Small Cell Lung Cancer: Sublobar Resection, Stereotactic Ablative Radiotherapy or Image-guided Thermal Ablation?

Objective: A significant proportion of patients with stage I non-small cell lung cancer (NSCLC) are considered at high risk for complications or mortality after lobectomy. The American Association for Thoracic Surgery (AATS) previously published an expert consensus document detailing important considerations in determining who is at high risk. The current objective was to evaluate treatment options and important factors to consider during treatment selection for these high-risk patients.

Systematic Review of Image-guided Thermal Ablation for Treatment of High-Risk Patients with Stage I Non-Small Cell Lung Cancer.

Image-guided thermal ablation (IGTA) applied to pulmonary pathology is an alternative to surgery in high-risk patients with stage I non-small cell lung cancer (NSCLC). Its application to lung neoplasm was first introduced in 2001 and has been implemented to treat metastatic disease to the lung or in select medically inoperable patients with peripheral stage I NSCLC. IGTA may also be an alternative to treat stage I NSCLC in non-operable patients with interstitial lung disease in whom a radiation modality is deemed too high risk.

The Importance of Pulmonary Nodule Features in the Selection of Treatment for the High-risk Patient with Stage I Non-Small Cell Lung Cancer.

Objective: The American Association for Thoracic Surgery (AATS) Clinical Practice Standards Committee (CPSC) previously published important considerations in determining who is at high risk for complications or mortality after lobectomy. Sublobar resection, stereotactic ablative radiotherapy, or image-guided thermal ablation is typically considered when the risks associated with lobectomy are high. The current objective was to evaluate important lung-nodule-related factors to consider during treatment selection for high-risk patients with stage I non-small cell lung cancer (NSCLC).

Angiotensin Receptor-Neprilysin Inhibitor Prescribing Patterns in Patients Hospitalized for Heart Failure.

Importance: Angiotensin receptor-neprilysin inhibition (ARNI) improves mortality among patients with heart failure with reduced ejection fraction (HFrEF), ie, those with an EF of 40% or less.

Objective: To describe national longitudinal trends in ARNI prescribing patterns among hospitalized patients with HFrEF.

Design, Setting, And Participants: Using data from the Get With The Guidelines-Heart Failure (GWTG-HF) registry, hospitalized patients with HFrEF at 614 participating hospitals were identified.

High-Flow Nasal Oxygen vs Noninvasive Ventilation in Patients With Acute Respiratory Failure: The RENOVATE Randomized Clinical Trial.

Importance: High-flow nasal oxygen (HFNO) and noninvasive ventilation (NIV) are commonly used respiratory support therapies for patients with acute respiratory failure (ARF).

Objective: To assess whether HFNO is noninferior to NIV on the rates of endotracheal intubation or death at 7 days in 5 patient groups with ARF.

Design, Setting, And Participants: This noninferiority, randomized clinical trial enrolled hospitalized adults (aged ≥18 years; classified as 5 patient groups with ARF: nonimmunocompromised with hypoxemia, immunocompromised with hypoxemia, chronic obstructive pulmonary disease [COPD] exacerbation with respiratory acidosis, acute cardiogenic pulmonary edema [ACPE], or hypoxemic COVID-19, which was added as a separate group on June 26, 2023) at 33 hospitals in Brazil between November 2019 and November 2023 (final follow-up: April 26, 2024).

Equity Landscape in Healthcare Quality: A Mixed-Methods Study of Efforts within Surgical Quality Programs.

Background: Addressing equity in healthcare is necessary to improve population health outcomes. In doing so, a requisite level of foundational resources, organization, and processes are needed. Although increasing attention is being devoted to addressing health inequities, the current landscape supporting these efforts remains unknown.

Prevalence and Outcomes of Chronic Kidney Disease-Associated Pruritus: International Results from Peritoneal Dialysis Outcomes and Practice Patterns Study.

Key Points: CKD-associated pruritus is highly prevalent among peritoneal dialysis patients. Pruritus is associated with reduced health-related quality of life, and the composite of mortality and transfer to hemodialysis for peritoneal dialysis patients. Efforts to better identify and manage pruritus in this population are needed.

A Review of Photon-Counting Computed Tomography (PCCT) in the Diagnosis of Cardiovascular Diseases.

Photon-counting computed tomography (PCCT) is an innovative mechanism used for imaging and provides higher spatial resolution and contrast sensitivity in comparison with the orthodox energy-integrating detectors (EIDs). Unlike EID-based CT systems, which indirectly convert X-ray photons to electrical signals, PCCT directly counts and quantifies each photon's energy, enhancing image quality and material separation. With all of these features, PCCT is especially useful for cardiovascular imaging, where it is essential to precisely observe cardiac tissues, vascular structures, and coronary arteries.

Evaluation of dimethandrolone undecanoate in non-human primates as a candidate for long-acting injectable male contraceptive.

Background: Dimethandrolone undecanoate (DMAU) is under development as a single agent hormonal male contraceptive. DMAU is a prodrug hydrolyzed by esterase(s) to the active metabolite dimethandrolone (DMA) which has dual androgenic and progestogenic actions. Phase 1 clinical trial results show DMAU to be well-tolerated as an oral contraceptive in healthy men; however, delivery of DMAU as a long-acting injectable rather than a daily oral formulation would provide user compliance benefits and address oral bioavailability concerns.

Associations between neighborhood built-environment characteristics and hepatic steatosis: The Multi-Ethnic Study of Atherosclerosis.

Objective: To characterize the spatio-temporal association between features of the built environment and subclinical liver disease.

Design: We used data from a large community-based population, the Multi-Ethnic Study of Atherosclerosis (2000-2002, N = 5542) with linked historical residential data that characterized past exposure to alcohol outlets (bars and liquor stores), healthy foods stores, and physical activity facilities (1990-2001). We examined whether and how past residential relate to hepatic steatosis (proxied by liver attenuation measured using computed tomography, with lower attenuation indicating higher hepatic steatosis).

Revisiting ICD Therapy for Primary Prevention in Patients With Heart Failure and Reduced Ejection Fraction.

Implantable cardioverter-defibrillators (ICDs) are recommended to reduce the risk of sudden cardiac death (SCD) in patients with heart failure with reduced ejection fraction (HFrEF). The landmark studies leading to the current guideline recommendations preceded the 4 pillars of guideline-directed medical therapies (GDMTs). Therefore, some have questioned the role of ICDs for primary prevention in current clinical practice.

Rationale and design of the PE-TRACT trial: A multicenter randomized trial to evaluate catheter-directed therapy for the treatment of intermediate-risk pulmonary embolism.

Background: The optimal management of patients with intermediate-risk pulmonary embolism (PE), who have right heart dysfunction (determined by a combination of imaging and cardiac biomarkers) but a normal blood pressure, is uncertain. These patients suffer from reduced functional capacity and a lower quality of life over the long-term, despite use of anticoagulant therapy. Catheter-directed therapy (CDT) is a promising treatment for acute PE that rapidly removes thrombus and potentially improves cardiac dysfunction.

Epigenetic Upregulation of Carotid Body Angiotensin Signaling Increases Blood Pressure.

Background: Epigenetic changes can be shaped by a wide array of environmental cues, maternal health, and behaviors. One of the most detrimental behaviors to the developing fetus is nicotine exposure. Perinatal nicotine exposure remains a significant risk factor for cardiovascular health and, in particular, hypertension.