Residual Mitral Regurgitation Interacts With Transmitral Mean Pressure Gradient to Modify the Association With Mortality Following Transcatheter Edge-to-Edge Repair.

Background: The association, if any, between the transmitral mean pressure gradient (TMPG) after mitral transcatheter edge-to-edge repair and 1-year mortality is controversial in patients undergoing mitral transcatheter edge-to-edge repair with the MitraClip system. We sought to estimate the association between intraoperatively measured residual mitral regurgitation (rMR) and TMPG and 1-year mortality among patients undergoing mitral transcatheter edge-to-edge repair to facilitate decisions on additional devices.

Methods: In patients with severe secondary (functional) MR, we analyzed registry data using generalized estimating equations.

Case Report: ESR1::CITED2 Fusion in a Malignant Uterine Tumor Resembling Ovarian Sex Cord Tumor.

Uterine tumor resembling ovarian sex cord tumor (UTROSCT) is a rare, typically benign uterine tumor occurring over a wide age range (mean 52.4 yr). UTROSCTs often harbor translocations between ESR1 and nuclear receptor coactivators NCOA1-NCOA3.

Analysis of Platelet Morphological Parameters as Clinical Risk Stratification in Acute Coronary Syndrome.

Background: Platelet activation plays a central role in the pathogenesis of acute coronary syndrome (ACS). Platelet morphological parameters, including MPV, PDW, and P-LCR, are emerging as biomarkers for predicting the severity of ACS and prognosis.

Aims: This study aims to assess the relationship between these parameters and coronary severity and to evaluate their predicting adverse outcomes.

Geographical Distribution of Newly Accredited Anesthesiology Training Programs in Relation to Health Professional Shortage Areas and Medically Underserved Populations.

Background: Expanding the physician workforce in underserved areas is imperative for addressing healthcare disparities. The creation of new residency training programs has assisted in these efforts. However, anesthesiology training programs are infrequently studied in this regard.

Medial Deviation of a 6° Prosthetic Trochlear Groove After Kinematically Aligned Total Knee Arthroplasty Occurs in Four Types of Coronal Plane Alignment of the Knee (CPAK) and Decreases the Forgotten Joint Score.

Background: The study focused on kinematically aligned total knee arthroplasty (KA TKA). It identified which coronal plane alignment of the knee (CPAK) types are associated with a higher proportion of medial deviation of the 6° prosthetic trochlear groove (PTG) relative to the quadriceps' line of pull and whether medial deviation adversely affected the Forgotten Joint Score (FJS). The research calculated the minimum PTG angle required to prevent medial deviation by at least 2° in all patients.

Bowel regimens before radical cystectomy: An analysis of a modern cohort.

Introduction: Bowel regimens (BR) before radical cystectomy (RC) are currently not recommended by Enhanced Recovery After Surgery (ERAS) protocols, as prior studies have shown BRs lead to worsened outcomes. However, many of those studies have used historic literature before recent surgical advancements such as minimally invasive RC and have not investigated the impact BRs have by type of urinary diversion. Our goal is to determine the outcomes of preoperative BR in patients undergoing RC based on diversion type using a modern patient cohort.

Practical insights into bispecific antibody therapy in multiple myeloma.

Introduction: The rise of recent novel therapies teclistamab, elranatamab, and talquetamab for the treatment of relapsed/refractory multiple myeloma (RRMM) is a rapidly evolving area with significant clinical implications that require exploration and evaluation.

Areas Covered: The current review highlights the clinical trial data, safety endpoints, and practical administration considerations for the bispecific therapies currently used in multiple myeloma. This article reviewed the efficacy and safety results between the three different bispecifics, and the differences in dosing and monitoring requirements.

A new tibial insert design with ball-in-socket medial conformity and posterior cruciate ligament retention has low tibial baseplate migration after unrestricted kinematically aligned total knee arthroplasty: a cohort study using radiostereometric analysis.

Background And Purpose:  In total knee arthroplasty (TKA), an insert with ball-in-socket (BS) medial conformity (MC) and posterior cruciate ligament (PCL) retention restores kinematics closer to native than an insert with intermediate (I) MC. However, high medial conformity might compromise baseplate stability as indicated by maximum total point motion (MTPM). Using the BS MC insert with PCL retention, we aimed to determine whether (i) the baseplate is stable as indicated by mean MTPM < 0.

Updates in Coccidioidomycosis.

Coccidioidomycosis is the clinical disease caused by the dimorphic pathogenic fungi Coccidioides immitis and C posadasii. The number of clinically recognized coccidioidomycosis cases continues to increase yearly including in regions outside the traditional regions of endemicity. Following inhalation of Coccidioides spores, the course may range from asymptomatic exposure with resultant immunity, to a subacute pulmonary illness, to life-threatening disseminated infection.

Mortality patterns in candidemia: Insights from a multispecies analysis using a global research network.

Understanding the impact of different Candida species on patient outcomes is crucial for effective management and treatment strategies. This study aims to comprehensively analyze the association between Candida species and mortality in documented candidemia. We queried TriNetX, a global research network database, to identify patients diagnosed with candidemia through polymerase chain reaction from 2020 to 2023.

Treatment-Resistant Chromoblastomycosis Successfully Managed With Surgical Excision.

Chromoblastomycosis is an uncommon, chronic granulomatous fungal infection of the skin and subcutaneous tissue. Chromoblastomycosis is most commonly caused by the traumatic inoculation of dematiaceous (pigmented) fungi, most commonly species,  species, and species. Chromoblastomycosis usually affects agricultural workers in tropical and subtropical climates.

Managing Cavitary Coccidioidomycosis Expert Opinions for Improving Patient Outcomes.

Coccidioidomycosis, caused by the dimorphic fungi Coccidioides immitis and Coccidioides posadasii, is recognized as an increasing threat both nationally and worldwide. This is in large part secondary to the expanding range of Coccidioides species and increased international travel to endemic regions. Most individuals exposed to airborne Coccidioides organisms do not need medical attention, but approximately 30% will demonstrate primary pulmonary coccidioidomycosis with signs and symptoms that mimic community-acquired pneumonia or other respiratory illnesses.

Endovascular repair with the Gore thoracoabdominal multibranch endoprosthesis for proximal degeneration after prior fenestrated endovascular aortic repair.

Degeneration of the thoracoabdominal aorta proximal to a prior fenestrated endovascular aortic repair represents a complex issue with limited options for repair. Previously, modified endografts or open conversion with endograft explant offered the only options for management. Here we describe use of the Gore Thoracoabdominal Multibranch Endoprosthesis for exclusion of an extent III thoracoabdominal aneurysm in the setting of degeneration proximal to a previously placed fenestrated device.

The impact of mild episodic ketosis on microglia and hippocampal long-term depression in 5xFAD mice.

Ketotherapeutics is a potential metabolic intervention for mitigating dementias; however, its mechanisms and optimal methods of application are not well understood. Our previous in vitro study showed that β-hydroxybutyrate (BHB), a major ketone body, reverses pathological features of amyloid-β oligomer (AβO)-activated microglia. Here we tested the in vivo effects of BHB on microglia and synaptic plasticity in the 5xFAD Alzheimer's disease (AD) mouse model.

Unique N-glycosylation signatures in Aβ oligomer-and lipopolysaccharide-activated human iPSC-derived microglia.

Microglia are the immune cells in the central nervous system (CNS) and become pro-inflammatory/activated in Alzheimer's disease (AD). Cell surface glycosylation plays an important role in immune cells; however, the N-glycosylation and glycosphingolipid (GSL) signatures of activated microglia are poorly understood. Here, we study comprehensive combined transcriptomic and glycomic profiles using human induced pluripotent stem cells-derived microglia (hiMG).

Altered post-fracture systemic bone loss in a mouse model of osteocyte dysfunction.

Femur fracture leads to loss of bone at uninjured skeletal sites, which may increase risk of subsequent fracture. Osteocytes, the most abundant bone cells, can directly resorb bone matrix and regulate osteoclast and osteoblast activity, but their role in systemic bone loss after fracture remains poorly understood. In this study we used a transgenic (TG+) mouse model that overexpresses human B-cell lymphoma 2 (BCL-2) in osteoblasts and osteocytes.

Unbiased Method to Determine Articular Cartilage Thickness Using a Three-Dimensional Model Derived from Laser Scanning: Demonstration on the Distal Femur.

Measuring articular cartilage thickness from 3D models developed from laser scans has the potential to offer high accuracy. However, this potential has not been fulfilled, since generating these models requires that the cartilage be removed, and previous methods of removal have led to systematic errors (i.e.

Parkinson's Disease Polygenic Risk Score and Neurological Involvement in Carriers of the FMR1 Premutation Allele: A Case for Genetic Modifier.

Background: Premutation alleles of the FMR1 X-linked gene containing CGG repeat expansions ranging from 55 to 200 are associated with diverse late-onset neurological involvements, including most severe disorder termed Fragile X-associated Tremor/Ataxia Syndrome (FXTAS). It is intriguing that at least one-third of male, and a much lower than predicted from the X-linkage proportion of female carriers are free of this syndrome. This suggests the existence of secondary genetic factors modifying the risk of neurological involvements in these carriers.

The California collaborative network to promote data driven care and improve outcomes in early psychosis (EPI-CAL) project: rationale, background, design and methodology.

Background: A prolonged first episode of psychosis (FEP) without adequate treatment is a predictor of poor clinical, functional, and health outcomes and significant economic burden. Team-based "coordinated specialty care" (CSC) for early psychosis (EP) has established effectiveness in promoting clinical and functional recovery. However, California's CSC program implementation has been unsystematic and could benefit from standardizing its processes and data collection infrastructure.

Renovascular hypertension - a primer for the radiologist.

Renovascular hypertension (RVHT) is an important cause of secondary hypertension, accounting for approximately 75% of cases. This pictorial review describes the imaging modalities used to diagnose RVHT, including ultrasound, computed tomography angiography, and magnetic resonance angiography, provides their benefits and limitations, and explores the imaging findings, diagnostic criteria, and management of multiple causes of RVHT. Atherosclerosis is the most common cause of RVHT, particularly in older individuals, while fibromuscular dysplasia is more prevalent in younger females.