Initiation of home noninvasive ventilation in hypercapnic chronic obstructive pulmonary disease: when, where, and how?

Purpose Of Review: This review aims to highlight the importance of timely initiation of home noninvasive ventilation (homeNIV) for patients with chronic hypercapnic respiratory failure (CHRF) due to chronic obstructive pulmonary disease (COPD). As emerging evidence continues to show substantial benefits in reducing mortality and hospitalizations, it's crucial to identify which patients will benefit most and to provide clear guidance on implementing homeNIV effectively.

Recent Findings: Recent research supports the use of high intensity homeNIV for CHRF secondary to COPD, showing marked reductions in hospitalizations and mortality.

Impact of high spinal anesthesia in pediatric congenital heart surgery on postoperative recovery: a retrospective propensity score-matched study.

Background: High spinal anesthesia (HSA) has been utilized in cardiac surgery; however, there is limited evidence on its impact on facilitating postoperative recovery. This study aimed to evaluate the impact of HSA in pediatric congenital heart surgery on postoperative recovery.

Methods: A single center, propensity score-matched retrospective cohort study was designed using data from pediatric patients under 18 years old, who underwent congenital heart surgeries classified as Risk Adjustment for Congenital Heart Surgery-1 (RACHS-1) score 3 or less.

Structure and assembly of the dystrophin glycoprotein complex.

The dystrophin glycoprotein complex (DGC) has a crucial role in maintaining cell membrane stability and integrity by connecting the intracellular cytoskeleton with the surrounding extracellular matrix. Dysfunction of dystrophin and its associated proteins results in muscular dystrophy, a disorder characterized by progressive muscle weakness and degeneration. Despite the important roles of the DGC in physiology and pathology, its structural details remain largely unknown, hindering a comprehensive understanding of its assembly and function.

Supplementary oxygen efficacy for chronic pulmonary disorders and exertion desaturation.

Introduction: Exertion-induced desaturation (EID) is a common complication of numerous pulmonary disorders and often treated with supplementary oxygen during exertion. We performed a systematic review and meta-analysis of randomised clinical trials (RCTs) to evaluate the efficacy of supplementary oxygen for EID in pulmonary disorders.

Material And Methods: Medline and Embase were systematically searched from July 2022 to June 2023 following PRISMA guidelines.

Comparison of outcomes by race among a population-based matched sample of multiple myeloma patients.

Purpose: It is important to understand racial inequities in multiple myeloma treatment and survival, particularly in the Midwest where clear differences exist in cancer incidence and mortality. Since age and geographic location can greatly impact treatment and prognosis, matching patients on these characteristics can help identify reasons for outcome differences.

Methods: Retrospective data from the Iowa Cancer Registry's Surveillance, Epidemiology, and End Results database were analyzed for adult patients diagnosed with first primary MM between 1/1/2010-12/31/2019.

Immediate change following valve deployment in left ventricular systolic and diastolic functions in transcatheter aortic valve replacement: a retrospective cohort study.

Background: Transcatheter aortic valve replacement (TAVR) is an effective treatment for aortic valve disorder. Several studies have reported improvements in systolic and diastolic function following TAVR. However, few studies have addressed immediate post-deployment changes.

Needlessly Treated: Evaluation of Prehospital Needle Thoracostomy.

Background: Needle thoracostomy is a potentially life-saving intervention for tension pneumothorax but may be overused, potentially leading to unnecessary morbidity.

Objective: To review prehospital needle thoracostomy indications, effectiveness, and adverse outcomes.

Methods: A retrospective cohort study was conducted based on registry data for a United States Midwestern Level I trauma center for a 7.

Update on Antisocial Personality Disorder.

Purpose Of Review: Antisocial personality disorder (ASPD) is a characterized by lifelong or recurrent behavioral problems that begin in childhood or early adolescence. This communication provides an overview on ASPD including findings from recent reviews and new research.

Recent Findings: With regard to DSM-5's Section III Alternative Model of Personality Disorder criteria for ASPD, advocates point to the broader symptom coverage and harmonization with ICD-11; yet critics point to the lack of evidence for improved outcomes.

Management of pediatric patients admitted for colonic disimpaction: A scoping review protocol.

Objectives: Chronic constipation is a common condition in pediatric patients worldwide and is associated with decreased quality of life. Inpatient management of constipation is required when outpatient therapy fails and a child becomes obstipated, and unable to pass stool or gas. There is a growing body of evidence regarding different management strategies for pediatric obstipation.

A Teach-the-Teacher Module for Human Trafficking Bedside Instruction.

Introduction: Human trafficking (HT) is a public health issue that adversely affects patients' well-being. Despite the prevalence of trafficked persons in health care settings, a lack of educational modules exists for use in clinical contexts. We developed a 50-minute train-the-trainer module on HT.

Prevalence of Bronchodilator Responsiveness: A Comparison of Old Versus New Criteria.

Background: In 2021, the European Respiratory Society (ERS)/American Thoracic Society (ATS) guidelines issued a new definition of bronchodilator responsiveness, which is now defined as an increase in FEV or FVC by ≥ 10% of the predicted FEV or FVC. The impact of this revised definition on bronchodilator responsiveness prevalence has been relatively understudied.

Methods: We retrospectively analyzed data from 2,696 subjects who performed pulmonary function testing at the University of Iowa from 1997 to 2018.

Respiratory Therapist-Driven Mechanical Ventilation Protocol Is Associated With Increased Lung Protective Ventilation.

Background: Mechanical ventilation is a common life-saving procedure but can lead to serious complications, including ARDS and oxygen toxicity. Nonadherence to lung-protective ventilation guidelines is common. We hypothesized that a respiratory therapist-driven mechanical ventilation bundle could increase adherence to lung-protective ventilation and decrease the incidence of pulmonary complications in the ICU.

Reassessing the Use of Race in Clinical Algorithms: An Interactive, Case-Based Session for Medical Students Using eGFR.

Introduction: Medical curricula implicitly teach that race has a biological basis. Clinical rotations reinforce this misconception as race-based algorithms are used to guide clinical decision-making. This module aims to expose the fallacy of race in clinical algorithms, using the estimated glomerular filtration rate (eGFR) equation as an example.

Impact of index admission cholecystectomy interval cholecystectomy on readmission rate in acute cholangitis: National Readmission Database survey.

Background: Elective cholecystectomy (CCY) is recommended for patients with gallstone-related acute cholangitis (AC) following endoscopic decompression to prevent recurrent biliary events. However, the optimal timing and implications of CCY remain unclear.

Aim: To examine the impact of same-admission CCY compared to interval CCY on patients with gallstone-related AC using the National Readmission Database (NRD).

A recurrent missense variant in ITPR3 causes demyelinating Charcot-Marie-Tooth with variable severity.

Charcot-Marie-Tooth (CMT) disease is a neuromuscular disorder affecting the peripheral nervous system. The diagnostic yield in demyelinating CMT (CMT1) is typically ∼80-95%, of which at least 60% is due to the PMP22 gene duplication. The remainder of CMT1 is more genetically heterogeneous.

Perceptions of families and healthcare providers about feeding preterm infants in the neonatal intensive care unit: protocol for a qualitative systematic review.

Introduction: The underdevelopment of preterm infants can lead to delayed progression through key early milestones. Demonstration of safe oral feeding skills, constituting proper suck-swallow reflex are requirements for discharge from the neonatal intensive care unit (NICU) to ensure adequate nutrition acquisition. Helping an infant develop these skills can be draining and emotional for both families and healthcare staff involved in the care of preterm infants with feeding difficulties.

Sex differences in the association of pretransfusion haemoglobin and cognition in preterm infants.

Objectives: To assess sex-specific differences in the association between pre-transfusion haemoglobin values and early neurodevelopmental function.

Design: Observational follow-up of infants with birth weights <1000 g and gestational ages 22-28 weeks who were enrolled in the NICHD Neonatal Research Network Transfusion of Prematures (TOP) Trial at 19 U.S.

Impact of metabolic dysfunction-associated steatotic liver disease on COVID-19 hospitalizations: A propensity-matched analysis of the United States.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formally known as nonalcoholic fatty liver disease, is the most common chronic liver disease in the United States. Patients with MASLD have been reported to be at a higher risk of developing severe coronavirus disease 2019 (COVID-19) and death. However, most studies are single-center studies, and nationwide data in the United States is lacking.

White matter tract integrity in isolated oral clefts: relationship to cognition and reading skills.

Children with isolated cleft of the lip and/or palate (iCL/P) have been shown to be at risk for impaired reading ability. Structural and functional neuroimaging studies have revealed subtle morphological and functional abnormalities correlated to cognition and reading ability. However, the integrity of white matter tracts and their potential relationship to reading performance in iCL/P is under-studied.

Mitochondrial dysfunction in neurodegenerative disorders.

Recent advances in understanding the role of mitochondrial dysfunction in neurodegenerative diseases have expanded the opportunities for neurotherapeutics targeting mitochondria to alleviate symptoms and slow disease progression. In this review, we offer a historical account of advances in mitochondrial biology and neurodegenerative disease. Additionally, we summarize current knowledge of the normal physiology of mitochondria and the pathogenesis of mitochondrial dysfunction, the role of mitochondrial dysfunction in neurodegenerative disease, current therapeutics and recent therapeutic advances, as well as future directions for neurotherapeutics targeting mitochondrial function.

Repeat thrombectomy after large vessel re-occlusion: a propensity score matched analysis of technical and clinical outcomes.

Background: Endovascular thrombectomy (EVT) remains the standard of care for acute large vessel occlusion (LVO) stroke. However, the safety and efficacy of repeat thrombectomy (rEVT) in recurrent LVO remains unclear. This study uses a large real-world patient cohort to study technical and clinical outcomes after rEVT.