Procedural Interventions for Terminally Ill Children - Are We Aiding Palliation?

Many children undergo surgery or an invasive procedure during their terminal hospital admission. The types of procedures, patients, and the intent of the procedures has not been well defined. Understanding these details may help pediatric surgeons better determine the clinical settings in which certain procedures will not enhance palliation or survival.

Donor call simulation: A novel medical education tool to evaluate trainees' clinical decision-making in transplant infectious disease.

Background: Evaluating organ suitability for transplantation based on infection risk is a core competency in transplant infectious disease (TID). It is unclear if trainees have opportunities to practice during training. We created a simulation curriculum to develop and evaluate this skill among infectious disease (ID) trainees.

Randomized Phase III BMT CTN Trial of Calcineurin Inhibitor-Free Chronic Graft-Versus-Host Disease Interventions in Myeloablative Hematopoietic Cell Transplantation for Hematologic Malignancies.

Purpose: Calcineurin inhibitors (CNI) are standard components of graft-versus-host disease (GVHD) prophylaxis after hematopoietic cell transplantation (HCT). Prior data suggested that CNI-free approaches using donor T-cell depletion, either by ex vivo CD34 selection or in vivo post-transplant cyclophosphamide (PTCy) as a single agent, are associated with lower rates of chronic GVHD (cGVHD).

Methods: This multicenter phase III trial randomly assigned patients with acute leukemia or myelodysplasia and an HLA-matched donor to receive CD34-selected peripheral blood stem cell, PTCy after a bone marrow (BM) graft, or tacrolimus and methotrexate after BM graft (control).

An Uncommon Cause of Shock: Acute Thrombosis of the Inferior Vena Cava.

Background: Obstructive shock is an uncommon presentation to the emergency department (ED) and is most often caused by an acute pulmonary embolism. A very rare cause of obstructive shock is extensive deep venous thrombosis, otherwise known as phlegmasia cerulea dolens. We present a case of obstructive shock caused by placement of an inferior vena cava filter complicated by acute occlusion with extensive deep venous thrombosis.

Relative Energy Deficiency in Sport: an Orthopaedic Perspective.

Relative energy deficiency in sport (RED-S) is a constellation of clinical findings related to low energy availability. Manifestations are variable but may include endocrine and reproductive dysfunction, impaired bone and muscle health, psychological complaints, and performance issues, among many others. Unlike the previously common terminology, the female athlete triad, RED-S encompasses a broader range of signs and symptoms and includes descriptions for the male athlete.

Blood Flow Restriction Therapy: Where We Are and Where We Are Going.

Blood flow restriction therapy (BFRT) is an innovative training method for the development of muscle strength and hypertrophy in the athletic and clinical settings. Through the combination of venous occlusion and low-load resistance training, it induces muscle development through a number of proposed mechanisms including anaerobic metabolism, cellular swelling, and induction of type 2 muscle fibers. Muscle weakness and atrophy are prevalent among musculoskeletal rehabilitation patients, causing delayed return to functional activity.

MRI findings of absorbable hydrogel spacer for prostate cancer therapy: a pictorial review.

Prior studies have shown that dose-escalated radiation therapy for prostate cancer improves clinical outcomes. However, this is associated with increased rectal toxicity. Hydrogel spacer for prostate cancer therapy is an effective way of decreasing rectal toxicity in the late post-therapeutic stages.