Pulmonary langerhans cell histiocytosis secondary to Marijuana use: a case report and systematic review of the literature.

Background: Pulmonary Langerhans Cell Histiocytosis (PLCH) is a rare interstitial lung disease primarily affecting young to middle-aged smokers. While traditionally linked to tobacco use, there is growing evidence that cannabis use may contribute to PLCH.

Methods: We present a case of a 52-year-old male with PLCH associated with heavy cannabis use.

Mechanical thrombectomy in elderly stroke patients with low ASPECTS: insights from STAR.

Background: The elderly population (≥80 years) were underrepresented in recent trials of endovascular thrombectomy (EVT) for anterior circulation large vessel occlusion acute ischemic stroke (LVO-AIS) with low Alberta Stroke Program Early CT Score (ASPECTS) (≤5).

Methods: This study analyzed data from a prospectively maintained database of 37 thrombectomy centers. The primary cohort of the study comprised patients with LVO-AIS aged ≥80 who underwent EVT with ASPECTS≤5 from 2013 to 2023.

Consensus on Safe Initiation and Monitoring of Transanal Irrigation to Optimize Adherence With Therapy.

Background: Transanal irrigation is a well-established minimally invasive therapy that addresses symptoms of both constipation and incontinence. The therapy has been extended from just neurogenic bowel dysfunction patients to those with disorders of brain-gut interaction and postsurgical conditions.

Aim: To summarized the literature on transanal irrigation and update the contraindication profile.

Study of Histotripsy With Subsequent Heating on In Vitro VX2 Cancer Cells.

Objective: Focused ultrasound has emerged as a precise and minimally invasive modality for effective cancer treatment. In this study, we propose a novel method that integrates the mechanical effects of focused ultrasound, known as histotripsy, with heating to enhance both the immediate and sustained cytotoxic effects on cancer cells.

Methods: Our investigation focused on VX2 cancer cells in suspension, examining five experimental groups: blank control, negative control, heating alone, histotripsy alone, and histotripsy with subsequent heating.

Managing Calciphylaxis: Insights from Real-World Cases at a Tertiary Academic Center.

Calciphylaxis is a rare and potentially fatal condition involving chronic, nonhealing wounds caused by microvascular calcification. There is currently no approved treatment for calciphylaxis, contributing to its devastating impacts on quality of life. In this case series, the authors highlight instances of potentially misdiagnosed calciphylaxis in a cohort of patients and emphasize the importance of accurate diagnosis through multidisciplinary management approaches.

Variation in compressive mechanical properties between subacute and chronic venous thrombosis in a novel unilateral iliac thrombosis model.

Interventional therapies to relieve chronic deep vein thrombosis (DVT) fail through inability to penetrate, cross, and remove the occlusion. Development of suitable tools requires fundamental understanding of chronic DVT mechanical properties and a reliable model for testing. Female farm swine underwent a novel, endovenous generation of long-segment unilateral iliac vein thrombosis.

Disparities in 180-day Infection Rates Following Coronary Artery Bypass Grafting and Aortic Valve Replacement.

Objective: To compare sex and racial differences in 180-day infection rates after coronary artery bypass grafting (CABG) and aortic valve replacement (AVR).

Methods: A Statewide Society of Thoracic Surgeons Adult Cardiac Surgery Database was linked to Medicare claims data to identify 8,887 beneficiaries undergoing CABG and AVR (surgical or transcatheter) between 2017 and 2021. The primary outcome was the incidence of 180-day infection.

The DIMASHQ Procedure: AO Plug pseudoaneurys repair in cending aorta using uality intracardiac ecocardiography.

The transcatheter management of complex cardiovascular diseases has significantly evolved, offering less invasive alternatives to traditional surgical interventions. In this report we describe 2 cases of patients who developed ascending aortic pseudoaneurysms soon after coronary artery bypass grafting. With meticulous computed tomography angiography planning and with live intracardiac echography, these patients underwent successful transcatheter repair using a 6/4-mm Amplatzer Duct Occluder II (Abbott) vascular plug.

Aspiration of Left Atrial Masses Using the Large-Bore Manual Aspiration System: The ASPIRATE LA Procedure.

Transcatheter mass extraction of left-sided cardiac masses has gained popularity in recent years, with scarce data on effectiveness, safety, and types of devices used. Mostly, left-sided aspirations use mechanical and continuous-flow-mediated devices (the AngioVac [AngioDynamics] and Penumbra systems [Penumbra]). To our knowledge, the use of manual aspiration devices has not been reported yet.

Blood Culture Use in Medical and Surgical Intensive Care Units and Wards.

Importance: Blood culture (BC) use benchmarks in US hospitals have not been defined.

Objective: To characterize BC use in adult intensive care units (ICUs) and wards in US hospitals.

Design, Setting, And Participants: A retrospective cross-sectional study of BC use in adult medical ICUs, medical-surgical ICUs, medical wards, and medical-surgical wards from acute care hospitals from the 4 US geographic regions was conducted.

Effect of Prepectoral Versus Subpectoral Implant-Based Reconstruction on Post-Mastectomy Radiation Dosimetry.

Background: The placement of breast implants in a prepectoral plane has become increasingly popular in breast reconstruction, although data on how this affects radiation delivery in women with breast cancer are limited. This study aimed to assess the dosimetric differences in radiation plans for immediate breast reconstruction between prepectoral and subpectoral implants.

Methods: In this study, a retrospective review and dosimetric analysis of patients with breast cancer who underwent immediate implant-based reconstruction and postmastectomy radiation therapy (PMRT) were performed.

2024 HRS perspective on advancing workflows for CIED remote monitoring.

Cardiac implantable electronic devices (CIEDs) generate substantial data, often stored in image or PDF formats. Remote monitoring, now an integral component of patient care, places considerable administrative burdens on clinicians and staff, in large part due to the challenge of integrating these data seamlessly into electronic health records. Since 2006, the Heart Rhythm Society, in collaboration with the CIED industry, has led an initiative to establish a unified standard nomenclature.

Association of Pre- and Postinjury Mental Health With Long-term Clinical and Financial Outcomes.

Background: As increased attention is placed on optimizing long-term outcomes of trauma patients by addressing mental health, little is known regarding the interplay of pre- and postinjury mental health on long-term financial and functional outcomes.

Methods: Patients from 19 Level 1 and 2 trauma centers took part in serial surveys 1 to 24 months postdischarge. Preinjury mental health diagnoses were identified using trauma registry data and postinjury mental health symptoms from survey data.

Interhospital Variability in 180-day Infections Following Cardiac Surgery.

Objective: This study sought to: (1) evaluate hospital-level variation in infections following cardiac surgery and (2) develop and evaluate a 180-day infection quality metric.

Methods: This study evaluated Medicare claims that were merged with institutional Society of Thoracic Surgeons Adult Cardiac Surgery Database files among patients undergoing cardiac surgery across 33 Michigan centers. The primary outcome was an infection within 180 days of surgery.

Small Extracellular Vesicles Derived from Cord Blood Plasma and Placental Mesenchymal Stem Cells Attenuate Acute Lung Injury Induced by Lipopolysaccharide (LPS).

Sepsis is a risk factor associated with increasing neonatal morbidity and mortality, acute lung injury, and chronic lung disease. While stem cell therapy has shown promise in alleviating acute lung injury, its effects are primarily exerted through paracrine mechanisms rather than local engraftment. Accumulating evidence suggests that these paracrine effects are mediated by mesenchymal stem cell (MSC)-derived small extracellular vesicles (sEVs), which play a critical role in immune system modulation and tissue regeneration.

Thoracic Surgery Outcomes Research Network (ThORN) Consensus Document on Defining a High Quality Wedge Resection for Early Stage Lung Cancer.

With the publication of CALGB 140503, an increase in wedge resections for small, peripheral non-small cell lung cancer is expected; however, a relative paucity of data exists as to what defines a high quality oncologic wedge resection. The Thoracic Surgery Outcomes Research Network (ThORN), through expert discussion, guided by review of what limited data does exist, and through use of a modified Delphi process, provides these consensus statements defining an oncologically sound, high quality wedge resection. The statements are classified into five categories: 1) Preoperative Considerations 2) Technical Aspects 3) Lymph Node Assessment 4) Margin Assessment and 5) Tissue Handling by Pathology.

Endoscopic techniques for the diagnosis of pancreatic cystic lesions.

Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans, with few patients presenting with abdominal pain or other symptoms. The accurate diagnosis of cysts is important as management depends on the type (neoplastic or non-neoplastic). Cross-sectional imaging is fast being replaced with endoscopic ultrasound (EUS) and various techniques based on that such as EUS-guided fine needle aspiration, EUS-guided needle confocal laser endomicroscopy, EUS-through-the-needle biopsy, and contrast-enhanced EUS.

Fear of Childbirth Among Pregnant People Facing Anti-Fat Bias.

Explicit and implicit anti-fat biases are widespread among healthcare providers, leading to significant negative consequences for pregnant people, including poorer health outcomes. Fear of childbirth (FOC) can affect the length of labor, increase the risk of cesarean delivery, and negatively influence a new parent's perception of infant bonding. This study investigated the impact of perceived anti-fat bias on FOC among pregnant people.

Regional Anesthesia and Surgical Volume in Children Undergoing Nuss Repair: A Multicenter Review.

Introduction: Regional anesthetic approach and surgical volume have been shown to outcomes in patients undergoing Nuss procedure for pectus excavatum. However, their independent relationship is not described. We investigated how regional anesthesia and surgical volume are associated with length of stay (LOS), postoperative opioid use, operating room utilization, and complications.

Clinical pearls for the management of duloxetine patients with medical comorbidities.

The effective use of duloxetine can be complicated by acute kidney injury, acute and/or chronic hepatic dysfunction, dysphagia, enteral nutrition, and common pharmacokinetic interactions. This article aimed to review the pharmacological properties of duloxetine pertinent to its use and to discuss the management of duloxetine in patients with common acute and chronic medical comorbidities. Management strategies based on clinical data and expert opinion are reviewed in 3 patient cases.

Self-Reported Comfort and Use of Tobacco Cessation Interventions by Healthcare Providers.

Background The effects of tobacco use create a significant burden on the American healthcare system. The U.S.

Mixed-methods multicenter assessment of healthcare workers' knowledge, perceptions, and practices related to blood culture utilization in hospitalized adults.

Objective: To understand healthcare workers' (HCWs) beliefs and practices toward blood culture (BCx) use.

Design: Cross-sectional electronic survey and semi-structured interviews.

Setting: Academic hospitals in the United States.

Computational deconvolution of cell type-specific gene expression in COPD and IPF lungs reveals disease severity associations.

Background: Chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF) are debilitating diseases associated with divergent histopathological changes in the lungs. At present, due to cost and technical limitations, profiling cell types is not practical in large epidemiology cohorts (n > 1000). Here, we used computational deconvolution to identify cell types in COPD and IPF lungs whose abundances and cell type-specific gene expression are associated with disease diagnosis and severity.