Association Between Delayed/Forgone Medical Care and Resource Utilization Among Women with Breast Cancer in the United States.

Background: Although high treatment costs of breast cancer care are well documented, the relationship between delayed/forgone (D/F) care and resource utilization among patients with breast cancer is unknown. This study sought to investigate the relationship between D/F care, resource use, and healthcare expenditures among patients with breast cancer.

Methods: Data on adult female patients with breast cancer were obtained from the Medical Expenditure Panel Survey to assess resource utilization and expenditures in the United States from 2007 to 2017.

Palliative Electroconvulsive Therapy: A Descriptive Cohort Study.

Background: Palliative care (PC) is the standard of care for patients with serious medical illnesses, or those conditions associated with high risk of mortality and negative impact on quality of life (QOL). Electroconvulsive therapy (ECT) is the gold standard treatment for certain psychiatric conditions, which may co-occur with serious medical illnesses. However, the use of "palliative ECT" (PECT) in this context is understudied.

Assessing Your Job: When to Consider Changing Jobs.

Over half of orthopedic surgeons will change jobs prior to their fifth year in practice. Commonly cited reasons behind the change include compensation, work-life balance, poor job fit, and dissatisfaction with management. Many of these factors are difficult to vet as a job applicant and are often only realized during the course of real-life practice.

Safety and tolerability of tegoprubart in patients with amyotrophic lateral sclerosis: A Phase 2A clinical trial.

Background: The interaction of CD40L and its receptor CD40 on activated T cells and B cells respectively control pro-inflammatory activation in the pathophysiology of autoimmunity and transplant rejection. Previous studies have implicated signaling pathways involving CD40L (interchangeably referred to as CD154), as well as adaptive and innate immune cell activation, in the induction of neuroinflammation in neurodegenerative diseases. This study aimed to assess the safety, tolerability, and impact on pro-inflammatory biomarker profiles of an anti CD40L antibody, tegoprubart, in individuals with amyotrophic lateral sclerosis (ALS).

Emergency Department Management of Maxillofacial Trauma.

Patients with maxillofacial trauma require careful evaluation due to the anatomical proximity of the maxillofacial region to the head and neck. Facial trauma can lead to life-threatening airway compromise or hemorrhage, or permanent facial deformity. Although the Advanced Trauma Life Support guidelines provide a framework for the management of trauma patients, they do not provide a detailed reference for many subtle or complex facial injuries.

Early drivers of clonal hematopoiesis shape the evolutionary trajectories of acute myeloid leukemia.

Mutations commonly found in AML such as , and can be found in the peripheral blood of otherwise healthy adults - a phenomenon referred to as clonal hematopoiesis (CH). These mutations are thought to represent the earliest genetic events in the evolution of AML. Genomic studies on samples acquired at diagnosis, remission, and at relapse have demonstrated significant stability of CH mutations following induction chemotherapy.

Beyond PhacoTrainer: Deep Learning for Enhanced Trabecular Meshwork Detection in MIGS Videos.

Purpose: The purpose of this study was to develop deep learning models for surgical video analysis, capable of identifying minimally invasive glaucoma surgery (MIGS) and locating the trabecular meshwork (TM).

Methods: For classification of surgical steps, we had 313 video files (265 for cataract surgery and 48 for MIGS procedures), and for TM segmentation, we had 1743 frames (1110 for TM and 633 for no TM). We used transfer learning to update a classification model pretrained to recognize standard cataract surgical steps, enabling it to also identify MIGS procedures.

Exploring health disparities in diagnosing multiple myeloma.

Background: Multiple myeloma (MM) is a plasma cell neoplasm, which accounts for 1-2% of cancers and approximately 17% of hematological malignancies in the United States each year. Fifty percent of patients with symptomatic MM have three or more primary care visits before being referred to a specialist, which is greater than any other cancer. A delay in the diagnosis of multiple myeloma has been shown to negatively impact the clinical course of the disease; patients with longer diagnostic intervals have been shown to experience shorter disease-free survival and higher rates of treatment-related complications.

Unexpected diagnosis of WHIM syndrome in refractory autoimmune cytopenia.

WHIM (warts, hypogammaglobulinemia, infections, and myelokathexis) syndrome is a rare primary immunodeficiency predominantly caused by heterozygous gain-of-function mutations in the C-terminus of the gene CXCR4. These CXCR4 variants display impaired receptor trafficking with persistence of the CXCR4 receptor on the surface, resulting in hyperactive downstream signaling after CXCL12 stimulation. In turn, this results in defective lymphoid differentiation, and reduced blood neutrophil and lymphocyte numbers.

Overview of infectious complications among CAR T- cell therapy recipients.

Chimeric antigen receptor-modified T cell (CAR T-cell) therapy has revolutionized the management of hematological malignancies. In addition to impressive malignancy-related outcomes, CAR T-cell therapy has significant toxicity-related adverse events, including cytokine release syndrome (CRS), immune effector cell associated neurotoxicity syndrome (ICANS), immune effector cell-associated hematotoxicity (ICAHT), and opportunistic infections. Different CAR T-cell targets have different epidemiology and risk factors for infection, and these targets result in different long-term immunodeficiency states due to their distinct on-target and off- tumor effects.

Predictors of Aneurysm Obliteration in Patients Treated with the WEB Device: Results of a Multicenter Retrospective Study.

Background And Purpose: Despite the numerous studies evaluating the occlusion rates of aneurysms following WEB embolization, there are limited studies identifying predictors of occlusion. Our purpose was to identify predictors of aneurysm occlusion and the need for retreatment.

Materials And Methods: This is a review of a prospectively maintained database across 30 academic institutions.

Multiplexed Spatial Profiling of Hodgkin Reed-Sternberg Cell Neighborhoods in Classic Hodgkin Lymphoma.

Purpose: Classic Hodgkin lymphoma (cHL) is a B-cell lymphoma that occurs primarily in young adults and, less frequently, in elderly individuals. A hallmark of cHL is the exceptional scarcity (1%-5%) of the malignant Hodgkin Reed-Sternberg (HRS) cells within a network of nonmalignant immune cells. Molecular determinants governing the relationship between HRS cells and their proximal microenvironment remain largely unknown.

Disease-free survival after pancreatectomy for pancreatic neuroendocrine tumors: A 17-year single-center experience of 223 patients.

Background: Metastasis or recurrence of pancreatic neuroendocrine tumors (pNETs) after pancreatectomy is an important source of postsurgical morbidity. This study aimed to define disease-free survival (DFS) in this population.

Methods: Patients who underwent pancreatectomy for pNETs between January 2005 and January 2022 were included.

Skin cancer screening recommendations by U.S. cancer centers: Inconsistency with national guidelines.

Objective: The incidence of melanoma has increased dramatically over the past four decades, while overall mortality has remained stable. This increase in incidence without a change in overall mortality may be due to overdiagnosis through skin cancer screening. Despite the USPSTF citing insufficient evidence for or against professional skin cancer screening in average-risk adults, U.

Eczema exacerbation following herpes zoster infection in an immunocompetent patient: A case report.

This case report highlights a severe eczematous rash manifesting broadly across the scalp, face, and neck of a 54-year-old female following a resolved herpes zoster infection. Notably, such cutaneous reactions post-varicella zoster virus infection, which may present weeks to years after the acute phase, have been documented but remain poorly understood in their pathogenesis. This patient exhibited a blistering rash diagnosed as shingles with overlying cellulitis, initially treated with valacyclovir and cefalexin.

Determinants of radiation exposure during mobile cone-beam CT-guided robotic-assisted bronchoscopy.

Background And Objective: Robotic-assisted bronchoscopy (RAB) is an emerging modality to sample pulmonary lesions. Cone-beam computed tomography (CBCT) can be incorporated into RAB. We investigated the magnitude and predictors of patient and staff radiation exposure during mobile CBCT-guided shape-sensing RAB.

Impact of an Inter-Professional Clinic on Pancreatic Cancer Outcomes: A Retrospective Cohort Study.

Pancreatic ductal adenocarcinoma (PDAC) presents significant challenges in diagnosis, staging, and appropriate treatment. Furthermore, patients with PDAC often experience complex symptomatology and psychosocial implications that require multi-disciplinary and inter-professional supportive care management from health professionals. Despite these hurdles, the implementation of inter-professional clinic approaches showed promise in enhancing clinical outcomes.