Impact of Time to Catheter-Based Therapy on Outcomes in Acute Pulmonary Embolism.

Background: The aim of this study was to examine the impact of early versus delayed catheter-based therapies (CBTs) on clinical outcomes in patients with acute intermediate-risk pulmonary embolism (PE).

Methods: This retrospective cohort study analyzed data from 2 academic centers involving patients with intermediate-risk PE from January 2020 to January 2024. Patients were divided into early (<12 hours) and delayed CBT (≥12 hours) groups.

Synthesis, Pharmacological Characterization, and Binding Mode Analysis of 8-Hydroxy-Tetrahydroisoquinolines as 5-HT Receptor Inverse Agonists.

The serotonin 7 receptor (5-HTR) regulates various processes in the central nervous system, including mood, learning, and circadian rhythm control, among others. Receptor activation can lead to activation of the Gα protein and a subsequent increase of intracellular cyclic adenosine monophosphate (cAMP). Receptor interaction with inverse agonists results in a decrease of basal cAMP levels and therefore a downstream effect of reduced neuronal excitability and neurotransmission.

Differentiation of Atherosclerotic Carotid Plaque Components With Dual-Energy Computed Tomography.

Objectives: Carotid plaque vulnerability is a strong predictor of recurrent ipsilateral stroke, but differentiation of plaque components using conventional computed tomography (CT) is suboptimal. The aim of our study was to evaluate the ability of dual-energy CT (DECT) to characterize atherosclerotic carotid plaque components based on the effective atomic number and effective electron density using magnetic resonance imaging (MRI) and, where possible, histology as the reference standard.

Materials And Methods: Patients with recent cerebral ischemia and a ≥2-mm carotid plaque underwent computed tomography angiography and MRI.

The Landscape of Vascular Endothelial Growth Factor Inhibition in Retinal Diseases.

Ever since the US Food and Drug Administration (FDA) approved the first vascular endothelial growth factor (VEGF) antagonist 2 decades ago, inhibitors of VEGF have revolutionized the treatment of a variety of ocular disorders involving pathologic neovascularization and retinal exudation. In this perspective, we evaluate the current status of anti-VEGF therapies and the real-world challenges encountered with maintaining therapeutic outcomes. Finally, we describe novel VEGF-based and combinatorial approaches that are in clinical development.

Fundus Autofluorescence Variation in Geographic Atrophy of Age-Related Macular Degeneration: A Clinicopathologic Correlation.

Purpose: The purpose of this study was to develop ground-truth histology about contributors to variable fundus autofluorescence (FAF) signal and thus inform patient selection for treating geographic atrophy (GA) in age-related macular degeneration (AMD).

Methods: One woman with bilateral multifocal GA, foveal sparing, and thick choroids underwent 535 to 580 nm excitation FAF in 6 clinic visits (11 to 6 years before death). The left eye was preserved 5 hours after death.

MAO-B-triggered reaction for an optical triple-signal assay and AND logic gate application based on PEI-functionalized silver nanoparticles.

A novel analytical method was designed and developed that exhibited ultraviolet-visible (UV-Vis), fluorescence (FL), and resonance Rayleigh scattering (RRS) signals for straightforward and comprehensive determination of monoamine oxidase B (MAO-B) using polyethylenimine-functionalized silver nanoparticles (PEI-Ag NPs). Through a facile one-step experiment, and NaOH assisted, in an aqueous solution of 100 ℃ for 40 min PEI reacted with AgNO to generate PEI-Ag NPs with a yellow color and weak blue fluorescence. Interestingly, phenylacetaldehyde (PAA), a specific product of MAO-B, causes significant enhancement of the three optical signals of UV-Vis, FL, and RRS.

Microvascular blood flow ultrasound imaging with microbubble-based H-Scan technology.

Ultrasound blood flow imaging plays a crucial role in the diagnosis of cardiovascular and cerebrovascular diseases. Conventional ultrafast ultrasound plane-wave imaging techniques have limited capabilities in microvascular imaging. To enhance the quality of blood flow imaging, this study proposes a microbubble-based H-Scan ultrasound imaging technique.

The tissue-plasminogen activator-challenged thromboelastography provides a comprehensive assessment of fibrinolysis in the severely injured.

Background: Tissue-plasminogen activator-challenged thromboelastography (tPA-TEG) predicts massive transfusion and mortality better than conventional rapid thromboelastography (rTEG), with little concordance between their lysis values (LY30). We hypothesized that the main fibrinolytic inhibitors plasminogen activator inhibitor-1 (PAI-1) and α-2 antiplasmin (A2AP), as well as markers of fibrinolytic activation (plasmin-antiplasmin [PAP], tPA-PAI-1 complex, tPA activity), would correlate more strongly with tPA-TEG versus rTEG LY30 and may explain the recent findings of four distinct fibrinolytic phenotypes in trauma based on these two TEG methodologies.

Methods: Adult trauma patients (n = 56) had tPA-TEG, rTEG, and plasma obtained on arrival to the emergency department with institutional review board approval.

Prospective Validation of an Automated Hybrid Multidimensional MRI Tool for Prostate Cancer Detection Using Targeted Biopsy: Comparison with PI-RADS-based Assessment.

Purpose To evaluate the use of an automated hybrid multidimensional MRI (HM-MRI)-based tool to prospectively identify prostate cancer targets before MRI/US fusion biopsy in comparison with Prostate Imaging and Reporting Data System (PI-RADS)-based multiparametric MRI (mpMRI) evaluation by expert radiologists. Materials and Methods In this prospective clinical trial (ClinicalTrials.gov registration no.

MRI-assessed Dynamic Hyperinflation Induced by Tachypnea in Chronic Obstructive Pulmonary Disease: The SPIROMICS-HF Study.

Purpose To assess the repeatability of real-time cine pulmonary MRI measures of metronome-paced tachypnea (MPT)-induced dynamic hyperinflation and its relationship with chronic obstructive pulmonary disease (COPD) severity. Materials and Methods SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) (ClinicalTrials.gov identifier no.

Endovascular versus Best Medical Treatment for Acute Carotid Occlusion BelOw Circle of Willis (ACOBOW): The ACOBOW Study.

Background Symptomatic acute occlusions of the internal carotid artery (ICA) below the circle of Willis can cause a variety of stroke symptoms, even if the major intracranial cerebral arteries remain patent; however, outcome and safety data are limited. Purpose To compare treatment effects and procedural safety of endovascular treatment (EVT) and best medical treatment (BMT) in patients with symptomatic acute occlusions of the ICA below the circle of Willis. Materials and Methods This retrospective, multicenter cohort study from 22 comprehensive stroke centers in Europe and Asia includes patients treated between January 1, 2008, and December 31, 2022.

CT, MRI, and FDG PET/CT in the Assessment of Lymph Node Involvement in Pediatric Hodgkin Lymphoma: An Expert Consensus Definition by an International Collaboration on Staging Evaluation and Response Criteria Harmonization for Children, Adolescent, and Young Adult Hodgkin Lymphoma (SEARCH for CAYAHL).

Staging of pediatric Hodgkin lymphoma is currently based on the Ann Arbor classification, incorporating the Cotswold modifications and the Lugano classification. The Cotswold modifications provide guidelines for the use of CT and MRI. The Lugano classification emphasizes the importance of CT and PET/CT in evaluating both Hodgkin lymphoma and non-Hodgkin lymphoma but focuses on adult patients.

Contrast-enhanced US of High-Risk Indeterminate Focal Liver Observations Categorized as LR-4 or LR-M at CT/MRI.

Background Indeterminate focal liver observations in patients at risk for hepatocellular carcinoma (HCC) may require invasive biopsy or follow-up, which could lead to delays in definitive categorization and to postponement of treatment. Purpose To examine clinical effect of contrast-enhanced US (CEUS) in participants with high-risk indeterminate liver observations categorized as Liver Imaging Reporting and Data System (LI-RADS) category LR-4 (probably HCC) or LI-RADS category LR-M (probably or definitely malignant but not HCC specific) at CT or MRI. Materials and Methods This was a secondary analysis of a prospective international multicenter validation study for CEUS LI-RADS (January 2018 to August 2021).

Therapeutic approach to patients with early stage diffuse large B cell lymphoma: retrospective, multicenter, real-life study of the 'RTL' (regional Tuscan lymphoma network).

Treatment strategies for early stage diffuse large B-cell lymphoma (ES-DLBCL) include R-CHOP, with a similar schedule to that used in advanced stage, or a reduced number of cycles followed by radiation therapy (RT). We retrospectively analyzed 179 ES-DLBCL patients, managed according to the clinical practice. Treatment regimens include chemoimmunotherapy 4-6 cycles +/- RT as consolidation.

Disulfide Compound-Impregnated Paper Substrate-Based Highly Efficient Colorimetric Gas Sensor for Detection of Volatile Sulfur Compounds in Noninvasive Breath Analysis.

Volatile sulfur compounds (VSCs) are prevalent human biogases detectable in individuals with periodontal disease; therefore, measuring VSC gases in human breath can yield significant, noninvasive diagnostic information indicative of such diseases. In this study, we developed a gas sensor with selective and enhanced sensing capabilities for VSCs methyl mercaptan and hydrogen sulfide. This sensor comprises a cellulose paper substrate impregnated with 2,2'-dithiobis(5-nitropyridine) and sodium acetate.

The Role of Central Sensitization in Autoimmune Connective Tissue Diseases: A Comparative Cross-Sectional Study.

Objective: To investigate the central sensitization (CS) in patients with autoimmune connective tissue diseases (ACTDs) and its relationship with disease activity, laboratory findings, medical treatments, organ involvements, and comorbidity.

Methods: One hundred and eleven patients with ACTDs and 40 healthy individuals were included. All patients were divided into three groups in terms of their diseases: Sjögren's syndrome (SS), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE).

An immunosenescent CD8+ T cell subset in patients with axial Spondyloarthritis and Psoriatic Arthritis links spontaneous motility to telomere shortening and dysfunction.

Objective: A pathogenetic role of CD8+ T lymphocytes in radiographic axial spondyloarthritis (r-axSpA) and other spondyloarthritis (SpA) is sustained by genome-wide association studies (GWAS) and by the expansion of public T cell clonotypes in the target tissues. This study investigates the migration of CD8+ T cells, along with their phenotype and functions in patients with r-axSpA and psoriatic arthritis (PsA).

Methods: Peripheral blood CD8+ and CD4+ T cells were isolated from r-axSpA (n= 128), PsA (n= 60) and rheumatoid arthritis (RA, n= 74) patients and healthy donors (HD, n= 79).

Non-Canonical TERT Activity Initiates Osteogenesis in Calcific Aortic Valve Disease.

Background: Calcific aortic valve disease is the pathological remodeling of valve leaflets. The initial steps in valve leaflet osteogenic reprogramming are not fully understood. As TERT (telomerase reverse transcriptase) overexpression primes mesenchymal stem cells to differentiate into osteoblasts, we investigated whether TERT contributes to the osteogenic reprogramming of valve interstitial cells.

Education Research: Making a Tweetorial Fly: Features of Educational Social Media Posts Associated With High Sharing and Engagement.

Background And Objectives: Social media platforms such as X (formerly Twitter) are increasingly used in medical education. Characteristics of tweetorials (threaded teaching posts) associated with higher degrees of engagement are unknown. We sought to understand features of neurology-themed tweetorials associated with high sharing and engagement.

Potent human antibodies against SpA5 identified by high-throughput single-cell sequencing of phase I clinical volunteers' B cells.

The drug resistance problem of needs to be solved urgently. Here, we report the rapid identification of human antibodies by high-throughput single-cell RNA and VDJ sequencing of memory B cells derived from 64 volunteers immunized with recombinant five-component vaccine (clinical phase I). From 676 antigen-binding IgG1 clonotypes, TOP10 sequences were selected for expression and characterization, with the most potent one, Abs-9, having nanomolar affinity for the pentameric form of the specific antigen protein A.

Efficacy and safety of dapagliflozin in patients with CKD: real-world experience in 93 Italian renal clinics.

Background: Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are recommended for reducing the renal and cardiovascular risk in patients with chronic kidney disease (CKD) based on the positive results reported by clinical trials. However, real-world data on the efficacy and the safety of these drugs in CKD population followed in nephrology setting are lacking.

Methods: We report the effects of dapagliflozin in CKD patients by using data collected during a learning program in which 105 nephrologists added dapagliflozin (10 mg/day) to consecutive patients referred to their renal clinics.

DISCOntinuation of disease-modifying therapies in MS: The DISCOMS extension trial.

Background: In the DISCOMS (DISCOntinuation of disease-modifying therapies (DMTs) in multiple sclerosis (MS)) randomized clinical trial, we could not demonstrate that discontinuing MS DMTs in older, stable adults was not inferior to continuing DMTs. Relapses were rare in both groups, and most new disease activity was one to two new brain magnetic resonance imaging (MRI) lesions unassociated with clinical changes.

Objective/aims: Describe results of the DISCOMS extension study.

A phase II study of ramucirumab and somatostatin analog therapy in patients with advanced neuroendocrine tumors.

Objectives: Well-differentiated neuroendocrine tumors (NET) are highly vascular tumors characterized by their expression of vascular endothelial growth factor (VEGF). This trial investigated the activity of ramucirumab, a monoclonal antibody that targets VEGF receptor-2 (VEGFR-2) and inhibits activity of VEGF, in combination with somatostatin analog therapy in patients (pts) with advanced extra-pancreatic NET.

Methods: We conducted a single-arm phase II trial enrolling pts with advanced, progressive extra-pancreatic NET.

The Utility and Impact of Telemedicine in Childhood Cancer Care: A Mixed Methods Study.

Background: While teleconsultation has proven feasible for adult cancer patients, its utility in childhood cancer care in India is unknown. This study assesses caregiver satisfaction, feasibility, and the economic impact of teleconsultation for children with cancer.

Procedure: This mixed methods study was conducted in the pediatric cancer outpatient service at a tertiary care cancer center in India.

Interventions for adult congenital heart disease.

Advances in imaging diagnostics, surgical techniques and transcatheter interventions for paediatric patients with severe congenital heart disease (CHD) have substantially reduced mortality, thereby extending the lifespan of these individuals and increasing the number of adults with complex CHD. Transcatheter interventions have emerged as an alternative to traditional open-heart surgery to mitigate congenital defects. The evolution of techniques, the introduction of new devices and the growing experience of operators have enabled the treatment of patients with progressively more complex conditions.