A spinal perimedullary arteriovenous fistula treated by Walter Dandy and illustrated by Dorcas Hager Padget in 1934.

Dorcas Hager Padget was a renowned neurosurgical illustrator and neuroembryologist. She collaborated closely with Walter E. Dandy, founder of the field of vascular neurosurgery, from 1928 until his death in 1946.

Interprofessional Collaboration and Patient/Family Engagement on Rounds in a Comprehensive Stroke Center: A Mixed-Methods Study.

Background And Objectives: Daily rounds provide an opportunity for interprofessional collaboration and patient/family engagement, which are critical to stroke care. As part of a quality improvement program, we conducted a baseline assessment to examine interprofessional collaboration and patient/family engagement during the current rounding process in a 12-bed comprehensive stroke center. Findings from the baseline assessment will be used to inform the development, implementation, and evaluation of a new rounding model.

Readability of Online Pediatric Orthopaedic Trauma Patient Education Materials.

Introduction: The importance of web resources for educating orthopaedic trauma patients is well recognized. Yet these resources often exceed the sixth-grade reading level and are too complex for most patients to understand. This study examines the readability of the American Academy of Orthopaedic Surgeons' (AAOS) pediatric trauma-related educational content compared with similar materials from the Pediatric Orthopaedic Society of North America (POSNA).

If it is a solid tumor target, then it may be a hematologic cancer target: Bridging the great divide.

Tumor-agnostic US Food and Drug Administration approvals are transforming oncology. They include larotrectinib/entrectinib/repotrectinib (NTRK fusions), selpercatinib (RET fusions), dabrafenib/trametinib (BRAF mutations), pembrolizumab/dostarlimab (microsatellite instability), pembrolizumab (high tumor mutational burden), and trastuzumab deruxtecan (HER2 3+ expression) (all solid cancers). Pemigatinib is approved for FGFR1-rearranged myeloid/lymphoid neoplasms.

Electronic evaluation of infection risk from room environment and prior room occupants: the transmission from room environment events (TREE) measure.

Over a 2-year period, we identified Transmission from Room Environment Events (TREE) across the Johns Hopkins Health System, where the subsequent room occupant developed the same organism with the same antimicrobial susceptibilities as the patient who had previously occupied that room. Overall, the TREE rate was 50/100,000 inpatient days.

Impact of anterior cruciate ligament tears on player efficiency ratings and salary in National Basketball Association over the past 20 years: a retrospective case control study.

Objectives: Players in the National Basketball Association (NBA) are at high risk for ACL tears which are detrimental to their career due to the months of rehabilitation. The authors hypothesize that after anterior crucial ligament (ACL) injury, older players will be less likely to return to the NBA, players that do return will have a lower performance efficiency rating (PER), and the decrease in PER will be associated with a lower salary.

Methods: This case-control study utilized the publicly available database maintained by the NBA, professional basketball players from 2002 to 2022 who suffered an ACL tear were identified.

Bridging the Gap: Subspecialty Telemedicine Consultations at a Level III Neonatal Intensive Care Unit.

Many neonatal intensive care units (NICUs) lack access to subspecialist consultants and may transfer patients requiring subspecialty care to referral facilities or seek informal consultation. The objective of this work was to evaluate the feasibility, acceptability, and impact of extending pediatric subspecialty services from a children's hospital to a level III NICU via teleconsultation and describe processes, facilitators, and challenges. Monitored consultations for 1 year and surveyed clinicians regarding feasibility, perceived benefits, and challenges.

YAP1::KMT2A-rearranged sarcomas harbor a unique methylation profile and are distinct from sclerosing epithelioid fibrosarcoma and low-grade fibromyxoid sarcoma.

Sclerosing epithelioid fibrosarcoma (SEF) was originally described as a peculiar variant of fibrosarcoma in 1995. Subsequent studies showed that conventional SEF was associated with both immunohistochemical expression of MUC4 and EWSR1/FUS gene rearrangements with CREB3L1 as the predominant fusion partner. Since then, a distinct group of fibrous tumors characterized by YAP1::KMT2A and KMT2A::YAP1 gene rearrangements and SEF-like morphology has been described.

Survey of Latin American ketogenic diet centers: Challenges and success for "La Terapia Cetogénica".

Objective: Despite growing recognition of the efficacy of ketogenic diet therapies (KDT) in reducing seizure frequency and improving the quality of life for individuals with epilepsy, several factors hinder their widespread adoption across Latin America. Specific challenges in the region have been discussed but not formally studied. Currently, no data exist on the availability and operation of KDT teams in the region.

Late Diagnostic Clues in Rapidly Progressing Probable Heidenhain Variant of Creutzfeldt-Jakob Disease.

Presenting symptoms of sporadic Creutzfeldt-Jakob disease (sCJD) are variable, and as imaging and EEG may be normal in the early to middle stages of the disease process, serial testing is vital when there is clinical suspicion for sCJD. We present a case of probable Heidenhain variant of sCJD (HvCJD) with notable rapid progression. A 72-year-old woman presented with neurological decline following new-onset visual changes.

Use of Hepatitis C Viremic Donors to Expand the Pediatric Donor Pool.

The use of hepatitis C virus (HCV)-positive donors in organ transplantation has become increasingly viable due to advancements in direct-acting antiviral (DAA) therapies, which offer high cure rates. This review aims to evaluate the current practices, benefits, and challenges of utilizing HCV-positive donors for organ transplantation. The recent data show that transplant centers are progressively accepting HCV-positive donors for various organs, including kidneys, livers, and hearts, given the efficacy of post-transplant antiviral treatment.

Structure-Function Relationship of the Ryanodine Receptor Cluster Network in Sinoatrial Node Cells.

The rate of spontaneous action potentials (APs) generated by sinoatrial node cells (SANC) is regulated by local Ca release (LCR) from the sarcoplasmic reticulum via Ca release channels (ryanodine receptors, RyRs). LCR events propagate and self-organize within the network of RyR clusters (Ca release units, CRUs) via Ca-induced-Ca-release (CICR) that depends on CRU sizes and locations: While larger CRUs generate stronger release signals, the network's topology governs signal diffusion and propagation. This study used super-resolution structured illumination microscopy to image the 3D network of CRUs in rabbit SANC.

Qualitative metrics from the biomedical literature for evaluating large language models in clinical decision-making: a narrative review.

Background: The large language models (LLMs), most notably ChatGPT, released since November 30, 2022, have prompted shifting attention to their use in medicine, particularly for supporting clinical decision-making. However, there is little consensus in the medical community on how LLM performance in clinical contexts should be evaluated.

Methods: We performed a literature review of PubMed to identify publications between December 1, 2022, and April 1, 2024, that discussed assessments of LLM-generated diagnoses or treatment plans.

Implementation of Pharmacist Driven Gabapentinoid Titration for Diabetic Peripheral Neuropathy in a Primary Care Setting.

Previous studies suggest that patients with diabetic peripheral neuropathy (DPN) frequently do not receive the minimum effective doses of a gabapentinoid according to guidance from national organizations. There is opportunity to assess the implementation of pharmacist intervention for patients not meeting minimum effective gabapentinoid dosing for DPN. This prospective, single site quality improvement project was conducted at a primary care clinic and included patients with DPN prescribed a gabapentinoid by their primary care provider (PCP) at a dose lower than minimum effective dosing.

A standardized carotid endarterectomy care pathway is associated with lower ICU admission rates and a significant reduction in hospital charges.

Background: This study investigated the outcomes before and after initiation of a postoperative care pathway for carotid endarterectomy (CEA) patients.

Methods: A CEA pathway was developed with stakeholders. We compared in-hospital outcomes and charges (USD) for patients undergoing CEA 18 months before (11/2019-04/2021) vs.

Evaluation and Treatment of Acute Laryngeal Injury at Time of Tracheostomy for Prolonged Intubation.

Objectives: The primary objective was to assess incidence and severity of acute laryngeal injury (ALgI) following intubation at time of tracheostomy using a proposed grading scale. The secondary objective was to evaluate what factors influence the rate of decannulation.

Methods: Single institution cohort study with review of prospectively maintained database including patients from October 2021 to October 2022 who underwent tracheostomy for prolonged intubation/critical illness.

Implementation of a Pharmacist-Driven Protocol to Improve Screening and Treatment of Iron Deficiency in Hospitalized Patients with Chronic Kidney Disease.

While intravenous (IV) iron repletion is an effective tool to treat anemia and improve outcomes in chronic kidney disease (CKD), guideline laboratory definitions of iron deficiency differ, resulting in variability in screening and repletion strategies. This study sought to describe current practices surrounding identification and treatment of iron deficiency in CKD and then implement a pharmacist-led protocol to optimize care at a tertiary medical center. This single center, retrospective, pre- and post-protocol implementation study of adults with CKD admitted to the inpatient setting first analyzed historic practices for iron deficiency screening and treatment, followed by deployment of a pharmacist-driven protocol for iron deficiency screening and treatment.

Association of Antibiotic Route and Outcomes in Children with Methicillin-Resistant Staphylococcus aureus Bacteremic Osteomyelitis.

Introduction: There remains uncertainty about whether transitioning to oral antibiotic therapy is appropriate for the management of children with methicillin-resistant Staphylococcus aureus (MRSA) bacteremic osteomyelitis. We compared clinical outcomes for children with MRSA osteomyelitis with associated bacteremia who were transitioned to discharge oral antibiotic therapy to those discharged on outpatient parenteral antibiotic therapy (OPAT).

Methods: We performed a retrospective, multicenter, cohort study of children ≤ 18 years hospitalized with MRSA bacteremic osteomyelitis across four children's hospitals from 2007 to 2018 discharged on oral antibiotic therapy versus OPAT.

Air pollution exposure and head and neck cancer incidence.

To investigate air pollution's effect in the form of PM (particulate matter measuring less than 2.5 microns) on head and neck aerodigestive cancer incidence, an epidemiological cohort analysis was performed using data from the Surveillance Epidemiology and End Results national cancer database from the years 2002-2012. The relationship between US county mean PM levels and head and neck cancer (HNC) incidence rates were examined using a linear mixed model.

The Role of the Pharmacist on an Inpatient Child and Adolescent Psychiatry Unit.

As the landscape of psychiatry evolves, psychiatric clinical pharmacists are positioned to use their expertise to enhance the quality of care on inpatient child and adolescent units. By playing key roles in comprehensive medication management, psychotropic stewardship, transitions of care, and educational initiatives, they can help not only interdisciplinary teams but also greater health care systems improve outcomes and address unmet needs. It is in the best interest of patients, providers, and broader health care systems to advocate for the inclusion of psychiatric clinical pharmacists, operating at the fullest extent of their licensure and training, on every interdisciplinary care team.

Splitting apheresis platelets as a contingency measure for inventory shortages.

Background: Splitting apheresis platelet (PLT) units increase available inventory during shortages. The impact of prolonged storage in gas-impermeable aliquot bags on PLT quality in vitro and transfusion outcomes in patients remains uncertain.

Study Design And Methods: We assessed in vitro PLT quality and thromboelastography (TEG) in PLTs stored for 8 or 24 h in aliquot bags compared with baseline (T0).