Coenzyme Q10 Supplementation May Be Correlated With Resolution of New Daily Persistent Headache.

New daily persistent headache is a chronic, treatment-resistant primary headache disorder with limited guidance on effective management. Despite its significant impact on headache-related quality of life, few studies have identified targeted therapies that contribute to symptom resolution. This study aims to describe the outcomes of pediatric patients diagnosed with new daily persistent headache and assess associations between specific interventions and headache resolution.

Mosaic Loss of Y Chromosome Defines a Proximal Tubular Cell State Associated with Recovery from DGF and of Allograft Quality and Functional Reserve Post DCD Kidney Transplantation.

Objective: To determine the drivers of proximal tubular cell regeneration and repair over time in the setting of recovery from delayed graft function (DGF) post donation after cardiac death (DCD) kidney transplantation.

Background: DCD Kidney allografts are at increased risk of graft loss. Despite this, due to organ shortages, DCD transplantation is increasing, which offers a novel and valuable platform for the study of adaptive/maladaptive repair mechanisms after injury.

Experience With 117 Donation After Circulatory Death Expanded Criteria Donor Kidney Transplants: What Are the Limits of Acceptability?

Introduction: Nonuse of expanded criteria donor (ECD) kidneys from donation after cardiocirculatory death (DCD) donors remains high. The study purpose was to analyze our experience with kidney transplantation (KT) from DCD donors stratified by ECD versus non-ECD (standard criteria donor [SCD]).

Methods: Single center retrospective cohort study of all primary DCD KT recipients.

Kidney Retransplantation in the Elderly: Are the Benefits Worth the Risks?

Introduction: An increasing number of elderly patients are undergoing either primary kidney transplantation (PrKT) or retransplantation (ReKT).

Methods: Single-center retrospective cohort study of all deceased donor KTs (DDKTs) performed in elderly patients (age ≥65 years).

Results: From December 2004 through August 2022, we performed 668 DDKTs in elderly patients including 39 ReKTs and 629 PrKTs.

Does Severity of Donor Acute Kidney Injury Influence Outcomes Following Kidney Transplantation?

Introduction: The study purpose was to review retrospectively our single-center experience transplanting kidneys from deceased donors (DD) with acute kidney injury (AKI) according to terminal serum creatinine (tSCr) level.

Methods: AKI kidneys were defined by a doubling of the DD's admission SCr and a tSCr ≥ 2.0 mg/dL.

Continuous flow local anesthetic wound infusion for post-operative analgesia following kidney transplantation.

Background: Some patients with end stage renal disease are or will become narcotic-dependent. Chronic narcotic use is associated with increased graft loss and mortality following kidney transplantation. We aimed to compare the efficacy of continuous flow local anesthetic wound infusion pumps (CFLAP) with patient controlled analgesia pumps (PCA) in reducing inpatient narcotic consumption in patients undergoing kidney transplantation.

The Kidney Not Taken: Single-Kidney Use in Deceased Donors.

Background: The nonuse rate for kidneys recovered from deceased donors is increasing, rising to 27% in 2023. In 10% of these cases, 1 kidney is transplanted but the mate kidney is not.

Study Design: We conducted a retrospective, single-center cohort study from December 2001 to May 2023 comparing single kidneys transplanted at our center (where the contralateral kidney was not used) to kidneys where both were transplanted separately, at least 1 of which was at our center.

Single center experience and literature review of kidney transplantation from non-ideal donors with acute kidney injury: Risk and reward.

Introduction: There is limited experience transplanting kidneys from either expanded criteria donors (ECD) or donation after circulatory death (DCD) deceased donors with terminal acute kidney injury (AKI).

Methods: AKI kidneys were defined by a donor terminal serum creatinine level >2.0 mg/dL whereas non-ideal deceased donor (NIDD) kidneys were defined as AKI/DCD or AKI/ECDs.

Does dialysis modality or duration influence outcomes in simultaneous pancreas-kidney transplant recipients? Single center experience and review of the literature.

Aim: The influence of dialysis modality and duration on outcomes following simultaneous pancreas-kidney transplantation (SPKT) remains uncertain.

Methods: We performed a single-center retrospective review in 255 SPKT recipients according to dialysis modality (55 preemptive/no dialysis-ND, 70 peritoneal dialysis-PD, 130 hemodialysis-HD) and duration (55 none, 137 < 2 years, 41 2-4 years, 22 > 4 years).

Results: Mean follow-up was 9.

Knowing When to Ignore the Numbers: Single-Center Experience Transplanting Deceased Donor Kidneys with Poor Perfusion Parameters.

Background: Hypothermic machine perfusion is frequently used in evaluating marginal kidneys with poor perfusion parameters (PPP) contributing to delays in kidney placement or discard. We examined outcomes in deceased donor kidney transplants with PPP compared with those with optimal perfusion parameters (OPP).

Study Design: We conducted a retrospective single-center cohort study from 2001 to 2021 comparing PPP (n = 91) with OPP (n = 598) deceased donor kidney transplants.

Pediatric Headache Experience During the COVID-19 Pandemic.

Objective: Headache disorders are exceedingly common in children and adolescents. The association between headaches, emotional stress, and disruptions in daily routines are well established. The goal of this study is to compare the experiences of patients with a preexisting diagnosis of a primary headache disorder in terms of headache frequency and severity, lifestyle techniques for headache prevention, screen use, and mood from before and after the onset of the COVID-19 pandemic.

Pediatric screen exposure and school related headache disability.

Background And Objectives: Prolonged screen exposure is often cited as a trigger for pediatric headache. We present initial findings evaluating the association between adolescent screen use type, duration, and school disability.

Methods: New patients aged 12-17 years presenting to a headache clinic were screened and surveyed regarding headache characteristics, behavioral habits, school attendance, and screen utilization.

Quality of Life Associated with Open vs Minimally Invasive Pancreaticoduodenectomy: A Prospective Pilot Study.

Background: This prospective study was designed to compare quality of life (QoL) among patients who underwent open (O-PD) vs minimally invasive pancreaticoduodenectomy (MI-PD), using a combination of validated qualitative and quantitative methodologies.

Study Design: From 2017 to 2019, patients scheduled for pancreaticoduodenectomy (PD) were enrolled and presented with Functional Assessment of Cancer Therapy-Hepatobiliary surveys preoperatively, before discharge, at first postoperative visit and approximately 3 to 4 months after operation ("3 months"). Longitudinal plots of median QoL scores were used to illustrate change in each score over time.

Natural History of Abortive Medication Withdrawal in the Management of Pediatric Medication Overuse Headache.

Objective: The objective of this study is to document pain scores during withdrawal of abortive medication in patients diagnosed with medication overuse headache.

Design: Cross-sectional study.

Setting: Children's National Hospital's Headache Program.

Robot-assisted kidney transplantation is a safe alternative approach for morbidly obese patients with end-stage renal disease.

Background: Many centres deny obese patients with a body mass index (BMI) >35 access to kidney transplantation due to increased intraoperative and postoperative complications.

Methods: From August 2017 to December 2019, 73 consecutive cases of kidney transplantation in morbidly obese patients were enrolled at a single university at the initiation of a robotic transplant surgery program. Outcomes of patients who underwent robotic assisted kidney transplant (RAKT) were compared to frequency-matched patients undergoing open kidney transplant (OKT).

Donor Morbidity Is Equivalent Between Right and Left Hepatectomy for Living Liver Donation: A Meta-Analysis.

Maximizing liver graft volume benefits the living donor liver recipient. Whether maximizing graft volume negatively impacts living donor recovery and outcomes remains controversial. Patient randomization between right and left hepatectomy has not been possible due to anatomic constraints; however, a number of published, nonrandomized observational studies summarize donor outcomes between 2 anatomic living donor hepatectomies.

Hepatic Artery Thrombosis and Takotsubo Syndrome After Liver Transplantation - Which Came First?

BACKGROUND Takotsubo syndrome is a transient, reversible, stress-induced cardiomyopathy that affects only 1.4% of liver transplant patients and can cause complications, including cardiogenic shock, arrhythmia, and thromboembolism. Hepatic artery thrombosis is also rare, affecting just 2-4% of these patients, but can have disastrous consequences.

Leveraging Aberrant Vasculature in Celiac Artery Stenosis: The Arc of Buhler in Pancreaticoduodenectomy.

Celiac artery stenosis and occlusion have been described rarely in patients undergoing pancreaticoduodenectomy (PD), although it occurs relatively frequently in this group. An arterial connection between the celiac and superior mesenteric arteries, known as the Arc of Buhler, provides alternative flow to the celiac distribution once the gastroduodenal artery (GDA) is ligated in PD. A 69-year-old man, in whom pre- and intraoperative efforts to stent an occluded celiac artery failed, had sufficient retrograde flow from an unrecognized Arc of Buhler to maintain adequate hepatic arterial perfusion after ligation of the GDA during a PD.

Minimally Invasive Surgical Site Infection in Procedure-Targeted ACS NSQIP Pancreaticoduodenectomies.

Background: Pancreaticoduodenectomy (PD) incurs a surgical site infection rate of up to 18%. Published rates after minimally invasive PD are comparable or superior to open, but data are limited to high-volume, single-institution series. This study aimed to determine national outcomes.

Severe anemia after Roux-en-Y gastric bypass: a cause for concern.

Background: The current popularity of metabolic surgery has led to increasing attention to long-term nutritional complications.

Objective: The purpose of this retrospective study is to accurately define the long-term incidence of clinically significant anemia after Roux-en-Y gastric bypass (RYGB) and to identify factors that contribute to increased risk.

Methods: The study cohort consisted of 2116 patients who underwent RYGB with necessary laboratory information available, and with longitudinal follow-up available (mean 5.

Initial In Vivo Quantification of Tc-99m Sestamibi Uptake as a Function of Tissue Type in Healthy Breasts Using Dedicated Breast SPECT-CT.

A pilot study is underway to quantify in vivo the uptake and distribution of Tc-99m Sestamibi in subjects without previous history of breast cancer using a dedicated SPECT-CT breast imaging system. Subjects undergoing diagnostic parathyroid imaging studies were consented and imaged as part of this IRB-approved breast imaging study. For each of the seven subjects, one randomly selected breast was imaged prone-pendant using the dedicated, compact breast SPECT-CT system underneath the shielded patient support.

TRIAD II: do living wills have an impact on pre-hospital lifesaving care?

Background: Living wills accompany patients who present for emergent care. To the best of our knowledge, no studies assess pre-hospital provider interpretations of these instructions.

Objectives: Determine how a living will is interpreted and assess how interpretation impacts lifesaving care.

PF4/heparin complexes are T cell-dependent antigens.

Heparin-induced thrombocytopenia (HIT) is a life-threatening, thrombotic disorder associated with development of anti-platelet factor 4 (anti-PF4)/heparin autoantibodies. Little is known about the antigenic and cellular requirements that initiate the immune response to these complexes. To begin to delineate mechanisms of autoantibody formation in HIT, we studied the immunizing effects of murine PF4 (mPF4)/heparin in mice with and without thymic function.