Kidney Transplant Outcomes in Recurrent Versus IgA Nephropathy.

Introduction: IgA nephropathy (IgAN) recurs frequently in kidney transplants, although the reported frequency of recurrence varies because many studies do not distinguish recurrent IgAN from IgAN occurring in the allograft. In addition, there are only limited studies of graft outcomes in patients with recurrent IgAN.

Methods: We retrospectively examined 264 kidney transplant biopsies with glomerular IgA deposits, distinguishing whenever possible recurrent versus IgAN, and compared clinical and pathologic features of biopsies of patients within these groups.

Improvement in Functional Outcomes Following Ileal Pouch-Anal Anastomosis: Results from the United States Ileal Pouch-Anal Anastomosis Study.

Background: Ileal pouch-anal anastomosis is the standard procedure for patients with ulcerative colitis or unclassified inflammatory bowel disease seeking intestinal continuity post-proctocolectomy. Previous studies on function are limited by retrospective design, single-center scope, and insufficient functional domain data.

Objective: To provide prospective, multicenter data on functional outcomes after ileal pouch-anal anastomosis.

The Use of Virtual Reality During Arterial Puncture and Evaluating Its Impact on Patient-Reported Pain Scores, Anxiety Scores, and Patient Satisfaction.

Arterial puncture for blood gas sampling is a painful procedure, often requiring multiple attempts. At this institution, the current standard of care does not include regular use of analgesics, which may lead to high anxiety and low patient satisfaction. Virtual reality (VR) technology has shown promise in reducing pain and anxiety in various medical procedures, though its use in arterial puncture remains unexplored.

A prospective clinical trial of GVHD prophylaxis with posttransplant cyclophosphamide and abatacept.

We conducted a prospective randomized clinical trial to investigate the combination of posttransplant cyclophosphamide (PTCy) and abatacept (Aba) for graft-versus-host disease (GVHD) prophylaxis. Patients with hematologic malignancies undergoing an allogeneic transplant from an 8/8 matched related or unrelated donor were randomized 1:1 to tacrolimus and methotrexate (standard-of-care arm [SOC]) or PTCy on days +3 and +4, followed by Aba on an extended schedule: days +5, +14, and +28, and every 4 weeks up to day +168 (PTCy+Aba). All patients received peripherally collected stem cells.

Evaluating the mechanism of action behind controlled hypothermic preservation of donor hearts: A randomized pilot study.

Background: Controlled hypothermic preservation of donor hearts is associated with decreased post-transplant primary graft dysfunction compared to conventional cold storage. However, mechanisms underlying this benefit in human subjects are unclear.

Methods: We randomized 20 heart transplant recipients at a single institution to receive donor hearts preserved with either controlled hypothermic preservation or standard cold storage.

Advance Care Planning Before and After In-Hospital Cardiac Arrest.

In-hospital cardiac arrest (IHCA) is a common event with high morbidity and mortality. This study seeks to evaluate advance care planning (ACP) among hospitalized patients who experienced IHCA. Single center retrospective cohort study.

Staged Nipple Delay Procedure Expands Candidacy for Nipple-Sparing Mastectomy.

Background: Nipple delay (ND) is a staged procedure that improves nipple-areolar complex (NAC) viability in nipple-sparing mastectomy (NSM) patients who are high-risk for NAC or skin-flap necrosis. This study compared postoperative outcomes and risk factors between patients treated with ND-NSM and NSM alone.

Methods: Patient demographics, risk factors for NAC or skin-flap necrosis, tumor characteristics, and operative outcomes were compared between ND-NSM and NSM groups from 2009 to 2023.

Ten-year follow-up cohort of the everolimus versus azathioprine multinational prospective study focusing on intravascular ultrasound findings.

Background: Long-term clinical outcomes of early intravascular ultrasound (IVUS) findings in a prospective cohort of heart transplantation (HTx) patients have not been evaluated.

Methods: This study included patients from 20 centers across Europe and North and South America among the original cohort of the RAD B253 study. Among these patients, 91 had paired IVUS images at baseline and 1-year post-transplant: everolimus 1.

Disparities and Underutilization of Surgery for Early Stage Small Cell Lung Cancer.

Background: The National Comprehensive Cancer Network recommends surgical resection for stage I small cell lung cancer (SCLC). Despite these recommendations and the curative potential of such surgery, many continue to underutilize surgery. Our aim is to investigate factors that contribute to underutilization of surgery for stage I SCLC.

Comparative Effectiveness of Psychotherapy vs Antidepressants for Depression in Heart Failure: A Randomized Clinical Trial.

Importance: Heart failure (HF) affects more than 6 million adults in the US and more than 64 million adults worldwide, with 50% prevalence of depression. Patients and clinicians lack information on which interventions are more effective for depression in HF.

Objective: To compare the effectiveness of behavioral activation psychotherapy (BA) vs antidepressant medication management (MEDS) on patient-centered outcomes inpatients with HF and depression.

Incidence and Outcomes of Simultaneous Thoracoabdominal Triple Organ Transplantation in the United States.

Background: This study aims to evaluate patient outcomes of simultaneous triple organ transplants, which may provide insight into optimal donor allocation while maximizing recipient benefit.

Methods: Triple organ transplants and their corollary dual organ transplants were identified using the United Network for Organ Sharing database. Triple organ transplants evaluated included heart-lung-kidney (n = 12) and heart-liver-kidney (n = 37).

The ALPHA phase 1 study: pulmonary ArteriaL hypertension treated with CardiosPHere-Derived allogeneic stem cells.

Background: Pulmonary Arterial Hypertension (PAH) is a progressive condition with no cure. Even with pharmacologic advances, survival remains poor. Lung pathology on PAH therapies still shows impressive occlusive arteriolar remodelling and plexiform lesions.

Serum Testosterone and Dihydrotestosterone and Incidence and Progression of Lower Urinary Tract Symptoms: Results From the REDUCE Study.

Purpose: Though the pathogenesis of benign prostatic hyperplasia is unclear, it was previously believed that increasing androgen levels contributed, though not all data support this idea. We tested if elevated serum testosterone or dihydrotestosterone were risk factors for lower urinary tract symptoms incidence in asymptomatic men and for lower urinary tract symptoms progression in symptomatic men.

Materials And Methods: A post hoc analysis of REDUCE was performed in 3009 asymptomatic men and in 2145 symptomatic men.

Characteristics of Patients Restrained in the Emergency Department and Evaluation for Disparities in Care.

Background: Physical restraints are used in the emergency department (ED) for agitated patients to prevent self-harm and protect staff. Prior studies identified associations between sociodemographic factors and ED physical restraints use.

Objectives: The primary objective was to compare characteristics of ED patients receiving physical restraints for violent and nonviolent indications vs.

Safety and Efficacy Outcomes From a Single-Center Study of Image-Guided Percutaneous Microwave Ablation for Primary and Metastatic Lung Malignancy.

Introduction: Image-guided percutaneous microwave ablation (MWA) is becoming a more common treatment option for patients with primary and metastatic lung malignancies. Nevertheless, there is limited literature on the safety and efficacy of MWA compared with standard-of-care therapy, including surgical resection and radiation. This study will report the long-term outcomes after MWA for pulmonary malignancies and investigate the factors related to efficacy, including lesion size, location, and ablation power.

Efficacy of Anal Sphincter Division During Fistulotomy in Anal Fissure-Associated Fistula.

Background: A subset of chronic anal fissures beget focal infection, leading to concomitant fistula. The optimal management of fissure-associated fistula is unknown.

Objective: This study aimed to characterize healing rates and effects of fistulotomy in fissure-associated fistula.

Perinatal mood and anxiety disorders: biomarker discovery using plasma proteomics.

Background: Perinatal mood and anxiety disorders encompass a range of mental health disorders that occur during pregnancy and up to 1 year postpartum, affecting approximately 20% of women. Traditional risk factors, such as a history of depression and pregnancy complications including preeclampsia, are known. Their predictive utility, however, is not specific or sensitive enough to inform clinical decision-making or prevention strategies for perinatal mood and anxiety disorders.

Postdischarge Noninvasive Telemonitoring and Nurse Telephone Coaching Improve Outcomes in Heart Failure Patients With High Burden of Comorbidity.

Background: Noninvasive telemonitoring and nurse telephone coaching (NTM-NTC) is a promising postdischarge strategy in heart failure (HF). Comorbid conditions and disease burden influence health outcomes in HF, but how comorbidity burden modulates the effectiveness of NTM-NTC is unknown. This study aims to identify patients with HF who may benefit from postdischarge NTM-NTC based on their burden of comorbidity.

Change in First-year Intravascular Ultrasound Results Predicts Adverse Events in Heart Transplant Recipients: Implications for Clinical Trial Endpoints.

Background: Heart transplantation (HTx) is an established therapeutic option for patients with advanced heart failure who are refractory to conventional guideline-directed treatments. This study aimed to reassess whether intravascular ultrasound variables could predict adverse events after HTx in the modern era.

Methods: One hundred primary HTx recipients with available serial intravascular ultrasound examination results of the left anterior descending artery 4-8 wk and 1 y after HTx were enrolled, with an average follow-up duration of 5.

A Banff-based histologic chronicity index is associated with graft loss in patients with a kidney transplant and antibody-mediated rejection.

Antibody-mediated rejection (AMR) is the major cause of graft loss in kidney transplant recipients. The Banff classification defines two classes of AMR, active and chronic active but over time this classification has become increasingly complex. To simplify the approach to AMR, we developed activity and chronicity indices based on kidney transplant biopsy findings and examined their association with graft survival in 147 patients with active or chronic active AMR, all of whom had donor-specific antibodies and were treated for AMR.

Treatment of Cushing Disease With Pituitary-Targeting Seliciclib.

Context: Preclinical studies show seliciclib (R-roscovitine) suppresses neoplastic corticotroph proliferation and pituitary adrenocorticotrophic hormone (ACTH) production.

Objective: To evaluate seliciclib as an effective pituitary-targeting treatment for patients with Cushing disease (CD).

Methods: Two prospective, open-label, phase 2 trials, conducted at a tertiary referral pituitary center, included adult patients with de novo, persistent, or recurrent CD who received oral seliciclib 400 mg twice daily for 4 consecutive days each week for 4 weeks.

Pre-transplant angiotensin II receptor type I antibodies in pediatric renal transplant recipients: An observational cohort study.

Background: The role of angiotensin II type 1 receptor antibodies (AT1R-Ab) in pediatric renal transplantation is unclear. Here, we evaluated pre-transplant AT1R-Ab on transplant outcomes in the first 5 years. Secondary analysis compared pre-transplant AT1R-Ab levels by age.