Murine gut microbiota dysbiosis via enteric infection modulates the foreign body response to a distal biomaterial implant.

The gut microbiota influences systemic immunity and the function of distal tissues, including the brain, liver, skin, lung, and muscle. However, the role of the gut microbiota in the foreign body response and fibrosis is largely unexplored. To investigate this connection, we perturbed the homeostasis of the murine gut microbiota via infection with the pathogenic bacterial species enterotoxigenic (ETBF) and implanted particulate material (mean particle size <600 μm) of the synthetic polymer polycaprolactone (PCL) into a distal muscle injury.

Murine gut microbiota dysbiosis via enteric infection modulates the foreign body response to a distal biomaterial implant.

Unlabelled: The gut microbiota influences systemic immunity and the function of distal tissues, including the brain, liver, skin, lung, and muscle. However, the role of the gut microbiota in the foreign body response (FBR) and fibrosis around medical implants is largely unexplored. To investigate this connection, we perturbed the homeostasis of the murine gut microbiota via enterotoxigenic (ETBF) infection and implanted the synthetic polymer polycaprolactone (PCL) into a distal muscle injury.

Association Between Blood Type and Mortality Among Severely Injured Patients Enrolled in the Pragmatic Randomized Optimal Platelet and Plasma Ratios Trial.

Introduction: Previous studies suggested that type O blood may be associated with increased mortality and/or thrombotic complications among trauma patients. The purpose of this analysis was to evaluate the relationship between endogenous blood type, mortality, and complications among patients receiving massive transfusions, using data from the Pragmatic Randomized Optimal Platelet and Plasma Ratios trial.

Materials And Methods: This was a secondary analysis of the Pragmatic Randomized Optimal Platelet and Plasma Ratios trial that included patients with the reported blood type (A, AB, B, or O) data.

An improved 3T3-L1 adipocyte model of inflammation and insulin resistance.

Tumor necrosis factor alpha (TNF-α)/hypoxia-treated 3T3-L1 adipocytes have been used to model inflamed and insulin-resistant adipose tissue: this study examines gaps in the model. We tested whether modulating TNF-α/hypoxia treatment time could reduce cell death while still inducing inflammation and insulin resistance. Adipocytes were treated with TNF-α (12 h or 24 h) and incubated in a hypoxic chamber for 24 h.

Management of Incidental Thyroid Nodules.

Thyroid nodules are widely prevalent, and often discovered incidentally. Malignancy rates are low for incidental thyroid nodules, and overall outcomes are favorable regardless of diagnosis. Patients with thyroid nodules should be evaluated with TSH levels followed by ultrasound of the thyroid and cervical lymph nodes.

Diagnostic performance of the ABC score in the PROPPR trial.

Introduction: The Assessment of Blood Consumption (ABC) score is used to predict massive transfusions (MT). However, its diagnostic performance has not been widely examined, especially when used as an objective tool to enroll patients in multi-center clinical trials. The purpose of this study was to evaluate the performance of the ABC score in enrolling patients in the Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) trial.

A Rare Case of Invasive Central Nervous System Aspergillus niger in a Previously Immunocompetent Patient After Corticosteroid Treatment for COVID-19.

is a ubiquitous saprophyte found in air, soil, and organic matter. Humans inhale the spore form of the fungus, but manifestations of the disease are typically predominantly seen in immunocompromised patients. Invasive central nervous system (CNS) aspergillosis is even more uncommon, and epidemiological data is sparse, particularly in immunocompetent patients.

The overtreatment of papillary thyroid microcarcinoma in the community.

Introduction: Total thyroidectomy is the traditional primary approach for papillary thyroid cancer. However, recent evidence supports conservative management for low-risk tumors like papillary thyroid microcarcinomas (PTMCs). This study explores the adoption of these practices in our community, using a cancer database to analyze treatment strategies.

Vein-first artery-first robotic lobectomy outcomes in non-small cell lung cancer.

Background: Data remains limited as to whether the order of pulmonary vessel division during performance of a lobectomy for non-small cell lung cancer (NSCLC) affects survival outcomes. Some authors have suggested that ligation of the pulmonary veins should be conducted first in order to minimize the spread of tumor cells secondary to manipulation of the lung. This study examines whether there is a difference in outcomes between patients who undergo robotic lobectomies for NSCLC using a vein-first (V-first) artery-first (A-first) technique.

Outcomes of patients enrolled in a prospective and randomized trial on basis of gestalt assessment or ABC score.

Background: The Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) trial rapidly enrolled patients based on an Assessment of Blood Consumption (ABC) ≥ 2 score, or physician gestalt (PG) when ABC score was <2. The objective of this study was to describe what patients were enrolled by the two methods and whether patient outcomes differed based on these enrollments. We hypothesized that there would be no differences in outcomes based on whether patients were enrolled via ABC score or PG.

Treatment of Hypercalcemic Hyperparathyroidism After Kidney Transplantation Is Associated With Improved Allograft Survival.

Background: Hyperparathyroidism (HPT) and malignancy are the most common causes of hypercalcemia. Among kidney transplant (KT) recipients, hypercalcemia is mostly caused by tertiary HPT. Persistent tertiary HPT after KT is associated with allograft failure.

Establishment of a tissue-engineered colon cancer model for comparative analysis of cancer cell lines.

To overcome the limitations of in vitro two-dimensional (2D) cancer models in mimicking the complexities of the native tumor milieu, three-dimensional (3D) engineered cancer models using biomimetic materials have been introduced to more closely recapitulate the key attributes of the tumor microenvironment. Specifically, for colorectal cancer (CRC), a few studies have developed 3D engineered tumor models to investigate cell-cell interactions or efficacy of anti-cancer drugs. However, recapitulation of CRC cell line phenotypic differences within a 3D engineered matrix has not been systematically investigated.

Social Determinants of Health in Imaging-based Cancer Screening: A Case-based Primer with Strategies for Care Improvement.

Health disparities, preventable differences in the burden of disease and disease outcomes often experienced by socially disadvantaged populations, can be found in nearly all areas of radiology, including emergency radiology, neuroradiology, nuclear medicine, image-guided interventions, and imaging-based cancer screening. Disparities in imaging-based cancer screening are especially noteworthy given the far-reaching population health impact. The social determinants of health (SDoH) play an important role in disparities in cancer screening and outcomes.

Pain in Trauma Patients: Measurement and Predisposing Factors.

Introduction: Acute pain is common after injury. This study intended to evaluate the feasibility of quantifying pain experience over an entire admission using "area under the pain curve" and to identify factors associated with increased pain.

Methods: This retrospective single-center study included all trauma patients admitted from 2013 to 2020.

Preserving the Pipeline of Surgeon Scientists: The Role of a Structured Research Curriculum.

Introduction: With shrinking National Institute of Health support, increased clinical demands, and less time for research training during residency, the future of surgeon scientists is in jeopardy. We evaluate the role of a structured research curriculum and its association with resident academic productivity.

Methods: Categorical general surgery residents who matched between 2005 and 2019 at our institution were analyzed (n = 104).

An Upstream Reparative Justice Framework for Improving Diversity in Radiology.

Health care workforce diversity is vital in combating health disparities. Despite much recent attention to downstream strategies to improve diversity in radiology, such as increased recruitment efforts and holistic application review, workforce diversity has not tangibly improved in recent decades. Yet, little discussion has been devoted to defining the obstacles that might delay, complicate, or altogether prevent persons from groups that have been traditionally marginalized and minoritized from a career in radiology.

Change Management Strategies Toward Dismantling Race-Based Structural Barriers in Radiology.

Political momentum for antiracist policies grew out of the collective trauma highlighted during the COVID pandemic. This prompted discussions of root cause analyses for differences in health outcomes among historically underserved populations, including racial and ethnic minorities. Dismantling structural racism in medicine is an ambitious goal that requires widespread buy-in and transdisciplinary collaborations across institutions to establish systematic, rigorous approaches that enable sustainable change.

Practical Approaches to Advancing Health Equity in Radiology, From the Special Series on DEI.

Despite significant advances in health care, many patients from medically under-served populations are impacted by existing health care disparities. Radiologists are uniquely positioned to decrease health disparities and advance health equity efforts in their practices. However, literature on practical tools for advancing radiology health equity efforts applicable to a wide variety of patient populations and care settings is lacking.

Robotic Redo Mitral Valve Replacement and Atrioventricular Groove Pseudoaneurysm Repair.

We report the use of robot-assisted right thoracotomy in the management of a patient who presented with acute-on-chronic congestive heart failure, associated with a contained atrioventricular dissection and 2 prior mitral valve replacements. Our patient had evidence of a contained rupture, as represented by preoperative cross-sectional imaging. The anatomic sequela from this was a ventricular pseudoaneurysm, which was likely survivable due to adhesions from prior operations buttressing the margins of the defect.

Getting Your Foot in the Door: Access to Surgical Care for Thyroid Disease.

Introduction: Access to specialty care can be challenging for patients, often involving multiple evaluations, laboratory tests, and referrals. To better understand the different pathways to specialty care, we examined the outcomes of patients evaluated for surgical thyroid disease at a single tertiary referral clinic.

Methods: We reviewed 691 patients seen in the endocrine surgery clinic for thyroid disease (2018-2021).

Pediatric traumatic hemorrhagic shock consensus conference recommendations.

Hemorrhagic shock in pediatric trauma patients remains a challenging yet preventable cause of death. There is little high-quality evidence available to guide specific aspects of hemorrhage control and specific resuscitation practices in this population. We sought to generate clinical recommendations, expert consensus, and good practice statements to aid providers in care for these difficult patients.

Hypercalcemia with a parathyroid hormone level of ≤50 pg/mL: Is this primary hyperparathyroidism?

Background: Primary hyperparathyroidism is characterized by hypercalcemia with inappropriately normal or elevated parathyroid hormone. However, the absolute parathyroid hormone value that is defined as inappropriately normal is unclear. We reviewed our experience with parathyroidectomy in patients with hypercalcemia and parathyroid hormone of ≤50.