Randomized Phase 2 Trial of an Extended and Flexible Dosing Schedule of Lu-PSMA Molecular Radiotherapy in Patients with Metastatic Castration-Resistant Prostate Cancer (FLEX-MRT): Study Protocol.

[Lu]Lu-PSMA-617 radiopharmaceutical therapy has been approved for the treatment of men with metastatic castration-resistant prostate cancer (mCRPC) using a fixed dosing schedule of once every 6 wk for up to a total of 6 doses. We hypothesized that patients may benefit from a flexible and extended dosing schedule, up to 12 doses with potential "treatment holiday" periods. The objective of this study is to determine the 2-y survival rate of patients with mCRPC treated with an extended and flexible dosing schedule of [Lu]Lu-PSMA-617 therapy in comparison to patients treated with the standard fixed dosing schedule of a maximum of 6 treatment cycles once every 6 wk.

Body Mass Index and Postsurgical Outcomes in Older Adults.

Importance: High body mass index (BMI) has been associated with increased postoperative complications including mortality in the general population, leading many perioperative clinicians to recommend preoperative lifestyle modifications aimed at achieving normal body weight. However, aging introduces physiological changes associated with frailty, such as altered body composition, fat redistribution, and stature reduction due to height loss, all of which may modify the association between BMI and surgical outcomes in older adults.

Objective: To determine if a higher BMI in older adults who are undergoing major elective surgery is associated with rates of all-cause mortality.

Antibodies to angiotensin II type 1 receptor and endothelin type A receptor are associated with cytokine production enriched for type 2 immune response and antibody production in pediatric kidney transplant recipients.

Activating antibodies to angiotensin II type 1 receptor (AT1R) and endothelin type A receptor (ETAR) have been associated with rejection, allograft loss, decline in allograft function, and development of human leukocyte antigen donor-specific antibodies in kidney transplantation. Understanding immune dysregulation and inflammatory signatures associated with these antibodies is important for generating targeted investigations of pathogenesis. We investigated a panel of 38 cytokines in a multicenter cohort of 133 pediatric kidney transplant recipients with 1 to 2 years of follow up to further elucidate AT1R and ETAR-Ab-associated inflammatory signatures.

RECOVID: Retrospective Observational Study of Renal Outcomes and Long-Term Mortality in Patients With COVID-19-Associated AKI, A Comparison Between Vaccinated and Unvaccinated Patients.

Rationale & Objective: Acute kidney injury (AKI) is a common complication in patients with Coronavirus disease-2019 (COVID-19) infections, with rates as high as 32% to 46%, and it has been associated with poor outcomes. However, the long-term renal and survival outcomes among hospitalized patients with COVID-19 and AKI are not fully understood.

Study Design: A single-center cohort study.

Patient preference for intraoperative opioid use and early recovery after noncardiac surgery: protocol for a randomised factorial design trial of opioid-free opioid-based anaesthesia (the PERFECT trial).

Introduction: Although opioids are commonly used to relieve pain associated with surgery, they are not consequence free. Moreover, the USA and many western countries are currently experiencing a significant health crisis because of opioid addiction and its related overdose potential. There have been no studies that have evaluated patient preference regarding opioid use and its potential impact on the quality of recovery.

Investigating the effectiveness of an intraoperative decision support guided fluid therapy intervention on postoperative outcome of high-risk patients undergoing high-risk abdominal surgery: protocol for an international multicentre stepped-wedge cluster-randomised implementation trial.

Background: Inappropriate fluid administration can impact patient outcome. Intraoperative advanced haemodynamic monitoring coupled with a treatment protocol based on stroke volume optimisation can help determine the appropriate timing for fluid boluses. Although recommended by several anaesthesia societies, this strategy is rarely implemented because protocols are complex and compliance is often poor.

Adequacy of Immune Checkpoint Inhibitor-Associated Thyroid Function Monitoring After Therapy.

Purpose: Immune checkpoint inhibitor (ICI)-induced thyroid dysfunction is a common endocrine immune-related adverse event. Although rates during therapy are well documented, data on post-treatment thyroid dysfunction are limited. We hypothesized that post-ICI thyroid dysfunction is under-recognized because of inadequate surveillance.

Does pre-emptive dexamethasone provide prophylaxis against sugammadex-induced bradycardia? A retrospective study.

Sugammadex is a cyclodextrin used to reverse neuromuscular block with amino-steroid nondepolarizing muscle relaxants, rocuronium and vecuronium. Sugammadex-induced bradycardia was recently demonstrated in a single-blind, placebo-controlled study in patients receiving rocuronium for neuromuscular block. It has also been hypothesized that the bradycardia and rare instances of cardiac arrest occurring after the use of sugammadex may be due to a transient decrease in circulating corticosteroids, causing a temporary 'mini Addisonian crisis.

Proof of concept study of the posterior quadratus lumborum block for laparoscopic myomectomy: A randomized controlled trial.

In the United States, 65,000 myomectomies are performed annually to treat uterine fibroids. The quadratus lumborum block (QLB) is an effective block for laparoscopic pelvic surgery, urologic surgery, hip surgery and cesarean sections, with limited data for laparoscopic myomectomies. We evaluated the posterior QLB in reducing MME consumption and numeric rating scale (NRS) pain scores in patients undergoing laparoscopic myomectomies.

Prediction of Imminent Sudden Cardiac Arrest Using a Combination of Warning Symptoms and Clinical Features.

Introduction: At least 50% of individuals who suffer sudden cardiac arrest (SCA) experience warning symptoms before their SCA. We have previously reported chest pain and dyspnea as the most common and potentially predictive symptoms. Combining with clinical features could improve sensitivity and specificity for prediction of imminent SCA (ISCA).

Early changes of PSMA PET expression after initiation of androgen receptor signaling inhibitors in CRPC: an international multicenter retrospective study.

Background: An increase of PSMA expression under androgen receptor signaling inhibitors (ARSi) measured on PSMA PET was reported: However, results were inconsistently reproduced clinically and the frequency and timing of the PSMA expression modulation by ARSi remains unknown.

Methods: In this multicenter retrospective study, we aimed at assessing in patients with CRPC the influence of ARSi early after initiation (≤ 30 days) on PSMA expression at the whole-body (WB) level by using WB PSMA PET quantitative parameters. (m)CRPC patients from 5 international sites who underwent a PSMA PET prior to (PET1) and early (< 30 days) after (PET2) ARSi initiation were included.

Implementation of a Multidisciplinary Team for Initiation of Extracorporeal Cardiopulmonary Resuscitation in Patients Presenting After Out-of-hospital Cardiac Arrest.

Objectives: Patents with out-of-hospital cardiac arrest (OHCA) are at high risk of death or poor neurologic recovery if spontaneous circulation is not rapidly restored. Emergent mechanical circulatory support with venoarterial extracorporeal membrane oxygenation (VA-ECMO) in the setting of extracorporeal cardiopulmonary resuscitation (ECPR) offers a bridge to diagnostic and therapeutic interventions but can be challenging to provide in a timely fashion. Coordination of multidisciplinary institutional resources into an ECMO Shock Team (ECMO-ST) may improve the survival of ECPR patients while concurrently increasing the number of OHCA patients placed on ECMO.

General movement assessments in neonates born with congenital gastrointestinal anomalies: a single site, retrospective study.

Objective: We aimed to characterize general movements in neonates with congenital gastrointestinal anomalies and to compare them to general movements in extremely low birth weight (ELBW) infants.

Study Design: This was a retrospective, single-site study. Subjects were divided into two groups: those with gastrointestinal (GI) anomalies and ELBW infants (birth weight <1 kg).

Quantitative 3-T Multiparametric MRI Parameters as Predictors of Aggressive Prostate Cancer.

Purpose To determine which quantitative 3-T multiparametric MRI (mpMRI) parameters correlate with and help predict the presence of aggressive large cribriform pattern (LCP) and intraductal carcinoma (IDC) prostate cancer (PCa) at whole-mount histopathology (WMHP). Materials and Methods This retrospective study included 130 patients (mean age ± SD, 62.6 years ± 7.

Decreases in hemoglobin and hematocrit may signal degree of hemorrhagic shock: retrospective evaluation in a dog model.

Objective: Data were extracted from preexisting published studies and evaluated retrospectively to compare lactate and base deficit values at baseline and posthemorrhage with changes in corresponding hemoglobin (Hb) and Hct measurements to assess any association of such changes with severity of hemorrhage over time. To understand the goal, the objective of this study was to demonstrate statistical changes in laboratory values as described above.

Methods: Previous prospectively designed experiments on 120 mixed-breed dogs were conducted.

High Omega-3, Low Omega-6 Diet With Fish Oil for Men With Prostate Cancer on Active Surveillance: The CAPFISH-3 Randomized Clinical Trial.

Purpose: Men on active surveillance (AS) for prostate cancer are extremely interested in dietary changes or supplements to prevent progression of their disease. We sought to determine whether a high omega-3, low omega-6 fatty acid diet with fish oil capsules (D + FO) decreases proliferation (Ki-67) in prostate biopsies in men with prostate cancer on AS over a 1-year time period.

Methods: In this phase II, prospective randomized trial, men (N = 100) with grade group 1 or 2 prostate cancer who elected AS were randomly assigned to the D + FO or a control group.

Prospective Cohort Study Investigating Polyunsaturated Fatty Acids and Chronic Lung Disease in Preterm Infants.

Chronic lung disease (CLD) is a complication of prematurity. Studies examining the effects of long-chain polyunsaturated fatty acids (LC-PUFAs) on CLD are conflicting. This study investigated LC-PUFAs in the red blood cell membrane (RBCM) in preterm infants.

Incidence and Risk Factors for Clinically Significant Oropharyngeal Dysphagia After Lung Transplantation.

Aspiration is one of many risk factors for chronic lung allograft dysfunction, which continues to limit survival in lung transplant recipients. Oropharyngeal dysphagia (OPD) occurring after lung transplant surgery increases the risk of antegrade aspiration. While the incidence and risk factors for OPD have been well described in cardiac surgery, there is less known in the lung transplant population.

Clinical, Pathologic, and Imaging Variables Associated with Prostate Cancer Detection by PSMA PET/CT and Multiparametric MRI.

Multiparametric MRI (mpMRI) and prostate-specific membrane antigen (PSMA) PET/CT are complementary imaging modalities used in the presurgical evaluation of patients with prostate cancer (PCa). The purpose of this study was to characterize clinically significant PCa (csPCa) detected and not detected by PSMA PET/CT and mpMRI, focusing on tumors detected solely by PSMA PET/CT and overlooked by mpMRI. We conducted a single-center, retrospective analysis of patients who underwent both PSMA PET/CT and mpMRI within 3 mo of each other and before radical prostatectomy.

A retrospective analysis using comorbidity detecting algorithmic software to determine the incidence of International Classification of Diseases (ICD) code omissions and appropriateness of Diagnosis-Related Group (DRG) code modifiers.

Background: The mechanism for recording International Classification of Diseases (ICD) and diagnosis related groups (DRG) codes in a patient's chart is through a certified medical coder who manually reviews the medical record at the completion of an admission. High-acuity ICD codes justify DRG modifiers, indicating the need for escalated hospital resources. In this manuscript, we demonstrate that value of rules-based computer algorithms that audit for omission of administrative codes and quantifying the downstream effects with regard to financial impacts and demographic findings did not indicate significant disparities.