Obstructive Sleep Apnea in Adult Dialysis Patients: A Review.

Obstructive sleep apnea (OSA) is an extremely common but underdiagnosed problem in adults receiving dialysis therapy. Patients with end-stage kidney disease (ESKD) on hemodialysis or peritoneal dialysis have a higher prevalence of OSA compared to the general population (1-3). This condition carries significant clinical implications, contributing to impaired sleep quality, daytime fatigue, and elevated cardiovascular risk if left untreated (4,5).

Mucorales Endocarditis: A Case Series and Review of the Literature.

Mucorales endocarditis is an extremely rare and devastating disease, with few cases reported in the literature. The infection is predominantly found in immunocompromised patients, although a few cases involving immunocompetent individuals have been reported. We reviewed all cases of mucor endocarditis reported to date with a focus on demographics, clinical presentations, and the range of predisposing conditions, including immunosuppressive states, recent surgery, and cardiac device implantation.

Agreement between transurethral resection of bladder tumor and radical cystectomy pathology in patients with bladder cancer subtype histology: A retrospective cohort study.

Introduction And Objectives: Transurethral Resection of Bladder Tumor (TURBT) is a diagnostic staging procedure for bladder cancer (BC). Its pathologic interpretation may be limited by cautery artifact, lack of spatial orientation of tumor specimens, inter-pathologist variance in identifying subtypes, and sampling bias. Accurately identifying subtype histology (SH) on TURBT is critical for clinical decisions.

Pulmonary Hypertension in Sickle Cell Disease: A Case Series.

Pulmonary hypertension (PH) is a serious and increasingly recognized complication in sickle cell disease (SCD), particularly in individuals with the homozygous genotype. Elevated tricuspid regurgitant velocity (TRV) increases the potential for future development of PH, yet no standardized management approach currently exists, likely because of the varied pathophysiology of PH in these patients. Transthoracic echocardiogram-derived elevated TRV of more than 2.

An open-label phase II trial of sotrovimab (VIR-7831) prophylaxis against COVID-19 infection in immunocompromised individuals with impaired SARS-CoV-2 humoral immunity.

Background: Immunocompromised individuals have a limited humoral immune response to SARS-CoV-2 vaccination and are at higher risk of severe COVID-19. Sotrovimab is a monoclonal antibody (mAb) targeting a conserved SARS-CoV-2 spike protein epitope.

Methods: This phase II open-label study evaluated the safety and tolerability of sotrovimab pre-exposure prophylaxis in immunocompromised adults with impaired vaccine response.

Female-to-female aggression in the workplace.

Background: Female-to-female aggression in the workplace describes behavior by a woman with higher power status that is intended to degrade, ridicule, or undermine the work of a woman with a lesser power status, and may impede the career goals of junior female radiologists. Senior women may or may not be aware of their role in perpetuating this behavior.

Objective: To characterize the prevalence, impact, and perceptions of female-to-female workplace aggression among pediatric radiologists in order to raise awareness and inform strategies for prevention and intervention.

Suture traction-assisted bearclaw fistula closure: a case series describing a novel endoscopic technique for fistula closure.

Background And Aims: Endoscopic therapies are currently the mainstay of treatment for GI fistulas. However, some GI fistulas are hard to treat as the result of the tissue's friability and large size defect. This case series describes a novel technique for managing hard-to-treat fistulas.

Successful Dostarlimab Rechallenge Following Pembrolizumab-Induced Autoimmune Hemolytic Anemia: A Case Report.

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, offering durable responses across multiple malignancies. However, these agents can trigger severe immune-related adverse events (irAEs), including drug-induced autoimmune hemolytic anemia (AIHA), which often necessitates treatment discontinuation. While management guidelines for irAEs are well established, the safety and feasibility of ICI rechallenge after resolution of severe hematologic toxicities remain poorly understood.

Insulin resistance, metabolic dysfunction-associated steatotic liver disease, and advanced liver fibrosis in lean US adults: a population-based study.

Background: While insulin resistance (IR) and metabolic dysfunction-associated steatotic liver disease (MASLD) are well established in obese individuals, their connection in lean populations remains underexplored.

Methods: This cross-sectional study investigated the relations of IR with MASLD and advanced liver fibrosis based on data from the 2017-2020 US National Health and Nutrition Examination Surveys. The subjects were lean adults (non-Asian body mass index [BMI] < 25 kg/m, Asian BMI <23 kg/m) with transient elastography data, free from viral hepatitis, human immunodeficiency virus, excessive alcohol use, and diabetes.

Chronic Kidney Disease as a Predictor of Mortality in Hospitalized Inflammatory Bowel Disease Patients With Clostridioides difficile Infection.

Introduction Clostridioides difficile infection (CDI) leads to significant morbidity and mortality in hospitalized patients. We aim to investigate whether chronic kidney disease (CKD) or end-stage renal disease (ESRD) are predictors of mortality in admitted patients with CDI, and whether the presence of inflammatory bowel disease (IBD) has any impact on the mortality rate.  Methods The data of 133,099 hospitalized patients with CDI were analyzed from the National Inpatient Sample (NIS) database from 2016 to 2018.

Gelatinous pleural effusion in advanced lung adenocarcinoma: a case report.

Background: Gelatinous pleural effusions, a rare subtype of exudative effusions with elevated viscosity due to high hyaluronic acid levels, are often associated with malignancies, particularly malignant pleural mesothelioma and some metastatic cancers. Such effusions present unique challenges in both diagnosis and management due to their thickness, which complicates drainage using standard techniques. This case highlights the clinical significance of recognizing unusual pleural fluid characteristics and employing advanced drainage interventions, particularly in metastatic lung adenocarcinoma.

Successful Management of HFpEF-Related Pulmonary Hypertension With Systemic-Level Pressures Using Sacubitril-Valsartan and Empagliflozin.

Background: Pulmonary hypertension (PH) is present in over two-thirds of patients who experience heart failure with preserved ejection fraction (HFpEF), and it worsens their prognosis, particularly when combined with right ventricular dysfunction. Effective treatments for HFpEF-related PH are limited.

Case Summary: A 70-year-old woman presented with severe exertional dyspnea and hypoxia.

Endoscopic ultrasound-guided celiac plexus block for painful chronic pancreatitis: A systematic review and meta-analysis.

Background: The efficacy of endoscopic ultrasound-guided celiac plexus block (EUS-CPB) for treatment of pain in chronic pancreatitis (CP) is unclear. Therefore, we aimed to assess this outcome using a systematic review and meta-analysis.

Methods: We conducted a comprehensive search of MEDLINE, EMBASE, and Cochrane Central for evaluating the efficacy of EUS-CPB for pain in CP.

Impact of Acute Kidney Injury on Mortality Outcomes in Patients Hospitalized for COPD Exacerbation: A National Inpatient Sample Analysis.

Acute kidney injury (AKI) worsens outcomes in COPD exacerbation (COPDe), yet limited data compare the demographics and mortality risk factors of COPDe admissions with and without AKI. Understanding this association may enhance risk stratification and management strategies. The aim of this study was to identify demographic differences and mortality risk factors in COPDe admissions with and without AKI.

Intestinal Microbiota and Fecal Transplantation in Patients with Inflammatory Bowel Disease and : An Updated Literature Review.

: Inflammatory bowel disease (IBD) is characterized by chronic relapsing and remitting inflammation of the gastrointestinal tract. Fecal microbiota transplantation (FMT) has emerged as an FDA-approved treatment for recurrent infections (CDIs), with promising potential in patients with IBD. This manuscript aimed to provide a comprehensive and updated review of the available literature on fecal microbiota transplantation, its clinical use in IBD in general, as well as in patients with IBD and CDI.

The Evolving Risk of Infective Endocarditis After Transcatheter Aortic Valve Implantation.

Objectives: Despite increased use of transcatheter aortic valve implantation (TAVI) in older adults with severe aortic stenosis, contemporary data on infective endocarditis (IE)-an infrequent but serious complication-are lacking. This study addresses this gap in knowledge.

Methods: We analysed 280 073 Medicare beneficiaries who underwent TAVI between 2013 and 2022.

Targeting Lipopolysaccharides in Gram-negative Sepsis: Therapeutic Advances and Challenges.

Gram-negative bacterial sepsis remains a major global health threat, exacerbated by rising antimicrobial resistance and limited efficacy of current therapies. Central to its pathogenesis is lipopolysaccharide (LPS), a potent endotoxin that triggers overwhelming inflammation and organ dysfunction. This review critically evaluates emerging therapies targeting LPS in sepsis.

Hypoalbuminemia associated perioperative mortality, reoperation, and readmission rates among total joint arthroplasty procedures: a systematic review and meta-analysis.

Background: Albumin had consistently demonstrated an association with readmission, reoperation and mortality rates among total joint arthroplasty (TJA) patients. The currently literature demonstrates variable effect sizes of hypoalbuminemia and postoperative outcomes.

Methods: PubMed/MEDLINE, Embase, Ovid, CENTRAL, the trial register, and Scopus were searched.

Retrospective analysis of vascular surgery complication rates compared to commonly used risk index calculators.

Background: Risk index calculator models are widely used to estimate perioperative risk of surgical procedures, directly impacting surgical planning and patient outcomes. This study assessed the accuracy of the National Surgical Quality Improvement Program Surgical Risk Calculator (NSQIP-SRC), Revised Cardiac Risk Index (RCRI) calculator, and Vascular Quality Initiative Cardiac Risk Index (VQI-CRI) calculators in predicting adverse event rates for common vascular procedures.

Methods: A retrospective cohort of all carotid endarterectomy (CEA), endovascular abdominal aortic aneurysm repair (EVAR), infrainguinal bypass, open abdominal aortic aneurysm (AAA) repair, and suprainguinal bypass procedures completed in a single hospital system between January 2020 and January 2023 was assembled.

Association of antiphospholipid syndrome with infective endocarditis and sepsis induced by Staphylococcus aureus: A U.S. nationwide inpatient sample analysis.

BackgroundAntiphospholipid syndrome (APS) predisposes patients to thrombosis and cardiac valve lesions such as Libman-Sacks endocarditis. These vegetations are sterile yet can provide a nidus for infection; the risk of infective endocarditis (IE) and other serious infections in APS patients remains poorly quantified in large populations, representing a knowledge gap.ObjectiveTo quantify the risk of the primary outcome, IE, and secondary outcomes of MRSA sepsis and MSSA sepsis, associated with APS using a large, nationally representative inpatient database.

Ambulatory Curriculum Enhancing Education for Modern Resident Learners.

Introduction: Data on the implementation of successful pediatric ambulatory curricula in residency are limited. Although most pediatric residents pursue careers in primary care, the educational focus in residency training sways toward inpatient medicine. Barriers exist to standardized, consistent teaching in the outpatient clinic.