Impact of Biologics and Proton Pump Inhibitors on Gastrointestinal Infection Risk in Inflammatory Bowel Disease Patients: A Retrospective Analysis of Pathogen-Specific Outcomes and Treatment Interactions.

: Inflammatory bowel disease (IBD) patients face elevated gastrointestinal (GI) infection risks due to immune dysregulation and gut dysbiosis. While steroids and immunosuppressants are known to increase infection risk, data on biologics and proton pump inhibitors (PPIs) remain limited, particularly for non-Clostridioides difficile (C.diff) infections.

Outcomes of Acute Pancreatitis in Lean Versus Non-lean Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Patients: A Nationwide Analysis.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a key contributor to the severity and outcomes of acute pancreatitis (AP). This study compares the clinical outcomes of AP in patients with lean versus non-lean MASLD.

Methods: We identified adult patients hospitalized with AP and a secondary diagnosis of MASLD from the National Inpatient Sample (NIS 2016-2020).

Clinical outcomes of endoscopic submucosal dissection for residual neoplasia after incomplete resection of large nonpedunculated colorectal polyps: a large multicenter propensity match study (with video).

Background And Aims: Data on endoscopic submucosal dissection (ESD) for residual neoplasia after incomplete endoscopic resection (ER) of large nonpedunculated colorectal polyps (LNPCPs) remain scarce. We aimed to evaluate and compare outcomes of ESD in patients with treatment-naïve (control) lesions versus those with previous failed ER.

Methods: This was a multicenter propensity-score (PS) match study of ESDs performed for LNPCPs between January 2021 and September 2024.

Comparison of the safety, efficacy, and rates of GERD between full-thickness versus modified peroral endoscopic myotomy for achalasia: a systematic review and meta-analysis.

Background And Aims: Studies have shown variable results when comparing full-thickness (FT) peroral endoscopic myotomy (POEM) with modified myotomy (MM) techniques (such as selective circular myotomy [CM] and oblique fiber-sparing myotomy [OS]). We performed a meta-analysis to reconcile the data.

Methods: Online databases were searched for studies comparing FT to MM POEM for treatment of achalasia.

The implications of preoperative hypoalbuminemia on postoperative readmission, reoperation, and mortality among orthopaedic trauma patients: A systematic review and meta-analysis.

Background/aims: Preoperative serum hypoalbuminemia (<3.5 g/dL) is the blanketed referenced threshold associated with postoperative readmission, reoperation, and mortality among medical and surgical patients. This systematic review and meta-analysis evaluates the specific role of preoperative serum albumin and readmission, reoperation, and mortality among orthopaedic trauma patients.

Assessing the Therapeutic Role of Rehabilitation Programs in Chemotherapy-Induced Peripheral Neuropathy (CIPN)-A Scoping Review.

Chemotherapy-induced peripheral neuropathy (CIPN) is a common, debilitating side effect of cancer treatment. Characterized by symptoms like pain, numbness, and muscle weakness, CIPN significantly impacts patients' quality of life. Current management strategies vary, with limited consensus on effective treatments.

Beneath the Label - Evaluating the FDA Approval of Copenhagen Classic Snuff as a Modified Risk Tobacco Product.

Description In this review, we critically evaluate the Food and Drug Administration's modified risk tobacco product (MRTP) status granted to a smokeless tobacco product (March 2023), Copenhagen Classic Snuff (CCS). This new status necessitates an assessment of the product CCS use and its public health impacts. We assess the impact of CCS as it relates to the reduction of lung cancer risk and the potential increased risk for nasopharyngeal cancer, chronic rhinitis, nicotine dependence, and other health hazards.

Pain Management in Autosomal Dominant Polycystic Kidney Disease: Clinical Challenges and a Stepwise Algorithmic Approach.

Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic kidney disorder. It is primarily caused by pathogenic variants in the PKD1 or PKD2 genes. This leads to the development of numerous kidney cysts, which can result in kidney enlargement and progression to kidney failure.

Treatment of diabetes in patients with advanced chronic kidney disease or kidney failure.

Chronic kidney disease (CKD) is common in both type 1 and type 2 diabetes and complicated glycemic control due to fluctuating insulin resistance and metabolism. In advanced CKD (stage 4 and stage 5, or eGFR <30 ml/min/1.73m2), reduced kidney clearance of insulin can lower or eliminated insulin needs, but glycemic control remains challenging.

Management of Bipolar Disorder in Pregnancy and Postpartum: A Clinicians' Guide.

Medication management in women with bipolar disorder (BD) in the perinatal period is challenging, given that many patients taper or stop medication during pregnancy, and the postpartum period is an extremely high-risk period for relapse. The objective of this narrative review was to investigate the perinatal efficacy as well as potential adverse effects on the child of common treatments for bipolar disorder. These treatments include lithium, lamotrigine, other antiepileptics, quetiapine, olanzapine, aripiprazole, other antipsychotics, antidepressants, benzodiazepines, Z-drugs, and other sleep medication.

Incidence and Clinical Relevance of Echocardiographic Visualization of Occult Ventricular Fibrillation: A Multicenter Prospective Study of Patients Presenting to the Emergency Department After Out-of-Hospital Cardiac Arrest.

Study Objectives: Ventricular fibrillation (VF) is traditionally identified on ECG but echocardiography can visualize myocardial fibrillation. The prevalence and importance of occult VF defined as a nonshockable ECG rhythm but VF by echocardiography is unknown.

Methods: In this multicenter, prospective study, emergency department patients presenting following out-of-hospital cardiac arrest were eligible for inclusion if echocardiography and ECG were performed simultaneously.

Foot Burn Injuries Associated with Hair Braiding.

An increasing number of burns are associated with a popular hair braiding trend incorporating synthetic hair extensions. These burns occur predominantly in young African American females and across all age groups. The hair technique involves the ends of the braid being dipped in scalding water to prevent unwinding.

Sex Differences in Non-Acute Myocardial Infarction Cardiogenic Shock: Insights from the Northwell-Shock Registry.

While the role of sex-based differences in acute myocardial infarction-related cardiogenic shock (AMI-CS) is well described, their relevance among patients with non-acute myocardial infarction-related CS (nonAMI-CS) is less well known. Adult patients treated for cardiogenic shock (CS) between 2016 and 2022 across eleven hospitals within our health system were included. NonAMI-CS etiologies were classified as heart failure or secondary CS (valvular and arrhythmia-triggered).

Hospitalization Outcomes of Patients with Asthma, COPD, and Asthma-COPD Overlap Syndrome.

Background And Objectives: Chronic obstructive pulmonary disease (COPD) and asthma account for a significant health care burden within the United States. The asthma-COPD overlap (ACO) phenotype has been associated with increased exacerbation frequency and health care utilization compared to either disease alone. However, hospital-based outcomes of these diagnoses have not been described in the literature.

Gastroduodenal Strongyloidiasis Diagnosed during Iron Deficiency Anemia Workup.

Introduction: The Strongyloidae family includes at least fifty species of intestinal nematode worms, and is the most prevalent one among humans. As a result of this parasite's complex lifecycle, it can either remain localized in the intestines or disseminate to different organs throughout the body, culminating in hyperinfection in case of immunosuppression. Strongyloidiasis is rarely encountered in the USA, and an associated gastric involvement is uncommon.

Reevaluating therapeutic strategies in Crohn's disease: Comparing Modulen and budesonide.

This article explores the significant implications of the study by Ovadia , which innovatively compares the efficacy of a nutritional intervention (Modulen) to conventional pharmaceutical therapy (budesonide) in promoting mucosal healing in Crohn's disease. Highlighting the paradox of a well-established yet underutilized nutritional approach, the findings suggest that Modulen may offer comparable therapeutic benefits despite its high withdrawal rate due to adherence challenges. This advancement underscores the evolving paradigm in inflammatory bowel disease treatment, shifting focus toward non-pharmacologic alternatives that target both clinical remission and endoscopic healing.

Migration of a Retained Epicardial Pacing Wire Into the External Carotid Artery.

Background: Temporary epicardial pacing wires (TEPWs) are commonly used for postoperative arrhythmia management in cardiac surgery. Although generally safe, they can cause rare complications, including migration years after placement.

Case Summary: A 59-year-old man with a history of cardiac arrest and acute myocardial infarction requiring urgent coronary artery bypass grafting 2 years prior presented with new-onset dysphagia and odynophagia.

Questionable role of opioids for analgesia in renal colic and its urological interventions.

Objectives: To review the different analgesic modalities and benefits of non-opioid pain management options as well as their evidence-based, established superiority, compared to opioid medications.

Materials: We review the updated literature about pain management of renal colic, a prevalent and painful urologic condition. Prescribers must know the efficacy, safety and possible ramifications of analgesic selections.

Statins and the Risk of Colorectal Cancer in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.

Background: Statins are reported to reduce colorectal cancer (CRC) risk in the general population, but their effect on individuals with inflammatory bowel disease (IBD) remains uncertain. We aimed to evaluate the relationship between statin use and CRC risk in patients with IBD.

Methods: A comprehensive review of the literature was conducted on PubMed, Web of Science, and EMBASE to evaluate the association between statin use and the development of CRC in patients with IBD.

Successful Slow Pathway Modification with Radiofrequency Ablation in a Patient with AVNRT and Congenital IVC Continuity with Azygos Vein.

Background: Congenital anomalies of the inferior vena cava (IVC), such as interrupted or azygos continuation, complicate catheter-based procedures like atrioventricular nodal reentrant tachycardia (AVNRT) ablation. Understanding IVC variations is crucial for successful outcomes in interventional cardiology.

Case Presentation: A 57-year-old male with long-standing paroxysmal atrial fibrillation (AF) underwent successful catheter ablation for AVNRT.

Impact of nocturnal duty on cardiometabolic health: Insights across professions.

This editorial explores the significant cardiometabolic outcomes of nocturnal sentry duty and its broader implications for other professions with overnight work. Highlighting the paradox of essential nighttime labor and its adverse physiological effects, we discuss how occupations like healthcare, hospitality, and emergency services are similarly affected. The study by Lin provides critical insights into these dynamics and lays the groundwork for understanding nocturnal duty's multifaceted impact on human health.

Anesthetic Management of a Patient With Pierre Robin Sequence: A Case Report.

Pierre Robin Sequence (PRS) is a rare congenital disorder characterized by a triad of micrognathia, glossoptosis, and airway obstruction. This case report presents a rare instance of PRS marked by congenital airway obstruction, which significantly complicated endotracheal intubation with vocal cord motion and a smaller airway to navigate. It will describe what can be expected from such airways and the approaches taken to manage them.