Medical Specialties Commons^™

Perspectives Of Healthcare Providers And Patients With Relapsed/Refractory Multiple Myeloma On Treatment Priorities And Novel Therapies., Sikander Ailawadhi, Yelak Biru, Solène Clavreul, Maite San Miguel, Nicolas Cormier, Yvonne Efebera, Maximilian Merz, Anna Sato, Cathy Zeanah, Jack L Watkins, James Farrell, Erinn Hoag Goldman, Rakesh Popat

Oncology Articles

PURPOSE: With novel therapies including chimeric antigen receptor T-cell (CAR-T) therapy and bispecific antibodies (BsAbs), healthcare providers (HCPs) face complexities managing treatment for patients with relapsed/refractory multiple myeloma (RRMM). This study, among the largest surveys on RRMM, examined unmet needs in care access, barriers to novel therapy use, and treatment decision-making.

METHODS: This survey-based study (March-June 2024) enrolled 2284 participants (patients: 1301; HCPs: 983) across 7 countries. Patients with >1 relapse/progression and HCPs managing ≥3 patients were included. Data were analyzed using descriptive statistics and Χ

RESULTS: For patients, treatment priorities included slowing disease progression (second line [2L], 47%; third …

Is Fixation Of A Single End Of Flail Segment Rib Fractures Enough?, Anthony Perugini, James Iandoli, Nicholas Pelz, Daniel Degenova, Anthony Melaragno, Mallory Faherty, Benjamin C Taylor

OhioHealth Research Institute Articles

BACKGROUND: Segmental rib fractures in blunt thoracic trauma present with increased morbidity and mortality with an association of increased pulmonary insult and concomitant injuries. There is a paucity within the literature regarding the necessity of fixation of one or both segments of rib fractures in a flail chest. This study aimed to analyze surgical rib fixation and assess outcomes for non-fixed fractured rib ends in segmental rib fractures.

METHODS: This is a retrospective review of 125 patients who underwent open reduction internal fixation of flail segmental rib fractures at our urban Level 1 trauma center. Initial plain films and CT …

Examining Isokinetic Knee Peak Torque And Time To Peak Torque As Predictors Of Vertical Jump Height In Division I Men's Basketball Players., Caroline Westwood, Arakua Welbeck, Carolyn Killelea, Peter Howard, Mallory Faherty, Daniel Le, Ryan Zerega, Charles R Reiter, Timothy C Sell

OhioHealth Research Institute Articles

The vertical jump (VJ) is one of the most important movements for basketball athletes and therefore determining modifiable predictors of the VJ would aid substantially in crafting more effective training regimens. The purpose of this study was to determine if isokinetic quadriceps strength and torque predict VJ height and which characteristics and testing speed is the strongest predictor of VJ height. Fifteen subjects (age: 18.5 ± 1.0 years, height: 195.9 ± 6.9 cm, weight: 96.2 ± 13.7 kg) from a single Division I men's basketball team were recruited for this study. All participants performed a standing vertical jump with arm-swing …

No Difference In Static Postural Stability Bilaterally Or Versus Control At 12 Weeks After Anterior Cruciate Ligament Reconstruction., Alessa R Lennon, Carolyn Killelea, Mallory S Faherty, Timothy C Sell

OhioHealth Research Institute Articles

BACKGROUND: Comparing static postural stability between the involved and uninvolved legs in individuals 12 weeks after ACL reconstruction (ACLR), and against healthy controls, may provide insight into rehabilitation progression.

PURPOSE: To compare static single-leg postural stability between the injured and uninjured legs of individuals 12 weeks post ACLR, and to a control group of healthy, physically active individuals.

STUDY DESIGN: Case-control study.

METHODS: Twenty-nine participants (17 male, 12 female; age = 20.9 ± 5.0) 12 weeks post ACLR and 87 healthy controls (51 male, 36 female; age = 19.4 ± 1.2) volunteered. Static single-leg postural stability was assessed using an …

Treatment Of Ovarian Clear Cell Carcinoma: A Case Of Successful Management With Targeted Therapies., Sydney Pence, Kellie Rath, Aine Clements

Women’s Health Articles

No abstract provided.

Multidisciplinary Emergent Control Of Traumatic Neovaginal Bleeding After Foreign-Body Insertion In The Early Postoperative Period After Gender-Affirming Vaginoplasty., Tanisha S Kashikar, Christopher D Mcclung, Michal A Radomski, Anand K Joshi, David C Evans

Trauma and Acute Care Articles

As gender-affirming surgery becomes more widespread, it is important that healthcare providers recognize complications related to gender-affirming surgery. Although rates of postoperative bleeding after gender-affirming vaginoplasty are relatively low, it is imperative that this potentially life-threatening complication is recognized and managed quickly. This case highlights the importance of a multidisciplinary approach to the management of neovaginal bleeding that was unable to be controlled intraoperatively by suture ligation.

An Evidence-Based Consensus For The Use Of Neurostimulation For The Treatment Of Non-Surgical Low Back Pain: The Neuron Group., Timothy Ray Deer, Jason E Pope, Erika A Petersen, Rany T Abdallah, Kasra Amirdelfan, Nomen Azeem, Vishal Bansal, Kaku Barkoh, Kenneth B Chapman, Daniel R Denis, Michael J Dorsi, Alexander Escobar, Steven Michael Falowski, Rosa Amelia Garcia, Jonathan M Hagedorn, Robert D Heros, Whitney S James, Hemant Kalia, Todd Lansford, Mark N Malinowski, Suzanne Marie Manzi, Pankaj Mehta, Robert Z Moghim, Gregory Anthony Moore, Soriaya Lizette Motivala, Yeshvant A Navalgund, Raj G Patel, Julie G Pilitsis, Michael E Schatman, Philip Michael Shumsky, Natalie Holmes Strand, Nestor D Tomycz, James J Yue, Dawood Sayed

Neuroscience Articles

INTRODUCTION: The use of electrical neuromodulation has often been limited to those with previous back surgery, peripheral neuropathy, and complex regional pain syndrome. Many patients with severe intractable low back pain were thought to be candidates for spinal cord stimulation (SCS), dorsal root ganglion stimulation, or peripheral nerve stimulation but did not meet the criteria. Recently, additional high-level data has supported the use of SCS in non-surgical low back pain (NSLBP), and United States Food and Drug Administration approval has been granted. The American Society of Pain and Neuroscience (ASPN) executive committee realized an unmet need to develop criteria for …

Real-World Clinical Utility Of A Multi-Protein, Blood-Based Biomarker Assay For Disease Activity Assessments In Multiple Sclerosis., Angela Sanchez, Elisa Sheng, Sarah Eagleman, James L Eubanks, Patricia Izbicki, Shannon Mccurdy, Matt Burril, Ferhan Qureshi, Ati Ghoreyshi, Mitzi Joi Williams, Megan Weigel, William Kilgo, Jacqueline Nicholas, Annette Okai, Martin Belkin, Julie Burnham, Yasir Jassam, Michael Sy, Taylor Gonyou

Neuroscience Articles

BACKGROUND: Blood-based biomarkers have emerged as promising tools to optimize treatment decisions in multiple sclerosis (MS) including initiation, switch, or cessation of disease modifying therapies.

OBJECTIVES: The clinically validated MS disease activity (MSDA) test measures 18 proteins to derive a disease activity score. This study tests the clinical utility of MSDA in real-world practice.

METHODS: Twenty clinicians from 14 clinics conducted a chart review utilizing a retrospective, longitudinal design, with a pre-post component. Chart reviews captured clinician decision-making before and after receipt of each MSDA result, while separate clinician assessments also captured the perceived impact of MSDA on MS management. …

Design Of A Post-Market Registry For The Extravascular Implantable Cardioverter-Defibrillator: The Enlighten Study., Lucas V A Boersma, Anish Amin, Nicolas Clémenty, David Duncker, Gregory Engel, Laurence Epstein, Vikas Kuriachan, Camille Frazier-Mills, Marianne Gwechenberger, Nobuhiro Nishii, Jeff Lande, Christopher Wiggenhorn, Ian Crozier

Heart and Vascular Articles

BACKGROUND: The extravascular implantable cardioverter-defibrillator (EV-ICD) with substernal lead placement has been shown to terminate ventricular arrhythmias safely and effectively while being outside the vasculature. The performance of the EV-ICD system with a novel inappropriate shock-reducing algorithm in a real-world setting has yet to be investigated.

OBJECTIVE: The objective of the Enlighten Study: the EV-ICD Post-Approval Registry is to provide a comprehensive measure of the safety and performance of the EV-ICD system in real-world clinical practice over the lifetime of the device.

METHODS: The Enlighten Study is a global, prospective, observational, multicenter, post-approval study utilizing the manufacturer's Product Surveillance Registry. …

High Neuraxial Blockade In A Parturient After Epidural Placement: A Quality Improvement Simulation., Samir Patel, Noah D Le, John Carter, Nick Melott, Andrew Kalnow, Camille D Hawkins, Alexander Luong, Matthias Franzen

Medical Education Articles

Background Epidural anesthesia is a commonly used procedure in obstetrics for managing labor pain, with a potential complication of high neuraxial blockade. Proficiency in performing epidural or spinal anesthesia and promptly recognizing and managing high neuraxial blockade are critical components of anesthesiology residency training. Methods A simulated case was designed involving a 21-year-old female in labor receiving epidural anesthesia. After the administration of local anesthetic, she develops symptoms of nausea, hypotension, and respiratory distress, progressing to high neuraxial blockade. The simulation environment included a labor and delivery suite setup, an epidural cart, airway supplies, a Laerdal SimMan 3G PLUS mannequin …

Parenteral Nutritional Support In Surgical Patients: Expert Consensus Statements Regarding Intravenous Lipid Emulsions Containing Omega-3 Fatty Acids., Robert G Martindale, David C Evans, Dan Waitzberg, Malissa Warren, Manpreet S Mundi, Stanislaw Klek, Paul E Wischmeyer, Martin D Rosenthal

Surgery Articles

OBJECTIVES: The International Lipids in Parenteral Nutrition (PN) Summit was convened to offer practical guidance and expert consensus opinion regarding the use of intravenous lipid emulsions (ILEs) in various clinical settings. Herein, we briefly review aspects from this summit that are of particular importance for surgical/hospitalized patients.

METHODS: Summit participants identified and discussed new evidence, data, and analyses, that potentially influence the benefits and risks of ILEs in PN or their use in clinical practice. The summit meeting consisted of expert presentations that assessed recent clinical data and best practice, followed by periodic panel discussions to formulate consensus statements. Consensus …

A Primer On Anatomy, Biophysics, Pathology, Imaging And Treatment Of The Intervertebral Disc And The Anterior Spinal Column: The Discogenic, Intervertebral, Spinal Column (Disc) Aspn Workgroup., Jay S Grider, Timothy R Deer, Douglas P Beall, Melissa Z Murphy, Jacob W Fleming, Steven M Falowski, Christopher J Mallard, Hamzah A Ramawad, Rosa Amelia Garcia, Usman Latif, Chau M Vu, Anne Christopher, Michael E Harned, Raj G Patel, Anuj J Shah, Iden M Cowan, Kristin Jarzombek, Jordan L Tate, Nasir Khatri, Mateusz J Graca, Marcin K Karcz, Timothy T Davis, Kaku Barkoh, Olivier Clerk-Lamalice, Brian Durkin, Mark N Malinowski, Dagmar K Gross, Thomas Hedman, Matthew Green, Michael J Dorsi, Kasra Amirdelfan, Dawood Sayed

Surgery Articles

OBJECTIVE: As therapeutic options are rapidly expanding to treat pain of discogenic and vertebrogenic origin, it is important for the clinician to have an evidence-based understanding of the latest information regarding the normal and pathological anatomy of the intervertebral disc as well as imaging characteristics and treatment strategies. The American Society of Pain and Neuroscience (ASPN) commissioned the DISC project to inform and update the interventional spine community about anterior column pain syndromes.

METHODS: Using established literature review methods a clinical oversight group was convened to create an outline covering topics that will be key to meeting the objectives delineated …

Levothyroxine-Associated Thyrotoxicosis And Hyperbilirubinemia On Preoperative Screening Evaluation., Carly J Suriano, Ian P Erkkila, Thomas M Vara

Surgery Articles

BACKGROUND: Levothyroxine is a commonly prescribed medication for treatment of hypothyroidism in the United States. This drug is titrated based on weight and serial laboratory evaluation and is often very well tolerated with few adverse effects. Levothyroxine-associated liver injury and cholestatic disease are regarded as rare phenomena. We report an additional case of levothyroxine-associated hepatic dysfunction with resolution upon decreased dosage and continued tolerance of the medication.

CASE PRESENTATION: We report a case of a 60-year-old male presenting for preoperative clearance for umbilical hernia repair with previous history of thyroidectomy for multinodular goiter. Laboratory work-up suggested thyrotoxicosis-associated hepatic dysfunction secondary …

Petechiae And A Persistent Violaceous Nodule: A Presentation Of Blastic Plasmacytoid Dendritic Cell Neoplasm To Dermatology., Madison Anzelc, Christina Druskovich, Austin Cusick, Matthew Franklin

Ambulatory and Primary Care Articles

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare, highly aggressive CD4+ CD56+ hematopoietic malignancy. The cutaneous presentation is variable but often includes violaceous nodules. We present a rare case of BPDCN, which featured dermatological findings consisting of erythematous macules, petechiae, purpura, and a violaceous nodule. A skin biopsy and peripheral blood smear supported a diagnosis of BPDCN. With BPDCN favoring cutaneous involvement, we urge dermatologists to be aware of the possibility of a BPDCN diagnosis in patients who present with purpuric nodules and petechial skin findings, especially when it is not easily explainable by another pathology or medication.

Prophylactic Use Of Lipid Emulsion Therapy After Inadvertent Administration Of 0.5% Ropivacaine For A Bier Block: A Case Report., Alexander Luong, Sirimas Lau, Elizabeth Johnson-Gray, Rayyan Bhutta, Austin Shaffer, Mitchell Hughes, Andrew Gable, Matthias Franzen

Surgery Articles

The Bier block for intravenous regional anesthesia is generally well tolerated, and few complications have been reported. It provides a bloodless surgical field and adequate analgesia when performed correctly. A diluted short-acting local anesthetic such as 0.5% lidocaine is typically used. Our case is a 41-year-old female who presented for endoscopic carpal tunnel release of her right wrist. An accidental injection of 30 mL of 0.5% ropivacaine was given instead of the normal 30 mL of 0.5% lidocaine, with a total tourniquet time of 46 min. Although the maximum safe dose of local anesthetic was not exceeded, lipid emulsion was …

Does Mean Arterial Pressure Augmentation Improve Neurological Recovery Of Blunt Spinal Cord Injuries: An East Multicenter Trial., Aimee Lariccia, Stephanie Doris, Bhairav Shah, Tanisha Kashikar, Erik Teicher, Lindsey Perea, Jennifer Huber, Malia Eischen, H Akin Erol, Michael Steven Farrell, Lauren Colom, Stephanie Scott, Brian Daley, James Bardes, Gregory Schaefer, Melissa Moncrief, William Devoe, Ryan Peter Dumas, Caitlin Anne Fitzgerald, William Brigode, John D Berne, Dalier R Mederos, Scott Armen, Melissa Linskey Dougherty, Asanthi Ratnasekera, Emily Alberto, Alison Smith, Bradley M Dennis, Stephen Gadomski, Jeffry Nahmias, Claudia Alvarez, Salina Wydo, Jennifer Schweinsburg, Carlos H Palacio, M Chance Spalding, Joshua Hill

Trauma and Acute Care Articles

BACKGROUND: Treatment of blunt traumatic spinal cord injuries (SCIs) often includes maintaining elevated mean arterial blood pressures (MAP) to enhance perfusion to the spinal cord. Optimal hyperperfusion protocols and treatment algorithms have yet to be delineated due to a paucity of large volume prospective studies. This study aims to identify predictors of neurological improvement in American Spinal Injury Association (ASIA) impairment score following blunt SCI.

STUDY DESIGN: Prospective (January 10, 2021 to June 1, 2023) multicenter study included blunt SCI patients age >18 with complete neurological examination documented on hospital arrival. Patients were divided into two groups: neurological improvement and …

Starting The Conversation: Patient Perceptions Of Self-Assessed Type-2 Diabetes Risk., Bennett Collis, Huda Kutmah, Peyton Couch, Neelima J Kale, Karen L Roper

Ambulatory and Primary Care Articles

INTRODUCTION: Little is known about patients' perceptions of their risk for type-2 diabetes (T2D), or if knowledge of risk could facilitate weight and diabetes prevention discussions with health care professionals.

METHODS: In our academic family medicine practice, 25 patients completed a previsit T2D risk assessment on their phone and answered interview and survey questions to assess their understanding of their risk for developing T2D.

RESULTS: Interest in their T2D risk was high, but self-estimation of risk before obtaining their score was low (21/25 reported ≤30% chance of developing diabetes). All patients perceived T2D to be very serious, most remembered their …

Obesity, Metabolic Health, And Diabetic Complications In People With Type 1 Diabetes., Yuanjie Mao, Jen-Tzer Gau, Ning Jiang

Ambulatory and Primary Care Articles

AIM: The concept of metabolically healthy obesity (MHO) has not been studied in type 1 diabetes (T1D). By analysing datasets from the DCCT/EDIC study, we compared the development of diabetic complications by obesity and metabolic health over 30 years of follow up.

MATERIALS AND METHODS: Insulin resistance was calculated by estimated glucose disposal rate (eGDR). The participants (n = 1127) were then divided into four groups based on time-weighted mean body mass index and mean eGDR: metabolically healthy non-obesity (MHN, n = 874), metabolically unhealthy non-obesity (MUN, n = 66), MHO (n = 146) and metabolically unhealthy obesity (MUO, n …

Wearable Surface Electromyography System To Predict Freeze Of Gait In Parkinson's Disease Patients., Anna Moore, Jinxing Li, Christopher H Contag, Luke J Currano, Connor O Pyles, David A Hinkle, Vivek Shinde Patil

Neuroscience Articles

Freezing of gait (FOG) is a disabling yet poorly understood paroxysmal gait disorder affecting the vast majority of patients with Parkinson's disease (PD) as they reach advanced stages of the disorder. Falling is one of the most disabling consequences of a FOG episode; it often results in injury and a future fear of falling, leading to diminished social engagement, a reduction in general fitness, loss of independence, and degradation of overall quality of life. Currently, there is no robust or reliable treatment against FOG in PD. In the absence of reliable and effective treatment for Parkinson's disease, alleviating the consequences …

A Retrospective Validation Of The Hear Score., Jordan Luli, Andrew Scheidemantel, Katelyn Bennett, Jessalyn Schafer, Andrew Costa, Marie Lockhart, Kevin Stiver

Heart and Vascular Articles

Studies have proposed the history, electrocardiogram, age, risk factors (HEAR) score to risk-stratify patients with chest pain in the emergency department. This paper assessed the utility of the HEAR score for ambulatory patients with chest pain. The findings demonstrate patients with low and high HEAR scores can be safely managed in the outpatient setting.

Improved Robustness For Deep Learning-Based Segmentation Of Multi-Center Myocardial Perfusion Cardiovascular Mri Datasets Using Data-Adaptive Uncertainty-Guided Space-Time Analysis., Dilek M Yalcinkaya, Khalid Youssef, Bobak Heydari, Janet Wei, C Noel Bairey Merz, Robert Judd, Rohan Dharmakumar, Orlando P Simonetti, Jonathan W Weinsaft, Subha V Raman, Behzad Sharif

Heart and Vascular Articles

BACKGROUND: Fully automatic analysis of myocardial perfusion cardiovascular magnetic resonance imaging datasets enables rapid and objective reporting of stress/rest studies in patients with suspected ischemic heart disease. Developing deep learning techniques that can analyze multi-center datasets despite limited training data and variations in software (pulse sequence) and hardware (scanner vendor) is an ongoing challenge.

METHODS: Datasets from three medical centers acquired at 3T (n = 150 subjects; 21,150 first-pass images) were included: an internal dataset (inD; n = 95) and two external datasets (exDs; n = 55) used for evaluating the robustness of the trained deep neural network (DNN) models …

Excellent Registry: A Prospective, Multicenter, Global Registry Of Endovascular Stroke Treatment With The Embotrap Device., Raul G Nogueira, Tommy Andersson, Diogo C Haussen, Albert J Yoo, Ricardo A Hanel, Osama O Zaidat, Werner Hacke, Tudor G Jovin, Jens Fiehler, Simon F De Meyer, Waleed Brinjikji, Karen M Doyle, David F Kallmes, David S Liebeskind, Renu Virmani, Malgosia A Kokoszka, Violiza Inoa, William Humphries, Keith B Woodward, Pascal M Jabbour, Olivier François, Elad I Levy, Hormozd Bozorgchami, Stephan Boor, Jose E Cohen, Shervin R Dashti, Muhammad A Taqi, Ronald F Budzik, Clemens M Schirmer, M Shazam Hussain, Laurent Estrade, Reade A De Leacy, Ajit S Puri, Rohan V Chitale, Caspar Brekenfeld, Adnan H Siddiqui

Neuroscience Articles

BACKGROUND: The EXCELLENT registry aimed to evaluate the effectiveness of the EMBOTRAP Revascularization Device in an all-comer population in a real-world setting, with a focus on the composition of retrieved clots.

METHODS: EXCELLENT is a prospective, global registry of patients with acute ischemic stroke treated with EMBOTRAP as the first-line mechanical thrombectomy device conducted at 34 sites (25 sites contributing clot) from September 2018 to March 2021, utilizing core imaging and central histology laboratories blinded to clinical data, independent 90-day modified Rankin Scale assessment and Clinical Events Committee.

RESULTS: After screening 3799 patients, a total of 997 subjects (mean age, …

Current State Of Frailty In Revision Arthroplasty., Brendan Kelly, Nicholas Stratigakis, Arsalaan Sayyed, Tyler K Williamson, Cameron Atkison, Taylor Manes, Nithin Gupta, Morgan Turnow, Frank A Buttacavoli

Surgery Articles

No abstract provided.

Sleep Architecture Changes In Diabetes., Yuanjie Mao

Ambulatory and Primary Care Articles

Data on the relationship between sleep architecture and diabetes are limited. However, some evidence suggests that slow-wave sleep (SWS) plays a crucial role in maintaining normal glucose homeostasis and influences insulin secretion capacity. Diabetes is often associated with reduced SWS, even in the absence of sleep-disordered breathing. Notably, selective suppression of SWS-without reducing total sleep time-can lead to significant increases in insulin resistance, decreased glucose tolerance, and a higher risk of diabetes. Given the growing interest in non-pharmacological lifestyle interventions, such as modifying sleep architecture, it is important to understand how sleep patterns differ in individuals with diabetes and whether …

Assessing Radiology And Radiation Therapy Needs For Cancer Care In Low-And-Middle-Income Countries: Insight From A Global Survey Of Departmental And Institutional Leaders., Stephanie A Parker, Joseph Weygand, Beata Gontova Bernat, Amanda M Jackson, Osama Mawlawi, Izabella Barreto, Yao Hao, Rao Khan, Afua A Yorke, William Swanson, Mohammed Saiful Huq, Eugene Lief, Cesar Della Biancia, Christopher F Njeh, Ahmad Al-Basheer, Oi Wai Chau, Stephen Avery, Wilfred Ngwa, Peter A Sandwall

Oncology Articles

PURPOSE: The global cancer burden and mortality rates are increasing, with significant disparities in access to care in low- and middle-income countries (LMICs). This study aimed to identify radiology and radiation therapy needs in LMICs from the perspective of departmental and institutional leaders.

METHODS AND MATERIALS: A survey was developed and conducted by the American Association of Physicists in Medicine Global Needs Assessment Committee and the American Association of Physicists in Medicine International Council. The survey, organized into 5 sections (Introduction, Infrastructure Needs, Education Needs, Research Needs, and General Information), was open to respondents from March 1, to August 16, …

Three-Year Outcomes Following Tavr In Younger (<75 Years) Low-Surgical-Risk Severe Aortic Stenosis Patients., Thomas Modine, Didier Tchétché, Nicolas M Van Mieghem, G Michael Deeb, Stanley J Chetcuti, Steven J Yakubov, Paul Sorajja, Hemal Gada, Mubashir Mumtaz, Basel Ramlawi, Tanvir Bajwa, John Crouch, Paul S Teirstein, Neal S Kleiman, Ayman Iskander, Rodrigo Bagur, Michael W A Chu, Pierre Berthoumieu, Arnaud Sudre, Rik Adrichem, Saki Ito, Jian Huang, Jeffrey J Popma, John K Forrest, Michael J Reardon

Heart and Vascular Articles

BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an alternative to surgery in patients with severe aortic stenosis, but data are limited on younger, low-risk patients. This analysis compares outcomes in low-surgical-risk patients agedsurgery.

METHODS: The Evolut Low Risk Trial randomized 1414 low-risk patients to treatment with a supra-annular, self-expanding TAVR or surgery. We compared rates of all-cause mortality or disabling stroke, associated clinical outcomes, and bioprosthetic valve performance at 3 years between TAVR and surgery patients aged < 75 >years.

RESULTS: In patients < 75 >years, 352 were randomized to TAVR and 351 to surgery. Mean age was 69.1±4.0 years (minimum 51 and maximum …

Mean Arterial Pressure (Map) Augmentation In Traumatic Spinal Cord Injuries: Early Hyperperfusion Treatment Influences Neurologic Outcomes., Aimee K Lariccia, Kimberly Sperwer, Michael L Lieber, M Chance Spalding

Trauma and Acute Care Articles

Context: Hyperperfusion therapy, mean arterial blood pressure (MAP) > 85 mmHg, is a recommended treatment of blunt traumatic spinal cord injury (SCI). We hypothesized the first 24 h of MAP augmentation would be most influential on neurological outcomes.Design: This retrospective study from a level 1 urban trauma center dating 1/2017 to 12/2019 included all blunt traumatic spinal cord injured patients receiving hyperperfusion therapy. Patients were grouped as "No improvement" vs "Improvement" measured by change in American Spinal Injury Association (ASIA) score during their hospitalization. MAP values for the first 12, first 24 and last 72 h were compared between the …

Alliance A061202: Ixazomib, Pomalidomide, And Dexamethasone For Patients With Lenalidomide-Refractory Mm In First Relapse., Peter Voorhees, Vera Suman, Yvonne Efebera, Noopur Raje, Sascha Tuchman, Cesar Rodriguez, Jacob Laubach, Misty Bova-Solem, Destin Carlisle, Saad Usmani, Philip Mccarthy, Paul G Richardson

Oncology Articles

Optimal therapy for the growing number of patients with lenalidomide (LEN)-refractory multiple myeloma in their first relapse remains poorly defined. We therefore undertook a randomized phase 2 study to evaluate the efficacy and safety of combining the oral proteasome inhibitor ixazomib (IXA) with pomalidomide (POM) and dexamethasone (DEX) in this patient population. The overall response rate (ORR) for POM-DEX was 43.6%, and for IXA-POM-DEX, it was 63.2%. The depth of response, measured by the attainment of at least a very good partial response, favored triplet therapy over doublet therapy (28.9% vs 5.1%; P = .0063). A preplanned interim analysis after …

Response To Letter To The Editor Concerning The Article "The Clinical And Economic Impact Of Extended Battery Longevity Of A Substernal Extravascular Implantable Cardioverter Defibrillator"., Bradley P Knight, Nicolas Clémenty, Anish Amin, Ulrika Maria Birgersdotter-Green, Henri Roukoz, Reece Holbrook, Jaimie Manlucu

Heart and Vascular Articles

No abstract provided.

Impact Of Functional Recovery On Patients Having Heart Surgery., Richard J Snow, Lauren Mckown, Geoffrey Blossom, Karen Vogel, Amy Creighton, Jason Shriver, Linda Will, Katie Lentz, Elizabeth Snow, Teresa Caulin-Glaser

Heart and Vascular Articles

OBJECTIVE: To describe the results of a program developed to manage institutional postacute care (IPAC) (postacute skilled nursing, inpatient rehabilitation facility, and long-term acute care) in a CMS Bundled Payments for Care Improvement (BPCI) project for coronary artery bypass graft (CABG) surgery.

STUDY DESIGN: We compared pre- and postutilization patterns during a 3-year period by evaluating risk-adjusted national, state, and other BPCI participant comparisons using a difference-in-differences (DID) analysis in a large urban community tertiary center with a CABG surgery program. Included in the analysis were all Medicare patients receiving CABG surgery at the institution (n = 504), across the …