Medical Specialties Commons^™

Risk-Based Nurse-Managed Personalized Heart Failure Interventions: The Alleviate-Hf Trial., Javed Butler, Rami Kahwash, Muhammad Shahzeb Khan, David Zhang, Jonathan W Dukes, Madhu Reddy, Anupam Basuray, Elie Gharib, Bart Gerritse, Aimee Laechelt, Jennifer Wehking, Shantanu Sarkar, Brian Van Dorn, Nirav Patel, Verla Laager, Michael R Zile, Alleviate-Hf Investigators

Heart and Vascular Articles

BACKGROUND: Early identification of worsening heart failure (HF) may improve outcomes.

OBJECTIVES: This study aims to assess if insertable cardiac monitor (ICM)-based high-risk detection combined with centrally managed, nurse-facilitated, individually protocolized diuretic interventions is safe and improves HF outcomes.

METHODS: A Reveal LINQ (Medtronic) ICM with an investigational HF risk-status software was implanted in participants with HF who were randomized 1:1 to an intervention arm (high-risk HF alert triggering protocolized diuretic regimen) or an observation arm (standard care). The primary safety endpoint was intervention-related serious adverse events and the primary efficacy endpoint was a 5-component hierarchical composite including cardiovascular death …

Arrhythmia Burden And Clinical Responses Under Continuous Monitoring In Heart Failure: Observations From The Alleviate-Hf Trial., Rami Kahwash, Javed Butler, Muhammad Shahzeb Khan, David Zhang, Jonathan Dukes, Madhu Reddy, Rachel M Kaplan, Anish Amin, Rahul Kanwar, Shantanu Sarkar, Verla Laager, Jennifer Wehking, Brian Van Dorn, Bart Gerritse, Nirav Patel, Aimee Laechelt, Michael R Zile, Alleviate-Hf Investigators

OhioHealth Research Institute Articles

BACKGROUND: Arrhythmia burden in ambulatory patients with symptomatic heart failure (HF) without cardiac implantable electronic devices (CIEDs) is not well defined, and it remains uncertain whether device-guided remote congestion management modifies arrhythmia occurrence.

OBJECTIVES: The goal was to assess whether arrhythmia burden differed between randomized congestion-management strategies and characterize the occurrences and associations of insertable cardiac monitor (ICM)-detected arrhythmias with therapeutic actions and clinical events.

METHODS: In ALLEVIATE-HF, patients with NYHA functional class II-III HF with any ejection fraction (EF) and a recent HF event, without prior CIEDs, underwent ICM implantation and were randomized to ICM-guided, physician-directed, nurse-facilitated congestion management …

The Effect Of The Lee Silverman Voice Treatment (Lsvt) Big Method Based On Occupation On Older Adult Functional Mobility Balance, Muhammad Luthfi, Kharisma Nur Idalasari

Jurnal Fisioterapi Terapan Indonesia

Balance impairment is one of the major problems commonly experienced by older adults as a result of degenerative processes, leading to an increased risk of falls. Falls may cause fear of recurrent falling, reduced physical activity, loss of physical capability, and may eventually result in disability and psychological consequences such as depression. Structured, occupation-based physical activity has been shown to provide various benefits for older adults, including improving physical function, slowing functional decline associated with degenerative processes, reducing fall risk, and enhancing postural control. This study aimed to analyze the effect of the occupation-based Lee Silverman Voice Treatment (LSVT) BIG …

Objective Biomarker Development For Parameter Optimization In Neuromodulation Using High-Density Emg Temporal And Spatial Features, Shirin Madarshahian, Nikoo Javadpour, Michael Trakhtorchuck, Tatiana Guerrero-David, Kristin Gustafson, James Harrop, Caio Matias, M. J. Mulcahey, Alessandro Naopli, Alex R. Vaccaro, Mijail Serruya

Farber Institute for Neuroscience Faculty Papers

Transcutaneous spinal cord stimulation (tSCS) is a promising neuromodulation approach for motor recovery after spinal cord injury (SCI), yet clinical programming remains largely dependent on subjective parameter selection. This study evaluated high-density surface EMG (HD-sEMG)–derived spatial and temporal features as objective biomarkers for tSCS optimization in three adults with chronic cervical SCI. A 64-channel electrode array recorded stimulation-evoked responses across five cervical stimulation levels, four pulse widths, and graded amplitudes. Features describing activation magnitude, spatial distribution, cluster morphology, and temporal dynamics were extracted from epoch-based activation maps. Of the three enrolled participants, two demonstrated measurable stimulation-evoked responses and contributed to …

Fractionated Stereotactic Radiotherapy (Fsrt) For Symptomatic Who Grade 1 Cavernous Sinus Meningiomas: Long-Term Local Control, Clinical Response, And Toxicity Outcomes, Ryan Shah, Shray Jain, Nilanjan Haldar, Lauren A. Holt, Robert Walker, Christopher J Farrell, Md, Debanjan Haldar, James J. Evans, Gregory S. Alexander, Wenyin Shi

Department of Radiation Oncology Faculty Papers

PURPOSE: Cavernous sinus meningiomas represent a significant clinical challenge, given the high prevalence of neurological deficits and limited surgical options. Radiation therapy is often the preferred treatment. This study evaluates the effectiveness of fractionated stereotactic radiation therapy (fSRT) in achieving local control and symptomatic relief in patients with cavernous sinus meningiomas.

METHODS: This is a single-institution retrospective analysis of patients with symptomatic presumed WHO grade 1 cavernous sinus meningiomas treated with fSRT (1.8-2 Gy per fraction). Clinical data were collected by chart review. Kaplan-Meier curves were generated to assess local control. Clinical responses were evaluated for symptom improvement, stability, or …

Kmt2d As An Epigenetic Target In Cervical Cancer: A Literature Review On Polyclonal Antibody Therapeutics And Translational Prospects, Farsya Hidayah Septiananda, Taurisma Aulia Nanda Wibisono, Rajendra Aulya Gilardino, Andreas Budi Wijaya

Preventia: The Indonesian Journal of Public Health

Cervical cancer remains a significant global health burden, particularly in regions with limited access to advanced therapeutics. Beyond viral oncogenesis, accumulating evidence highlights the crucial role of epigenetic dysregulation, particularly KMT2D, in tumor initiation and progression. This literature review aimed to critically synthesize current evidence regarding the biological role of KMT2D in cervical cancer and to explore the opportunities and limitations of antibody-based approaches for future epigenetic intervention. A structured narrative literature review was conducted using PubMed, Scopus, and Web of Science to identify relevant studies published between January 2020 and May 2025. Literature selection was guided by a modified …

Sex-Based Differences In Clinical Outcomes Among Cardiogenic Shock Patients Treated With Mechanical Circulatory Support, Emmanuel Olumuyide, Ju Young Bae, Rongras Damrongwatanasuk, Ezaz Rahman, Barbara Malaga-Espinoza, Jiun-Ruey Hu, S. Elissa Altin

School of Medicine Publications

Despite advances in therapies, cardiogenic shock (CS) remains associated with high mortality rates, often necessitating mechanical circulatory support (MCS) to preserve end-organ perfusion. Despite increasing rates of MCS utilization, less is known about sex-related differences in clinical outcomes to guide practice. Additionally, standardized management protocols for CS patients requiring MCS that account for sex differences are lacking. In this study, we evaluate sex-specific outcomes in CS patients requiring MCS, examine patterns of MCS utilization by sex, and further stratify clinical outcomes by sex across the overall CS cohort, including the acute myocardial infarction-related CS (AMI-CS), acute heart failure-related CS (AHF-CS), …

The Effect Of Plyometric Training On Leg Muscle Explosive Power In Adolescent Amateur Volleyball Players, Dany Fajar Muhlasin, Fendy Nugroho, Jasmine Kartiko Pertiwi

Jurnal Fisioterapi Terapan Indonesia

Background: Leg muscle explosive power is a crucial physical component in volleyball, particularly in supporting the execution of smashes and blocks. The ability to generate force rapidly and explosively plays a key role in determining an athlete’s jumping performance. One training method proven effective in enhancing leg muscle explosive power is plyometric exercise. Several recent studies have shown that plyometric training can significantly improve vertical jump performance in adolescent athletes. However, there is still limited research specifically examining the effect of plyometric exercise on jumping explosive power in amateur players aged 14–18 years, indicating a research gap that warrants further …

Pengaruh Rehabilitasi Berbantuan Robot Terhadap Pemulihan Fungsional Setelah Total Hip Arthroplasty: Literature Review, Dian Rahayu Wijayanti, Kholida Nabila, Nadzifa Salsabila Haris Putri, Nur Afrina Azra, Septina Olivia, Farid Rahman

Jurnal Fisioterapi Terapan Indonesia

Total Hip Arthroplasty (THA) remains a gold standard for restoring joint function in patients with severe hip osteoarthritis, yet achieving optimal functional recovery post-surgery remains a challenge. Robot-assisted rehabilitation (RAR) has emerged as a novel physiotherapy modality offering structured, repetitive, and sensor-driven training that may enhance recovery trajectories. Objective: This literature review aims to identify and synthesise current evidence on the effectiveness of RAR in improving functional outcomes after THA, focusing on gait performance, muscle strength, balance, and quality of life. Methods: A comprehensive search of PubMed, PEDro, ScienceDirect and Google Scholar was conducted for peer-reviewed articles published between 2015 …

Community-Based Exercise Programs Dalam Mengurangi Fear Of Falling Dan Meningkatkan Quality Of Life Pada Lansia: A Systematic Literature Review, Amirah Hasna Rafifah -, Hanif Maulana, Saffanah

Jurnal Fisioterapi Terapan Indonesia

The global increase in the elderly population presents significant challenges in maintaining independence and quality of life among older adults. One of the most common problems experienced by the elderly is fear of falling, which negatively affects physical activity, balance, and psychological well-being. Community-based exercise programs represent an approach that not only improves physical function but also strengthens social interaction and self-confidence among older adults. This study aims to review community-based exercise programs in reducing fear of falling and improving quality of life among the elderly through a Systematic Literature Review (SLR) using the PRISMA 2020 guidelines. The literature …

Us Race/Ethnic Disparities In Diabetes Technologies: A Systematic Review And Meta-Analysis Of 950 000 Individuals, Maria L. M. Rego, Maxim Barnett, Maria Helena Siqueira Tavares De Melo, Ana Rivadeneira

Einstein Health Papers

PURPOSE: To provide a descriptive summary and to quantitatively examine racial and ethnic disparities in the use of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) among people living with diabetes in the United States.

RESEARCH DESIGN AND METHODS: We followed the Cochrane and PRISMA guidelines (PROSPERO: CRD420251124678). Search was conducted on PubMed, Embase, and Cochrane up to August 2025. Observational studies were included if they (1) were conducted in the United States, (2) evaluated the use of CGM/CSII across different races/ethnic groups, and (3) reported odds ratios (ORs) for between-group comparisons. Three-level random-effect meta-analyses examined OR in …

Leading Healthcare Improvement: An Implementation Strategy, Kelley Arredondo, Anthony Ecker, Lindsay Vaclavik, Jacquelene Shahin, Ashley Thompson, Molly Horstman, David Ramsey, Kyler M Godwin

Faculty, Staff and Students Publications

Introduction: Healthcare professionals often implement quality improvement (QI) initiatives but lack training to implement and sustain QI initiatives. Leading Healthcare Improvement (LHI) is a course that combines principles from change management, team science, and leadership effectiveness into an implementation strategy to enable clinicians to lead sustainable change.

Methods: LHI is a 6-session, 4-month interactive training. Learners work on an active QI project throughout the course. A Wilcoxon signed-rank test was conducted to evaluate pre- and post-course changes in learners' self-reported confidence across five QI competencies.

Results: Veterans Healthcare Administration clinicians and fellows completed the LHI pre- (n = 111) and …

Extended-Phase Anticoagulation For Pediatric Venous Thromboembolism After Einstein Jr, Nathan Wilken, Jun Teruya

Faculty, Staff and Students Publications

No abstract provided.

Fgfr3::Tacc3 Fusion And Notch1 Loss-Of-Function In A Case Of Hpv-Associated Sinonasal Squamous Cell Carcinoma: Diagnostic Challenge And Implications For Targeted Therapy, Xu Cao, Hong Yu, Reham Hamdy Abdulazim Soliman, Pei Ying, Songlin Zhang, Li Liang

Faculty, Staff and Students Publications

Sinonasal squamous cell carcinoma (SNSCC) comprises a heterogeneous group of tumors with emerging molecular subtypes. Human papillomavirus (HPV)-associated SNSCC is a distinct entity, although actionable genomic alterations beyond HPV-driven pathways remain underexplored. Distinguishing HPV-associated SNSCC from carcinoma ex inverted papilloma can be particularly challenging in limited biopsy specimens, as these lesions may appear morphologically similar. We report a case of HPV-associated SNSCC with concurrent FGFR3::TACC3 fusion and NOTCH1 p.C1416 stop-gain mutation.

Oncocytic Intraductal Carcinoma Of The Parotid Gland With Strn::Alk Fusion, Reham H Soliman, Chris Shi, Kevin E Fisher, Hong Yu, Fouad El-Dana, Xu Cao, Li Liang, Pei Ying, Songlin Zhang

Faculty, Staff and Students Publications

Intraductal carcinoma (IDC) of the salivary gland is an uncommon epithelial neoplasm characterized by a predominantly intraductal or intracystic proliferation rimmed by a myoepithelial cell layer. Advances in molecular profiling have revealed recurrent gene fusions in IDC, most frequently involving RET, although fusions implicating other kinase genes have also been described. Among these, ALK rearrangements are rare and remain poorly characterized. Herein, we report a case of oncocytic IDC of the parotid gland harboring a STRN::ALK fusion, further expanding the molecular landscape of this tumor. Although this fusion has been previously reported in intercalated duct IDC, to our knowledge, this …

Effect Of Androgen Receptor Polymorphism On Hypogonadism Severity And Efficacy Of Testosterone Replacement Therapy, Nelson W Mills, Beatriz S Hernandez, Peyton J Coady, Arnaav Walia, Gal Saffati, Daniela Orozco Rendon, Dalia Khera, Nadia Khera, Weitao Song, Mohit Khera

Faculty, Staff and Students Publications

Background: The preferred treatment for hypogonadism, testosterone replacement therapy (TRT), has a varying efficacy that is currently not fully understood. This observation may be explained by polymorphism of the androgen receptor (AR), a ligand-binding transcription factor whose polyglutamine tract length affects various health conditions and androgen sensitivity. It has been theorized that this polymorphism may also affect the severity of hypogonadism. This study sought to determine a correlation between hypogonadism severity, TRT efficacy, and number of CAG trinucleotide repeats in the AR gene.

Methods: One hundred sixty-two males presenting to a single institution with symptoms of hypogonadism were recruited for …

Comments On The Letter – Intraoperative Tissue Oxygenation And Postoperative Creatinine Rise: Interpreting The Microcirculatory Context, Bhakti Banerjee, Haripada Das, Lini Srivastava, Snigdha Pramanik, Diptimay Majumder

Journal of the Saudi Heart Association

No abstract for this article type.

Intraoperative Tissue Oxygenation And Postoperative Creatinine Rise: Interpreting The Microcirculatory Context, Bedirhan Buğra Bayıcı,, Fatih Kızılyel

Journal of the Saudi Heart Association

No Abstract for this article type

Microelement Deficiencies In Perimenopausal Women And Their Impact On Metabolic And Physical Performance: Potential Applications Of Vis–Nir Tissue Spectrophotometry And The So/Check Platform, Izabela Pabin, Damian M. Dudek, Łukasz Jaworski, Ewa Maria Kłodzińska

Baltic Journal of Health and Physical Activity

Background: The perimenopausal period, typically occurring between the ages of 40 and 55 years, represents a critical transitional stage in women’s physiology characterized by profound hormonal, metabolic, and systemic adaptations. While the endocrine aspects of this transition have been extensively investigated, increasing attention has recently been directed toward the role of micronutrient homeostasis in maintaining metabolic health and physical performance during this period. Therefore, the aim of this narrative review is to summarize current knowledge regarding microelement deficiencies in perimenopausal women and their potential impact on metabolic health and physical performance. Additionally, the review discusses the potential applications of VIS–NIR …

Dnp Final Report: Enhancing Radiation Oncology Training For Advanced Practice Providers, Katherine A. Bukolt

DNP Final Reports

Background: Rising cancer incidence and improved survivorship are straining the oncology workforce, increasing reliance on Advanced Practice Providers (APPs). However, there is a lack of standardized educational resources for APP radiation oncology training across practice settings. Most APPs receive variable, resource-dependent, and on-the-job training. Evidence shows that the lack of standardized training leads to gaps in foundational knowledge, reduced confidence in toxicity management, inconsistent role development, and variable satisfaction with training and transition into practice.

Purpose: This quality improvement project evaluated the feasibility of implementing an 18-module Advanced Practice Radiation Oncology (APRO) asynchronous online curriculum to standardize APP radiation oncology …

Reply To: A Lethal Progressive Neuroinflammation Disguised As Mogad Revealing A Final Diagnosis Of Griscelli Syndrome: Regarding: Mogad Is The Most Common Cause Of Isolated Optic Neuritis In Children, Chaitanya Aduru, Akansha Chandrasekar, Kyla Blasingame, Jonathan Rosen, Jesse M Levine, Karla Salazar, Madhuri Chilakapati, Rod Foroozan, Victoria Adeseye, Jonathan M Yarimi, Nikita Shukla, Timothy E Lotze, Kristen S Fisher, Alexander J Sandweiss

Faculty, Staff and Students Publications

No abstract provided.

Chemotherapeutic Induction Of Cytosolic Single-Stranded Dna Accumulation Sensitizes Triple-Negative Breast Cancer To Immunotherapy, Yong Du, Li Yang, Hui Dai, Jianli Zhou, Zhicheng Zhou, Ruoxi Yuan, Rui Ye, Anh Thai Quynh Nguyen, Kishor Bhatia, Shiaw-Yih Lin

Faculty, Staff and Students Publications

Background: Despite the widespread adoption of chemoimmunotherapy in triple-negative breast cancer (TNBC), the mechanisms by which cytotoxic chemotherapy engages antitumor immunity remain poorly defined. Identifying tumor-intrinsic immunogenic programs that predict and enhance responsiveness to immune checkpoint blockade (ICB) is therefore of critical clinical importance.

Methods: Transcriptomic signatures of TREX1 deficiency were generated from CRISPR-engineered TNBC models and applied to multiple independent TNBC cohorts treated with chemoimmunotherapy. Cytosolic single-stranded DNA (ssDNA) accumulation was quantified using a flow cytometry-based assay to functionally screen chemotherapeutic agents. Immune activation and therapeutic efficacy were evaluated using in vitro assays, syngeneic mouse tumor models, flow cytometry, …

Cervical Insufficiency Revisited: A Proposal For A New Treatment-Aligned Definition, Vincenzo Berghella, Ilaria Paladino, Moti Gulersen, Rupsa Boelig, Amanda Roman

Department of Obstetrics and Gynecology Faculty Papers

Cervical insufficiency [CI] has traditionally been defined as painless cervical dilation resulting in recurrent second-trimester pregnancy loss in the absence of labor or placental pathology. Definitions from the American College of Obstetricians and Gynecologists and the Royal College of Obstetricians and Gynecologists emphasize historical clinical presentation. However, contemporary obstetrics relies increasingly on ultrasound-based cervical length surveillance and evidence-based cerclage indications rather than retrospective diagnosis. The objective of the review was to propose a definition of cervical insufficiency aligned with current evidence-based indications for mechanical prevention of preterm birth, i.e. cervical cerclage. In modern obstetric practice, the operational diagnosis of clinically …

Association Of Cerebrovascular Center Volume With Patient Outcomes, Stacey Quintero Wolfe, Justin R. Mascitelli, Kyle Fargen, Peter Kan, Ketan Bulsara, Christopher P. Kellner, Brian M. Howard, Michael R. Levitt, Rocco Armonda, Joshua Osbun, Clemens Schirmer, Mark Bain, William J. Mack, Stavropoula Tjoumakaris, Adam Arthur

Department of Neurosurgery Faculty Papers

Current guidelines acknowledge the importance of both microsurgical and neuroendovascular expertise in the treatment of cerebrovascular disease. To achieve optimal care for these patients, it is becoming increasingly evident that procedural volumes impact patient outcomes. This is demonstrated across various cerebrovascular diseases.In this literature review, we demonstrate the association of volume with patient outcomes across multiple cerebrovascular disease states and interventions. Microsurgical aneurysm clipping remains essential even with the rise of endovascular therapy and mortality and patient-safety indicator events are clearly lower at high-volume centers for both ruptured and unruptured aneurysms. Likewise, patients undergoing surgery for cerebrovascular malformations and carotid …

Two Decades Of Progress In The Prevention And Treatment Of Colorectal Cancer: From Aspirin To Targeted Therapy, Lovyanne Vergel De Dios, Salique Hassan Shaham, Puneet Vij, Manish Kumar Tripathi

School of Medicine Publications

No abstract provided.

Letter To The Editor: Hemodynamic Role In Hepatic Encephalopathy Pathogenesis Following Transjugular Intrahepatic Portosystemic Shunt Placement, John Halphen, Yash S Dayal, Cameron Laurie, Mohadese Ahmadzade, David Wynne, Mohammad Ghasemi-Rad

Faculty, Staff and Students Publications

Hepatic encephalopathy (HE) is a common complication following transjugular intrahepatic portosystemic shunt (TIPS) placement and is thought to result from reduced hepatic detoxification of neurotoxins. However, Zhuang et al in the World Journal of Radiology demonstrate that this understanding may be incomplete through exploration of the pathophysiology from a hemodynamic perspective. They found significant changes in cerebral blood flow (CBF) and spontaneous brain activity following TIPS. Initially, CBF increased in specific areas within the first month, followed by a return to baseline at three months. These CBF changes coincided with increased spontaneous brain activity that persisted in some areas, suggesting …

Unveiling Unwritten Curricula: Enhancing Junior Faculty Development In Academic Emergency Medicine, Abagayle Bierowski, Casey Morrone, Erin Hoag, Ridhima Ghei, Michael Pasirstein, Julie Blaszczak, Dimitrios Papanagnou

Department of Emergency Medicine Faculty Papers

INTRODUCTION: The transition from resident to junior faculty in academic emergency medicine (EM) may be shaped not only by formal training and institutional policies but also by the "unwritten curriculum," a set of norms and expectations embedded in institutional culture. However, the unwritten curriculum and its potential to impact junior faculty development remains largely unexplored. Little is known about how junior faculty perceive, experience, and navigate these informal expectations, or the formal and informal structures that influence this process. In this study we aimed to explore junior faculty members' experiences with the unwritten curriculum in academic EM, with a focus …

Long-Term Functional Synaptic Integration Of Genome-Edited Retinal Organoids In A Primate Model Of Macular Degeneration, Atsuta Ozaki, Akihiro Kawai, Ryutaro Akiba, Satoko Okayama, Nobuhiko Ohno, Keisuke Kajita, Tomohiro Masuda, Satoshi Yokota, Shin-Ichiro Ito, Du Peiyan, Kenta Onoue, Shigenobu Yonemura, Mineo Kondo, Yasuo Kurimoto, Yingbin Fu, Michiko Mandai

Faculty, Staff and Students Publications

Retinal organoids represent a promising regenerative strategy for restoring vision in retinal degenerative diseases, but the capacity of host cone bipolar cells in the primate macula to rewire with transplanted photoreceptors has not been established. In this study, we transplanted genome-edited ISL1-/- human retinal organoids lacking ON-bipolar cells into an acute laser-induced macular photoreceptor ablation non-human primate model. Using immunohistochemistry, ultrastructural imaging, and focal macular electroretinography, we demonstrate that host rod and cone bipolar cells actively extend dendrites toward grafted photoreceptors and form synaptic contacts, with evidence of functional signal transmission in a subset of transplanted eyes. Longitudinal, per-eye analyses …

Patent Ductus Arteriosus Spasm During Percutaneous Device Occlusion In Infants And Children, Hani M. Adel, Ashraf K. Mahmoud

Journal of the Saudi Heart Association

Background: Spasm of ductus arteriosus is an uncommon but significant phenomenon associated with transcatheter patent ductus arteriosus (PDA) occlusion. It can lead to procedural failure, improper device sizing, or even embolization of the occluder device as the spasm subsides post-procedure. Aim of this study is to report the frequency, features, management and outcome of PDA spasm during device closure in a single Egyptian center.

Patients and methods: Over about 3 years, 200 infants and children underwent percutaneous device occlusion. The echocardiographic and catheterization data of patients who developed spasm of PDA before or during or shortly after anesthesia …

Surviving Sepsis 2026: Key Updates, Amanda Rawa, Katherine Ghattas

Transformative Medicine

The 2026 update to the Surviving Sepsis Campaign guidelines introduces several important changes in the management of sepsis and septic shock, with a greater focus on tailoring treatment to individual patients. Notable updates include lower blood pressure targets for older adults with septic shock, continued support for early fluid resuscitation, the selective use of rapid diagnostic testing to guide antibiotic therapy, and increased flexibility in vasopressor selection for patients with cardiac dysfunction. These recommendations are based on emerging evidence aimed at improving patient outcomes while reducing unnecessary interventions and treatment-related complications. Overall, the updated guidelines reinforce a more personalized approach …