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Sa1260: DUPILUMAB NORMALIZES KEY HISTOPATHOLOGIC FEATURES OF EOSINOPHILIC ESOPHAGITIS: POST HOC ANALYSIS OF THE PHASE 3 LIBERTY EOE TREET STUDY
No full textExamining Complication Rates to Inform the Consent Process in Needle Electromyography: A Quality Improvement Project.
No full textINTRODUCTION/AIMS: Verbal informed consent prior to electrodiagnostic (EDx) studies, including nerve conduction study and needle electromyography (EMG), is considered the standard of care to counsel the patient of risks and benefits of the procedure. However, there is a paucity of population-based studies evaluating the actual occurrence of complications. We aim to improve the informed consent process for EMGs by accurately understanding rates of adverse events.
METHODS: A rapid cycle quality improvement approach was used to assess complication rates for EMGs at a US Veterans Administration tertiary medical center. Potential complications were compared to actual complications following 24,718 EMG procedures performed over a 14-year period. The occurrence of serious complications in the month following EMG was queried from the electronic health record.
RESULTS: About 35% of the patients used anticoagulants or antiplatelet agents, yet no cases of hematoma were recorded. Three reports of cellulitis occurred in patients on aspirin. No pneumothoraces were recorded. These findings were then used to update informed consent guidelines to more closely align with actual complication rates.
DISCUSSION: This study underscores the safety of EMGs, even in the setting of anticoagulation use, and helps guide the informed consent process. Taking into consideration the findings of prior studies, caution must still be exercised when performing EMGs in muscles with a high risk of pneumothorax. Based on our findings, anticoagulants and antiplatelet agents do not appear to increase the risk of bleeding-related complications. Cellulitis in the three patients on aspirin was most likely due to medical comorbidities
Corrigendum to Initial outcomes of a single-institution hepatic artery infusion pump program for colorectal liver metastases and intrahepatic cholangiocarcinoma: Safety, feasibility, and circulating tumor DNA tracking [Surgery 2025;182:109325].
No full textInstrument-Based Screening for the Detection of Amblyopia and Amblyopia Risk Factors: A Report by the American Academy of Ophthalmology.
No full textPURPOSE: To review the published literature on the diagnostic accuracy of instrument-based screening devices used to detect amblyopia and amblyopia risk factors (ARFs).
METHODS: A literature search of the PubMed database with no date restrictions and limited to articles published in English was last conducted in January 2025. The search yielded 291 articles; 41 were reviewed in full text, and 33 met the criteria for inclusion in this assessment. The panel methodologist assigned a level of evidence rating to each of the included studies.
RESULTS: All 33 articles (which reported results from 28 072 children) were rated level III. Nine screening devices were discussed in the included studies; the most common were the Plusoptix, Spot, and Retinomax. Results from 28 072 children were reported, and most studies focused on children aged 6 years and younger. The most common study setting was ophthalmology clinics, followed by school-based settings and then community-based settings. For detecting ARFs, sensitivity ranged from 32.3% to 100% and specificity ranged from 38.7% to 94% (Plusoptix sensitivity 32.3%-100%, specificity 38.7%-100%; Retinomax sensitivity 70%-95%, specificity 58%-94%; Spot sensitivity 60%-94%, specificity 67%-97%). Examination failure thresholds varied, but most studies after 2013 followed the 2013 American Association for Pediatric Ophthalmology and Strabismus (AAPOS) guidelines. For the 21 studies that reported the referral rate (percentage of children who failed based on the screening result), the rate varied significantly (2.26%-63%). Higher referral rates were seen in studies based in ophthalmology clinics.
CONCLUSIONS: The best available evidence supports the use of instrument-based screening devices to detect amblyopia and ARFs, although there were high levels of variability in the study design, setting, and target age for screening. Additionally, diagnostic accuracy varied on the basis of the screening device used. Future studies of instrument-based screening devices would benefit from following standardized reporting measures for diagnostic accuracy, which will strengthen the evidence base and provide more complete data on which to base decisions about the most appropriate screening programs and strategies.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references
Cardiovascular Effects of Sucrose in Experimental Animals and Humans.
No full textSucrose, a disaccharide composed of glucose and fructose, is one of the most widely consumed dietary sugars. The recent global rise in sugar intake is a growing concern regarding its potential contribution to the development of metabolic and cardiovascular disorders. While the metabolic effects of glucose and fructose have been extensively studied individually, the impact of sucrose on cardiovascular health remains an evolving area of research. In rats with a high-sucrose diet, hallmarks of metabolic syndrome were observed including weight gain, insulin resistance, ≈15-mm Hg elevation in blood pressure, and systemic inflammation. It also caused disruptions in gut microbiota. Recently, we reported that high-sucrose ingestion via drinking water induces hypertension and cardiovascular complications associated with hyperinsulinemia in mice. In humans, excessive sucrose intake is associated with elevated plasma glucose, insulin, and lipid levels, particularly in individuals with obesity. Although long-term epidemiological data are limited, a recent study demonstrated that sucrose intake increased the risk for hypertension in women. These findings highlight the need to reassess the relationship between sucrose consumption and cardiovascular disease in humans. This review discusses current evidence from both animal and human studies covering molecular mechanisms and pathophysiological outcomes to explore how sucrose influences cardiovascular and metabolic health. As sucrose remains a major component of global diets, particularly in industrialized nations, further longitudinal and mechanistic studies are needed to clarify its long-term health consequences. Reducing excess sucrose intake may represent a prudent public health strategy, especially for individuals at increased risk for cardiovascular diseases including hypertension
Transorbital Approach With and Without Lateral Rim Osteotomy: Anatomical Reappraisal and Clinical Experience to the Orbit and Middle Cranial Fossa.
No full textBACKGROUND AND OBJECTIVES: The lateral transorbital approach (LTOA) has gained increased recognition, but there is still a paucity of data on its effectiveness and advantages compared with the LTOA with lateral orbitotomy, herein denoted as the lateral orbital wall approach (LOWA). The aim of this study was to provide an anatomical reappraisal and the authors\u27 clinical experience to compare the 2 approaches to the orbit and middle cranial fossa (MCF).
METHODS: Eight latex-injected cadaveric specimens were used to perform LTOA and LOWA. The operative depth of each approach to key anatomical landmarks was measured. Fifty high-resolution computed tomography studies were reviewed to calculate the operative angles. We reviewed 40 consecutive cases treated with LTOA and LOWA at our institution.
RESULTS: Compared with the LTOA, the LOWA provided shorter operative depths to the optic foramen (P \u3c .05), foramen ovale (P \u3c .05), and to the junction eyeball-cranial nerve II (P = .13). It also offered better access to the anterior aspect of the orbit with less orbital content retraction. The LTOA and LOWA provided different operative angles to key anatomical landmarks in the orbit and MCF (P \u3c .05). In our chart review, 31 patients underwent the LTOA, whereas 9 underwent the LOWA to treat orbital and MCF lesions. Patients undergoing LOWA experienced postoperative complications related to periorbital nerves, such as frontalis palsy (n = 1) and supraorbital neuralgia (n = 1). Patients undergoing LTOA were more prone to complications associated with intraorbital manipulation (n = 4), including diplopia and ptosis.
CONCLUSION: Our data suggest that the LTOA can be an effective surgical strategy for addressing orbital apex and MCF lesions. Although the LOWA provides access to the aforementioned areas, it may be more suitable for anterior orbital lesions that require direct access with wider entry exposure and extensive orbital content manipulation
A high range of intrinsic disorder values for tumor resident, T-cell receptor beta V-complementarity determining region 3-J amino acid sequence assemblies correlates with better melanoma outcomes.
No full textMetastatic melanoma is characterized by high rates of treatment resistance. While various factors have been studied for their prognostic significance, this study evaluated the potential prognostic value of the intrinsic disorder of T-cell receptor beta (TRB) polypeptides. TRB recombination sequencing reads were extracted from tumor RNA-seq files representing The Cancer Genome Atlas, Skin Cutaneous Melanoma dataset, and genomics files representing the National Institutes of Health, phs002683 dataset. Intrinsic disorder values were computed for the TRB V-complementarity determining region 3 (CDR3)-J amino acid sequences for all cases. Survival analyses assessed overall survival and disease-specific survival for case sets based on assigning cases to upper or lower 50th percentile groups, based in turn on intrinsic disorder values. For the phs002683 dataset, intrinsic disorder values were compared between cases representing resistance to immune checkpoint inhibitors (ICIs) and cases representing no observed resistance. The results indicated that the upper 50th percentile of the range of intrinsic disorder values was linked to better outcomes. This was obtained for two TRB datasets representing different RNA-seq file, recombination read extraction algorithms, and was observed for two different intrinsic disorder models. Furthermore, low minimum various long-3 and various short-long 2 values correlated with ICI treatment resistance. The findings of this study suggest that the diversity of intrinsic disorder values representing TRB V-CDR3-J assemblies may represent a novel prognostic biomarker for metastatic melanoma cases and a potential biomarker for indicating different personalized treatments
Outcomes of bypass surgery in asymptomatic moyamoya angiopathy: A multicenter study with propensity-score weighting.
No full textINTRODUCTION: Asymptomatic moyamoya angiopathy (MMA) is increasingly detected through noninvasive imaging; however, its optimal management remains controversial. This multicenter retrospective cohort study compared outcomes in asymptomatic versus symptomatic MMA patients undergoing surgical revascularization.
PATIENTS AND METHODS: A total of 475 patients treated with bypass surgery across multiple academic centers were included, with 56 (11.8%) classified as asymptomatic and 419 (88.2%) as symptomatic. Baseline demographics, surgical characteristics, and outcomes-including perioperative stroke, intraoperative complications, and follow-up stroke events-were collected. Asymptomatic MMA was defined as the absence of any prior ischemic or hemorrhagic stroke, seizures, or other neurological symptoms at the time of diagnosis. Both unadjusted analyses and propensity score weighting using inverse probability of treatment weighting (IPTW) were performed to adjust for potential confounders.
RESULTS: In the unadjusted analysis, asymptomatic patients had significantly lower rates of all perioperative strokes (1.7% vs 11.4%;
CONCLUSION: Bypass surgery in selected asymptomatic MMA patients is associated with reduced intraoperative complications, and fewer follow-up stroke rates. These findings support the careful consideration of surgical intervention in asymptomatic patients, emphasizing the importance of patient selection for optimal outcomes