RocScholar (Rochester Regional Health)
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S232 Efficacy and Safety of FOLFIRINOX as First-Line Treatment for Advanced Biliary Tract Cancers: A Single-Arm Meta-Analysis
No full textS2595 Temporal Trends and Disparities in Hepatocellular Carcinoma Mortality Among Cirrhotic Patients in the United States: Insights From CDC Wonder Analysis
No full textHyponatremia and 40 Years of Controversy: Looking Back and Moving Forward
No full textHyponatremia and 40 Years of Controversy: Looking Back and Moving Forward traces and probes the prolonged, contentious debate surrounding the treatment of severe hyponatremia, a low-sodium concentration in the blood that can result in severe brain damage if managed incorrectly. A mix of memoir and science, the book explains how slow correction of hyponatremia became accepted and how consensus was disrupted by assertions that caution was unnecessary and harmful. It scrutinizes the controversy, offers an approach to management, and unpacks research limitations – reminding us that what is believed true today may change tomorrow.
Hyponatremia and 40 Years of Controversy: Looking Back and Moving Forward is a vital resource for both experienced medical specialists and novice trainees. It explains the physiology of how hyponatremia happens and how it hurts. By offering historical insights, scientific rigor, and practical guidance, this book promises to enhance clinical decision making, foster new research, and improve outcomes in patients with hyponatremia
Catheter Ablation for Ventricular Tachycardia in Ischemic Cardiomyopathy: A Meta-Analysis With Reconstructed Time-to-Event and Trial Sequential Analysis
No full textBACKGROUND: Ventricular tachycardia (VT) is a major contributor to sudden cardiac death among patients with ischemic heart disease (IHD). While catheter ablation reduces the arrhythmic burden, the impact on long-term outcomes remains uncertain. We assess the efficacy of catheter ablation in patients with IHD.
METHODS: We performed a meta-analysis by systematically searching electronic databases from inception to April 2025. Pairwise, reconstructed time-to-event data meta-analyses and Trial Sequential analyses were conducted.
RESULTS: A total of seven studies (1192 participants) were included. Among patients with IHD with ICD, VT ablation was associated with a significant reduction in ICD shocks (RR = 0.50, 95% CI = [0.34-0.74]), a trend toward reduced VT storm (RR = 0.64, 95% CI = [0.40-1.04], p = 0.07), and lower rates of cardiovascular hospitalization (RR = 0.73, 95% CI = [0.53-1.01], p = 0.06) compared to ICD alone. However, no significant differences were observed when compared to patients receiving ICD plus antiarrhythmic drugs (AADs). VT ablation showed no significant impact on mortality or VT/VF recurrence compared to either ICD alone or ICD with AADs. Reconstructed Kaplan-Meier analysis for all-cause mortality showed no significant difference between VT ablation and AAD + ICD. Trial Sequential Analysis provided conclusive evidence for VT/VF recurrence, while further data is required for other outcomes.
CONCLUSION: Among patients with IHD with ICD, VT ablation reduces ICD shocks, VT storm, and cardiovascular hospitalizations compared to ICD-only therapy, but offers no significant advantage over ICD combined with AADs. VT ablation does not impact overall mortality or the recurrence of VT/VF. Trial sequential analysis confirmed conclusive evidence for VT/VF recurrence, while additional data is needed for other outcomes
Neurohospitalist Core Competencies
No full textThe Neurohospitalist Core Competencies comprise a set of competency-based learning objectives that encapsulate the knowledge, skills, and attitudes of neurohospitalitists who specialize in the care of hospitalized patients with neurologic conditions. These competencies serve to characterize the rapidly expanding field of neurohospitalist medicine. The 27 chapters are divided into 3 sections entitled: neurological conditions, clinical interventions and interpretation of ancillary studies, and neurohospitalist role in the healthcare system. Each individual learning objective in the chapters describes a specific concept with an action verb to illustrate the behavior that the neurohospitalist exhibits. The individual neurohospitalist may not exhibit mastery in each of the topics included as individual practices vary in scope and practice pattern. A few examples of how the complete set of competencies may be used include in the creation of curricula for neurohospitalist fellowships, to assist in defining the scope of practice of neurohospitalists for administrative leaders of hospitals and departments, and in influencing the direction of further research and quality improvement in the field
Emerging Therapies for Diffuse Large B-Cell Lymphoma
No full textEmerging Therapies for Diffuse Large B-Cell Lymphoma. Dr. Joseph DiTursi, Hematology & Oncology Department, Rochester Regional Health
Objectives: Understand demographics, diagnosis, and initial workup of diffuse large B-Cell lymphoma (DLBCL) Understand front line treatment options of diffuse large B-Cell lymphoma Recognize treatment options for relapsed/refractory DLBCL Understand basic principles of cellular therapies for DLBCL Recognize toxicities of cellular therapies for DLBCL and their initial management Understand upcoming treatment options and principle for DLBC
Inpatient outcomes of diffuse large B-cell lymphoma: Racial and socioeconomic disparities in a nationally representative sample
No full textImpact of c-KIT and FLT3 mutations on survival outcomes in core-binding factor acute myeloid leukemia: A systematic review and meta-analysis
No full textDevelopment of clinical research networks in rural America: Our experience from the Accelerating COVID-19 Therapeutic Interventions and Vaccines-1 trialau
No full textRural America remains deeply under-represented in clinical trials. St Lawrence Health (SLH) was the sole rural site and one of the top recruiters in the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV)-1 trial, which was a large international trial that studied the efficacy of three immune modulators in hospitalized patients with COVID-19. In this article, we analyze the structural and clinical factors that enabled SLH\u27s success in the context of previously described barriers to research participation in rural areas. We conclude with lessons learned from the SLH experience and offer a broader replicable model for developing clinical research capacity in rural areas. SLH\u27s success in ACTIV-1 can be attributed to early and sustained support from the ACTIV-1 network, a small and integrated inpatient COVID-19 treatment team, regular and consistent communication between this team and the clinical research team at SLH, and SLH\u27s ongoing support and development of its clinical research department. SLH was, in turn, able to overcome several known barriers to implementation of clinical trials at community sites, including lack of provider time and a lack of trained research and clinical staff, and its experience in ACTIV-1 offers a replicable model for developing clinical research capacity in rural communities
Impact of sodium-glucose co-transporter 2 inhibitors on cardiovascular outcomes in patients with acute myocardial infarction: Systematic review and meta-analysis
No full textBackground: The role of sodium-glucose co-transporter inhibitors (SGLT2i) in heart failure is well-established. However, evidence supporting their use in acute myocardial infarction remains limited.
Methods: Two independent researchers conducted a comprehensive literature review on PubMed and Embase until April 2024. They identified 14 articles, consisting of randomized controlled trials and observational studies, investigating the use of SGLT2i in acute myocardial infarction. The analysis focused on cardiovascular outcomes, including all-cause mortality, cardiovascular mortality, major adverse cardiovascular events (MACE), heart failure exacerbation, strokes, and recurrence of acute coronary syndrome.
Results: Our pooled analysis of 19,319 participants revealed a significant reduction in MACE [OR 0.50, 95 % CI [0.36; 0.70], p-value = 0.0001] and hospitalization due to heart failure [OR 0.59 (0.43-0.79), P \u3c 0.0004] in the SGLT2i group compared to the control group. In contrast, there were no statistically significant differences between the SGLT2i and control groups regarding all-cause mortality, cardiovascular mortality, recurrence of acute coronary syndrome, or new-onset arrhythmia.
Conclusions: Our study highlights that among patients with acute myocardial infarction, the use of SGLT2i reduces MACE and hospitalizations due to heart failure. However, there was no significant reduction in mortality, recurrence of acute coronary syndrome, or arrhythmia in the SGLT2i group