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Erratum to “Disparities Between Clinical Trial Recruitment and Real-World Demographics in Macular Edema Secondary to Retinal Vein Occlusion,” Am J Ophthalmol 2025; 269:429–434 (American Journal of Ophthalmology (2025) 269 (429–434), (S0002939424004598), (10.1016/J.Ajo.2024.09.031))
No full textThe publisher regrets that in the above article published in the January 2025 issue of the Journal, an author\u27s suffix was incorrectly placed in front of his name. The author\u27s correct name is Basil K. Williams Jr. The publisher would like to apologise for any inconvenience caused
Safety and Tolerability of Daptomycin Rapid Infusion: Implications for Nationwide Shortage of Intravenous Fluids
No full textTransfusion Strategy Effect on Quality of Life in Patients With Myocardial Infarction and Anemia: A Secondary Analysis of the MINT Randomized Clinical Trial
No full textImportance: Both myocardial infarction (MI) and anemia have deleterious effects on health-related quality of life (QOL). Red blood cell (RBC) transfusion may improve QOL after MI by relieving symptoms and/or increasing functional capacity. Objective: To evaluate whether a liberal transfusion strategy compared with a more restrictive transfusion strategy affects QOL in patients with MI and anemia. Design, Setting, and Participants: This analysis of QOL as a prespecified secondary outcome of the Myocardial Ischemia and Transfusion (MINT) trial, a randomized clinical trial comparing a liberal vs restrictive RBC transfusion strategy, included participants from 144 sites across 6 countries. Hospitalized adults with acute MI and anemia (hemoglobin [Hb] less than 10 g/dL). The MINT trial randomized 3504 patients, and this analysis included those who had QOL data collected and those who died before the 30-day follow-up period. Data were collected from April 2017 to April 2023, and data were analyzed from February 2024 to January 2025. Interventions: The MINT trial randomized patients to a restrictive (Hb of 7 to 8 g/dL) or a liberal (Hb of less than 10 g/dL) RBC transfusion strategy. Main Outcomes and Measures: QOL was measured using the EQ-5D-5L 30 days after randomization. Results: Of 2844 included patients, 1551 (54.5%) were male, and the mean (SD) age was 71.9 (11.5) years. A total of 2525 (88.8%; 1254 [49.7%] in the restrictive group and 1271 [50.3%] in the liberal group) had QOL data, and 319 (11.2%) died before 30-day follow-up. Overall, there were no differences in mean or median scores for any EQ-5D-5L QOL outcome between assigned transfusion strategies at 30 days postrandomization. Although a higher percentage of patients in the liberal compared with the restrictive transfusion group reported no problems compared with any problem in usual activities (506 of 1268 [39.9%] vs 473 of 1247 [37.9%]), mobility (474 of 1270 [37.3%] vs 460 of 1254 [36.7%]), and self-care (858 of 1271 [67.5%] vs 803 of 1254 [64.0%]) domains, none of these differences were statistically significant. Adjusted mixed-effects linear regressions showed no association between assigned transfusion strategy and mean differences in any QOL outcome. Adjusted regressions in several prespecified subgroups showed an association between a liberal transfusion strategy and better QOL scores in domains related to functional capacity, but the effects were only statistically significant in patients with a history of heart failure (Health Today rating: β, 2.06 [95% CI, -0.23 to 4.35] vs -1.44 [95% CI, -3.81 to 0.92]; P =.04). Conclusions and Relevance: This secondary analysis of the MINT trial found that in patients with MI and anemia, a liberal transfusion strategy compared with a restrictive transfusion strategy did not affect QOL outcomes 30 days after randomization. This suggests that higher Hb levels maintained with RBC transfusion may not offer significant benefits to QOL overall in patients with MI and anemia. Additional studies may be useful for further examining and validating transfusion\u27s effect on QOL in patients with MI and heart failure. Trial Registration: ClinicalTrials.gov Identifier: NCT02981407
Distinct Cell Types Along Thick Ascending Limb Express Pathways for Monovalent and Divalent Cation Transport
No full textKidney thick ascending limb (TAL) cells reabsorb sodium, potassium, calcium, and magnesium and contribute to urinary concentration. These cells are typically viewed as a single type that recycles potassium across the apical membrane and generates a lumen-positive transepithelial voltage driving calcium and magnesium reabsorption, though variability in potassium channel expression has been reported. Additionally, recent transcriptomic analyses suggest that different cell types exist along this segment, but classifications have varied and have not led to a new consensus model. We used immunolocalization, electrophysiology, and enriched single-nucleus RNA-Seq to identify TAL cell types in rats, mice, and humans. We identified 3 major TAL cell types defined by expression of potassium channels and claudins. One has apical potassium channels, has low basolateral potassium conductance, and is bordered by a monovalent cation-permeable claudin. A second lacks apical potassium channels, has high basolateral potassium conductance, and is bordered by calcium- and magnesium-permeable claudins. A third type also lacks apical potassium channels and has high basolateral potassium conductance, but these cells are ringed by monovalent cation-permeable claudins. The recognition of diverse cell types may resolve longstanding questions about how solute transport can be modulated selectively and how disruption of these cells leads to human disease
Redo Axillary Artery Cannulation in Aortic Reoperations: Technical Variations and Implications for Optimal Outcomes
No full textObjectives: Recannulation of the right axillary artery (Redo-AX) is a valuable yet underutilized technique in aortic reoperations. The present study sought to analyze the outcomes of 1 of the largest redo AX cannulations experiences. Methods: From February 2005 to December 2024, AX cannulation was planned for 804 aortic repairs and analyzed according to the intention-to-treat principle. Fifty patients had Redo-AX, whereas 754 patients had primary AX cannulation. Cannulation-related events included technical failure, vascular injury, additional vascular rep, and iatrogenic retrograde dissection. Results: This cohort included 196 redo sternotomies (24.4%) and 381 type A aortic dissections (47.4%). Among the 50 Redo-AX procedures, 46 patients had direct AX cannulation, and 4 patients had the side-graft technique in their initial surgery. Forty-five patients were successfully cannulated for cardiopulmonary bypass. Two patients underwent the side-graft technique with a graft extension, and direct AX cannulation was performed in 43 patients via arteriotomy (n = 40), the Seldinger technique (n = 2), and direct cannulation through an old polyethylene terephthalate graft (n = 1). The overall rate of cannulation-related events was 2.1% (17 out of 804), and the rate of cannulation site shift was 2.7% (22 out of 804). Cannulation-related events (10% vs 1.6%; P \u3c .001) were significantly more common in the Redo-AX group. Operative mortality was comparable between groups (Redo-AX, 0% vs Primary-AX, 4.8%; P = .220), as was the incidence of stroke (0% vs 4.9%, P = .209). Conclusions: Redo-AX is a durable approach for complex redo aortic cases. Careful preoperative evaluation and certain surgical expertise are paramount to achieving optimal outcomes
Commentary: Evaluating the Impact of Grit as a Measure of Resilience Among Families Affected by Pediatric Cancer
No full textSymposium #32
No full textRemarks and Moderator: Edward C. Halperin, M.D., M.A. I am over 70 years of age. Is there an age when it\u27s appropriate to stop doing screenings for cancer with mammograms, colonoscopies, and PSA testing? : Maria T. Castaldi, M.D; Edward Lebovics, M.D.; John L. Phillips, M.D., FACS; Toan Nguyen, M.D. Is a screening hearing test part of routine healthcare or should people only be advised to go for hearing testing if they notice that they\u27re having trouble getting through the day because It\u27s getting hard to hear ? What about if the patient thinks they\u27re fine but the spouse says, You don\u27t hear me ?: Gregg Goldhagen, MS, F-AAA My son or daughter just graduated from high school and they\u27re leaving for college next month. Should they see the family doctor before leaving for college? Do they need certain vaccines? Should I be worried about meningitis? : Marisa A. Montecalvo, M.D; Lori A. Weir Solomon, M.D., M.P.H. Q & A: Edward C. Halperin, M.D., M.A.https://touroscholar.touro.edu/ninety_minutes/1009/thumbnail.jp
Experimental Animal Models and Patient-Derived Platforms to Bridge Preclinical Discovery and Translational Therapeutics in Pulmonary Arterial Hypertension
No full textPulmonary arterial hypertension (PAH) is a progressive vascular disease characterized by sustained elevation of pulmonary arterial pressure, endothelial cell dysfunction, and right ventricular failure. A wide range of experimental animal models, including the monocrotaline model, Sugen combined with hypoxia, and pulmonary artery banding in large animals, have been pivotal in uncovering disease mechanisms such as vascular remodeling, metabolic dysregulation, and hypoxia-inducible signaling. More recently, human-based platforms, including induced pluripotent stem cell-derived vascular cells, organ-on-chip systems, and precision-cut lung slices, have emerged as powerful tools to model patient-specific pathophysiology and study pharmacological responses. These systems enable the interrogation of BMPR2 mutations, mitochondrial dysfunction, and sex-specific responses, factors often overlooked in traditional preclinical models. Moreover, integrating these platforms with omics technologies and comorbidity-driven experimental systems addresses key translational gaps. This review provides an overview of animal and human-based models used in PAH research and highlights emerging strategies to enhance their translational relevance. We advocate for a multi-platform and precision medicine-oriented approach that bridges preclinical insights with clinical outcomes to accelerate therapeutic development in PAH
Racial and Ethnic Survival Disparities Among Children With High-Risk Neuroblastoma: A Children\u27s Oncology Group Report
No full textImportance: Whether population-based racial and ethnic survival disparities for children with high-risk neuroblastoma persist in the clinical trial setting is unknown. Objective: To investigate racial and ethnic survival disparities among children with high-risk neuroblastoma treated on frontline clinical trials. Design, Setting, and Participants: This retrospective cohort study used data from Children\u27s Oncology Group (COG) high-risk neuroblastoma trials from January 1, 2007, to December 31, 2016, with a data freeze on June 30, 2021. Children with high-risk neuroblastoma were analyzed in 2 cohorts: induction/consolidation trial participants and post-consolidation trial participants. Statistical analyses were performed from September 2, 2021, to December 30, 2024. Exposures: Race and ethnicity were the primary exposures, categorized as Hispanic, non-Hispanic Black, non-Hispanic other (American Indian or Alaska Native, Asian, and Native Hawaiian or Other Pacific Islander), or non-Hispanic White. Main Outcomes and Measures: Primary outcomes included overall survival (OS) and event-free survival (EFS) from time of trial enrollment, estimated by Kaplan-Meier methods. Associations with race and ethnicity were evaluated by log-rank tests and Cox proportional hazards regression models. Secondary outcomes included induction delays, early trial withdrawal, relapse as first event, death as first event, postrelapse OS, and early phase trial enrollment. Results: The induction/consolidation cohort (median follow-up, 8.3 years [IQR, 6.1-9.8 years]) included 696 patients (404 males [58.1%]; 79 Hispanic patients [11.4%], 109 non-Hispanic Black patients [15.7%], 27 patients of non-Hispanic other race [3.9%], and 481 non-Hispanic White patients [69.1%]). The post-consolidation cohort (median follow-up, 7.5 years [IQR, 5.8-9.4 years]) included 935 patients (567 males [60.6%]; 87 Hispanic patients [9.3%], 145 non-Hispanic Black patients [15.5%], 41 patients of non-Hispanic other race [4.4%], and 662 non-Hispanic White patients [70.8%]). In multivariable Cox proportional hazards regression models, Hispanic children experienced significantly inferior OS (hazard ratio [HR], 1.78; 95% CI, 1.25-2.53; P = .01) on induction/consolidation studies compared with non-Hispanic White children; EFS did not differ. Non-Hispanic Black (HR, 1.54; 95% CI, 1.13-2.11) and Hispanic children (HR, 1.63; 95% CI, 1.09-2.43) experienced inferior OS on post-consolidation studies compared with non-Hispanic White children (P = .009); Hispanic children in post-consolidation studies experienced inferior EFS (HR, 1.68; 95% CI, 1.14-2.47; P = .02). Death as first event and postrelapse OS also differed by race and ethnicity. Conclusions and Relevance: This study suggests that Black and Hispanic children with high-risk neuroblastoma experienced inferior OS despite uniform planned treatment on frontline COG clinical trials. Investigated mechanisms did not completely explain survival disparities. Future evaluation of disparate treatment-related toxicities and postrelapse care as explanatory mechanisms are key next steps to promote equity
