Citations

ABSTRACT In 567 PH‐COPD patients from the PVRI GoDeep Meta‐Registry, ACE inhibitor use was associated with improved survival only in severe PH (PVR > 5 WU), supporting prospective trials targeting this high‐risk subgroup.

Background: Aortic endograft infection (AEGI) is a rare complication of abdominal endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR). Surgical explantation with reconstruction is recommended, but data on medical management remain limited. We present our institutional experience with AEGI. Objective: To describe the clinical presentation, microbiology, management strategies, and outcomes of patients with AEGI, with the aim of addressing current gaps in the literature and informing future research to improve patient outcomes. Design: Retrospective descriptive study. Methods: Adult patients admitted with AEGI at our institution between January 2017 and August 2024 were identified using ICD-10 codes and confirmed using the Management of Aortic Graft Infection Collaboration (MAGIC) diagnostic criteria. Clinical, microbiological, radiographic, treatment, and outcome data were collected and analyzed. Results: We screened 517 patients, and 46 met AEGI criteria (EVAR 54%, TEVAR 46%). Most (63%) presented with late-onset infections (⩾3 months). Fever (54%) and sepsis (48%) were common presenting symptoms. Computed tomography (CT) (85%) was the primary imaging modality. Blood cultures were positive in 54% of the cases, with Staphylococcus aureus being the most common monomicrobial pathogen (24%), and 24% of cases were polymicrobial. The majority (67%) received combined medical and surgical therapy. Chronic antibiotic suppressive therapy was used in 34 (74%), most often tetracyclines (33%). Overall, treatment success rates were similar between surgical and medical groups (58% vs 60%, p = 0.250) with comparable mortality. However, relapses were more frequent in the medical-only group (33% vs 16%, p = 0.185). Conclusion: Most patients presented with late-onset AEGI. Fever was absent in nearly half of cases, and blood cultures were positive in only 54%. Overall, surgical and medical therapy had similar success, though relapses were more frequent in those treated medically alone.

Functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C) are prevalent disorders of gut–brain interaction with limited effective treatments. The vagus nerve exerts considerable influence on the gastrointestinal (GI) tract, indicating that noninvasive electrical neuromodulation targeting this nerve could provide a promising therapeutic avenue for both FC and IBS-C. This review explores several emerging noninvasive neuromodulation techniques involving the vagus nerve, such as transcutaneous auricular vagal nerve stimulation, percutaneous electrical nerve field stimulation, and transcutaneous electrical acustimulation. The clinical applications of these methods in managing FC and IBS-C are evaluated. Existing evidence supports the efficacy and safety of noninvasive neuromodulation in relieving symptoms of these conditions. Future investigations should aim to refine these techniques, advance device technology, and further clarify the mechanisms of action.

We demonstrate the structural and functional similarities of organoid-derived gastric mucus and native mucus collected from human patients. The bioengineered gastric mucus mimics its native counterpart in its proteomic profile and physical architecture. This work highlights the translational potential of organoid-derived mucus for functional investigations of the human gastric mucus layer.

Abstract Objectives To describe and compare anorectal manometry findings in constipated adolescents with and without dyssynergic defecation (DD). Methods We retrospectively reviewed adolescents ≤18 years who underwent anorectal manometry (ARM) and/or balloon expulsion testing (BET) between 2015 and 2022. Patients with prior pelvic floor therapy, inflammatory bowel disease, or colon surgery were excluded. DD was defined by abnormal ARM (paradoxical anal contraction or inadequate anal relaxation ≤20% during simulated evacuation) and/or abnormal BET (>60 s). Manometric parameters were compared between patients with and without DD and between those with abnormal versus normal BET. Diagnostic performance of rectoanal pressure gradient cutoffs were assessed. Results A total of 170 adolescents were included; 69 (40.6%) met criteria for DD. Median age was 17 years (interquartile range [IQR] 16–18), and 80.7% were female. Gastrointestinal symptoms did not differ between groups. Patients with DD demonstrated significantly more negative rectoanal pressure gradients compared with those without DD (median [IQR]: −49.0 mmHg [−73.9 to −31.4] vs. −25.2 mmHg [−40.2 to −9.8]; p < 0.001). Rectal sensory thresholds did not differ significantly between groups. A rectoanal pressure gradient cutoff of −45 mmHg demonstrated the best balance of sensitivity (58%) and specificity (86%) for identifying DD. Depression was more prevalent among adolescents with DD ( p = 0.007). Conclusions Rectoanal pressure gradient is a useful manometric parameter for identifying DD in constipated adolescents, particularly when BET is unavailable. Psychological factors such as depression may be more prevalent in this population.

Background: Increased posterior tibial slope (PTS) and anterior tibial translation (ATT) result in a higher risk of anterior cruciate ligament reconstruction failure. Accurate measurement of PTS and ATT is essential to guide surgical planning in these patients. Full-length weightbearing lateral tibial radiographs yield the most accurate measurement of PTS and ATT compared with short-film tibial radiographs, computed tomography scans, and magnetic resonance imaging. Indications: We aim to demonstrate a validated, reproducible technique in a stepwise fashion to accurately measure PTS and ATT using full-length weightbearing lateral tibial radiographs. This presentation adds to the field by offering a precise measurement technique for surgical planning purposes. Technique Description: To precisely measure PTS using a full-length weightbearing lateral tibial radiograph, first, perpendicular lines are drawn 5 cm proximal to the ankle joint and 5 cm distal to the knee joint. A line is then extended proximally from the center of the perpendicular line near the ankle through the center of the perpendicular line near the knee, and then extended up to the tibial articular surface. Next, a line is drawn along the medial tibial plateau. The angle measured between these 2 lines is subtracted from 90° to yield the PTS. To precisely measure ATT, a line is drawn along the diaphysis of the tibia and approximated to the posterior aspect of the proximal tibia. Then, another parallel line is drawn and approximated to the posterior aspect of the distal femur. The distance between these lines is measured to yield anterior tibial translation. Results: We measured a PTS of 14.2° and an ATT of 12.6 mm using the technique described in this presentation. Discussion/Conclusion: This technique demonstrates an accurate and reproducible method to precisely measure PTS and ATT using full-length weightbearing lateral tibial radiographs. This technique yields greater accuracy in PTS and ATT than other imaging modalities. As a result, there is a direct benefit for surgical planning when using this technique. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Abstract: Extracorporeal membrane oxygenation (ECMO) is increasingly used to support patients with severe cardiac or respiratory failure. Neurological complications occur across ECMO configurations and represent a major contributor to mortality and long-term disability. Major neurological complications include ischemic and hemorrhagic stroke, hypoxic ischemic brain injury, seizures, delirium, spinal cord and peripheral nervous system injury, and brain death. The mechanisms underlying neurological injury during ECMO are multifactorial and are influenced by ECMO configuration, reflecting differences in cerebral perfusion, gas exchange, anticoagulation exposure, and precannulation physiologic insults. This review synthesizes neurological complications associated with ECMO, neurological monitoring, and outcomes.

Abstract Provided herein are novel benzofuran derivatives as SARM1 inhibitors, pharmaceutical compositions, use of such compounds in treating axonal degeneration, and processes for preparing such compounds.

Understanding the complex interplay between electrical activity and neurochemical signaling is essential for advancing neuromodulation therapies, yet current technologies often measure these modalities in isolation and suffer from technical limitations such as stimulation artifacts. To address these challenges, we developed the Multifunctional Apparatus for Voltammetry, Electrophysiology, and Neuromodulation (MAVEN), a compact, battery-powered platform designed for high-resolution, concurrent multimodal data acquisition. Preclinical validation in both small- and large-animal models demonstrated that MAVEN provides stable, high-fidelity multimodal readouts while effectively minimizing stimulation artifacts during simultaneous programmable neurostimulation. By capturing phasic and tonic neurochemical changes, alongside real-time electrophysiological data, we established the system's feasibility for continuous monitoring. Beyond its utility in investigating the mechanisms of neurological and neuropsychiatric disorders, MAVEN has been engineered as a versatile analytical platform. Recent successful applications in monitoring pharmacological agents, such as vancomycin, further demonstrate its potential as a robust point-of-care device for real-time diagnostic and therapeutic monitoring. These results position MAVEN not only as a powerful tool for developing personalized, closed-loop neuromodulation strategies but also as a next-generation analytical device capable of broader clinical and bio-sensing applications.