Baylor University Medical Center Proceedings最新文献

{"title":"An underappreciated hot topic.","authors":"Robert T Dahlquist","doi":"10.1080/08998280.2026.2730095","DOIUrl":"10.1080/08998280.2026.2730095","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1091"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of anti-Ro/SSA antibodies in heart block among adult patients.","authors":"Rona Yu, Stamatina Tolias, Rachel C Robbins, Jess D Edison, Matthew Needleman, J Edwin Atwood","doi":"10.1080/08998280.2026.2718588","DOIUrl":"10.1080/08998280.2026.2718588","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1167-1168"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fever, lymphadenopathy, and a diagnostic dilemma: a case of Kikuchi-Fujimoto disease masquerading as tuberculosis in a diabetic patient.","authors":"Chirag Bhojwani, Anirudh Jeedigunta, Shivam Thaker, Megha Murali, Hrishikesh Pandey, M Mukhyaprana Prabhu","doi":"10.1080/08998280.2026.2665058","DOIUrl":"10.1080/08998280.2026.2665058","url":null,"abstract":"<p><p>Kikuchi-Fujimoto disease is a rare, self-limiting autoimmune necrotizing lymphadenitis that poses unique diagnostic challenges due to vague, overlapping clinical and laboratory features with numerous important and common differential diagnoses. Accurate diagnosis is needed to avoid unnecessary and unwanted treatment. Herein, we report a unique case of a middle-aged diabetic man from South India presenting with prolonged fever, significant weight loss, and generalized lymphadenopathy. Laboratory findings revealed leukopenia, markedly elevated inflammatory markers, and a moderately positive antinuclear antibody titer, raising immediate concern for systemic lupus erythematosus. Results of an extensive infectious workup, including tuberculosis testing, were negative. The definitive diagnosis was established by lymph node biopsy demonstrating necrotizing lymphadenitis with karyorrhectic debris and crescentic histiocytes, without caseating granulomas or hematoxylin bodies. This case underscores the need for early lymph node biopsy in tuberculosis-endemic settings to avoid misdiagnosis and inappropriate antitubercular therapy and also highlights the emerging association between Kikuchi-Fujimoto disease and autoimmune serological markers.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1141-1145"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148534723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of amyloid cardiomyopathy diagnosis on heart failure readmission and length of stay.","authors":"Abdallah Fawaz Masri, Ufuk Vardar, Umair Jabbar, Mukunthan Murthi, Saurabh Malhotra","doi":"10.1080/08998280.2026.2717973","DOIUrl":"10.1080/08998280.2026.2717973","url":null,"abstract":"<p><strong>Background: </strong>Amyloid cardiomyopathy (CM) portends poor outcomes in heart failure (HF). Whether establishing a diagnosis of amyloid CM influences healthcare utilization remains unclear.</p><p><strong>Methods: </strong>We identified patients admitted with a primary diagnosis of HF between January 2018 and December 2020, using medical record-linked administrative data. Amyloid CM was diagnosed using technetium-99m pyrophosphate scintigraphy and assessment for paraproteinemia, with endomyocardial biopsy as needed. Annualized HF readmission rates and length of stay (LOS) were compared between patients with confirmed amyloid CM and those referred for testing but without amyloid CM. The date of amyloid testing served as the comparison cutoff.</p><p><strong>Results: </strong>Among 108 HF patients referred for amyloid testing, 26 (24%) had amyloid CM. Amyloid CM patients were older (77 vs 69 years, <i>P</i> = 0.003). Annualized HF admission rates were unchanged before and after testing and were similar between amyloid CM and nonamyloid CM groups. Patients with amyloid CM had persistently elevated annualized LOS despite diagnosis confirmation (4.5 vs 3.1 days/patient/year, <i>P</i> = 0.12), whereas nonamyloid CM patients experienced a significant reduction in LOS (2.3 vs 1.3 days/patient/year, <i>P</i> = 0.02).</p><p><strong>Conclusions: </strong>HF patients with amyloid CM had persistently high LOS despite the diagnosis, unlike patients without amyloid CM. Additional tailored interventions may be needed to reduce healthcare utilization in this population.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"982-991"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The utility of genetic testing for pheochromocytoma and paraganglioma.","authors":"Brennan Gagen, Melissa S Angel, Kimberly Mattern, Ana Vargas, Tamanie Yeager, Stacey Milan","doi":"10.1080/08998280.2026.2716568","DOIUrl":"10.1080/08998280.2026.2716568","url":null,"abstract":"<p><strong>Background: </strong>Pheochromocytoma and paragangliomas are unique neuroendocrine tumors that can be a significant source of morbidity and mortality. It was previously thought that these tumors were largely sporadic. There is a paucity of literature to support routine genetic testing. The aim of this study was to determine the utility of preoperative genetic testing for these tumors.</p><p><strong>Methods: </strong>This study was a retrospective review of all patients >18 years of age with a diagnosis of a pheochromocytoma or paraganglioma who were evaluated in our surgical oncology clinic from January 1, 2014, through January 1, 2025. Basic demographic data, along with genetic testing, recurrence, and final pathology findings, were collected.</p><p><strong>Results: </strong>A total of 48 patients were reviewed, with 21 patients completing genetic testing. Fourteen patients (66.6%) were found to have negative genetic testing, while 7 patients (33.3%) had positive genetic testing. There was no difference in age, race, or sex of the patients with positive and negative genetic testing. There was no difference in recurrence (<i>P</i> = 1.0) or findings of metastasis (<i>P</i> = 1.0) on final pathology between patients with positive versus negative genetic testing.</p><p><strong>Conclusion: </strong>Given the high rate of genetic mutations found in this study, we recommend that all patients with pheochromocytomas and paragangliomas undergo genetic testing.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"960-964"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preexisting cardiovascular disease and inpatient arrhythmias after autologous stem cell transplantation for multiple myeloma: a National Inpatient Sample analysis.","authors":"Hector Garcia Pleitez, Nehemias Guevara Rodriguez, Chanokporn Puchongmart, Dina Soliman, Andrea Ortiz Maldonado, Noemy Coreas, Jonathan Hernandez Munoz, Ben Thiravetyan, Sakditad Saowapa, Lukman Tijani, Ranju Kunwor","doi":"10.1080/08998280.2026.2716565","DOIUrl":"10.1080/08998280.2026.2716565","url":null,"abstract":"<p><strong>Background: </strong>Autologous stem cell transplantation (ASCT) remains the standard for transplant-eligible multiple myeloma (MM) patients. However, data on inpatient arrhythmias among MM-ASCT hospitalizations with preexisting cardiovascular disease (CVD) remain limited. We evaluated present-on-admission (POA)-coded new-onset inpatient arrhythmias according to preexisting CVD status.</p><p><strong>Methods: </strong>We analyzed the unweighted National Inpatient Sample (2016-2022) and identified adult MM-ASCT hospitalizations with valid POA indicators. Preexisting CVD included coronary artery disease, atrial fibrillation, valvular disease, conduction disorders, congestive heart failure, and prior cardiac arrest. The primary outcome was POA-coded new-onset inpatient arrhythmia. Secondary outcomes included length of stay, hospital charges, and discharge disposition. Firth's penalized logistic regression was used for sparse events, with LASSO regression performed as an exploratory sensitivity analysis.</p><p><strong>Results: </strong>Among 58 MM-ASCT hospitalizations, 12 (21%) had preexisting CVD. New-onset inpatient arrhythmias occurred in 9 hospitalizations (16%) and were more frequent with preexisting CVD (66.7% vs 2.2%, <i>P</i> < 0.001). No clear differences were observed in length of stay, charges, or discharge disposition.</p><p><strong>Conclusions: </strong>New-onset inpatient arrhythmias were more frequent among MM-ASCT hospitalizations with preexisting CVD. These findings are hypothesis-generating and warrant validation in larger clinically adjudicated cohorts.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"978-981"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of bariatric surgery on cardiovascular and cerebrovascular outcomes in metabolic dysfunction-associated steatotic liver disease: a nationwide analysis.","authors":"Omar Alkasabrah, Mohamed ElZayat, Muhammad Qasim Chaudhry, Mohamed H Eldesouki, Sameeha Ibrahim, Abdullah Serhan, Tanuj Sharma","doi":"10.1080/08998280.2026.2724644","DOIUrl":"10.1080/08998280.2026.2724644","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) continues to rise, with strong associations with obesity and cardiometabolic diseases. Bariatric surgery (BS) has shown metabolic benefits in MASLD, but its impact on major adverse cardiovascular and cerebrovascular events (MACCE) remains unclear.</p><p><strong>Methods: </strong>National Inpatient Sample data from 2016 to 2022 were used to identify adults aged ≥18 years with hepatic steatosis or steatohepatitis and at least one metabolic risk factor, approximating established MASLD criteria. Patients were then stratified by prior BS status, and multivariable logistic regression was used to assess the outcomes after adjustment for potential confounders. Outcomes were reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Among 3,668,314 MASLD patients, 394,535 underwent BS. BS was associated with lower odds of all-cause mortality (aOR 0.33, 95% CI 0.32-0.34), myocardial infarction (aOR 0.38, 95% CI 0.36-0.39), stroke (aOR 0.87, 95% CI 0.86-0.88), atrial fibrillation (aOR 0.73, 95% CI 0.72-0.74), and heart failure (aOR 0.52, 95% CI 0.52-0.57); all <i>P</i> < 0.001. Length of stay and total hospital charges were also significantly reduced.</p><p><strong>Conclusion: </strong>BS was associated with lower risk of MACCE, mortality, and resource utilization in patients with MASLD, supporting its beneficial role.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1004-1011"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management and outcomes of patients undergoing high-risk oncologic pancreatic surgery: do patients presented at pancreatic multidisciplinary tumor board fare better?","authors":"Caroline Breit, Jacob Gibbs, Shalini Sharma, Ala Obaid, Charles Kimbrough, John Preskitt, Catherine Davis","doi":"10.1080/08998280.2026.2718630","DOIUrl":"10.1080/08998280.2026.2718630","url":null,"abstract":"<p><strong>Background: </strong>Few studies have examined the impact of multidisciplinary tumor board (MDT) discussion on pancreatic cancer treatment and diagnosis. We aimed to determine whether these patients who are presented at MDT meetings have improved outcomes compared with those who are not presented.</p><p><strong>Methods: </strong>A retrospective chart review was performed of patients diagnosed with pancreatic cancer at our tertiary referral center between 2019 and 2022.</p><p><strong>Results: </strong>Of the 190 patients included in the study, 166 (87.4%) were presented at MDT. Patients presented were more likely to receive appropriate pretherapy workup (81.9% vs 37.5%, <i>P</i> < 0.001) and posttreatment surveillance (52.4% vs 20.8%, <i>P</i> = 0.004) and had fewer postoperative complications (30.7% vs 58.3%, <i>P</i> = 0.008) compared to patients who were not presented.</p><p><strong>Conclusion: </strong>All patients diagnosed with pancreatic cancer should be discussed at MDT meetings.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"947-951"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Payment adjustments by physician specialty and participation type in the Merit-Based Incentive Payment System.","authors":"Sunjay Letchuman, Raj Letchuman, Jashvant Poeran, Jonathan Gal","doi":"10.1080/08998280.2026.2724233","DOIUrl":"10.1080/08998280.2026.2724233","url":null,"abstract":"<p><strong>Background: </strong>The Merit-Based Incentive Payment System (MIPS) is a federal program that adjusts Medicare physician payment based on performance across four domains: quality measures, cost, improvement activities, and promoting interoperability. Clinicians primarily participate either through a group or through a MIPS alternative payment model (APM), in which performance is aggregated at the health system level. Although APM participation is generally associated with higher scores than group reporting, the specialty-specific financial implications of this difference have not been quantified.</p><p><strong>Methods: </strong>Using coarsened exact matching and weighted quantile regression on 2023 Centers for Medicare and Medicaid Services data from 291,121 clinicians across 29 specialties, we compared participation rates and estimated median payment adjustments under each reporting structure.</p><p><strong>Results: </strong>APM participation varied substantially by specialty, ranging from 7.6% in dermatology to 40.6% in hospital medicine. We found that across nearly all specialties, clinicians participating through an APM received meaningfully higher predicted payment adjustments than otherwise comparable group-reporting clinicians. The adjusted difference ranged from $100 for obstetrics/gynecology to $2327 for radiation oncology.</p><p><strong>Discussion: </strong>These findings suggest that MIPS reimbursement reflects not only clinical performance but also the structural pathway through which that performance is reported. Specialist physicians, who tend to have lower APM access, may face a systematic financial disadvantage. Given that MIPS participation itself carries estimated costs of several thousand dollars per physician annually, specialties with limited APM access may experience a net financial burden. Expanding specialty-relevant APM measure sets and improving APM access could help align incentives more equitably across disciplines.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1109-1112"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are we really providing the best care possible to older stroke survivors?","authors":"Jennifer Heffernan","doi":"10.1080/08998280.2026.2720845","DOIUrl":"10.1080/08998280.2026.2720845","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1053-1054"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}