Montefiore Medical Center is a premier academic medical center and the primary teaching hospital of the Albert Einstein College of Medicine in the Bronx, New York City. Its main campus, the Henry and Lucy Moses Division, is located in the Norwood section of the northern Bronx. It is named for Moses Montefiore and is one of the 50 largest employers in New York. In 2020, Montefiore was ranked No. 6 New York City metropolitan area hospitals by U.S. News & World Report. Adjacent to the main hospital is the Children's Hospital at Montefiore, which serves infants, children, teens, and young adults aged 0–21.
Obstructive sleep apnea (OSA) is strongly associated with obesity, and weight loss is a cornerstone of its management. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), are a class of medications that induce significant weight loss and have shown promise in improving OSA severity. This meta-analysis aimed to evaluate the pooled efficacy of GLP-1 RAs on sleep-disordered breathing, body weight, and cardiovascular risk factors in patients with OSA. A systematic review and meta-analysis of four randomized controlled trials were performed, comparing GLP-1 RA therapy with placebo in adults with OSA. The primary outcomes analyzed were the mean differences in the change from baseline for the apnea-hypopnea index (AHI), body weight, and systolic and diastolic blood pressure. In the pooled analysis, treatment with GLP-1 RAs was associated with a robust and statistically significant reduction in AHI (mean difference [MD]: -13.89 events/hour; p < 0.01). Therapy also resulted in substantial weight loss compared to placebo (MD: -12.46 kg; p < 0.01). For cardiovascular parameters, the use of GLP-1 RA was associated with a significant reduction in systolic blood pressure (mean difference [MD]: -4.86 mmHg; p < 0.01) and diastolic blood pressure (p = 0.03). GLP-1 receptor agonists significantly reduce OSA severity, promote substantial weight loss, and lower systolic and diastolic blood pressure in patients with obstructive sleep apnea and obesity. These findings support the role of GLP-1 RAs as a multifaceted and effective therapeutic intervention for managing OSA.
Although the Woven EndoBridge (WEB) device is increasingly used for the treatment of wide-neck intracranial aneurysms, including in the acute rupture setting, comparative evidence assessing the impact of rupture status remains limited. This study compared angiographic, safety, and clinical outcomes between ruptured and unruptured intracranial aneurysms treated with WEB. We conducted a retrospective analysis of prospectively collected data from the multicenter cohort registry WorldWideWEB, including consecutive adult patients with intracranial aneurysms treated with the WEB. Patients were stratified into groups of ruptured and unruptured aneurysms. Propensity score matching was used to balance baseline characteristics between both groups. Retreatment rate was the primary outcome. Secondary outcomes included mRS, safety events (thromboembolic complications) and angiographic outcomes (periprocedurally and last follow-up). Among 1,220 patients, 342 (28.0
Ventral hernia repair (VHR) is commonly performed in patients with multiple modifiable risk factors. Preoperative rehabilitation programs aim to optimize these risk factors and improve surgical outcomes; however, their implementation and effectiveness remain variable. This systematic review evaluates current evidence on the role of preoperative optimization in patients undergoing VHR. Cochrane Central, Embase, and PubMed were searched for studies comparing preoperative interventions versus standard care in patients undergoing VHR. The primary outcome was characterization of rehabilitation strategies. Secondary outcomes included surgical utilization, emergent repair, readmission, surgical site infection (SSI), surgical site occurrence (SSO), recurrence, reoperation, and mortality. Six studies were included, comprising a total of 3,556 patients, of whom 1,805 (50.7
To better understand the gap in literature by comparing umbilical hernia repair techniques for < 2 cm umbilical hernias in patients with class I and class II obesity Methods: A retrospective review of data from the ACHQC was performed to include adult patients with a BMI of 30.0–39.9 kg/m2 who underwent elective UHR for a hernia defect of < 2 cm. Patients within each obesity underwent propensity score matching analysis for diabetes mellitus, hypertension, chronic obstructive pulmonary disorder, and smoking status. Outcomes of interest included: compare surgical site infection, surgical site occurrence, 30-day reoperation, recurrence, and re-admission. 1896 patients were included in the analysis after matching. There was no difference in 30-day recurrence, re-admission, or reoperation. There was a statistically greater number of SSO in the class II obesity group (4.6
Tissue repair requires a highly coordinated cellular response to injury. In the lung, alveolar type 2 cells (AT2s) act as stem cells to replenish both themselves and alveolar type 1 cells (AT1s); however, the complex orchestration of stem cell activity after injury is poorly understood. Here, we establish longitudinal imaging of AT2s in murine intact tissues ex vivo and in vivo in order to track their dynamic behavior over time. We discover that a large fraction of AT2s become motile following injury and provide direct evidence for their migration between alveolar units. High-resolution morphokinetic mapping of AT2s further uncovers the emergence of distinct motile phenotypes. Inhibition of AT2 migration via genetic depletion of ArpC3 leads to impaired regeneration of AT2s and AT1s in vivo. Together, our results establish a requirement for stem cell migration between alveolar units and identify properties of stem cell motility at high cellular resolution.
