NYU Langone Health is one of the nation’s premier academic medical centers. Our trifold mission to serve, teach, and discover is achieved daily through an integrated academic culture devoted to excellence in patient care, education, and research.
The microbiome has been described as the last human “organ” and is currently the topic of great research interest worldwide. The application of culture-independent methods, like 16S ribosomal next-generation sequencing, has offered researchers the opportunity to identify bacterial populations that were impossible to detect previously using conventional culture methods. Further standardization of these new approaches to characterizing the microbiome is desirable. The present review discusses the mounting evidence suggesting that alterations in the microbiome and microbial metabolites, such as short-chain fatty acids in the gut, mouth, and ocular surface, may play a key role in the pathogenesis of ocular pathologies such as ocular surface disease, glaucoma, uveitis, age-related macular degeneration, and diabetic retinopathy. Clarifying the probable role of the microbiome in ocular diseases would not only offer valuable insights into pathogenesis but could also enable the development of novel therapeutic approaches. As yet, microbial-based therapeutic applications in ophthalmology are limited. Nevertheless, recently emerging strategies utilizing probiotics and prebiotics, or even fecal transplantation to regulate microbiome composition, offer promising research avenues for developing future innovative therapies for ocular diseases. Further studies employing standardized methodological protocols are needed to ensure the reproducibility of results and to eventually unlock the precise links between the microbiome and the eye.
The extensor mechanism of the knee is essential for maintaining normal daily function and for activities such as walking and athletic performance. It comprises the quadriceps muscles and tendon, patella and peripatellar fat pads, patellofemoral joint and retinacula, patellar tendon, and tibial tuberosity. Disruption of any component can result in pain, instability, or loss of active extension. Owing to its superficial location and continuous biomechanical loading, it is particularly vulnerable to acute trauma, repetitive microtrauma, chronic degeneration, and traction apophysitis in the pediatric population. Imaging is essential for accurately differentiating between diagnoses and guiding management. Radiographs remain indispensable for assessing patellar height, fracture morphology, and skeletal variants, while computed tomography (CT) is a reliable preoperative tool for defining fracture configuration, comminution, and articular involvement. Ultrasound (US) offers dynamic, high-resolution evaluation of tendons and retinacula, facilitating differentiation of partial from complete tears and assessment of postoperative integrity. Magnetic resonance imaging (MRI) provides comprehensive characterization of soft tissues, bone marrow, cartilage, and associated intra-articular pathology, and is central to preoperative planning in complex injuries and patellofemoral instability. In addition to diagnosis, imaging findings directly influence treatment decisions, including fracture fixation strategies, tendon repair or augmentation, and treatment selection. Postoperative imaging plays a vital role in monitoring healing, detecting complications such as construct elongation, re-tear, hardware irritation, and recurrent instability, and guiding rehabilitation. This review highlights the radiological anatomy and injury patterns of the knee extensor mechanism, emphasizing that integrated use of radiographs, ultrasound, and MRI enables accurate, clinically relevant assessment.
Advances in understanding the molecular landscape of gastroesophageal junction (GEJ) adenocarcinoma underscore the need for biomarker-driven treatment approaches. The Society of Surgical Oncology (SSO) Gastrointestinal (GI) Disease Site Working Group has developed practice guidelines for the biomarker-based management of nonmetastatic GEJ adenocarcinoma, with specific integration of microsatellite instability (MSI) status. Although multimodal therapy has improved outcomes, treatment strategies for GEJ adenocarcinoma remain largely stage-based rather than biomarker-directed. With emerging evidence supporting the prognostic and predictive roles of MSI-high (MSI-H), human epidermal growth factor receptor 2 (HER2), and other novel targets, there is an urgent need for clear guidance on how to incorporate biomarkers into the management of resectable disease. These guidelines provide evidence-based recommendations to support precision oncology in GEJ cancer care.
Care for individuals with laryngectomy (IWL) is complex, requiring access to specialized multidisciplinary services along the full care continuum. However, evidence supports that challenges are experienced by some IWL accessing supportive care, with current care systems not addressing patients' postoperative and long-term needs, contributing to poor outcomes and increased patient and caregiver burden. This study explored perceptions of IWL about overall health services and speech-language pathology (SLP) care to identify and prioritize opportunities for supportive care optimization. Concept mapping methodology was used to identify what IWL perceived were important to support their care. Through the multistep concept mapping process, qualitative and quantitative data were used to identify, then prioritize, critical elements of care that IWL feel should be optimized in the care pathway. Fourteen IWL from two health services generated 32 unique statements. Hierarchical cluster analysis revealed that statements fell within seven clusters: (1) comprehensive healthcare professional access and support; (2) psychological care and trust in healthcare; (3) supporting adjustment to life after surgery; (4) managing the treatment and recovery pathway; (5) communication restoration and peer-support; (6) inpatient care; and (7) no underlying theme. The Go-Zone map revealed 15 statements that were rated highest for importance, with the majority of these focusing on improving psychological care and adjustment postsurgery. IWL identified and prioritized actions to enhance services relating to preoperative education, psychological care, access to healthcare professionals, peer support, and financial supports. These findings can be used to inform an enhanced care pathway for IWL.
PURPOSE:The Children's Oncology Group (COG) protocol AALL0434 evaluated the safety and efficacy of multi-agent chemotherapy with Capizzi-based methotrexate/pegaspargase (C-MTX) in patients with newly diagnosed pediatric T-cell lymphoblastic lymphoma (T-LL) and gained preliminary data using nelarabine in high-risk patients. PATIENTS AND METHODS:The trial enrolled 299 patients, age 1-31 years. High-risk (HR) patients had ≥ 1% minimal detectable disease (MDD) in the bone marrow at diagnosis or received prior steroid treatment. Induction failure was defined as failure to achieve a partial response (PR) by the end of the 4-week induction. All patients received the augmented Berlin-Frankfurt-Muenster (ABFM) C-MTX regimen. HR patients were randomly assigned to receive or not receive 6 5-day courses of nelarabine incorporated into ABFM. Patients with induction failure were nonrandomly assigned to ABFM C-MTX plus nelarabine. No patients received prophylactic cranial radiation; however, patients with CNS3 disease (CSF WBC ≥ 5/μL with blasts or cranial nerve palsies, brain/eye involvement, or hypothalamic syndrome) were ineligible. RESULTS:At end-induction, 98.8% of evaluable participants had at least a PR. The 4-year event-free survival (EFS) and overall survival (OS) were 84.7% ± 2.3% and 89.0% ± 2.0%. The 4-year disease-free survival (DFS) from end-induction was 85.9% ± 2.6%. There was no difference in DFS observed between the HR and standard-risk groups (P = .29) or by treatment regimen (P = .55). Disease stage, tumor response, and MDD at diagnosis did not demonstrate thresholds that resulted in differences in EFS. Nelarabine did not show an advantage for HR patients. CNS relapse occurred in only 4 patients. CONCLUSION:COG AALL0434 produced excellent outcomes in one of the largest trials ever conducted for patients with newly diagnosed T-LL. The COG ABFM regimen with C-MTX provided excellent EFS and OS without cranial radiation.
