Yale New Haven Hospital (YNHH) is a 1,541-bed hospital located in New Haven, Connecticut. It is owned and operated by the Yale New Haven Health System. YNHH includes the 168-bed Smilow Cancer Hospital at Yale New Haven, the 201-bed Yale New Haven Children's Hospital, and the 76-bed Yale New Haven Psychiatric Hospital, making it one of the largest hospitals in the world and the largest in Connecticut. It is the primary teaching hospital for Yale School of Medicine and Yale School of Nursing.The hospital is a Magnet hospital and is accredited by the Joint Commission. It is also a Level I trauma center for adult and pediatric patients. It operates a pediatric critical care transport team including registered nurses, respiratory therapists, and physicians who transfer pediatric patients from smaller community hospitals to Yale New Haven Children's Hospital. In 2021, YNHH was ranked nationally in 8 of 15 specialties by U.S. News & World Report: Psychiatry (#11); Geriatrics (#21); Diabetes and Endocrinology (#33); Pulmonology (#27); Neurology and Neurosurgery (#42); Kidney Disorders (#35); Gastroenterology (#45); Ear, Nose and Throat (#47); and Gynecology (#47).In 2020, the hospital had more than 1.3 million outpatient visits, 128,382 emergency room visits and 68,894 inpatient discharges. YNHH is among the largest employers in New Haven, Connecticut, with 14,592 employees.S.S.
Glioblastoma (GBM) remains the most common and lethal primary central nervous system tumor, with a median survival of only 14.6 months under standard care. The tumor’s characteristic "Warburg effect"—a dependency on aerobic glycolysis for energy—creates a metabolic vulnerability. This review evaluates the efficacy and safety of the ketogenic diet (KD) as an adjunctive metabolic therapy aimed at exploiting this glucose dependency. This PRISMA-compliant systematic review updates clinical evidence by synthesizing data from databases from 2000 to September 2025. We searched PubMed, Embase, Cochrane, and Web of science for human studies assessing the ketogenic diet (KD) in glioblastoma and high-grade gliomas. Primary outcomes included overall survival (OS), progression-free survival (PFS), feasibility, and adverse events. Study quality was assessed using Joanna Briggs Institute tools. Prospero registration: CRD420251232650. Forty-one studies were included, ranging from randomized trials to case series and abstracts, utilizing interventions such as the classic 4:1 ketogenic diet, Modified Atkins Diet, and calorie restriction. Adherence was high (> 75
BACKGROUND:Cardiovascular disease remains the leading cause of morbidity and mortality in the United States. JACC Cardiovascular Statistics 2026 reports the most up-to-date data on cardiovascular health in the United States. The report covers major cardiovascular risk factors (hypertension, diabetes, obesity, cholesterol, and cigarette smoking) and conditions that collectively account for most cardiovascular deaths and disability: coronary heart disease, acute myocardial infarction, heart failure, peripheral artery disease, and stroke. OBJECTIVES:JACC Cardiovascular Statistics was developed to provide a clear, comprehensive, and accessible snapshot of cardiovascular health in the United States. An annual synthesis of contemporary cardiovascular statistics is needed to inform patients, clinicians, researchers, public health professionals, policymakers, and the public. METHODS:This report synthesizes data from multiple national sources, including population-based surveys, clinical registries, administrative datasets, and vital statistics. For each risk factor and condition, we evaluated trends in disease epidemiology, quality of care, and morbidity and mortality. Data are presented overall and, where available, stratified by age, sex, race and ethnicity, socioeconomic status, and geography. Findings are presented using a standardized, visually accessible framework. RESULTS:Cardiovascular risk factors-hypertension, diabetes, obesity, cholesterol, and cigarette smoking-remain prevalent among U.S. adults, with persistent gaps in prevention and treatment. Across cardiovascular conditions-coronary heart disease, acute myocardial infarction, heart failure, peripheral artery disease, and stroke-long-term gains in mortality are slowing or reversing, with ongoing gaps in quality of care and persistent health disparities. CONCLUSIONS:JACC Cardiovascular Statistics 2026 provides a comprehensive snapshot of cardiovascular health in the United States, serving as an annual benchmark to guide clinical practice, inform health policy, and promote accountability in efforts to improve cardiovascular health and outcomes for all.
RATIONALE:Older adults (those 65 years old or greater) compose a substantial proportion of the ICU population. As older adults with critical illness possess unique factors and considerations relevant to their care and outcomes, there is a need for evidence-based recommendations to guide critical care clinicians in the care of older ICU patients. OBJECTIVE:The objective of this guideline is to develop evidence-based recommendations addressing the care of older adults during and after critical illness. DESIGN:The American College of Critical Care Medicine Board convened a 22-member interprofessional panel, comprising physicians, advanced practice providers, nurses, a pharmacist, physical therapist, occupational therapist, and a patient representative. The panel included two expert methodologists specialized in developing evidence-based recommendations in alignment with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Conflict-of-interest policies were strictly followed during all phases of guideline development including task force selection and voting. METHODS:The panel members prioritized five Population, Intervention, Comparator, and Outcomes questions. A systematic review was conducted for each question to identify the best available evidence, synthesize the evidence and assess the certainty of evidence using GRADE. The evidence-to-decision framework was used to formulate recommendations. RESULTS:The panel generated two conditional recommendations and three "no recommendation" statements. The conditional recommendations are: 1) We suggest a geriatric model of care for all older adults admitted to the ICU and 2) We suggest not using antipsychotic medications for the prevention of delirium in older adults with critical illness. The three "no recommendation" statements are: 1) We make no recommendation regarding specialized post-ICU follow-up for older survivors of critical illness, 2) For older adults (age 65 and over) admitted to the ICU with vasodilatory shock, we make no recommendation with regard to targeting a mean arterial pressure (MAP) of 60-65 mm Hg as compared with usual care (MAP target > 65 mm Hg), and 3) We make no recommendation regarding the use of antipsychotic medication in the treatment of delirium in older adults with critical illness. CONCLUSIONS:The guideline panel developed recommendations on caring for older adults during and after critical illness. Areas for future research were also identified during the guideline process.
The American Society of Plastic Surgeons guidelines emphasize the need for additional evidence regarding perioperative glycemic control in patients with diabetes undergoing breast reduction surgery. This study evaluates the association between preoperative hemoglobin A1c (HbA1c) levels and postoperative complications in patients with diabetes undergoing reduction mammaplasty. A retrospective cohort study of the National Surgical Quality Improvement Program (NSQIP) database was performed, identifying patients diagnosed with diabetes who underwent breast reduction surgery from 2021 to 2023. Patients were stratified by preoperative HbA1c levels: well-controlled (HbA1c < 6.5
This cross-sectional study identifies the prescribing rate and most commonly prescribed classes of potentially inappropriate medications for older patients at emergency department discharge.
