isosorbide dinitrate SR

Patient-Reported Outcomes of Concomitant Deltoid and/or Syndesmotic Reconstruction With Broström for Global Chronic Ankle Instability: The Role of Deltoid Stability.

Hadley Steven M SM, Durudogan Eric H EH, Bergman Rachel R, Westvold Sarah J SJ et al.

Medial and syndesmotic instability are risk factors for failure to return to pre-injury activity following Broström. This investigation aims to understand the extent to which superficial deltoid reconstruction (DR) and/or syndesmotic reconstruction (SR) affect global ankle stability in patients with global chronic ankle instability (GCAI) as measured by the validated Cumberland Ankle Instability Tool (CAIT) and Patient-Reported Outcomes Measurement Information System (PROMIS). All 574 patients who underwent lateral ankle ligament reconstruction at a single institution (2013-2024) were retrospectively reviewed. Revisions, allografts, nonanatomic reconstructions, flexor digitorum longus transfers, progressive collapsing foot deformity, hindfoot arthrodesis, ankle arthroplasties, fractures, those without minimum 1-year follow-up, and those who did not complete preoperative CAIT were excluded. Forty-three of 71 patients with concurrent deltoid and/or syndesmotic injury completed postoperative PROMIS/CAIT. GCAI was determined via history, examination, imaging, and intraoperative findings. Primary outcome was postoperative change in CAIT. For patients who underwent concomitant DR (13/43), the mean CAIT score improved by 16.0 ± 8.9 points (P < .001). The mean PROMIS physical function (PF) was 53.8 ± 6.8, the mean PROMIS pain interference (PI) was 46.7 ± 8.5, and the mean postoperative CAIT score was 22.0 ± 7.8. For those who had SR (16/43), the mean CAIT improved by 8.0 ± 12.6 (P = .02). The mean PROMIS PF, PI, and postoperative CAIT scores among those who underwent associated SR were 49.3 ± 8.2, 51.3 ± 8.9, and 16.0 ± 9.1, respectively. For patients who underwent both SR and DR (14/43), average CAIT improved by 17.7 ± 7.0 (P < .001). Mean PF, PI, and postoperative CAIT were 51.9 ± 6.3, 48.2 ± 6.7, and 22.3 ± 7.0, respectively. Change in CAIT was significantly higher in DR and DR+SR compared to SR alone (P = .05). Concomitant DR/SR in patients undergoing Broström may be associated with significant improvements in ankle stability from preoperative baseline. Those with DR and DR+SR had the largest improvements in CAIT, which may suggest the role of deltoid stability in GCAI. Therefore, addressing global stability should be considered in some GCAI patients. Level III, retrospective comparative study.

Author Correction: Host macrophages/monocytes promote malaria transmission by modulating mosquito microbiota via SR-A-mediated phagocytosis.

He Biao B, Li Meilin M, Guo Shuai S, Fang Jiaqin J et al.

Short-term outcomes of robotic-assisted distal pancreatectomy using domestic KangDuo Surgical Robot-2000 System versus Da Vinci Xi system: a two-center prospective observational cohort study.

Weng Guihu G, Cao Zhe Z, Ma Yongsu Y, Luo Wenhao W et al.

Robotic surgery is a transformative approach for abdominal tumors. With the emergence of multiple robotic systems, evidence on their comparative oncological outcomes remains limited. This two-center prospective observational cohort study aimed to compare surgical efficacy and short-term oncological outcomes between the novel KangDuo Surgical Robot System-2000 (KD-SR-2000) and the Da Vinci Xi system in robot-assisted distal pancreatectomy (RDP). This two-center prospective observational cohort study enrolled patients with pancreatic tumors who scheduled for RDP at Peking Union Medical College Hospital and Peking University First Hospital between December 2023 and May 2025. Eligible patients were assigned into either the KD-SR-2000 group (n = 33) or the Da Vinci Xi group (n = 50) in a non-randomized, non-blinded manner. Baseline demographics, perioperative parameters, postoperative complications, ergonomics, and hospitalization costs were prospectively collected and compared between groups. Baseline characteristics were balanced. One case in the Da Vinci Xi group was converted to laparotomy due to severe adhesions and splenic vein bleeding. No significant differences were observed in surgical success, conversion, spleen preservation, or 90-day mortality rates (all P > 0.05). NASA-TLX scores indicated higher physical demand, effort, and total workload in the KD-SR-2000 group, though differences were not significant (all P > 0.05). Major complications (Clavien-Dindo ≥ III) and specific complications showed no significant differences. The KD-SR-2000 group had significantly lower hospitalization costs ($8131.6 [7642.4-9960.7] vs. $9859.6 [9022.4-18,965.8], P < 0.001). Intraoperative blood loss, operation time, and postoperative stay did not differ significantly. In this preliminary prospective observational study, the KD-SR-2000 system demonstrated comparable efficacy and safety to the Da Vinci Xi in the RDP procedure. While further improvements are needed in its ergonomic design, it possesses significant advantages in surgical costs and may be considered a viable alternative to the Da Vinci Xi system.

Chromosome 1q Gain Defines a Plasma Cell-Dominant Adverse-Risk Subtype in AL Amyloidosis With Inferior Long-Term Survival.

Hellou Tamer T, Mariotti Estefania Gauto EG, Alnughmush Ahmed A, Baughn Linda B LB et al.

The prognostic relevance of multiple myeloma (MM)-defined high-risk (HR) cytogenetic abnormalities in AL amyloidosis is incompletely defined. We retrospectively evaluated 517 newly diagnosed AL amyloidosis patients seen at Mayo Clinic between 2012 and 2021 who had baseline plasma cell FISH. HR cytogenetics were defined as t(4;14), t(14;16), t(14;20), del(17p), or 1q gain/amplification (+1q). HR abnormalities were identified in 151 patients (29%); +1q accounted for most HR cases (122/151, 81%). Compared with standard-risk (SR), patients harboring +1q demonstrated a greater clonal disease burden, including higher dFLC and bone marrow plasma cells, greater intact immunoglobulin secretion, higher plasma cell proliferative index, and enrichment for modified SLiM-CRAB features. Hematologic and organ response patterns of +1q patients were generally comparable to SR patients, whereas non-1q HR patients had a higher proportion of early hematologic responses. Patients harboring +1q demonstrated significantly inferior overall survival (OS) compared with both non-1q HR patients and SR patients (median OS 57 months vs. not reached vs. 120 months, p = 0.02). In multivariable piecewise Cox analysis, the adverse prognostic impact of +1q was most evident beyond 24 months from diagnosis (HR 2.89, 95% CI 1.64-5.09, p < 0.001), whereas non-1q HR lesions were not independently prognostic. These findings suggest that +1q identifies a biologically distinct AL amyloidosis subset characterized by plasma cell-dominant features and inferior long-term disease control. In contrast, other MM-defined HR cytogenetic abnormalities appear to have limited prognostic relevance in AL amyloidosis.