DAVID R. HOLMES JR., M.D.

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This study looked at how a specific virus, called rAAV9, can be used to label cells in adult mice after being delivered through their veins. Researchers found that, over six months, they could reliably see marked activity in various cell types beyond just blood vessels, with particular labeling in 25 different targets. This is important because it can help improve ways to deliver genes throughout the body for treating diseases. Who this helps: This benefits researchers and doctors working on gene therapy.

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This study looked at how moderate or severe leaking of the heart's mitral and tricuspid valves affects survival rates in patients after they had a transcatheter aortic valve replacement (TAVR). It found that after one year, patients with moderate to severe tricuspid regurgitation (leaking) faced a higher risk of dying, with a mortality rate of 26.7% compared to 13.2% for those with mild or no leaking. After five years, the rates were 68.3% for those with severe tricuspid regurgitation versus 48.7% for those without, highlighting that severe tricuspid regurgitation significantly affects long-term survival. Who this helps: This research benefits patients with heart valve issues, especially those undergoing TAVR, as well as their doctors in assessing risks before surgery.

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This study examined how to better select patients with atrial fibrillation for a procedure called left atrial appendage occlusion (LAAO) instead of long-term blood thinner medications. Researchers analyzed data from over 744,000 patients and found that while LAAO did not show significant benefits compared to blood thinners in the first year, it did provide a lower risk of serious complications after two years. Specifically, 30.1% of patients were identified as likely to benefit from LAAO after two years, with 69.7% seeing no clear advantage and 1.4% potentially experiencing harm. Who this helps: This research helps doctors make more informed decisions about which patients should consider LAAO for their atrial fibrillation treatment.

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This study looked at the effectiveness of a specific pain management technique called the erector spinae plane block (ESPB) using a medication called liposomal bupivacaine in women who had cesarean deliveries. Researchers found that while the use of ESPB did not significantly lower the amount of opioid pain medication taken in the first two days after surgery (12.5 mg versus 25.0 mg), patients who received ESPB reported less pain compared to those who did not. This finding is important because it suggests that while ESPB may not reduce opioid use, it could lead to a more comfortable recovery for the patients. Who this helps: This helps postpartum women recovering from cesarean deliveries.

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This study looked at how doctors can best monitor patients after a procedure called left atrial appendage closure (LAAC), which helps people with a heart condition called atrial fibrillation. Researchers found that while complications from the procedure are getting less common, some still happen and can affect patient outcomes, so follow-up imaging is essential. They reviewed different imaging techniques to recommend a combined approach for monitoring patients from immediately after the procedure and into the long term. Who this helps: This benefits patients undergoing LAAC and their doctors by improving long-term care and outcomes.

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This study looked at how older adults in Hawaii fare in terms of maintaining their abilities when living at home versus in community care foster homes and nursing facilities. It found that over eight years, older adults living at home had much slower declines in their functional abilities compared to those in foster homes and nursing homes. Specifically, home residents showed stable functional status, while those in nursing homes experienced the most significant decline. Who this helps: This research benefits older adults and their families when choosing care options.

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This study looked at the long-term effects of a procedure called left atrial appendage occlusion (LAAO), which helps prevent strokes in older patients with a type of irregular heartbeat known as atrial fibrillation. Researchers analyzed data from nearly 35,000 Medicare patients over an average follow-up period of about 2.8 years and found that the overall stroke rate was low at 1.57 strokes per 100 person-years, with 1.70% at one year and 5.70% at five years. However, there was a high mortality rate, with about 44% of patients having died within five years, highlighting the need to consider patients' preferences when deciding on this treatment. Who this helps: This research benefits older patients with atrial fibrillation and their doctors as they weigh treatment options.

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This study looked at how different ways of splinting the foot and ankle can affect pressure on the heel, which can lead to injuries. They tested different padding thicknesses and positions for the heel and found that keeping the heel elevated on a pillow while using 8 or 10 layers of padding significantly reduced pressure, bringing it below a harmful level of 32 mm Hg. Properly applying the padding is crucial since poorly arranged padding can increase pressure up to three times. Who this helps: This benefits patients with foot and ankle injuries who are using splints.

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The study looked at how often children in the U.S. are diagnosed with cancer and how many die from it between 1973 and 2014. Researchers found that about 92,594 kids were diagnosed with cancer, with white children diagnosed at a higher rate (16.4%) compared to black children (12.4%). Also, boys were 16% more likely to die from cancer than girls, and black children had a 37% higher risk of dying from it compared to white children. This research highlights the growing issue of pediatric cancer and the unequal outcomes based on race and gender, which needs attention for better treatment and support. Who this helps: This information benefits children with cancer, their families, and healthcare providers.

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This study looked at how new medical devices for heart disease are developed and approved in the U.S. It found that many devices that start their development in the U.S. are often tested and approved in other countries before coming back to the U.S. for use. The research highlights the importance of various initiatives, like Early Feasibility Studies and the Breakthrough Devices Program, which aim to speed up the process of getting safe and effective devices to patients. Who this helps: This helps patients with heart disease by providing quicker access to innovative treatments.

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This study looked at how coronary artery spasms and problems with blood vessel function might cause heart attacks in people whose arteries aren’t blocked, a condition known as MINOCA. Researchers found that these issues may be responsible for over half of MINOCA cases and play a significant role in long-term chest pain. Understanding this helps doctors better diagnose and treat patients, improving their care and outcomes. Who this helps: This helps patients who experience unexplained chest pain or have had heart attacks without blocked arteries.

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This study looked at the costs of different treatments for reducing stroke risk in patients with a type of irregular heartbeat called atrial fibrillation. The researchers found that after 10 years, using a device to close off part of the heart (LAAC) costs $48,337, which is cheaper than both blood thinners called NOACs and warfarin, which cost $81,198 and $52,359 respectively. This matters because LAAC not only saves money over time, but also has lower costs for patients compared to blood thinners, which can lead to unexpected expenses from complications. Who this helps: This benefits patients with atrial fibrillation and their doctors in making cost-effective treatment decisions.

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This study looked at the differences in infant mortality rates between Black children and white children in the U.S. from 1968 to 2015, focusing on deaths linked to medical errors and car accidents. The findings showed that Black children are more than twice as likely to die from medical mistakes (37% higher from 1999 to 2015 compared to earlier years) and have higher rates of mortality due to vehicle accidents, with a 17% excess death risk over white children. Addressing these disparities is crucial to improving health outcomes for Black children. Who this helps: This helps Black children and their families by highlighting the need for better healthcare and safety measures.

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This study looked at how boosting a molecule called NAD could help reduce inflammation caused by a protein known as IL-13, which is linked to allergies, Parkinson's disease, and cancer. The research found that increasing NAD levels might lower inflammation connected to IL-13, offering potential benefits for health conditions related to inflammation. This is important because managing inflammation can improve outcomes for patients with various diseases. Who this helps: This helps patients with allergies, Parkinson's disease, and cancer.

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This study looked at patients with severe aortic stenosis (AS) who had a condition called atrial fibrillation (AF) compared to those with a regular heartbeat (sinus rhythm) and how it affected their treatment and outcomes after a procedure called transcatheter aortic valve replacement (TAVR). It found that patients with AF had higher calcium scores in their aortic valves (2,850 for men and 1,942 for women) and lower mean gradients in heart function tests, leading to delays in treatment and shorter survival rates after the procedure (3.2 years for AF patients compared to 5.4 years for those with sinus rhythm). This matters because it highlights that AF patients often have more advanced heart issues that can lead to worse outcomes if not recognized early. Who this helps: This helps patients with atrial fibrillation and their doctors by improving understanding of their treatment needs.

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Researchers developed a new antibiotic called lolamicin that specifically targets harmful Gram-negative bacteria, which are known to cause serious infections. In lab tests, lolamicin effectively killed over 130 types of drug-resistant bacteria and worked well in mouse models for pneumonia and severe infections without harming the beneficial bacteria in the gut. This is important because it helps prevent secondary infections, like those from Clostridioides difficile, which can occur when the gut microbiome is disrupted. Who this helps: This benefits patients with infections while preserving their gut health.

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This study looked at the types of germs living in the breathing systems of healthy horses, comparing samples taken from different parts of their respiratory tracts. Researchers found a wide variety of microbes, identifying over 1,700 different types, but the specific groups of germs were mostly similar across different regions of the lungs, suggesting that a simple lung sampling method could be effective for future research. This is important because understanding these microbial communities could help in diagnosing and treating respiratory diseases in horses. Who this helps: This helps veterinarians and horse owners.

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This study looked at the impact of exclusively breastfeeding infants for the first six months on the risk of dental issues, like toothaches and cavities, in young children. Out of nearly 25,000 children, about 9.7% experienced dental problems, and while children who were exclusively breastfed for six months had a 28% lower chance of facing these issues compared to those who weren't breastfed, this difference disappeared when considering other factors like the mother's health and race. The research highlights that a mother’s health and background are crucial in determining a child's dental health, suggesting that tackling these issues could lead to better oral health in children. Who this helps: This benefits parents and healthcare providers focusing on pediatric health.

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This study looked at how race and gender affect the occurrence and risk of a rare type of thyroid cancer in children that happens after another cancer, known as second primary thyroid malignancy (SPTM). Researchers found that from 1973 to 2014, there were 3,457 pediatric thyroid cancer cases, with SPTM making up about 3% (or 99 cases). They discovered that Black children were 60% less likely to develop SPTM compared to white children, and girls were 63% less likely than boys to be diagnosed with this condition. Who this helps: This research helps doctors understand the risks of thyroid cancer in children, which can improve screening and treatment plans.

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This study looked at the outcomes of a heart procedure called left atrial appendage occlusion (LAAO) in over 3,000 patients in China to see how different methods of performing the procedure and the use of blood thinners influenced results after one year. They found that only 4.5% of patients experienced serious issues like death or stroke, and combining LAAO with another treatment reduced these serious events to 3.5%, compared to 5.2% for LAAO alone. These findings show that LAAO is a safe option for patients and that combining it with other treatments can further lower risks. Who this helps: This research helps patients with atrial fibrillation and their doctors in choosing effective treatment options.

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This study looked at pediatric renal cell carcinoma (pRCC), a rare and aggressive kidney cancer in children, and found that Black or African American children with this cancer have significantly lower survival rates compared to white children. Specifically, Black or African American children were nearly three times more likely to die from pRCC than their white counterparts (with a hazard ratio of 2.90) and faced even higher risks in urban areas. These findings highlight the impact of race and living environment on survival rates, suggesting that social and economic factors play a critical role in health outcomes for these children. Who this helps: This research helps patients, families, and healthcare providers by highlighting the urgent need to address health disparities in pediatric cancer care.

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This study compared the results of two treatments for a specific type of ankle fracture known as Weber B fractures. It found that patients who did not have surgery (29 patients) had better outcomes in several areas, such as overall function and pain management, compared to those who had surgery (20 patients) at an average follow-up of about 6.8 years. For example, nonoperative patients scored an average of 75 on a function scale, while surgery patients scored 68. This is important because it suggests that many patients might do better and face fewer risks if they are treated without surgery. Who this helps: Patients with isolated Weber B ankle fractures.

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This study examined the effects of atrial fibrillation (AF) on patients hospitalized for non-traumatic brain hemorrhage. Out of nearly 293,000 hospitalizations, about 20% had AF and these patients faced higher risks, including a 2.34 times greater chance of dying in the hospital and more complications like respiratory failure and heart issues. Understanding these risks is crucial for improving care and outcomes for patients with both conditions. Who this helps: This helps patients with atrial fibrillation and their doctors in managing treatment and hospitalization strategies.

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This study followed patients who needed heart procedures over ten years to identify what factors affect survival rates. It found that people with conditions like diabetes and a higher waist size, as well as those who smoke or have chronic illnesses, had a higher risk of dying within a decade. On the other hand, patients who received thorough medical therapy, used statins, or had certain types of heart surgery had better survival rates. Who this helps: This benefits heart disease patients and their doctors by providing insights for better treatment options.

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This study looked at how well a machine learning model can predict ischemic stroke (IS) risk in patients who have undergone a procedure called percutaneous coronary intervention (PCI). Researchers analyzed data from over 17,000 patients and found that about 1.5% experienced a stroke within five years after the procedure. The machine learning model was better at predicting these strokes compared to a traditional statistical method, especially for those at higher risk, such as patients who had a stroke during the procedure. Who this helps: This research benefits doctors and hospitals as they can better identify patients at risk for stroke post-PCI and take steps to prevent it.

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This study examined the lateral talar subluxation (LTS) measurements in patients with a specific type of ankle fracture (Weber B) who were treated without surgery. Out of 42 patients, 83% had LTS measurements of 4 mm or less, and despite using 4 mm as a cutoff to determine surgical need, the researchers found no significant differences in recovery outcomes based on different LTS measurements. This matters because it suggests that the 4 mm guideline might not be reliable for deciding whether surgery is necessary for these fractures. Who this helps: This helps patients with Weber B ankle fractures and their doctors in understanding treatment options.

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This study looked at how a type of crustacean reacts at the genetic level when exposed to a fungal infection. Researchers found that the number of genes that changed their activity increased over time in the infected crustaceans, with many of these genes related to immune responses and protection. Understanding these immune responses is important because it helps us learn more about how diseases spread among invertebrate populations. Who this helps: This helps researchers and ecologists studying disease in marine life.

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This study looked at how well people can return to sports after undergoing a specific foot surgery called first metatarsophalangeal arthrodesis, which is done to relieve pain and correct deformities in the big toe. Out of 450 patients reviewed, about 34% were able to score an average of 70.4 on a sport ability test about two and a half years after surgery. The findings showed significant variation in how patients returned to sports; most reported being able to participate in activities like running and hiking without much difficulty, while a small number found it harder. Who this helps: This helps patients recovering from foot surgery and their doctors understand what to expect regarding sports participation.

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This study looked at how well young adults (ages 18-30) recover from Achilles tendon ruptures when treated either with surgery or without surgery. The researchers found that both groups had similar outcomes: rerupture rates were 3% for those who had surgery and 2.7% for those who didn't, and rates of blood clots were also similar (around 6% for surgery and 5.4% for non-surgery). This is important because it shows that young adults can safely choose either treatment option without significant differences in recovery outcomes. Who this helps: Young adults with Achilles tendon ruptures and their doctors.

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This study looked at whether dual antiplatelet therapy (DAPT) is as safe as traditional blood thinners (like warfarin or direct oral anticoagulants) for patients who had a procedure to reduce stroke risk from atrial fibrillation. Researchers analyzed data from over 49,000 patients and found that the rates of serious complications like death, stroke, and major bleeding were very similar among those using DAPT and those using blood thinners. This is important because it suggests that DAPT can be a viable option for patients who may be at risk for bleeding complications. Who this helps: This helps patients with atrial fibrillation at risk of bleeding who need alternatives to traditional blood thinners.

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This study looked at how often blood clots (called device-related thrombus or DRT) occur after a procedure to close off a part of the heart called the left atrial appendage. Researchers found that of the 214 patients studied, 28.5% had their blood clots remain or come back, and larger initial blood clot sizes were linked to a higher chance of this happening. This is important because patients with persistent or recurring DRT faced a 2-fold higher risk of serious complications like strokes. Who this helps: Patients who have undergone left atrial appendage closure procedures.

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This study looked at a surgical procedure called plantar condylectomy combined with the imbrication of the plantar plate to address foot pain and instability in patients with mild toe joint injuries. Out of 22 patients, those who had this surgery showed a slight improvement in their physical function scores from an average of 40.5 to 44.5 and a reduction in pain interference from 62.5 to 56 over an average follow-up of 13 months. These findings matter because they indicate that this surgical approach may provide a helpful option for individuals suffering from this specific type of foot problem. Who this helps: This helps patients experiencing metatarsalgia and toe joint instability.