Anne Arundel Medical Center

The purpose of this study was to evaluate the incidence of new-onset anxiety and depression (NOAD) in younger patients undergoing common sports medicine procedures, determine risk factors associated with NOAD, and identify which treatments are used. A retrospective review of the PearlDiver national database was done. All patients included had no diagnosis of depression or anxiety before undergoing the following surgical procedures: anterior cruciate ligament reconstruction (ACLR), meniscus repair, hip arthroscopy (HA), shoulder instability repair, rotator cuff repair, or Achilles tendon repair. All patients were 25 years or younger and had ≥1-year follow-up. The primary outcome was development of NOAD within 1 year postoperatively. Multivariate regression was used to assess risk factors for NOAD. A total of 178,759 patients were included in this study. Overall, 8,900 (5.0%) of patients developed NOAD within 1 year postoperatively; HA patients had the highest rate of NOAD (8.43%). Logistic regression identified age (P < 0.001), female sex (P < 0.001), Charlson Comorbidity Index score (P < 0.001), alcohol disorders (P < 0.001), headaches/migraines (P < 0.001), obesity (P < 0.001), and tobacco use (P < 0.001) as predictors of NOAD. Compared with ALCR, HA patients (OR, 1.81; P < 0.001) had the greatest risk of developing NOAD. The incidence of NOAD in the first year after common sports medicine procedures was 5% for patients aged 25 years or younger. Increased age, substance use, comorbidities, and HA were identified as risk factors for NOAD. Additional study of both mental health and functional outcomes, prevention, and treatment strategies is required to elucidate the risk of NOAD.

BackgroundBioZorb (Hologic, Inc) is an implantable fiducial marker used in breast-conserving surgery. Since the US Food and Drug Administration (FDA) approved BioZorb in 2012, numerous adverse effects have been reported, prompting the FDA to issue a warning about potential risks on February 27, 2024. BioZorb was subsequently recalled, and on October 25, 2024, the FDA classified the recall as a Class 1, the most serious category, because of the risk of severe injury or death associated with the device. Limited research is available on the management of BioZorb-related complications.MethodsIn a retrospective medical records review of 296 patients who had BioZorb placed and had more than 30 days of follow-up in the electronic medical record, we identified the patients who were treated for BioZorb complications from January 2012 to February 2025.ResultsWith an average follow-up of 38.4 months, 13 patients (4%) experienced device-related complications, identified at a median of 6.2 months. Most affected patients had multiple complications, with the most common being chronic pain (54%), surgical site infection (39%), and wound dehiscence (31%). BioZorb was removed in 62% of patients; the remainder of the patients were managed nonoperatively.ConclusionWe identified several complications associated with the use of BioZorb in our patient population, and most of the patients who experienced complications required device removal. Because complications can develop many years after the initial surgery, surgeons should be aware of the existence of complications and the varied presentations. To our knowledge, this study is the first report on the management of BioZorb complications and subsequent outcomes, providing valuable insights for surgeons.

Background: Patients with type 2 diabetes mellitus (T2DM) and inflammatory bowel disease (IBD) face elevated risk of hepatobiliary complications. The biliary safety of GLP-1 and dual GLP-1/GIP receptor agonists in this population is uncertain. Methods: We conducted a retrospective cohort study using the TrinetX LIVE global health research network. Adults (≥18 years) with coexisting T2DM and IBD were assigned to exposure (semaglutide or tirzepatide) or comparator (no GLP-1/GIP therapy) cohorts. The index was first prescription (or matched date). Primary outcomes—cholelithiasis, cholecystitis, choledocholithiasis, and cholangitis—were identified by ICD-10 codes. Propensity score matching (1:1 greedy nearest neighbor; caliper 0.1 SD) balanced demographics, comorbidities, GI surgeries, and antidiabetic medications. Results: After propensity score matching, 32,052 patients were included (16,026 per cohort), achieving excellent covariate balance with standardized mean differences < 0.1 for nearly all variables. GLP-1/GIP agonist use was associated with significantly lower risks of multiple biliary complications. Cholelithiasis occurred in 3.5% of GLP-1/GIP users compared with 6.3% of nonusers (risk ratio [RR] 1.81, 95% CI 1.64–2.00; hazard ratio [HR] 1.27, 95% CI 1.14–1.41; p < 0.001). Cholecystitis similarly occurred less frequently among users (0.8% vs. 2.2%; RR 2.74, 95% CI 2.24–3.34; HR 1.85, 95% CI 1.50–2.27; p < 0.001). Choledocholithiasis was also reduced in the GLP-1/GIP cohort (0.6% vs. 1.5%; RR 2.72, 95% CI 2.14–3.46; HR 1.90, 95% CI 1.48–2.44; p < 0.001). Cholangitis events were rare in both groups (0.1% vs. 0.2%) with no significant difference on survival analysis (HR 1.07, 95% CI 0.58–1.97; p = 0.08). Conclusions: In adults with T2DM and IBD, GLP-1 and dual GLP-1/GIP receptor agonists are associated with substantially reduced risks of gallstone-related complications. These real-world data support the gastrointestinal safety of GLP-1–based therapy in a high-risk population and suggest possible biliary protective effects warranting prospective, agent-specific studies.

As survival rates for lymphoid malignancies continue to improve, understanding the late effects after treatment, such as secondary myeloid neoplasms (sMN), is increasingly critical for survivorship. This large-scale population-based (SEER-Medicare) study investigated the risk factors and cumulative incidence of sMNs in patients with diagnosis of diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), and multiple myeloma between 2000 and 2011, with follow-up through 2015. Patients with FL had a continuous increase in the cumulative incidence of sMNs with longer follow-up, whereas incidence of patients with multiple myeloma plateaued after 60 months. Notably, patients with DLBCL diagnosed in more recent years (2004–2007 and 2008–2011) had a higher cumulative sMN incidence compared with those diagnosed earlier (2000–2003). In the Medicare population, older age at diagnosis was associated with significant increase in sMN risk in patients with DLBCL and FL. Chemotherapy exposure or G-CSF exposure significantly increased sMN risk across all three malignancies. Chronic autoimmune conditions increased sMN risk in patients with DLBCL. These findings provide crucial insights into sMN risk factors. Chemotherapy exposure is a recognized risk factor, and comorbidities such as a history of autoimmunity and G-CSF exposures have been identified as additional mediators of sMN risk in our study.Significance:Our study reveals population-level risk factors for sMNs, including novel links to autoimmune disease and G-CSF, in addition to known causes like chemotherapy/radiation. These findings underscore the complex pathogenesis of sMNs and the need for molecular data in prospective studies to guide prevention, detection, and survivorship care.

We present a case of pulmonary hypertension (PH) and right heart failure in a 66-year-old female patient with longstanding neurofibromatosis Type I (NF1) since 1973 and sarcoidosis since 2009. She had a history of breast cancer 30 years ago, which was treated with left mastectomy followed by chemotherapy, and she has remained in remission thereafter. We detail her clinical presentation, diagnostic evaluation, and therapeutic course, highlighting the diagnostic challenges posed by multifactorial PH and the implications for targeted management.