Faculty Bibliography

Background: Cardiovascular (CV) procedures are a large driver of revenue for hospitals and CV practices. Hence, understanding trends in reimbursement is critical to their financial sustainability. The purpose of this study is to characterize trends in reimbursement for major commonly performed CV procedures.
Method(s): The physician fee schedule look-up tool provided by the Centers for Medicare & Medicaid Services was used to obtain reimbursement data on many CV procedures (see Table). Current procedural terminology codes were used to identify each of these procedures. Values were adjusted for inflation rate using the consumer price index relative to 2020. The relative change and linear trends were analyzed for each of the procedures and categories.
Result(s): When adjusting for inflation, reimbursement for all procedures has decreased since the procedures' initial evaluation. Percutaneous aortic valve replacement and paravalvular leak repair had the largest yearly relative change of -2.01% and -3.31%, respectively, whereas intra-aortic balloon placement and percutaneous septal defect repair (atrial and ventricular) had the highest overall relative change since their initial evaluation (-25.56% and =-24%, respectively). After adjusting for inflation, the largest significant change in reimbursement was seen in percutaneous aortic valve replacement (-$28.95, R2 = 0.619, p = 0.02), percutaneous mitral valve replacement (-$27.92, R2 = 0.937, p = 0.002), and left atrial appendage occlusion (-$16.58, R2 = 0.976, p = 0.012). [Formula presented]
Conclusion(s): Reimbursement for all major CV procedures has declined since their initial evaluation after adjustments were made for inflation. Recognition of these trends is important for health care providers and institutions to ensure the financial stability of their models of care. Categories: OTHER: Quality, Guidelines, Appropriateness Criteria, Cost-Effectiveness, and Public Health Issues
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Revolutionizing treatment strategies is an urgent clinical need in the fight against cancer. Recently the scientific community has recognized chromatin-associated proteins as promising therapeutic candidates. However, there is a need to develop more targeted epigenetic inhibitors with less toxicity. Sin3 family is one such target which consists of evolutionary conserved proteins with two paralogues Sin3A and Sin3B. Sin3A/B are global transcription regulators that provide a versatile platform for diverse chromatin-modifying activities. Sin3 proteins regulate key cellular functions that include cell cycle, proliferation, and differentiation, and have recently been implicated in cancer pathogenesis. In this chapter, we summarize the key concepts of Sin3 biology and elaborate the recent advancements in the role of Sin3 proteins in cancer with specific examples in multiple endocrine neoplasia type 2, pancreatic ductal adenocarcinoma, and triple negative breast cancer. Finally, a program to create an integrative approach for screening antitumor agents that target chromatin-associated factors like Sin3 is presented.

Mouse erythroleukemia (MEL) cell erythroid differentiation induced by dimethyl sulfoxide or hexamethylene bisacetamide (HMBA) is accompanied by the production of hemoglobin, terminal cell division and decreases in lactate production and fructose 2,6-bisphosphate levels. A number of studies have suggested that decreases in the cellular level of protein phosphotyrosine content may play a role in MEL cell differentiation. In particular, it was shown that the expression of several protein tyrosine phosphatase genes accompany this process and that the transfection of one of these genes into MEL cells followed by its subsequent expression induced eythroid differentiation. However, none of the physiological substrates for these protein tyrosine phosphatases have been identified. It is shown here that MEL cell differentiation is accompanied by decreases in tyrosine phosphorylation of Vav and possibly of the erythropoietin receptor (EpoR). Immunoprecipitation of the EpoR and analysis of co-precipitated proteins, indicates that the EpoR associates with Vav, STAT5 and an unidentified 60 Kd protein, . HMBA-induced erythroid differentiation abrogates these associations. The phosphatase inhibitors, Na3VO4 and levamisole, inhibit HMBA-induced differentiation as well as the association of the EpoR with Vav, STAT5 and the 60 Kd protein. This is of interest since Na3VO4, at the concentrations used here, has been shown to be a potent inhibitor of the activity of protein tyrosine phosphatases. These results suggest that levamisole, at least indirectly, acts by a molecular mechanism similar to that of Na3VO4 and that the loss of the association of the EpoR with Vav, STAT5, and and/or the reduction in the level of tyrosine phosphorylation of these proteins may play a role in MEL cell differentiation

After decades of decline, tuberculosis has emerged as a global health challenge. In the setting of HIV immunocompromise, TB occurs frequently, early, and often atypically. New infections can take an accelerated course. The usual tests for diagnosing Mycobacterium tuberculosis infection are less sensitive when CD4+ counts are low. Increased prevalence of treatment failure, drug-resistant strains, and nosocomial transmission of multidrug-resistant TB are discussed as are new diagnostic tests that will accelerate the time to diagnosis and allow better epidemiologic tracking. Early recognition, isolation, appropriate therapy, and environmental controls that will protect staff and patients from the risk of exposure are also described