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Background: After colorectal surgery, acute kidney injury (AKI) results from a complex interplay of multiple independent causes and preventive measures that occur during the hospitalization. Prophylactic stenting for ureter identification has been identified as a potential cause, but the evidence is conflicting, possibly because of differing baseline characteristics and procedure-related approaches. Objective: This retrospective cohort study assesses the role of stents in the etiology of AKI after determining the independent predictors of AKI. Methods: From a population of 1224 consecutive colorectal patients (from 8/1/2016 through 12/31/2021), 382 (31.2%) received ureteral stents, and propensity score matching was used to create stented and control groups. Emergent cases and patients with sepsis were excluded from the analysis. Previously identified independent predictors of AKI, minimally invasive procedures, and a history of diabetes mellitus were used as criteria to create two balanced groups. Results: Baseline demographic characteristics and procedure-related factors baseline factors were similar between the groups. There was no difference in the rate of AKI between stented patients and controls (P= 0.82), nor was there any difference in postoperative complications, such as chronic renal insufficiency (CRI, P= 0.49), average postoperative creatinine (P= 0.67), urinary tract infections (UTI, P= 0.82), any postoperative infection (P= 0.48), in-hospital complications (P= 1.00), length of stay (LOS, P= 0.15), and 30-day readmissions (P= 0.79). Conclusions: In a population of patients where stenting was frequently employed, ureter stents placed for identification did not appear to cause AKI or AKI-related complications. Graphical Abstract:

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Children with Down syndrome (DS) may experience changes in sleep architecture (i.e., different sleep stages) that then affect waketime functioning, including learning, mood, and disruptive behavior. For designing and testing interventions, it is important to document any differences in sleep architecture in children with DS with and without co‐occurring diagnoses, including neuropsychiatric diagnoses and obstructive sleep apnea (OSA). A retrospective cohort study was performed at Massachusetts General Hospital for children and adolescents with DS who underwent polysomnography (PSG) between August 2016 and July 2022. Patient data collected from the electronic medical record included diagnoses, age at PSG, and PSG report. Statistical analysis included unpaired T tests to test hypotheses about differences in sleep architecture within age groups, and differences between children with DS and a co‐occurring diagnosis. One way ANOVA was used to determine statistical significance of OSA severity within patients with DS. When compared by age group, those with DS had negative changes in sleep architecture (e.g., less sleep and more wake) when compared to normative data. Within this cohort, having a co‐occurring diagnosis of autism resulted in further, negative effects on sleep architecture. 89% of those with DS had diagnosed OSA but only those with severe OSA experienced negative effects on sleep architecture. Age is an important covariate when studying the sleep of children with DS and neurotypical children. Studies are needed to test whether minimizing the observed differences in sleep architecture will translate to improved learning, mood, and behavioral outcomes, and how treating OSA affects sleep architecture.

In the inpatient setting, dysphagia is a common, morbid, and costly condition. Antipsychotic medications in older patients have been associated with dysphagia. The purpose of this study was to determine if hospitalized patients who were exposed to antipsychotic medications had worse swallowing function than those who were not exposed. Retrospectively, all patients referred for swallowing difficulty who underwent a videofluoroscopic swallowing study during the course of their hospital care were considered eligible. We excluded patients younger than 50 years and those with a history of dysphagia, a medical cause for dysphagia, or chronic antipsychotic medication usage. Patients exposed to antipsychotics (n = 17) were matched at a 31 ratio to patients without exposure (n = 51) for age, comorbidity, and anticholinergic risk. Videofluoroscopic swallowing study was scored according to the Dysphagia Severity Rating Scale (range, 0-6; 6 = worst). Patients who were given antipsychotic medications scored significantly worse on the Dysphagia Severity Rating Scale compared with matched controls (4.1 ± 1.0 vs 3.0 ± 1.4; P< 0.01). Using the medication and dosage, the antipsychotic exposure was quantified by converting to chlorpromazine equivalency units. Higher doses of antipsychotic medication were associated with worse swallowing function (P= 0.04). Thus, the potential impact on swallow functions should be considered when prescribing antipsychotic medications in older patients.