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Objective: This study aims to analyze health determinants affecting patients with cleft palate, specifically examining the relationships between the Social Vulnerability Index (SVI), failure to thrive (FTT), and healthcare utilization within the initial 30 days and first year of life., Methods: A retrospective analysis was conducted on patients with a cleft palate at a tertiary care center over an 11-year period. Data included demographics, weight percentile trends, pediatric emergency department (PED) visits, hospital admissions, SVI scores, cleft palate type, and FTT diagnoses. Statistical analyses were performed using SPSS., Results: Social Vulnerability Index was not significantly correlated with health outcomes in cleft palate. Patients with FTT exhibited lower gestational age ( P  = .002) and birth ( P  = .005), one-month ( P  = .001), and one-year ( P  = .001) weight percentiles. FTT diagnosis was associated with increased PED visits ( P  = .000) and hospital admission ( P  = .000) in the first year of life. Early presentation to the PED was associated with increased PED visits ( P  = .000) and hospital admissions ( P  = .004) within the first year of life., Conclusion: No direct link was found between SVI and FTT. Early hospital readmission emerged as a significant outcome, indicating increased healthcare utilization in patients that require early medical intervention. Failure to thrive significantly impacted healthcare utilization, emphasizing the importance of addressing feeding issues early in this patient population. This study contributes to understanding health disparities in cleft palate patients and highlights the need for nuanced exploration of regional factors influencing outcomes., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Prior studies have linked the timing of craniosynostosis surgeries to several postoperative outcomes. However, less is known regarding the influence of sociodemographic factors on surgical timing for this population. This study investigates the influence of social vulnerability index (SVI), race, and urbanicity on the timing of craniosynostosis surgery., Retrospective data from 2013 to 2023 were queried from Cosmos, a national deidentified database from Epic electronic health record. Patients were stratified into sociodemographic cohorts, and chi-square tests were used to compare the proportion of each cohort undergoing craniosynostosis surgeries before and after 6 months of age., More than 3000 patients were identified for each predetermined metric for sociodemographic analysis (SVI n = 3369, race n = 3541, urbanicity n = 3375). The proportion of patients undergoing surgery at 5 months or less decreased and those undergoing any surgery at 6 months or more increased ( P  < .0001) with increasing SVI. There was also a significant association of surgical timing and patient race ( P  < .0001) but not urbanicity., SVI and patient race are associated with the timing of craniosynostosis surgery. Specifically, higher social vulnerability and certain racial groups are correlated with delayed surgical intervention. This delay in presentation may result in the inability to take advantage of more minimally invasive options, such as strip craniectomy with or without cranial spring placement. These findings highlight the need for targeted, patient-specific, interventions to address disparities in access to timely craniosynostosis surgery., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Melanoma is an aggressive malignancy accounting for approximately 1% of all skin cancers. The standard of care for distant melanoma of the skin is immunotherapy with PD-1 inhibitors (nivolumab) or CTLA-4 inhibitors. In March 2022, the FDA approved the combination of nivolumab with relatlimab, a lymphocyte-activation gene 3 antibody. There are few reports on the efficacy of treating widespread multivisceral metastatic melanoma with nivolumab plus relatlimab with a complete clinical response. We describe the diagnosis and management of a patient with metastatic nodular melanoma treated with palliative resection of the primary tumor followed by immunotherapy with nivolumab and relatlimab. Four months after his first treatment, he had no evidence of disease on PET scan. He continued to show no evidence of disease at recent follow-up. Treatment of metastatic melanoma of the skin with nivolumab and relatlimab is an effective approach showing greater benefit to patients than nivolumab alone., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.