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Alosaimi A, Algarni A, Alharbi A, Alotaibi A, Alomairi A, Alsurayhi M, Alharbi W. Comparative efficacy of minoxidil alone versus minoxidil combined with low-level laser therapy in the treatment of androgenic alopecia: a systematic review and meta-analysis. J DERMATOL TREAT 2025; 36:2447355. [PMID: 39828269 DOI: 10.1080/09546634.2024.2447355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2024] [Accepted: 12/20/2024] [Indexed: 01/22/2025]
Abstract
OBJECTIVE This systematic review evaluates the efficacy of minoxidil alone versus minoxidil with low-level laser therapy (LLLT) for androgenic alopecia. STUDY DESIGN systematic review and meta-analysis. METHODS An online search of PubMed, Web of Science, and MEDLINE was conducted. Randomized clinical trials comparing minoxidil monotherapy with minoxidil and LLLT combination therapy were included based on predefined criteria. The Risk of Bias 2.0 (RoB 2.0) tool was used for quality assessment. RESULTS From 38 identified studies, 34 remained after excluding 4 duplicates. Further exclusions left 4 eligible studies comparing minoxidil alone with minoxidil and LLLT. The meta-analysis found no statistically significant differences in hair counts between the two groups at baseline, 12 weeks, and 8 weeks post-treatment [mean difference = -0.04, 95% CI -1.22 to 1.14, p = .95, I² = 0%]. Similarly, hair diameter showed no significant differences at the same time points [mean difference = 0.00, 95% CI -0.00 to 0.00, p = .98, I² = 38%]. CONCLUSION The combination of minoxidil and LLLT does not significantly improve outcomes compared to minoxidil alone for treating androgenic alopecia.
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Affiliation(s)
- Abdulmajeed Alosaimi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | | | - Abdulrahman Alharbi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdulmalik Alotaibi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdullah Alomairi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | | | - Waleed Alharbi
- Dermatology Department, King Fahad Hospital Jeddah, Jeddah, Saudi Arabia
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Hayes E, Mai E, Uflacker A, Freidin N. Challenges encountered to creating a renal biopsy program at a tertiary care academic institution in the United States. Ren Fail 2025; 47:2449576. [PMID: 39819352 PMCID: PMC11748854 DOI: 10.1080/0886022x.2024.2449576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Accepted: 12/30/2024] [Indexed: 01/19/2025] Open
Abstract
Biopsy is the gold standard for diagnosing renal pathology and the procedure is required to be learned per ACGME guidelines for Nephrology Fellowship graduation. We describe the process for the planning and development of a new Nephrologist directed native renal biopsy program to increase the opportunity to train Nephrology fellows in this procedure. The article outlines the barriers, complications and lessons learned to developing the program, highlighting the key challenges and progress that has been made within a single American tertiary academic medical center.
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Affiliation(s)
- Eily Hayes
- Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA
| | - Erik Mai
- Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA
| | - Andre Uflacker
- Vascular and Interventional Radiology, Savannah Vascular Institute, Savannah, GA, USA
| | - Natalie Freidin
- Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA
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Ouyang L, Pan Y, Wu YF, Tang Q, Wang DF, Lou N. Early and high-volume administration of sodium bicarbonate in sepsis-associated acute kidney injury in patients with malignancies, during continuous renal replacement therapy. Ren Fail 2025; 47:2443026. [PMID: 39806784 PMCID: PMC11734398 DOI: 10.1080/0886022x.2024.2443026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Revised: 12/06/2024] [Accepted: 12/11/2024] [Indexed: 01/16/2025] Open
Abstract
INTRODUCTION Sepsis is an uncontrolled systemic response to infection that leads to life-threatening organ dysfunction. The in-hospital mortality rate remains significantly high in septic shock patients with malignancies. This study investigates whether early and high-volume administration of sodium bicarbonate during continuous renal replacement therapy (CRRT) can reduce 28-day mortality, increase shock reversal rates, and shorten the duration of CRRT, mechanical ventilation, and intensive care unit (ICU) stays. The goal is to provide valuable clinical data for the management of cancer patients with sepsis-associated acute kidney injury (SAKI). MATERIALS AND METHODS A retrospective study was performed on 88 patients who were admitted to the ICU and received continuous renal replacement therapy (CRRT) for acute renal failure secondary to sepsis at the Cancer Center of Sun Yat-sen University from March 2010 to October 2021. Based on the initiation time of CRRT and the volume of sodium bicarbonate infusion, patients were divided into four groups: the early high-volume group, early low-volume group, late high-volume group, and late low-volume group. RESULTS The results of this study showed that in the 28-day mortality model, established using the Cox proportional hazards method, early CRRT (HR 0.473; 95% CI 0.245-0.915, p = 0.026) and high-volume sodium bicarbonate infusion (HR 0.173; 95% CI 0.078-0.383, p < 0.001) were identified as two independent protective factors. The 28-day mortality rate in the early high-volume group (15.0%) was significantly lower than that of the other three groups (60.0%, 30.0%, and 75.0%, respectively; χ2 = 23.822, p < 0.001). Additionally, the shock reversal rate in the early high-volume group (80.0%) was significantly higher compared to the other groups (35.0%, 45.0%, and 35.7%; χ2 =13.576, p = 0.004). The duration of CRRT was shorter in the early high-volume group (35.0 ± 4.45 h) than in the other groups (70.0 ± 30.19 h, 48.0 ± 5.22 h, and 72.0 ± 19.84 h; χ2 =11.278, p = 0.01). Furthermore, the duration of mechanical ventilation (7.0 ± 3.33 days) was lower in the early high-volume group compared to the other groups (8.0 ± 1.12 days,10.0 ± 1.11 days, and 8.0 ± 2.65 days; χ2 =8.064, p = 0.045), as was the length of ICU stay (7.0 ± 0.89 days) compared to the other groups (13.0 ± 3.35 days, 10.0 ± 1.49 days, and10.0 ± 3.70 days; χ2 = 9.184, p = 0.027). CONCLUSION Early and high-volume administration of sodium bicarbonate during CRRT may reduce 28-day mortality and improve shock reversal rates in patients with sepsis-associated acute kidney injury complicated by malignancy. Prospective randomized controlled large sample studies are needed to confirm this.
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Affiliation(s)
- Lamei Ouyang
- Department of Critical Care Medicine, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R, China
- The Affiliated Guangdong Second Provincial General Hospital of Jinan University China, Guangzhou, P. R. China
| | - Yin Pan
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Ya-Fei Wu
- Department of Critical Care Medicine, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R, China
- Department of Emergency, The First Affiliated Hospital of Ningbo University, Ningbo, P. R. China
| | - Qiang Tang
- Department of Critical Care Medicine, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R, China
| | - Dao-Feng Wang
- Department of Critical Care Medicine, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R, China
| | - Ning Lou
- Department of Critical Care Medicine, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R, China
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Tisseghem E, Fleer J, Horlait M, Pype P, Lauwerier E. From trainee to general practitioner: A qualitative study of transition experiences of Flemish GP trainees. Eur J Gen Pract 2025; 31:2443603. [PMID: 39772933 PMCID: PMC11722024 DOI: 10.1080/13814788.2024.2443603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 11/26/2024] [Accepted: 12/12/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND The transition from trainee to professional marks a key milestone in a family doctor's career, bringing both emotional and mental challenges. This critical period of specialisation shapes how young doctors adapt and influences their future career choices. OBJECTIVES We explored trainees' experiences during their first year of advanced medical training in family medicine/general practice, including barriers and facilitators. METHODS Using qualitative methodology, we conducted ten focus group interviews with 111 trainees. These group interviews were held as part of small-group sessions integrated into a self-guided reflection course. All interviews were held between February 2021 and March 2021, conducted online via MS Teams, recorded, and transcribed verbatim for analysis. FINDINGS Our analysis uncovered two adaptational processes during this transition period: personal adaptation and professional socialisation. We interpreted this as a complex balancing act, with impact on mental health aspects such as energy, exhaustion, and self-confidence. Multiple elements at different levels influenced these processes, including the workplace (e.g. interactions with colleagues and patients), the educational program (e.g. assignments, courses), and societal expectations (e.g. role expectations, support). CONCLUSION The findings highlight the importance of understanding both personal adaptation and professional socialisation to support trainees effectively during their transition into practice. Future studies should validate these findings and explore their evolution over time, particularly in relation to adaptation and career choices.
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Affiliation(s)
- Ellen Tisseghem
- Department of Public Health, Vrije Universiteit Brussel, Brussel, Belgium
| | - Joke Fleer
- Department of Health Sciences, Section Health Psychology, University Medical Centre Groningen, University of Groningen, The Netherlands
| | - Melissa Horlait
- Department of Public Health, Vrije Universiteit Brussel, Brussel, Belgium
| | - Peter Pype
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
- Interprofessional Collaboration in Education, Research and Practice (IPC-ERP), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Emelien Lauwerier
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
- Department of Experimental-Clinical and Health Psychology, Ghent University
- Department of Psychology, Open University, The Netherlands
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Reardon DC. Suicide risks associated with pregnancy outcomes: a national cross-sectional survey of American females 41-45 years of age. J Psychosom Obstet Gynaecol 2025; 46:2455086. [PMID: 39838528 DOI: 10.1080/0167482x.2025.2455086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 01/08/2025] [Accepted: 01/12/2025] [Indexed: 01/23/2025] Open
Abstract
OBJECTIVE Numerous studies have linked abortion to an elevated risk of suicide. One hypothesis is that this association is entirely incidental and most likely fully explained by preexisting mental illness. This hypothesis can be tested by examining women's own self-assessments of the degree, if any, that abortion and other pregnancy outcomes contributed to suicidal thoughts and behaviors. METHODS A topic blind survey was distributed to 2829 American females 41-45 years of age. Respondents were asked about any history of attempted suicide(s) and reproductive histories. Grouped by reproductive history, respondents were then asked to rank on visual analog scales the degree, if any, to which their pregnancy outcome contributed to suicidal thoughts, self-destructive behaviors, and any attempted suicides. RESULTS Aborting women were twice as likely to have attempted suicide compared to other women. Aborting women, especially those who underwent coerced or unwanted abortions, were significantly more likely to say their pregnancy outcomes directly contributed to suicidal thoughts and behaviors compared to women in all other groups. CONCLUSIONS The hypothesis that higher rates of suicide following abortion can be entirely explained by preexisting mental health problems is inconsistent with women's own self-assessments of the degree their abortions directly contributed to suicidal and self-destructive behaviors.
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Affiliation(s)
- David C Reardon
- Elliot Institute, Gulf Breeze, FL, USA
- Charlotte Lozier Institute, Arlington, VA, USA
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Dave U, Rubin J, Chang N, Bi AS, Atkins M, Gómez-Verdejo F, Verma NN, Chahla J. Patellar tendon repair restores extensor mechanism function with a low complication rate: A systematic review. J Orthop 2025; 66:146-153. [PMID: 39902150 PMCID: PMC11787557 DOI: 10.1016/j.jor.2025.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Revised: 01/05/2025] [Accepted: 01/14/2025] [Indexed: 02/05/2025] Open
Abstract
Introduction The patellar tendon plays a crucial role in knee extension and lower extremity mobility. Although PT ruptures are rare, they result in severe loss of function when untreated. The purpose of this study was to evaluate clinical and functional outcomes and complications following primary, acute patellar tendon (PT) repair. Methods In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, Embase, and Cochrane Library databases were searched in August 2024 for studies published after 2004. Studies were included if they met these criteria: evaluated patients who underwent acute PT repair with any technique including for mid-substance tear or avulsion, were prospective or retrospective studies, and reported functional outcomes or complications. Studies not written in English were excluded. Results The initial screen identified 1737 studies, 9 of which were included in this systematic review. There were three retrospective cohort studies, three retrospective case series, one retrospective case control study, and two prospective case series. Each study had low risk of bias. A total of 970 patients (93.8 % males) were included. Mean age across studies ranged from 32.1 to 44.6 years. Five included studies reported on mean extension at follow-up, ranging from 0 to 6.4 degrees of extension. Five included studies reported on mean flexion at follow-up, ranging from 128.5 to 143.3 degrees of flexion. The range of re-rupture and re-operation were 0-21.4 % with an overall re-rupture rate of 3.9 % and an overall re-operation rate of 5.7 %. Only one study reported a significant difference in re-rupture rates with transosseous repair versus suture anchor repair (7.5 % versus 0 % respectively). Other complications identified were venous thromboembolism (VTE) (0-5.0 %), stiffness (0-35.0 %), hardware discomfort (0-5.0 %), and infection (0-5.0 %). Conclusions Patellar tendon repair with both transosseous and suture anchor technique restores range of motion in patients post-operatively with a low complication rate. Decisions regarding operative technique should be tailored to individual patient characteristics and surgeon preferences. Level of evidence Level IV, systematic review of level III-IV studies.
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Affiliation(s)
- Udit Dave
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Jared Rubin
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Nicole Chang
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Andrew S. Bi
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Myles Atkins
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | | | - Nikhil N. Verma
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Jorge Chahla
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
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Kunugiza Y, Tsuji S, Fujito T, Tamaki M, Nishikawa M, Nomura K, Ishibashi T, Tomita T. Tenderness over the Pes anserinus and Gerdy's tubercle before and after total knee arthroplasty. J Orthop 2025; 62:133-138. [PMID: 39640364 PMCID: PMC11616626 DOI: 10.1016/j.jor.2024.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 10/23/2024] [Accepted: 10/25/2024] [Indexed: 12/07/2024] Open
Abstract
Objectives Several patients experience chronic pain after total knee arthroplasty (TKA), with the source of postoperative pain attributed to intra- and extra-articular factors. This study focused on the proximal tibia with either the Pes anserinus (PA) or around Gerdy's tubercle (GT) as the most common site of extra-articular pain. Methods This prospective study included 270 patients (360 knees) with advanced varus osteoarthritis (OA) of the knee scheduled for primary TKA and the patient population comprised 289 women and 71 men with a mean age of 74.7 ± 7.4 years. Operative procedure was performed by a single surgeon. This study investigated the prevalence of PA and GT tenderness over the knee before and after TKA and the association between this tenderness and several factors. Results Before TKA, 66.1 % of the patients experienced PA tenderness, whereas 33.1 % experienced GT tenderness. One year after TKA, 49.7 % of the patients experienced PA tenderness, whereas 19.7 % experienced GT tenderness. More than half of the postoperative symptoms in the extra-articular region remained from the preoperative period. Female sex and high body mass index were associated with preoperative and postoperative tenderness of the PA and postoperative tenderness of GT. Postoperative PA and GT tenderness is associated with lower Knee Scoring System 2011 subjective and functional activity scores. Conclusions The extra-articular region (PA or GT) is associated with postoperative joint pain and function after knee arthroplasty, and more than half of the postoperative symptoms in the extra-articular region remained from the preoperative period.
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Affiliation(s)
- Yasuo Kunugiza
- Department of Orthopaedic Surgery, Japan Community Health Care Organization (JCHO) Hoshigaoka Medical Center, Hoshigaoka 4-8-1, Hirakata City, Osaka, 573-8511, Japan
| | - Shigeyoshi Tsuji
- Department of Orthopaedics, Rehabilitation, Rheumatology & Psoriasis Center Nippon Life Hospital, Enokojima 2-1-54, Osaka City Nishiku, Osaka, 550-0006, Japan
| | - Toshitaka Fujito
- Department of Orthopaedic Surgery, National Hospital Organization Osaka National Hospital, Hoenzaka 2-1-14, Osaka City Chuo-ku, Osaka, 540-0006, Japan
| | - Masashi Tamaki
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita City, Osaka, 565-0871, Japan
| | - Masataka Nishikawa
- Department of Rheumatology, Japan Community Health Care Organization (JCHO) Osaka Hospital, Fukushima 4-2-78, Osaka City Fukushimaku, Osaka, 553-0003, Japan
| | - Koji Nomura
- Department of Orthopaedic Surgery, Osaka General Medical Center, Mandai-Higashi 3-1-56, Osaka City Sumiyoshiku, Osaka, 558-8558, Japan
| | - Teruya Ishibashi
- Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita City, Osaka, 565-0871, Japan
| | - Tetsuya Tomita
- Graduate School of Health Sciences, Morinomiya University of Medical Siences, Nankokita 1-26-16, Osaka City Suminoe-ku, Osaka, 559-8611, Japan
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Torriero AAJ, Fitz MJ, Mruthunjaya AKV. Calibration-free disposable electrochemical sensor with co-facing electrodes for viscosity monitoring of plasma samples. Talanta 2025; 285:127290. [PMID: 39642607 DOI: 10.1016/j.talanta.2024.127290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Revised: 11/22/2024] [Accepted: 11/24/2024] [Indexed: 12/09/2024]
Abstract
Plasma viscosity measurement is crucial in clinical diagnostics, providing insights into blood rheology and health status. Traditional methods, such as capillary and rotational viscometers, require large sample volumes and complex calibration. This study presents a novel disposable electrochemical sensor with co-facing electrodes for viscosity monitoring of plasma samples. The sensor independently determines the diffusion coefficient (D) of the electroactive test molecule ferrocyanide, eliminating the need for calibration curves. This enables the subsequent calculation of the solution's viscosity via the Stokes-Einstein relation. The sensor's performance was validated against a standard quartz-crystal microbalance method, demonstrating high accuracy and reliability. It maintained consistent measurements despite the presence of common electroactive plasma interferents such as ascorbic acid (≤160 μM), dopamine (<9.0 nM), uric acid (<1.0 mM), and urea (<15.6 mM). Although these interferents impacted D at concentrations exceeding twice the maximum levels typically present in plasma, the sensor exhibited robust performance under normal physiological conditions and standard interferent concentrations. The sensor offers rapid response times of less than 20 s, requires only 7 μL of sample, and is cost-effective, making it suitable for point-of-care applications. Bland-Altman plot analysis confirmed its precision, showing a mean difference of 0.00877 and narrow limits of agreement compared to the standard method used.
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Affiliation(s)
- Angel A J Torriero
- School of Life and Environmental Sciences, Deakin University, Burwood, Victoria, 3125, Australia.
| | - Megan J Fitz
- School of Life and Environmental Sciences, Deakin University, Burwood, Victoria, 3125, Australia
| | - Ashwin K V Mruthunjaya
- School of Life and Environmental Sciences, Deakin University, Burwood, Victoria, 3125, Australia
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Leung B, Treleaven J, Dinsdale A, Marsh L, Thomas L. Serious adverse events associated with conservative physical procedures directed towards the cervical spine: A systematic review. J Bodyw Mov Ther 2025; 41:56-77. [PMID: 39663097 DOI: 10.1016/j.jbmt.2024.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 07/16/2024] [Accepted: 10/13/2024] [Indexed: 12/13/2024]
Abstract
BACKGROUND Previous reviews on serious adverse events (SAEs) following physical interventions involving the neck have focused on vascular SAEs or those related to cervical manipulation. OBJECTIVE To review the evidence for all serious adverse events associated with any physical cervical procedures and describe SAE characteristics. METHODS Searches were conducted in PubMed, EMBASE, CINAHL, Scopus, Cochrane, Web of Science and Index to Chiropractic Literature from inception to May 2023 for studies reporting characteristics of SAE following any neck intervention and patient demographics. RESULTS Two hundred and thirty-three studies describing 334 SAE cases were identified. Forty-one were reported in the last 5 years. The results confirmed findings of past reviews with most events being vascular (58%) and mainly arterial dissection or vertebral artery related and the majority involving manipulation (75%). However lesser-known SAES ie neurological (25%), combined vascular/neurological (12%) and others (5%) which included cases such as cerebrospinal fluid leaks, phrenic nerve palsies and retinal detachments were identified. Further, some followed procedures such as vestibular testing, gentle mobilization, exercises, acupuncture or even massage. Initial symptoms included sharp increases in headache/neck pain, nausea, vomiting, dizziness and altered sensation, during treatment or within 48 h, often preceding neurological signs. Most recovered favourably (62%), 16% with disability, 6% died, the rest were unspecified. CONCLUSION Most SAEs were vascular and associated with manipulation but awareness of potential neurological and orthopaedic injuries and other procedures should be raised. Monitoring for early signs of SAEs for up to 48 h post-intervention is advisable if a SAE is suspected.
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Affiliation(s)
- Bryden Leung
- School of Health and Rehabilitation Sciences, University of Queensland, Australia
| | - Julia Treleaven
- School of Health and Rehabilitation Sciences, University of Queensland, Australia
| | - Alana Dinsdale
- School of Health and Rehabilitation Sciences, University of Queensland, Australia
| | - Linda Marsh
- School of Health and Rehabilitation Sciences, University of Queensland, Australia
| | - Lucy Thomas
- School of Health and Rehabilitation Sciences, University of Queensland, Australia.
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Preuss K, Hymel E, Acquazzino M, Watanabe-Galloway S. Association Between Rurality and Race/Ethnicity and Pediatric Cancer Early Mortality: A Population-Based Cohort Study Using SEER Data from 2000 to 2021. Pediatr Blood Cancer 2025; 72:e31520. [PMID: 39762713 DOI: 10.1002/pbc.31520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 11/23/2024] [Accepted: 12/17/2024] [Indexed: 01/25/2025]
Abstract
BACKGROUND Pediatric cancer mortality rates have steadily declined since 2009, but over a thousand deaths still occur annually. While existing research highlights the effects of race/ethnicity and rurality on overall survival, few studies have specifically analyzed these factors in relation to early mortality, defined as death within 12 months of diagnosis. PROCEDURE This study utilized SEER Research Plus Limited-Field Data (2000-2021) to examine the association between race/ethnicity, rurality, and early mortality in pediatric cancer patients. A cohort of 138,648 individuals was analyzed using Cox proportional hazards regression models to calculate hazard ratios and 95% confidence intervals (CIs). RESULTS The results demonstrated that both race/ethnicity and rurality were significantly associated with early mortality. Non-Hispanic Black patients were 70% (95% CI: 1.60-1.82) more likely to die within the first year of diagnosis compared to non-Hispanic Whites, and other racial/ethnic groups also saw significant associations. The adjusted hazard ratio for early mortality compared to urban counties greater than 1 million was significant (p < 0.05) for all degrees of rurality. Pediatric cancer patients in rural counties not adjacent to urban counties had the highest risk of early mortality, 27% (95% CI: 1.13-1.42), within 1 year of diagnosis. A subanalysis of adolescent patients also showed similar patterns. CONCLUSIONS These findings emphasize the need to address disparities in early mortality for pediatric cancer patients, particularly among racial/ethnic minorities and those in rural communities.
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Affiliation(s)
- Kiersten Preuss
- Department of Epidemiology, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Emma Hymel
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Melissa Acquazzino
- Department of Pediatric Hematology/Oncology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Shinobu Watanabe-Galloway
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Chien S, Sarojini H, Rajaee A, Bayat M, Chien S, Kotwal G. Creating an Extremely Long-lasting Neuroischemic Wound Model. JID INNOVATIONS 2025; 5:100328. [PMID: 39811762 PMCID: PMC11728989 DOI: 10.1016/j.xjidi.2024.100328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/28/2024] [Accepted: 10/29/2024] [Indexed: 01/16/2025] Open
Abstract
In wound study and dressing development, a lack of a suitable animal model that can recapitulate the complex pathophysiology of human chronic wounds has been a major hurdle. Chronic wounds are defined as wounds that heal with a significant delay, usually over a period >2-3 months, but no current animal wound model has such a longischemia. After a longexploration, our group has developed an animal wound model with ischemia and nerve damage lasting for at least 6 months. This model can be easily combined with other conditions such as diabetes and aging for wound mechanistic study and critical testing of dressings. This report presents the method that has significant utility in evaluating therapies that could become the future standard for screening all new wound dressings.
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Affiliation(s)
- Sufan Chien
- Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Harshini Sarojini
- Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Arezoo Rajaee
- Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Mohammad Bayat
- Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Samson Chien
- Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Girish Kotwal
- Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
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Tohmasi S, Cullinan DR, Naaseh A, Awad MM, Klingensmith ME, Wise PE. Flexibility in Surgical Training Does Not Affect American Board of Surgery Board Eligibility or Certification: Long-term Outcomes from a Prospective, Multi-Institutional Study of General Surgery Residents. JOURNAL OF SURGICAL EDUCATION 2025; 82:103390. [PMID: 39721838 DOI: 10.1016/j.jsurg.2024.103390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/10/2024] [Accepted: 12/03/2024] [Indexed: 12/28/2024]
Abstract
OBJECTIVE In 2011, the American Board of Surgery (ABS) implemented a policy to permit greater flexibility in the structure of general surgery (GS) residency training. Our goal was to investigate the impact of flexibility in surgical training (FIST) on resident success in obtaining ABS board eligibility and certification. DESIGN A prospective, multi-institutional study was conducted to examine the feasibility of incorporating flexibility tracks across residency programs and measure educational outcomes including ABS In-service Training Exam (ABSITE) scores, Accreditation Council for Graduate Medical Education (ACGME) Milestones, operative case log volumes, and ABS Qualifying (QE) and Certifying (CE) Examinations scores. We compared residents participating in flexibility tracks ("FIST residents") to contemporaneous residents not involved in subspecialty tracks ("non-FIST residents"). SETTING Seven academic GS residency programs. PARTICIPANTS GS residents at participating institutions were granted the opportunity to customize up to 12 of the final 24 months of residency with subspecialty rotations. RESULTS From 2013 to 2019, 186 (52.2%) of 356 residents participated in a flexibility track. The most frequently selected subspecialty tracks were hepatobiliary (26.9%), gastrointestinal (15.1%), and cardiothoracic surgery (15.1%). There were no significant differences in ABSITE scores (573.0 vs. 562.0; p = 0.191) or total major operations performed (1056.5 vs 1018.0; p = 0.074) between FIST and non-FIST post-graduate year 5 residents. Residents participating in FIST scored significantly higher on 15 of 16 ACGME Milestones when compared to non-FIST residents. The first-time pass rate for the ABS QE was 92.2% and 91.1% for FIST and non-FIST residents, respectively (p = 0.756). The first-time pass rate for the ABS CE was 85.8% and 83.6% for FIST and non-FIST residents, respectively (p = 0.687). Overall, FIST residents had a higher first-time pass rate on both the QE (92.2% vs. 90.6%) and CE (85.8% vs. 81.7%), when compared to the national average. CONCLUSIONS Despite spending more time on subspecialty-focused flexible rotations, residents participating in FIST perform similarly to their peers in multiple measures, including on the ABS QE and CE. Incorporating integrated subspecialty training within GS residency does not interfere with the future success of trainees in obtaining ABS board certification. These findings could help inform modifications to the structure of surgical training, including allowing for earlier entry into subspecialty training.
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Affiliation(s)
- Steven Tohmasi
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Darren R Cullinan
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Ariana Naaseh
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Michael M Awad
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Mary E Klingensmith
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri; Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Paul E Wise
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
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13
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Xu C, Ren P, Zhao G, Wei L, Xie P. Solitary Scapula Metastasis From Intrahepatic Cholangiocarcinoma Detected by PET/CT. Clin Nucl Med 2025; 50:243-245. [PMID: 39629693 DOI: 10.1097/rlu.0000000000005619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
Abstract
ABSTRACT A 59-year-old man presented with a mass and pain in the left side of his back for 6 months. 18 F-FDG PET/CT demonstrated increased FDG uptake in the inferior aspect of his left scapula and the left hepatic lobe, highly suggesting the possibility of hepatic malignancy with solitary scapula metastasis. Finally, solitary scapula metastasis from intrahepatic cholangiocarcinoma was confirmed.
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Affiliation(s)
- Churun Xu
- From the Department of Nuclear Medicine, The Third Hospital, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Pengcheng Ren
- Department of Joint Surgery, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Guoxing Zhao
- From the Department of Nuclear Medicine, The Third Hospital, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Lingge Wei
- From the Department of Nuclear Medicine, The Third Hospital, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Peng Xie
- From the Department of Nuclear Medicine, The Third Hospital, Hebei Medical University, Shijiazhuang, Hebei, China
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14
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Guideline for pharmacological treatment of schizophrenia 2022. Neuropsychopharmacol Rep 2025; 45:e12497. [PMID: 39587785 DOI: 10.1002/npr2.12497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 10/12/2024] [Accepted: 10/14/2024] [Indexed: 11/27/2024] Open
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15
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Bery AK, Hale DE, Newman-Toker DE, Saber Tehrani AS. Evaluation of Acute Dizziness and Vertigo. Med Clin North Am 2025; 109:373-388. [PMID: 39893018 DOI: 10.1016/j.mcna.2024.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2025]
Abstract
Dizziness and vertigo are common presenting symptoms in acute care settings. This article describes the most common causes of acute dizziness and vertigo with practical, evidence-based guidance on evaluation of these patients. A timing-and-triggers approach should be used to first characterize the patient's vestibular symptoms as continuous or episodic. If acute and continuous, determine whether symptoms are post-exposure or spontaneous. If episodic, determine whether symptoms are triggered or spontaneous. Classify the patient as having post-exposure acute vestibular syndrome (AVS), spontaneous AVS, triggered episodic vestibular syndrome (EVS), or spontaneous EVS.
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Affiliation(s)
- Anand K Bery
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, USA
| | - David E Hale
- Department of Neurology, Division of Neuro-Visual & Vestibular Disorders, Johns Hopkins Hospital, Johns Hopkins School of Medicine, Baltimore, MD, USA.
| | - David E Newman-Toker
- Department of Neurology, Division of Neuro-Visual & Vestibular Disorders, Johns Hopkins Hospital, Johns Hopkins School of Medicine, Baltimore, MD, USA; Armstrong Institute Center for Diagnostic Excellence, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Ali S Saber Tehrani
- Department of Neurology, Division of Neuro-Visual & Vestibular Disorders, Johns Hopkins Hospital, Johns Hopkins School of Medicine, Baltimore, MD, USA
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16
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Vandoorne CZ. Suicidal Iron and Paracetamol Overdose: A Case Report. Am J Forensic Med Pathol 2025; 46:e5-e7. [PMID: 39621068 DOI: 10.1097/paf.0000000000000997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2025]
Affiliation(s)
- Carmen Zenda Vandoorne
- Medical Registrar, Department of Forensic Medicine, University of Pretoria, Prinshof Campus, Pretoria, South Africa
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17
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Sonenklar M, Marks S, Donald C, Valrie C, Smith W, Sisler I. Association of Unmet Social Needs With Disease-Related Outcomes in Pediatric Patients With Sickle Cell Disease. Pediatr Blood Cancer 2025; 72:e31478. [PMID: 39654091 DOI: 10.1002/pbc.31478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 11/06/2024] [Accepted: 11/22/2024] [Indexed: 01/25/2025]
Abstract
BACKGROUND Social determinants of health (SDoH) are socioeconomic factors that influence health and well-being, though when unmet can greatly contribute to health disparities. Individuals with sickle cell disease (SCD) are at increased risk of mortality, disability, and healthcare utilization. However, there are limited data linking specific social needs with disease outcomes in this population. Therefore, we sought to identify the unmet needs in one institution and their association with healthcare utilization. METHODS Children with SCD and their guardians answered demographic and SDoH questionnaires during routine Sickle Cell Clinic appointments. We defined an unmet social need as any positive answer to the SDoH questionnaire. Disease outcome variables were electronic health record (EHR)-documented emergency department (ED) visits, hospitalizations, clinic appointment attendance, and guardian-reported acute SCD events in the previous year. RESULTS A total of 114 parent-guardian dyads participated, with 103 having complete data to analyze. In all, 52% of subjects reported at least one unmet social need with food insecurity (36%), trouble paying utility bills (28%), and unemployment (16%) being the most prevalent. Subjects with at least one unmet need had two times the rate of ED visits and/or hospitalizations and were 1.15 times more likely to have an SCD event in the past year. However, only the association with ED visits was statistically significant (p = 0.03). CONCLUSION Over half of subjects reported at least one unmet need; the most common being reliable access to food, which has the potential to impact health outcomes of sickle cell patients. Furthermore, unmet social needs are linked to healthcare utilization and SCD-related complications, supporting routine screening for SDoH in this population.
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Affiliation(s)
- Molly Sonenklar
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Sarah Marks
- Department of Health Policy and Behavior and MSTP Program, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Cerelia Donald
- School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Cecelia Valrie
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Wally Smith
- Division of General Internal Medicine, Department of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - India Sisler
- Division of Pediatric Hematology/Oncology, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia, USA
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18
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Schmidt L, Broszczak D, MacAndrew M, Parker C. Evaluation of the Short-Term Restorative Care program: Effects on physical functioning. Australas J Ageing 2025; 44:e13385. [PMID: 39737756 DOI: 10.1111/ajag.13385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 09/21/2024] [Accepted: 09/25/2024] [Indexed: 01/01/2025]
Abstract
OBJECTIVE The Short-Term Restorative Care program is an 8-week multidisciplinary early intervention funded by the Australian Government that aims to reverse or slow the functional decline of older Australians. Despite the large investment of tax-payer money to fund the program, very little peer-reviewed literature exists examining the ability of the program to deliver on its aims. METHODS This was a retrospective cohort study. SETTING Data were collected from an aged care provider (BallyCara Ltd) located in Australia. PARTICIPANTS Historical data from 1074 participants were analysed. OUTCOME MEASURES This study reported descriptives of the population that undertook the program and the activities completed by participants during the program, and investigated if the program is associated with changes across four domains of function (Modified Barthel Index, Lower Extremity Functional Scale, Upper Extremity Functional Index and Berg Balance Scale). RESULTS Findings suggest the program results in statistically significant improvements (p ≤ .0001) in disability and physical functioning as measured by the Modified Barthel Index, Lower Extremity Functional Scale, Upper Extremity Functional Index and Berg Balance Scale tools. Such findings validate the ability of the program to slow or reverse functional decline. CONCLUSIONS This study will help to inform future modifcations to the Short-Term Restorative Care program as well as inform program development of similar interventions.
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Affiliation(s)
- Luke Schmidt
- BallyCara Ltd, Scarborough, Queensland, Australia
- School of Biomedical Sciences, Centre for Biomedical Technologies, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Tissue Repair and Translational Physiology Group, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Daniel Broszczak
- School of Biomedical Sciences, Centre for Biomedical Technologies, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Tissue Repair and Translational Physiology Group, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Margaret MacAndrew
- School of Nursing, Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Christina Parker
- School of Nursing, Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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19
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Shanmugasundaram S, Shunmugam D, Gandhi A, Vijayasundar GB. Pelvic Actinomycosis Mimicking as an Ovarian Mass: A Case Series. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2025; 23:4. [DOI: 10.1007/s40944-024-00918-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 07/27/2024] [Accepted: 10/21/2024] [Indexed: 01/03/2025]
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20
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Rafiei Z, Saber Tanha A, Tayyebi Meibodi N, Zahed Anaraki S, Askari E. Cutaneous and Subcutaneous Prostate-Specific Membrane Antigen-Avid Lesions. Clin Nucl Med 2025; 50:e164-e165. [PMID: 39480246 DOI: 10.1097/rlu.0000000000005525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2024]
Abstract
ABSTRACT We report the case of a 62-year-old man with metastatic castration-resistant prostate cancer with subcutaneous involvement being treated with 177 Lu-prostate-specific membrane antigen (PSMA). Before treatment, he was diagnosed with 2 subcutaneous nodules in the chest wall and soft tissue edema in the pubic and inguinal regions showing PSMA avidity. Biopsy and immunohistochemistry assessment confirmed cutaneous metastases from prostate cancer. He received 3 cycles of 177 Lu-PSMA, resulting in a decline in PSA levels and resolution of symptoms. This case underscores the challenging diagnosis of cutaneous metastasis from prostate cancer, especially in atypical presentations. We also reviewed all causes of PSMA-avid lesions in the skin and subcutaneous tissues.
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Affiliation(s)
- Zahra Rafiei
- From the Department of dermatology, Imam Reza Hospital
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21
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Elias A, Das S, Kirkland J, Loyal S, Thomas N. Safety of electroconvulsive therapy in the context of physiological and medical complexity: A state-of-the art review. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2025; 4:e70051. [PMID: 39759458 PMCID: PMC11695668 DOI: 10.1002/pcn5.70051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2024] [Revised: 11/24/2024] [Accepted: 12/14/2024] [Indexed: 01/07/2025]
Abstract
Medical contraindications and complications pose challenges for electroconvulsive therapy (ECT). Most published reports are scattered across various physiological systems and individual disease conditions. This review aimed to evaluate the literature on physiological and medical complexities during ECT and discuss risk mitigation strategies in a comprehensive review. We searched PubMed and Embase for contraindications and precautions during ECT with relevant MeSH terms and appraised previous reviews on the same topic. The results suggest that mortality directly attributed to ECT is extremely rare. Instances of fatalities, including fetal deaths, have been reported after ECT in the presence of recent myocardial infarction, deep vein thrombosis, intracranial aneurysm and tumors, pheochromocytoma, sepsis, and pregnancy. However, there are no definite conclusions or consensus on attributions of the outcomes to ECT in all cases because of the time lag between the treatment and deaths and confounding factors. The risks can be mitigated with safety protocols, adequate stakeholder communication, collaboration with anesthetists and specialists, consultation-liaison services, and ECT education. Overall, ECT remains a relatively safe treatment even in the presence of medical and physiological complexities. In rare instances, certain medical conditions may indicate a high risk for ECT, where practitioners avoid the treatment or administer it with precautions if the risk-benefit ratio favors its use.
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Affiliation(s)
- Alby Elias
- Department of PsychiatryThe University of MelbourneMelbourneVictoriaAustralia
- Division of Mental Health and WellbeingWestern HealthMelbourneVictoriaAustralia
| | - Soumitra Das
- Department of PsychiatryThe University of MelbourneMelbourneVictoriaAustralia
- Division of Mental Health and WellbeingWestern HealthMelbourneVictoriaAustralia
| | - James Kirkland
- Division of Mental Health and WellbeingWestern HealthMelbourneVictoriaAustralia
| | - Sarabjit Loyal
- Division of Mental Health and WellbeingWestern HealthMelbourneVictoriaAustralia
| | - Naveen Thomas
- Division of Mental Health and WellbeingWestern HealthMelbourneVictoriaAustralia
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22
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Ravikumaran KS, Armiento S, De Castro C, Molinaro A, Wilson JC, Peak IR, Grice ID. Isolation and characterisation of a heparosan capsular polysaccharide and a core oligosaccharide from Moraxella lincolnii strain CCUG 52988. Carbohydr Res 2025; 549:109361. [PMID: 39778380 DOI: 10.1016/j.carres.2024.109361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2024] [Revised: 12/10/2024] [Accepted: 12/19/2024] [Indexed: 01/11/2025]
Abstract
Moraxella lincolnii is a Gram-negative bacterium that resides in the upper respiratory tract (URT) of humans and may have a role as a member of a protective microbial community. Structural characterisation studies of its outer membrane glycan structures are very limited. We report here the isolation and structural characterisation (NMR, GLC-MS) of a capsular polysaccharide (CPS) and an oligosaccharide (OS) (lipooligosaccharide (LOS)-derived) isolated from strain CCUG 52988. The repeat disaccharide unit of the isolated CPS is unmodified heparosan: [→4)-β-D-GlcpA-(1→4)-α-D-GlcpNAc-(1→]n, a glycosaminoglycan (GAG) also present in mammalian hosts. The core OS isolated was identified as a branched tetrasaccharide composed of: β-D-Glcp-(1→4)-[β-D-Glcp-(1→6)]-α-D-Glcp-(1→5)-α-Kdo-OH. This core OS structure is without heptose residues and is consistent with previously reported core OS structures from Moraxella spp. Genes encoding homologues of the Lgt6 and Lgt3 glycosyltransferases that catalyse these additions were identified in the genome. Additional glycosyltransferases and other proteins encoded downstream of lgt3 were considered to form the LOS biosynthesis locus. This is the first report of the isolation of CPS and core OS from M. lincolnii.
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Affiliation(s)
- Kosala S Ravikumaran
- School of Pharmacy and Medical Science, Griffith University, Gold Coast Campus, Queensland, 4222, Australia
| | - Samantha Armiento
- Dipartimento di Scienze Chimiche, Università di Napoli Federico II, Complesso Universitario Monte S. Angelo, Via Cintia 4, 80126, Napoli, Italy
| | - Cristina De Castro
- Dipartimento di Scienze Chimiche, Università di Napoli Federico II, Complesso Universitario Monte S. Angelo, Via Cintia 4, 80126, Napoli, Italy
| | - Antonio Molinaro
- Dipartimento di Scienze Chimiche, Università di Napoli Federico II, Complesso Universitario Monte S. Angelo, Via Cintia 4, 80126, Napoli, Italy
| | - Jennifer C Wilson
- School of Pharmacy and Medical Science, Griffith University, Gold Coast Campus, Queensland, 4222, Australia
| | - Ian R Peak
- School of Pharmacy and Medical Science, Griffith University, Gold Coast Campus, Queensland, 4222, Australia; Institute for Biomedicine and Glycomics, Griffith University, Gold Coast Campus, Queensland, 4222, Australia
| | - I Darren Grice
- School of Pharmacy and Medical Science, Griffith University, Gold Coast Campus, Queensland, 4222, Australia; Institute for Biomedicine and Glycomics, Griffith University, Gold Coast Campus, Queensland, 4222, Australia.
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Coggins SA, Greenberg RG. Pharmacokinetic and Pharmacodynamic Approaches to Optimize Antibiotic Use in Neonates. Clin Perinatol 2025; 52:67-86. [PMID: 39892955 DOI: 10.1016/j.clp.2024.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2025]
Abstract
Newborn infants (particularly those born preterm) are frequently exposed to empiric antibiotics at birth, and antibiotics are among the most commonly prescribed medications in neonatal intensive care units. Challenges in optimizing neonatal antibiotic dosing include: technical and ethical barriers to neonatal pharmacoanalytic study design and sampling, difficulty in extrapolating adult and pediatric data due to unique neonatal physiology, and a lack of validated pharmacodynamic targets specific to neonatal populations. In this review, we summarize basic concepts in pharmacokinetics (PK) and pharmacodynamics (PD), describe pharmacometric strategies utilized in contemporary PK/PD analyses, and review the evolution of PK/PD data guiding neonatal dosing among 3 commonly used antibiotics.
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Affiliation(s)
- Sarah A Coggins
- Department of Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Division of Neonatology (2 Main NW), Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
| | - Rachel G Greenberg
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, 300 West Morgan Street Suite 800, Durham, NC 27701, USA
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24
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Pedro BA, Harjunpää I, Young E, Mirsadraei L, Kholová I, Maleki Z. Squamous Cells in Thyroid Cytology and Their Clinical Significance: A Multi-Institutional Study. Diagn Cytopathol 2025; 53:93-101. [PMID: 39543941 DOI: 10.1002/dc.25421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Revised: 11/05/2024] [Accepted: 11/06/2024] [Indexed: 11/17/2024]
Abstract
BACKGROUND Squamous cells are uncommon in thyroid fine needle aspirations (FNAs) presenting diagnostic challenges. We report our multi-institutional experience. MATERIALS AND METHOD The electronic data were searched for thyroid FNAs containing squamous cells at the Johns Hopkins Medicine, New York University Langone Hospital, United States, and Fimlab Laboratories, Finland (2001-2023). The patients' demographics, clinical history, and pathologic diagnosis were recorded. RESULTS One hundred and seven cases (103 patients) were identified 35 males and 68 females (median age 58 years). Forty-eight cases (44.9%) were malignant, primary carcinomas with squamous features, such as anaplastic thyroid carcinoma (ATC), and metastatic or directly invasive squamous cell carcinomas (SqCC) including oral, oropharyngeal (HPV-related), esophageal, and laryngeal SqCC. Twenty-seven cases (25.2%) contained benign squamous cells with cystic background, suggestive of developmental cysts. Nineteen cases (17.8%) contained metaplastic benign squamous cells within an adenomatoid nodule. Seven cases (6.5%) contained atypical squamous cells. Four cases (3.7%) showed squamous cells with bacterial or fungal organisms, suggestive of esophageal fistula/diverticulum, and two cases (1.9%) contained benign squamous cells with unknown source. Thirty-six cases had surgical follow-up, 33 (91.7%) were concordant (23 metastatic or directly invasive SqCC, 8 undifferentiated/ATC, and 10 papillary thyroid carcinoma). Ancillary studies were used confirming HPV-related SqCC, or therapeutic targets (BRAF V600E), with highly variable staining in ATC. CONCLUSION Squamous cells in thyroid FNAs carry a broad differential diagnosis with variable prognoses. It is crucial to interpret squamous cells in the context of clinical and radiographic findings for optimal patient care.
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Affiliation(s)
- Brian A Pedro
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Iiris Harjunpää
- Department of Pathology, Fimlab Laboratories, Tampere, Finland and Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Eric Young
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Leili Mirsadraei
- Department of Pathology, New York University Grossman Long Island School of Medicine, Mineola, New York, USA
| | - Ivana Kholová
- Department of Pathology, Fimlab Laboratories, Tampere, Finland and Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Zahra Maleki
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland, USA
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Ghasemi A, Broomand Lomer N, Saberi A. Is there a link between Hepatitis A virus and Guillain-Barré syndrome? A systematic review of case reports. eNeurologicalSci 2025;38:100551. [PMI |