Management of androgenic alopecia: a systematic review of the literature.

We aimed to determine the efficacy of the various available oral, topical, and procedural treatment options for hair loss in individuals with androgenic alopecia. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of the National Library of Medicine was performed. Overall, 141 unique studies met our inclusion criteria.

Best Practices in Clinical Education: A Site Visit Decision-Making Model in Physical Therapist Education.

Stakeholders in health science education engage in site visits during student clinical education experiences, which may occur in person or remotely via videoconference, telephone, or email. Significant variability in practice highlights the need for a more consistent approach to conducting site visits based on evidence-based best practices. Site visits can be burdensome to both clinical and academic stakeholders considering the significant time and resources needed to conduct them effectively.

Clinical Site Visits: Perspectives of Clinical Instructors and Site Coordinators of Clinical Education.

Introduction: Site visits (SVs) are a common component of clinical education. The purpose of this paper was to explore clinicians' perspectives regarding SVs, including methods of communication used and their effectiveness, purposes of SVs, and the level of interaction between the stakeholders.

Review Of The Literature: Several communication methods are used to conduct SVs, with varying levels of "richness" and effectiveness.

Primary Care Physician Preferences Regarding Communication from Orthopaedic Surgeons.

Background: Musculoskeletal consultations constitute a growing portion of primary care physician (PCP) referrals. Optimizing communication between PCPs and orthopaedists can potentially reduce time spent in the electronic medical record (EMR) as well as physician burnout. Little is known about the preferences of PCPs regarding communication from orthopaedic surgeons.

Consumption of Different Egg-Based Diets Alters Clinical Metabolic and Hematological Parameters in Young, Healthy Men and Women.

Eggs-particularly egg yolks-are a rich source of bioactive nutrients and dietary compounds that influence metabolic health, lipid metabolism, immune function, and hematopoiesis. We investigated the effects of consuming an egg-free diet, three egg whites per day, and three whole eggs per day for 4 weeks on comprehensive clinical metabolic, immune, and hematologic profiles in young, healthy adults (18-35 y, BMI < 30 kg/m or <30% body fat for men and <40% body fat for women, n = 26) in a 16-week randomized, crossover intervention trial. We observed that average daily macro- and micronutrient intake significantly differed across egg diet periods, including greater intake of choline during the whole egg diet period, which corresponded to increased serum choline and betaine without altering trimethylamine -oxide.

Hip effusions or iliopsoas hematomas on ultrasound in identifying hip fractures in the emergency department.

Objective: We evaluated the sensitivity, specificity, predictive values, and likelihood ratios of hip effusion and/or iliopsoas hematoma on point-of-care ultrasound (POCUS) performed by ultrasound fellows and fellowship trained emergency providers to identify hip fractures in emergency department (ED) patients with a high suspicion of hip fracture.

Methods: This was a prospective observational study of a convenience sample of patients with high suspicion of hip fracture at two academic EDs between 2018 and 2021. Patients with negative x-rays who did not receive further imaging with magnetic resonance imaging (MRI) or computed tomography (CT) were excluded.

Endophthalmitis diagnosis supported by bedside ultrasound.

Endophthalmitis is a bacterial or fungal infection in the deep spaces of the eye. The diagnosis of endophthalmitis has traditionally been made by vitreous humor culture and is commonly missed on initial presentation. In this case report, we emphasize the role of ocular point-of-care ultrasound (POCUS) in revealing endophthalmitis as a primary differential diagnosis for a patient presenting with unilateral eye pain and significant swelling that limited physical examination of the eye.

Validating a Computable Phenotype for Nephrotic Syndrome in Children and Adults Using PCORnet Data.

Background: Primary nephrotic syndromes are rare diseases which can impede adequate sample size for observational patient-oriented research and clinical trial enrollment. A computable phenotype may be powerful in identifying patients with these diseases for research across multiple institutions.

Methods: A comprehensive algorithm of inclusion and exclusion ICD-9 and ICD-10 codes to identify patients with primary nephrotic syndrome was developed.

Clinical Challenges of Acute Porphyria in the Young Adult.

Porphyria is a metabolic disorder caused by a mutation in the heme biosynthetic pathway, with vague symptomatology and rare prevalence. A triad of hyponatremia, intermittent seizures, and abdominal pain should raise suspicion for porphyria. The diagnosis is based on increased blood porphobilinogen levels and genetic mutations.

Activation of retinal ganglion cells using a biomimetic artificial retina.

Biomimetic protein-based artificial retinas offer a new paradigm for restoring vision for patients blinded by retinal degeneration. Artificial retinas, comprised of an ion-permeable membrane and alternating layers of bacteriorhodopsin (BR) and a polycation binder, are assembled using layer-by-layer electrostatic adsorption. Upon light absorption, the oriented BR layers generate a unidirectional proton gradient.

The Influence of an Elastase-Sensitive Complement C5 Variant on Lupus Nephritis and Its Flare.

Introduction: A C5 polymorphism (rs17611, 2404G>A) exists where the G allele associates with enhanced C5a-like production by neutrophil elastase. This cohort study investigated the influence of this polymorphism as a risk factor for lupus nephritis (LN), and on C5a and membrane attack complex (MAC) levels in LN during flare.

Methods: A cohort of lupus patients (n = 155) was genotyped for the 2404G>A polymorphism.

Management of Early-Stage Rectal Cancer.

A 59-year-old man underwent screening colonoscopy that identified a 2-cm rectal polyp in the posterior midline, 7 cm from the anal verge. Biopsy revealed a tubular adenoma with high-grade dysplasia. The patient underwent a robotic-assisted transanal minimally invasive surgery with full-thickness excision (Fig.

Direct to Angiography vs Repeated Imaging Approaches in Transferred Patients Undergoing Endovascular Thrombectomy.

Importance: A direct to angiography (DTA) treatment paradigm without repeated imaging for transferred patients with large vessel occlusion (LVO) may reduce time to endovascular thrombectomy (EVT). Whether DTA is safe and associated with better outcomes in the late (>6 hours) window is unknown. Also, DTA feasibility and effectiveness in reducing time to EVT during on-call vs regular-work hours and the association of interfacility transfer times with DTA outcomes have not been established.

A Phase I Randomized, Controlled, Clinical Trial of Valganciclovir in Idiopathic Pulmonary Fibrosis.

Human herpesviruses Epstein-Barr virus and cytomegalovirus are frequently detectable in the lungs of patients with idiopathic pulmonary fibrosis (IPF) and could contribute to disease pathogenesis. With the goal of inhibiting herpesvirus replication, we tested the safety and tolerability of adding valganciclovir to standard IPF therapy (pirfenidone). We performed a single-center, Phase I, double-blind, randomized, placebo-controlled trial comparing valganciclovir 900 mg daily with placebo in patients with IPF with serologic evidence of prior Epstein-Barr virus and/or cytomegalovirus infection who were tolerating full-dose pirfenidone (2,403 mg/d).

Trends in COVID-19 Risk-Adjusted Mortality Rates.

Early reports showed high mortality from coronavirus disease 2019 (COVID-19). Mortality rates have recently been lower, raising hope that treatments have improved. However, patients are also now younger, with fewer comorbidities.

The use of point-of-care ultrasound to diagnose infective endocarditis causing an NSTEMI in a patient with chest pain.

Infective endocarditis is a severe condition that requires rapid identification and treatment. Early diagnosis is often difficult due to diverse and often vague presenting symptoms. One uncommon complication is acute coronary syndrome that can be secondary to dissemination of septic emboli.

Salvage after Retroperitoneal Kidney Allograft Torsion.

Torsion of a transplanted kidney into the retroperitoneal space is a rare occurrence, with only three other reported cases. Failure after kidney transplantation is caused by surgical, immunological, and infective complications. Torsion is a complication that poses a serious risk of ischemic graft failure, and, if suspected, sonographic evaluation helps ascertain the diagnosis.

Association Study of the Complement Component C4 Gene in Tardive Dyskinesia.

Tardive dyskinesia (TD) is a movement disorder that may develop in schizophrenia patients being treated long-term with antipsychotic medication. TD interferes with voluntary movements and leads to stigma, and can be associated with treatment non-adherence. The etiology of TD is unclear, but it appears to have a genetic component.

Influence of administration of antimicrobial medications after tibial plateau leveling osteotomy on surgical site infections: A retrospective study of 308 dogs.

Objective: To determine the influence of prophylactic administration of oral antimicrobial medications after tibial plateau leveling osteotomy (TPLO) on surgical site infections (SSI) and antimicrobial-resistant infections.

Study Design: Retrospective study.

Sample Population: Dogs treated with unilateral TPLO (n = 308) between January 2013 and December 2015.

A school-aged boy with super-refractory status epilepticus secondary to cortical dysplasia treated with dexmedetomidine.

This case report details a novel approach to the management of super-refractory status epilepticus (SRSE) in a boy with new-onset seizures progressing to SRSE. After exhausting multiple medications, dexmedetomidine, an α2-adrenoreceptor agonist used for sedation, stopped his SRSE. Dexmedetomidine provides a unique mechanism of action to treat this condition.

Light Harvesting by Equally Contributing Mechanisms in a Photosynthetic Antenna Protein.

We report supramolecular quantum mechanics/molecular mechanics simulations on the peridinin-chlorophyll a protein (PCP) complex from the causative algal species of red tides. These calculations reproduce for the first time quantitatively the distinct peridinin absorptions, identify multichromophoric molecular excitations, and elucidate the mechanisms regulating the strongly allowed S (1A) → S (1B) absorptions of the bound peridinins that span a 58 nm spectral range in the region of maximal solar irradiance. We discovered that protein binding site-imposed conformations, local electrostatics, and electronic coupling contribute equally to the spectral inhomogeneity.

The Forbidden 1B Excited Singlet State in Peridinin and Peridinin Analogues.

Theoretical studies have predicted the presence of a forbidden 1B state in proximity to the strongly allowed 1B excited state in polyenes and carotenoids. The 1B state is invariably predicted to have a very low oscillator strength, which precludes direct optical spectroscopic assignment. We report here a direct UV-vis optical spectroscopic feature assigned to the 1B state of S-2-peridinin, a synthetic analogue of the naturally occurring carotenoid, peridinin.

The Stress-Inducible Peroxidase Underlies a Conditionally Beneficial Chromosomal Duplication in .

Although chromosomal duplications are often deleterious, in some cases they enhance cells' abilities to tolerate specific genetic or environmental challenges. Identifying the genes that confer these conditionally beneficial effects to particular chromosomal duplications can improve our understanding of the genetic and molecular mechanisms that enable certain aneuploidies to persist in cell populations and contribute to disease and evolution. Here, we perform a screen for spontaneous mutations that improve the tolerance of haploid to hydrogen peroxide.