Injectable Estradiol Use in Transgender and Gender-Diverse Individuals in the U.S.: A Multicenter Retrospective Study.

Context: Guidelines for use of injectable estradiol esters (valerate [EV] and cypionate [EC]) among transgender and gender diverse (TGD) individuals designated male at birth vary considerably, with many providers noting supraphysiologic serum estradiol concentrations based on current dosing recommendations.

Objectives: 1. Determine dose of injectable estradiol (subcutaneous [SC] and intramuscular [IM]) needed to reach guideline-recommended estradiol concentrations for TGD adults using EC/EV.

Effects of implementing a vaccination tool in the electronic medical record on vaccination coverage of patients with immune-mediated inflammatory diseases: a prospective cohort study.

Background: The rising incidence of immune-mediated inflammatory diseases (IMID) requires innovative management strategies, including effective vaccination. We aimed to assess the impact of an electronic medical record (EMR)-integrated vaccination tool on vaccination coverage among patients with inflammatory bowel diseases (IBD), rheumatological and dermatological conditions.

Methods: A prospective observational study compared vaccination coverage before (2018) and after (2021) implementing the module.

Redefining the concept of residual renal function with kidney sodium MRI: a pilot study.

Background: The concept of residual kidney function (RKF) is exclusively based upon urine volume and small solute clearance, making RKF challenging to assess in clinical practice. The aim of this study was to test the technical feasibility of obtaining usable sodium magnetic resonance imaging (23Na-MRI) kidney images in hemodialysis (HD) participants.

Methods: We conducted an exploratory prospective study to quantify the cortico-medullary sodium gradient in 17 healthy volunteers and 21 HD participants.

Evaluating the impacts of climate change and land-use change on future droughts in northeast Thailand.

The impacts of climate change (CC) on droughts are well documented, but the effects of land-use change (LUC) are poorly understood. This study compares the projected individual and combined impacts of these stressors on future droughts (2021-2050), with respect to baseline (1981-2010) in one of the major tributaries of the Mekong River. LUC impacts on hydrological droughts are minimal compared to CC, with the latter expected to shorten the recurrence interval of a 20-year return period event to every 14 years.

Combined Dexamethasone and Dexmedetomidine as Adjuncts to Popliteal and Saphenous Nerve Blocks in Patients Undergoing Surgery of the Foot or Ankle: A Randomized, Blinded, Placebo-controlled Clinical Trial.

Background: Both dexamethasone and dexmedetomidine increase the duration of analgesia of peripheral nerve blocks. The authors hypothesized that combined intravenous dexamethasone and intravenous dexmedetomidine would result in a greater duration of analgesia when compared with intravenous dexamethasone alone and placebo.

Methods: The authors randomly allocated participants undergoing surgery of the foot or ankle under general anesthesia and with a combined popliteal (sciatic) and saphenous nerve block to a combination of 12 mg dexamethasone and 1 µg/kg dexmedetomidine, 12 mg dexamethasone, or placebo (saline).