Pain Management in the Older Adults: A Narrative Review.

With the increase in life expectancy in the United States, octogenarians and nonagenarians are more frequently seen in clinical practice. The older adults patients have multiple preexisting comorbidities and are on multiple medications, which can make pain management complex. Moreover, the older adults population often suffers from chronic pain related to degenerative processes, making medical management challenging.

A comparison of steroid dose with or without local anesthetic in lumbar interlaminar epidural steroid injections.

Introduction: Epidural steroid injections (ESIs) are commonly used as a treatment for lumbar radiculopathy. Currently, most research on comparative efficacy of various steroids in epidural steroid injections is focused on transforaminal ESIs (TFESIs). Through this study, we aimed to compare various steroid doses with or without local anesthetic in interlaminar ESIs (ILESIs).

Co-occurrence of collagenous gastrointestinal disease in siblings in early childhood: New insight into a rare condition.

Collagenous gastrointestinal (GI) disease is a rare inflammatory condition characterized by subepithelial collagen deposition and inflammatory cell infiltrates of the GI mucosa, which typically occurs in the stomach in children. There are few published reports of more extensive involvement in children, and descriptions of familial involvement are rare, with no previous reported cases of affected siblings in early childhood. We describe two siblings with contrasting medical backgrounds, who were simultaneously diagnosed with collagenous GI disease in early childhood.

Effectiveness of low dose computed tomography to detect fractures in paediatric suspected physical abuse: a systematic review.

Purpose: The skeletal survey X-ray series is the current 'gold standard' when investigating suspected physical abuse (SPA) of children, in addition to a non-contrast computed tomography (CT) brain scan. This systematic literature review synthesised findings of published research to determine if low dose computed tomography (LDCT) could detect subtle fractures and therefore replace the skeletal survey X-ray series in the investigation of SPA in children aged under 3 years.

Methods: Five electronic databases and grey literature were systematically searched from their inception to 28 April 2022.

Long-Term Survival in an Adolescent and Young Adult with Metastatic Relapse of an Undifferentiated Embryonal Sarcoma of the Liver.

Undifferentiated embryonal sarcoma of the liver (UESL) is an extremely rare and aggressive malignancy in adults. Adults with UESL have a worse prognosis compared to pediatric population. Due to the rarity of this disease in adults, there has been a lack of information that assists in treatment decisions within this group.

A Rare Case Report of Granular Cell Tumour of the Abdominal Wall and a Review of the Literature.

Granular cell tumours (GCTs) are rare soft tissue tumours of neural origin. They have been reported in multiple anatomical sites. However, only 14 cases worldwide have been reported arising from the abdominal wall.

Multiple circulating forms of neprilysin detected with novel epitope-directed monoclonal antibodies.

Neprilysin (NEP) is an emerging biomarker for various diseases including heart failure (HF). However, major inter-assay inconsistency in the reported concentrations of circulating NEP and uncertainty with respect to its correlations with type and severity of disease are in part attributed to poorly characterized antibodies supplied in commercial ELISA kits. Validated antibodies with well-defined binding footprints are critical for understanding the biological and clinical context of NEP immunoassay data.

Circulating Tumor DNA: A Promising Biomarker for Predicting Recurrence in Patients with BRAF-Negative Melanoma.

For patients with BRAF wild-type stage III and IV melanoma, there is an urgent clinical need to identify prognostic biomarkers and biomarkers predictive of treatment response. Circulating tumor DNA (ctDNA) is emerging as a blood-based biomarker and has shown promising results for many cancers, including melanoma. The purpose of this study was to identify targetable, tumor-derived mutations in patient blood that may lead to treatment alternatives and improved outcomes for patients with BRAF-negative melanoma.

Pain Management in the Elderly: A Narrative Review.

With the increase in life expectancy in the United States, octogenarians and nonagenarians are more frequently seen in clinical practice. The elderly patients have multiple preexisting comorbidities and are on multiple medications, which can make pain management complex. Moreover, the elderly population often suffers from chronic pain related to degenerative processes, making medical management challenging.

Group A induces CD1a-autoreactive T cells and promotes psoriatic inflammation.

Group A (GAS) infection is associated with multiple clinical sequelae, including different subtypes of psoriasis. Such post-streptococcal disorders have been long known but are largely unexplained. CD1a is expressed at constitutively high levels by Langerhans cells and presents lipid antigens to T cells, but the potential relevance to GAS infection has not been studied.

A new large-volume equilibration method for high-precision measurements of dissolved noble gas stable isotopes.

Rationale: Noble gases are widely used as physically based climate proxies, notably in dissolved water samples as tracers of past recharge temperature in groundwater and air-sea gas exchange processes in seawater. Recent advances in measuring large-volume samples of dissolved noble gas isotopic ratios at high precision have expanded the range of climate parameters that can be interpreted.

Methods: We build on prior methods for measuring noble gas stable isotopes at high precision with a new large-volume equilibration (LVE) method wherein sample gases are equilibrated in the sample flask between the dissolved phase and the headspace.

Clear Cell Sarcoma of the Kidney (CCSK) With Fusion: A Rare Case Report With a Brief Review of the Literature.

Pediatric renal tumors are a rare entity and majority of these tumors are accounted for by Wilms tumor. The second most common renal tumor is clear cell sarcoma of the kidney (CSSK). Most of the CSSK have either -internal tandem duplication (ITD) or fusion.

One-Shot Generation of Epitope-Directed Monoclonal Antibodies to Multiple Nonoverlapping Targets: Peptide Selection, Antigen Preparation, and Epitope Mapping.

This chapter describes an epitope-directed approach to generate antipeptide monoclonal antibodies to multiple nonoverlapping protein sites using a cocktail of fusion peptides as immunogen. It provides a step-by-step protocol on how antigenic peptides on a target protein can be identified by in silico prediction and discusses considerations for final peptide selection. Each antigenic peptide (10-20 amino acids long) is displayed as three-copy inserts on the surface exposed loop of a thioredoxin scaffold protein.

Xanthomatous Giant Cell Renal Cell Carcinoma: Another Morphologic Form of TSC -associated Renal Cell Carcinoma.

Over the past decade, several distinct novel renal epithelial neoplasms driven by underlying tuberous sclerosis comples ( TSC)/ mammalian target of rapamycin (MTOR) pathway mutations have been described. We report herein two distinctive TSC2 -mutated renal cell carcinomas which do not fit any previously described entity. The two renal carcinomas occurred in young patients (ages 10 and 31 y), and were characterized by highly permeative growth within the kidney with metastases to perirenal lymph nodes.

Immunoassay-Compatible Inactivation of SARS-CoV-2 in Plasma Samples for Enhanced Handling Safety.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) inactivation is an important step toward enhanced biosafety in testing facilities and affords a reduction in the biocontainment level necessary for handling virus-positive biological specimens. Virus inactivation methods commonly employ heat, detergents, or combinations thereof. In this work, we address the dearth of information on the efficacy of SARS-CoV-2 inactivation procedures in plasma and their downstream impact on immunoassays.

Delivery of an Incidental Appendiceal Mucinous Neoplasm.

Low-grade appendiceal mucinous neoplasms (LAMNs) are rare and non-invasive tumors of the appendix, and their unexpected discovery during surgery can pose challenges to management. To date, only two cases pertaining to LAMNs without peritoneal spread in pregnancy exist in the literature. Here, we present a literature review of appendiceal mucinous neoplasms and discuss our management and operative approach to a large, incidental appendiceal mucinous neoplasm discovered during an emergency cesarean section of a 38-year-old female.

Test-enhanced learning improves learner attendance during a laparoscopic box trainer simulation program.

Background: Laparoscopy is the gold standard approach for many surgical procedures, but it is a complex skill to learn. Laparoscopic simulation training may help, but it is unclear how to best engage trainees in these programs. Test-enhanced learning (TEL) uses regular, well-defined assessments of performance throughout the training phase of learning.

Finding a reliable assay for soluble neprilysin.

Background: Lack of validation and standardization of research-use-only (RUO) immunoassays brings with it inherent threats to authenticity and functional quality. Poor correlation between different commercial neprilysin RUO immunoassays is concerning and discordant findings need to be resolved. We seek to identify and validate reliable neprilysin immunoassays to strengthen the scientific rigor and reproducibility of neprilysin-related investigation and of biomarker research in general.

Toxicity Evaluation of New Generic Latanost and Latacom as an Ophthalmic Formulation.

Aim And Objective: To evaluate the safety of two new generic ophthalmic formulations, Latanost (latanoprost) and Latacom (latanoprost and timolol) by utilizing the three-dimensional reconstructed human cornea-like epithelium (RhCE) tissue constructs as an model in the assessment of ocular irritation.

Materials And Methods: irritation test was conducted on Latanost (LTN) and Latacom (LTC) and their corresponding innovators, Xalatan (XLT) and Xalacom (XLC), respectively, by using RhCE. According to the OECD guidelines No.

Acute Presentation of Rapunzel Syndrome and a Review of Bezoars.

Bezoars have different compositions and can be subdivided into trichobezoar, phytobezoar, pharmacobezoar, lactobezoar and food bolus. The reported incidence of bezoar is 0.4% with phytobezoar being the commonest.

Gallbladder Volvulus: An Uncommon Twist in Biliary Pathology.

Gallbladder volvulus (GBV) is an extremely rare disease, which presents similarly to acute cholecystitis. It has an incidence of less than 0.1% among urgent cholecystectomies and one in 356,000 hospital admissions.