Congenital Anterior Urethral Diverticulum in Identical Twins.

Congenital anterior urethral diverticulum (CAUD) is an uncommon abnormality of the male urethra. In the literature, cases of CAUD affecting both children within a set of identical twins or presenting concomitantly with another urethral condition are exceedingly rare. We describe 2 cases of CAUD in identical twins: a pair of newborns in which Twin 1A and Twin 1B both present with CAUD, and a second pair of newborns in which only Twin 2A presents with CAUD along with a partial collateral urethral duplication.

Retrospective Analysis in Patients With Moderate to Severe Plaque Psoriasis Treated With Tildrakizumab: Real-Life Clinical Data.

: Interleukin (IL)-23 antagonists have shown great efficacy with minimal side effect profile in clinical trial data for the treatment of moderate to severe plaque psoriasis. As of yet, there have been no published data regarding real-world patients who have received tildrakizumab therapy. : To analyze real-world efficacy and safety of tildrakizumab in patients with moderate to severe plaque psoriasis.

Ectopic hepatocellular carcinoma presenting as a right adrenal mass with IVC thrombus: Case report and review of the literature.

Hepatocellular carcinoma (HCC) arises from several different etiologies and carries a poor prognosis. Extrahepatic metastases of HCC are most frequently found in the lungs, lymph nodes, and bones, with adrenal metastases reported in less than 15% of metastatic cases. Herein, we report a case of a 71-year-old man without prior liver disease who presented with a 9-cm right adrenal mass extending into the IVC consistent with HCC on subsequent surgical pathology and immunohistochemical staining.

Digital triage: Novel strategies for population health management in response to the COVID-19 pandemic.

The COVID-19 pandemic has created unique challenges for the U.S. healthcare system due to the staggering mismatch between healthcare system capacity and patient demand.

Importance of clinical decision support system response time monitoring: a case report.

Clinical decision support (CDS) systems are prevalent in electronic health records and drive many safety advantages. However, CDS systems can also cause unintended consequences. Monitoring programs focused on alert firing rates are important to detect anomalies and ensure systems are working as intended.

Estimating HbA1c from timed Self-Monitored Blood Glucose values.

Aims: To analyze mathematical relationships between timed Self-Monitored Blood Glucose (SMBG) and HbA1c, and to identify the SMBG values that correlate most strongly with HbA1c.

Methods: We utilized the average premeal (Pre) and 90-min postmeal (Post) SMBG results from 547 A1c-Derived Average Glucose (ADAG) study participants (285 type 1, 178 type 2 and 84 non-diabetic) to analyze the mathematical relationships with HbA1c levels. Specific times of daily SMBG that best correlate with HbA1c were identified.

Using Google Glass in Surgical Settings: Systematic Review.

Background: In recent years, wearable devices have become increasingly attractive and the health care industry has been especially drawn to Google Glass because of its ability to serve as a head-mounted wearable device. The use of Google Glass in surgical settings is of particular interest due to the hands-free device potential to streamline workflow and maintain sterile conditions in an operating room environment.

Objective: The aim is to conduct a systematic evaluation of the literature on the feasibility and acceptability of using Google Glass in surgical settings and to assess the potential benefits and limitations of its application.

Cutaneous Manifestations of Familial Transthyretin Amyloid Polyneuropathy.

Familial amyloid polyneuropathy (FAP) is a rare inherited autosomal dominant form of systemic amyloidosis, which classically presents with severe motor, sensory, and autonomic dysfunction. Cutaneous involvement does not become clinically apparent until late stage symptomatic disease and is rarely reported in modern literature. Here, the authors review the clinical and histologic cutaneous findings of FAP previously described in the literature and report on 3 patients with unique genetic mutations (Thr60Ala and Gly6Ser; Trp41Leu; Glu89Gln) for which cutaneous involvement has not previously been described.

Pathways targeted by antidiabetes drugs are enriched for multiple genes associated with type 2 diabetes risk.

Genome-wide association studies (GWAS) have uncovered >65 common variants associated with type 2 diabetes (T2D); however, their relevance for drug development is not yet clear. Of note, the first two T2D-associated loci (PPARG and KCNJ11/ABCC8) encode known targets of antidiabetes medications. We therefore tested whether other genes/pathways targeted by antidiabetes drugs are associated with T2D.

Altered sphingoid base profiles in type 1 compared to type 2 diabetes.

Background: Sphingolipids are increasingly recognized to play a role in insulin resistance and diabetes. Recently we reported significant elevations of 1-deoxysphingolipids (1-deoxySL) - an atypical class of sphingolipids in patients with metabolic syndrome (MetS) and diabetes type 2 (T2DM). It is unknown whether 1-deoxySL in patients with diabetes type 1 (T1DM) are similarly elevated.

Glycemic control after hospital discharge in insulin-treated type 2 diabetes: a randomized pilot study of daily remote glucose monitoring.

Objective: Little is known about glycemic control in type 2 diabetes patients treated with insulin in the high-risk period between hospital discharge and follow-up. We sought to assess the impact of remote glucose monitoring on postdischarge glycemic control and insulin titration.

Methods: We randomly assigned 28 hospitalized type 2 diabetes patients who were discharged home on insulin therapy to routine specialty care (RSC) or RSC with daily remote glucose monitoring (RGM).

Empirically establishing blood glucose targets to achieve HbA1c goals.

OBJECTIVE To determine the average fasting, postprandial, and bedtime self-monitored blood glucose (SMBG) concentrations associated with specified HbA1c levels using data from the A1c-Derived Average Glucose (ADAG) study. RESEARCH DESIGN AND METHODS The ADAG study was a multicenter observational study that used continuous glucose monitoring and SMBG testing to determine the relationship between mean average glucose and HbA1c. We used the SMBG data from 470 of the ADAG study participants (237 with type 1 diabetes and 147 with type 2 diabetes) to determine the average fasting, premeal, 90-min postmeal, and bedtime blood glucose (BG) for predefined target HbA1c groups between 5.

Effect of hospital admission on glycemic control 1 year after discharge.

Objective: To assess the effect of hospital admission on glycemic control in patients with diabetes up to 1 year after discharge.

Methods: We retrospectively studied 826 adults with diabetes admitted to a tertiary care medical center and with available hemoglobin A1c (A1C) values for 6 months before admission and 1 year after discharge. We compared them with 826 nonhospitalized adults with diabetes matched for age, sex, race, comorbidity, and baseline A1C level.

Basal-bolus insulin protocols enter the computer age.

Diabetes affects approximately one quarter of all hospitalized patients. Poor inpatient glycemic control has been associated with increased risk for multiple adverse events including surgical site infections, prolonged hospital length of stay, and mortality. Inpatient glycemic control protocols based on physiologic basal-bolus insulin regimens have been shown to improve glycemia and clinical outcomes and are recommended by the American Diabetes Association, the American Association of Clinical Endocrinologists, and the Society of Hospital Medicine for inpatient glycemic management of noncritically ill patients.

Thyroid-associated paragangliomas.

Background: Paragangliomas in the region of the thyroid gland are rare tumors that can present a diagnostic challenge by mimicking follicular and c-cell derived thyroid tumors.

Summary: Thyroid-associated paragangliomas are likely a subset of laryngeal paragangliomas and, although quite rare, should be considered in the differential diagnosis of a hypervascular thyroid nodule. The preoperative diagnosis of thyroid-associated paragangliomas can be challenging since the cytologic and histologic features overlap with more common primary thyroid neoplasms, in particular medullary carcinoma.

Active site-labeled prothrombin inhibits prothrombinase in vitro and thrombosis in vivo.

Mouse and human prothrombin (ProT) active site specifically labeled with D-Phe-Pro-Arg-CH(2)Cl (FPR-ProT) inhibited tissue factor-initiated thrombin generation in platelet-rich and platelet-poor mouse and human plasmas. FPR-prethrombin 1 (Pre 1), fragment 1 (F1), fragment 1.2 (F1.