Prehospital Delta Shock Index Predicts Mortality and Need for Life Saving Interventions in Trauma Patients.

Objectives: The delta shock index (ΔSI), defined as the change in shock index (SI) over time, is associated with hospital morbidity and mortality, but prehospital studies about ΔSI are limited. We investigate the association of prehospital ΔSI with mortality and resource utilization, hypothesizing that increases in SI among field trauma patients are associated with increased mortality and blood product transfusion.

Methods: We performed a multicenter, retrospective, observational study from the Linking Investigators in Trauma and Emergency Services (LITES) network.

Diuretics-Induced Acute Pancreatitis: Case Series with a Review of the Literature.

Background: Although diuretic-induced Acute Pancreatitis (AP) cases are typically mild to moderate, severe and potentially fatal occurrences can arise. Case Series and Literature Review: We have, herein, presented a series of diuretic-induced AP cases from March 2018 to February 2024 of a 54-year-old woman treated with chlorthalidone, a 45-year-old male treated with hydrochlorothiazide, and a 48-year-old male treated with frusemide. The literature search has identified 26 cases published to date, 10 from frusemide and 16 from thiazide diuretics.

Cardiac Computed Tomography for Cardioembolic Stroke Evaluation in a Patient With a Mechanical Aortic Valve.

We present a case of cardioembolic stroke in a patient with a history of mechanical aortic valve who was compliant with anticoagulation medication. Cardiac computed tomography was used as an alternative, noninvasive means of evaluation for the cardioembolic source of stroke and identified subvalvular mobile pannus of the mechanical aortic valve.

Increased Perception of Head Tilt to Galvanic Vestibular Stimulation Correlates to Motion Sickness Susceptibility in Vestibular Migraine.

Background:  Vestibular migraine is associated with vertigo, persistent swaying, tilting, and disorientation, which suggests a heightened sensitivity of the neural mechanisms subserving spatial orientation. Whether a heightened sense of motion to vestibular stimulation in vestibular migraine is associated with sensitivity to visual motion (visual dependency) or physical motion (motion sickness susceptibility) is unclear.

Purpose:  The aim of this study was to explore whether a heightened sense of self-motion sensitivity in vestibular migraine is associated with visual dependency or motion sickness susceptibility.

Case Series: Variants in Four Patients with Metastatic Pheochromocytoma.

Few reports have highlighted the rare presence of somatic variants in clinically aggressive, metastatic pheochromocytoma/paraganglioma (PCC/PGL); however, none have addressed detailed clinical presentation (including biochemistry and imaging) and management of these patients. Here, we address these clinical features and management based on four PCC patients with somatic variants from our National Institutes of Health PCC/PGL cohort. A total of 192 patients underwent exome sequencing (germline, somatic, or both), and four males were found to have somatic variants (with additional somatic and oncogenic variants in patients 2 and 4, respectively).

Management of Infections Associated with Penile Prostheses and Artificial Urinary Sphincters.

Prosthetic urology can substantially enhance the quality of life for patients. However, it is not without challenges. Infections of penile prostheses and artificial urinary sphincters are often difficult to diagnose, manage, and treat.

Impact of dietary changes on retinal neuronal plasticity in rodent models of physical and psychological trauma.

Introduction: Blast injury has been implicated as the major cause of traumatic brain injury (TBI) and ocular system injury, in military operations in Iraq and Afghanistan. Soldiers exposed to traumatic stress also have undiagnosed, chronic vision problems. Here we hypothesize that excessive intake of ω-6 fatty acid linoleic acid (LA) and insufficiency of dietary long chain ω-3 polyunsaturated fatty acids (PUFAs, e.

Utilizing a portable magnetic resonance imaging (MRI) in the setting of an acute ischemic stroke in a patient with a cardiac implantable electronic device.

Background: Cardiac implantable electronic device (CIED) generally excludes patients from undergoing fixed, high-field magnetic resonance imaging (MRI). Acute ischemic stroke patients undergo MRI as a standard part of an assessment of infarct burden. The use of a portable MRI scanner may be useful in patients who have contraindications to high-field MRI.

Molecular Biomarkers for In Vitro Thrombogenicity Assessment of Medical Device Materials.

To develop standardized in vitro thrombogenicity test methods for evaluating medical device materials, three platelet activation biomarkers, beta-thromboglobulin (β-TG), platelet factor 4 (PF4), soluble p-selectin (CD62P), and a plasma coagulation marker, thrombin-antithrombin complex (TAT), were investigated. Whole blood, drawn from six healthy human volunteers into Anticoagulant Citrate Dextrose Solution A was recalcified and heparinized over a concentration range of 0.5-1.

Impact of aging on the frequency, phenotype, and function of CD4+ T cells in the human female reproductive tract.

Since CD4+ T cells are essential for regulating adaptive immune responses and for long lasting mucosal protection, changes in CD4+ T cell numbers and function are likely to affect protective immunity. What remains unclear is whether CD4+ T cell composition and function in the female reproductive tract (FRT) changes as women age. Here we investigated the changes in the composition and function of CD4+ T cells in the endometrium (EM), endocervix (CX), and ectocervix (ECX) with aging.

Evaluation of the Implementation of a Novel Fluid Resuscitation Device in the Prehospital Care of Sepsis Patients: Application of the Implementation Outcomes Framework.

Objectives: Early identification and fluid resuscitation are recognized performance measures within sepsis care. Despite fluid resuscitation, fluid goals are often not achieved in the prehospital environment. Furthermore, description of implementation process and evaluation of implementation success are historically underreported in prehospital research.

Investigation of Mirabegron-loaded Nanostructured Lipid Carriers for Improved Bioabsorption: Formulation, Statistical Optimization, and In-Vivo Evaluation.

Overactive bladder (OAB) is a usual medical syndrome that affects the bladder, and Mirabegron (MBG) is preferred medicine for its control. Currently, available marketed formulations (MYRBETRIQ® granules and MYRBETRIQ® ER tablets) suffer from low bioavailability (29-35%) hampering their therapeutic effectiveness and compromising patient compliance. By creating MBG nanostructured lipid carriers (MBG-NLCs) for improved systemic availability and drug release, specifically in oral administration of OAB treatment, this study aimed to address these issues.

Breast/chest imaging findings and clinical considerations in transgender patients.

The transgender population, a historically marginalized group, is growing in size, visibility, and cultural acceptance. However, lack of provider knowledge contributes to the disparities and discrimination that this group continues to face in the healthcare setting. Special considerations for transgender individuals undergoing imaging for breast/chest care can improve health equity, including appropriate evidence-based screening, tailored protocols, and inclusive radiology facilities.

Software using artificial intelligence for nodule and cancer detection in CT lung cancer screening: systematic review of test accuracy studies.

Objectives: To examine the accuracy and impact of artificial intelligence (AI) software assistance in lung cancer screening using CT.

Methods: A systematic review of CE-marked, AI-based software for automated detection and analysis of nodules in CT lung cancer screening was conducted. Multiple databases including Medline, Embase and Cochrane CENTRAL were searched from 2012 to March 2023.