Systematic Review and Meta-Analysis to Assess Safety and Early Mortality in Octogenarians undergoing Fenestrated and Branched Endovascular Aortic Repair for Complex Aortic Aneurysms.

Objectives: The population in the U.S., and across the world is aging rapidly which warrants an assessment of the safety of surgical approaches in elderly individuals to better risk stratify and inform surgeons' decision making for optimal patient care.

Hemolytic Anemia Secondary to Rasburicase Treatment in the Setting of Glucose-6-Phosphate-Dehydrogenase Deficiency: A Case Report.

Rasburicase is a recombinant form of urate oxidase, a medication used to treat hyperuricemia by metabolizing uric acid into an inactive and more soluble metabolite, allantoin. An oxidizing agent, hydrogen peroxide, is produced during the conversion of uric acid to allantoin. We present here a case of hemolytic anemia secondary to rasburicase treatment which was later confirmed to have glucose-6-phosphate dehydrogenase deficiency (G6PDD).

LGD-4033 and a Case of Drug-Induced Liver Injury: Exploring the Clinical Implications of Off-Label Selective Androgen Receptor Modulator Use in Healthy Adults.

Selective androgen receptor modulators (SARMs), designed to treat conditions such as muscle wasting and osteoporosis, are widely used among healthy adults seeking muscle hypertrophy and enhanced athletic performance, despite a lack of Food and Drug Administration (FDA) approval. This trend may be driven by the misconception that SARMs are safer alternatives to anabolic steroids. However, SARMs such as LGD-4033 (Ligandrol) are associated with significant adverse effects, including hepatotoxicity, cardiovascular complications, endocrine disturbances, and psychiatric symptoms.

History of Preoperative Use of Gabapentin Before Lower Extremity Bypass Predisposes Patients to a High Risk of Opioid Use and Dependence in a Dose-Dependent Manner.

Introduction: This study assesses the association of preoperative use of gabapentinoids (GBPs) with postoperative risk of opioid-related disorders in peripheral artery disease patients undergoing lower extremity bypass operation.

Methods: This is a retrospective propensity score-matched analysis of patients undergoing peripheral artery bypass in TriNetX, a multicenter national database. Two study groups were constituted based on the preoperative history of prescribed GBPs.

Leptomeningeal metastases in prostate cancer: A review of the current literature.

Leptomeningeal metastasis/leptomeningeal carcinomatosis (LMC; terms used interchangeably) is an inflammatory complication of primary tumors that involves the spread of the disease to the meninges (specifically the arachnoid and pia maters) and spinal cord. In the United States, approximately 110,000 new cases are diagnosed each year, and the prognosis is usually poor. Complications of LMC include cognitive impairment, cranial nerve dysfunction, ischemic stroke, and mortality.

How Agent Orange impacts prostate cancer risk, pathology, and treatment outcomes.

Between 2.6 and 3.8 million veterans served in Vietnam while the US military dispersed Agent Orange (AO), although the exact number of exposed individuals is unknown.

Testicular Cancer and Paraneoplastic Encephalitis: A Review of the Current Literature.

Introduction: Paraneoplastic encephalitis (PE) represents a rare but significant complication in patients with testicular cancer (TC). Given the paucity of comprehensive literature on this topic, our review seeks to consolidate current knowledge and provide evidence-based recommendations for the diagnosis, prognosis, and management of PE in the context of TC.

Materials And Methods: In adherence to PRISMA guidelines, a systematic literature review was conducted from 1950 to April 2024 using PubMed.

Determining Ideal Management for Patients With Coexisting Prolactinomas and Psychiatric Symptoms: A Systematic Review.

Objective: Prolactinomas-pituitary tumors that overproduce prolactin-can cause various troublesome symptoms. Dopamine agonists (DAs) reduce prolactin production in the prolactin pathway, making them the first-line treatment for prolactinomas. However, the main side effect of DA treatment, hyperdopaminergia, is an explicit etiology for psychiatric side effects.

Systematic review and meta-analysis to assess the racial disparities in the outcomes of carotid endarterectomy in the United States.

Objective: Race-based disparities in health care have been related to a myriad of prevailing factors among minorities in the United States. This study aims to study the race-based differences in the outcomes of carotid endarterectomy (CEA).

Methods: The PROSPERO database registered the review protocol (CRD42023428253).

Clinical Warburg Effect in a Patient With Mantle Cell Lymphoma: A Case Report.

The clinical Warburg effect is a rare occurrence in cancer biology where tumor cells primarily utilize glycolysis for energy production, leading to significant hypoglycemia and lactate formation. This presentation is associated with a poor prognosis for the patient. In this context, we describe the case of a 53-year-old woman with stage IV mantle cell lymphoma who developed the clinical Warburg effect with solely arrhythmia and without neurological symptoms.

Splenic Infarction Due to Epstein-Barr Virus: A Case Report and Literature Review.

Splenic infarction is a rare and likely underdiagnosed complication of Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM). Here, we describe an 18-year-old Guyanese male with persistent severe left-sided abdominal pain found to be EBV positive and have a large splenic infarct, along with a transient decrease in protein C, protein S, and antithrombin III activity levels. He was treated with supportive care and anticoagulated with heparin and apixaban.

Hemolytic Anemia and Pancytopenia Secondary to Vitamin B12 Deficiency: Evaluation and Clinical Significance.

Severe vitamin B12 deficiency presents a diagnostic challenge due to its diverse clinical manifestations, which can mimic serious hematologic disorders such as thrombotic thrombocytopenic purpura (TTP) or leukemia. The case we present here illustrates the unique characteristics of severe B12 deficiency, highlighting key differentiators from other conditions, including decreased reticulocyte counts and markedly elevated lactate dehydrogenase levels indicative of suppressed erythropoiesis. Advanced cobalamin deficiency affects all cell lines, leading to peripheral pancytopenia.

Examining the relationship between head trauma and opioid use disorder: A systematic review.

Objective: To examine recent literature and determine common clinical risk factors between antecedent traumatic brain injury (TBI) and the following development of opioid misuse and provide a framework for clinical identification of at-risk subjects and evaluate potential treatment implications within this association.

Design: A comprehensive systematic literature search of PubMed was conducted for articles between 2000 and December 2022. Studies were included if the human participant had any head trauma exposure and any chronic opioid use or dependence.

The Effect of Antipsychotics on Prolactinoma Growth: A Radiological and Serological Analysis.

Many antipsychotic (AP) medications work by reducing dopamine levels. As hyperdopaminergia is known to cause psychosis, antipsychotics work to relieve these symptoms by antagonizing dopamine receptors and lowering dopamine levels. Dopamine is also a known negative modulator of the prolactin pathway, which allows for drug agents like dopamine agonists (DAs) to be incredibly effective in managing tumors that secrete excess prolactin (prolactinomas).

Efficacy and safety of corticosteroids for the treatment of community-acquired pneumonia: A systematic review and meta-analysis of randomized controlled trials.

Background: The role of corticosteroids in the treatment of community-acquired pneumonia (CAP) remains uncertain. We conducted an updated meta-analysis to investigate the effectiveness and potential effect modifiers of adjunctive corticosteroids in patients with CAP.

Methods: The protocol of this meta-analysis was registered with PROSPERO (CRD42022354920).

Preload Reduction Therapies in Heart Failure.

Preload reserve represents an important concept in the normal physiologic responses of the body to meet the changing metabolic demands. The recruitment of preload in healthy patients leads to an increase in effective circulating blood volume with a concomitant increase in cardiac output. However, in the setting of heart failure (HF), preload augmentation may precipitate HF decompensation.

Patient satisfaction of specialist nurse-led renal cancer follow-up.

Background: For many patients with locally advanced renal cancer, management is surgery followed by surveillance imaging for several years. There is no concrete data regarding specialist nurse follow-up for patients after they have had surgery.

Aims: The authors' aim was to assess patient satisfaction with specialist nurse follow-up for patients with renal cancer who have undergone surgery.

A Stroke Mimic With Postictal Todd's Paresis and a Simplified Guide to Management of Acute Hyponatremia.

Stroke mimics typically involve non-vascular disease processes, accounting for approximately half of hospital admissions for suspected stroke. These mimics may manifest as functional (conversion) disorders or indicate other neurological or medical conditions, including hypoglycemia, brain tumors, toxic poisoning, migraines, sepsis, seizures, and electrolyte imbalances, which can imitate stroke symptoms, making the diagnosis complex. In this report, we present a unique case of a man in his sixties who developed acute postoperative hyponatremia, an electrolyte abnormality frequently encountered but rarely presented with focal neurological deficits.

Exploring the link between ACEs and opioid use: A systematic review.

Objective: To review the current literature surrounding the relationship between adverse childhood experiences (ACEs) and opioid use disorder (OUD) to guide clinical identification of high-risk individuals and assess treatment implications.

Design: A PubMed search was conducted from the year 2000 to 2022 using a series of primary and secondary search terms. A total of 21,524 unique results were screened for relevancy to ACEs and OUDs.

Association of Preoperative Frailty with Inferior Outcomes for Patients Undergoing Lower Extremity Bypass for Chronic Limb Threatening Ischemia: A Systematic Review.

Background: Frailty is a risk factor associated with adverse postoperative outcomes following lower extremity bypass (LEB) surgery in patients with peripheral arterial disease (PAD). Chronic limb threatening ischemia (CLTI) represents the worst form of PAD, and frailty is common among patients presenting with CLTI. Multiple frailty assessment scores have been developed for the past 2 decades; however, a universal clinical assessment tool for measuring frailty has not yet been established due to the complexity of the concept.

Black or African American patients undergo great saphenous vein ablation procedures for advanced venous disease and have the least improvement in their symptoms after these procedures.

Objective: Chronic venous insufficiency is an increasingly prevalent problem in the United States, with >25 million individuals currently affected. Previous work has shown that racial minorities and low socioeconomic status are associated with a worse clinical presentation and response to treatment. The present study aimed to determine the relationship between race, patient variables, hospital outcomes, and response to treatment for patients presenting for chronic venous insufficiency intervention.

An Etiological Investigation of Paraneoplastic Cerebellar Degeneration in Ovarian Cancer Patients: A Systematic Review.

Paraneoplastic syndromes (PNS) are uncommon, distinct clinical complications of a primary tumor. Paraneoplastic cerebellar degeneration (PCD) is a PNS that is described as an autoimmune response targeting Purkinje cells in the cerebellum. Ovarian cancer (OC) is one of the most prevalent causes of cancer-related deaths in women.

Effects of Inclusive Leadership on Quality of Care: The Mediating Role of Psychological Safety Climate and Perceived Workgroup Inclusion.

Purpose: The aim of the study is to investigate the multilevel effects of the inclusiveness of workgroup leaders on quality of care by intervening through a "psychological safety climate" at the group level and "perceived workgroup inclusion" at the individual level within professionally diverse workgroups of healthcare professionals.

Material And Methods: Data are collected from 305 healthcare professionals nested in 61 workgroups and 305 patients treated by the same workgroups working in public-sector hospitals in Pakistan. Hypothesized relationships are tested through multilevel analyses using Mplus 7.

Engineered red blood cells (activating antigen carriers) drive potent T cell responses and tumor regression in mice.

Activation of T cell responses is essential for effective tumor clearance; however, inducing targeted, potent antigen presentation to stimulate T cell responses remains challenging. We generated Activating Antigen Carriers (AACs) by engineering red blood cells (RBCs) to encapsulate relevant tumor antigens and the adjuvant polyinosinic-polycytidylic acid (poly I:C), for use as a tumor-specific cancer vaccine. The processing method and conditions used to create the AACs promote phosphatidylserine exposure on RBCs and thus harness the natural process of aged RBC clearance to enable targeting of the AACs to endogenous professional antigen presenting cells (APCs) without the use of chemicals or viral vectors.