Significance of cycle 1 bone marrow biopsy in predicting outcomes and toxicities of venetoclax-based therapy for myeloid malignancies.

For older unfit patients receiving venetoclax-based induction, data on the significance of interim bone marrow biopies (BMBx) findings on clinical outcomes is lacking. We retrospectively evaluated interim BMBx results performed on Cycle 1 days 21-28 of venetoclax-based therapy in 69 adults with myeloid malignancies to determine whether blast clearance was associated with overall survival (OS) and overall response rate (ORR). Median age was 75 years (range 69-78).

The Utility of Whole Body Computed Tomography in Trauma Activations and the Impact of Incidental Findings on Patient Management: A Review.

Traumatic injury remains a leading cause of death globally, necessitating rapid and accurate diagnostic tools in emergency settings. Whole-body computed tomography (WBCT) has emerged as an increasingly utilized component in trauma care due to its speed and diagnostic precision. This review summarizes current data on the impact of WBCT on trauma mortality and examines the frequency and clinical implications of incidental findings (IFs).

How I Treat: Secondary Acute Myeloid Leukemia.

Secondary acute myeloid leukemia (sAML) has traditionally been used to designate any AML disease arising from an antecedent hematologic disorder or following prior cytotoxic or radiation therapy. We now know sAML comprises multiple disease entities with distinct clinical and biological features: AML-myelodysplastic related (AML-MR), myeloproliferative neoplasm-blast phase (MPN-BP), and AML post-cytotoxic therapy (AML-pCT). These entities largely represent adverse-risk phenotypes with the majority of patients experiencing suboptimal outcomes with standard therapeutic options.

The Effect of Power Grip on Ulnar Variance A Computed Tomography Study of the Wrist and Elbow.

Although an increase in ulnar variance with power grip is well documented in the medical literature, there is a paucity of information concerning its mechanism. This concept was examined in five healthy individuals using computed tomography of their wrists and elbows. Images were obtained of both joints in the resting position and with maximum power grip.

Acute leukemia with rearrangement: A master of disguise.

Mixed-phenotype acute leukemia (MPAL) is a rare form of leukemia with ambiguous lineage, and there are challenges in accurately diagnosing this entity according to formal criteria. Here we report a case which was initially diagnosed as "AML" based on atypical peripheral blood flow cytometry that was subsequently determined to be B-ALL with rearrangement based on marrow results. Although rearrangements represent a defining genetic abnormality for acute leukemia of ambiguous lineage, this case did not meet the criteria for MPAL based on WHO 2022 criteria.

Association of platelet satellitism with immune thrombocytopenia: A case report and review of literature.

Platelet satellitism refers to the rosetting of the platelets around white blood cells, mostly neutrophils that could lead to spuriously low platelet counts on automated analyzers. The phenomenon has usually been described in EDTA processed blood samples. We describe the clinical course of a patient with immune thrombocytopenia with platelet satellitism in both EDTA as well as non EDTA processed blood samples.

NCCN Guidelines® Insights: Systemic Mastocytosis, Version 3.2024.

Mastocytosis is a heterogeneous group of disorders comprising cutaneous mastocytosis, systemic mastocytosis, and mast cell sarcoma. It is associated with a variety of symptoms related to the release of mast cell mediators and mast cell tissue infiltration. Referral to specialized centers with expertise in the management of mastocytosis and multidisciplinary collaboration with subspecialists (eg, allergists for the management of anaphylaxis and drug hypersensitivities, anesthesiologists for invasive procedures or surgery, high-risk obstetrician for pregnancy) is recommended.

Spiral ganglion neuron degeneration in aminoglycoside-deafened rats involves innate and adaptive immune responses not requiring complement.

Spiral ganglion neurons (SGNs) transmit auditory information from cochlear hair cells to the brain. SGNs are thus not only important for normal hearing, but also for effective functioning of cochlear implants, which stimulate SGNs when hair cells are missing. SGNs slowly degenerate following aminoglycoside-induced hair cell loss, a process thought to involve an immune response.

Cyclic AMP signaling promotes regeneration of cochlear synapses after excitotoxic or noise trauma.

Introduction: Cochlear afferent synapses connecting inner hair cells to spiral ganglion neurons are susceptible to excitotoxic trauma on exposure to loud sound, resulting in a noise-induced cochlear synaptopathy (NICS). Here we assessed the ability of cyclic AMP-dependent protein kinase (PKA) signaling to promote cochlear synapse regeneration, inferred from its ability to promote axon regeneration in axotomized CNS neurons, another system refractory to regeneration.

Methods: We mimicked NICS by applying a glutamate receptor agonist, kainic acid (KA) to organotypic cochlear explant cultures and experimentally manipulated cAMP signaling to determine whether PKA could promote synapse regeneration.

Use of Topical Anesthetics in the Management of Patients With Simple Corneal Abrasions: Consensus Guidelines From the American College of Emergency Physicians.

The management of corneal abrasions has largely excluded dispensing topical local anesthetics for home use due to concern for corneal toxicity. We have reviewed and critically appraised the available literature evidence regarding the use of topical anesthetics in patients with simple corneal abrasions. Using sequential Delphi review, we have developed these clinical guidelines.

Evolution of the Human Hand from Early Hominid to Today.

The human body has evolved greatly over time and the hand has shown some of the most intricate changes. Most evolutionary experts attribute this to the greater use of tools facilitated by the early hominid's transition to a bipedal gait. Increased tool use drove these changes by providing a convincing reproductive advantage for early humans.

Anti-inflammatory Therapy Protects Spiral Ganglion Neurons After Aminoglycoside Antibiotic-Induced Hair Cell Loss.

Destruction of cochlear hair cells by aminoglycoside antibiotics leads to gradual death of the spiral ganglion neurons (SGNs) that relay auditory information to the brain, potentially limiting the efficacy of cochlear implants. Because the reasons for this cochlear neurodegeneration are unknown, there are no neuroprotective strategies for patients. To investigate this problem, we assessed transcriptomic changes in the rat spiral ganglion following aminoglycoside antibiotic (kanamycin)-induced hair cell destruction.

TP53 or Not TP53: That Is the Question.

Azacitidine and venetoclax are a standard first-line regimen for patients with newly diagnosed unfit acute myeloid leukemia (AML). In a pooled subset analysis, TP53-mutated AML with poor-risk cytogenetics does not appear to benefit from the addition of venetoclax to azacitidine. This has clinical implications as these patients should be preferentially treated with alternative regimens.

CT perfusion as a potential biomarker for pancreatic ductal adenocarcinoma during routine staging and restaging.

Purpose: To evaluate the significance of CT perfusion parameters predicting response to neoadjuvant therapy in patients with pancreatic ductal adenocarcinoma (PDAC).

Materials And Methods: Seventy patients with PDAC prospectively had CT perfusion acquisition incorporated into baseline multiphase staging CT. Twenty-eight who were naïve to therapy were retained for further investigation.

Adjunctive Procedures for Median Nerve Decompression in Carpal Tunnel Syndrome An Intraoperative Somatosensory Evoked Potential Study.

The objective of this study was to determine the role of ad- junctive surgical procedures on the median nerve for carpal tunnel syndrome as measured by somatosensory evoked potentials (SEPs) on the nerve. Fifty-five median nerves in 47 patients were studied. In each patient, a base-line SEP was recorded in the operating room prior to incision and then intraoperatively following each of three sequential pro- cedures: division of the transverse carpal ligament, an epi- neurolysis of the nerve, and finally, either an epineurotomy or epineurectomy that we refer to as a "limited internal neu- rolysis" since it did not involve any intraneural dissection of fascicles.

Late Repair of Flexor Tendon Lacerations Within the Digital Sheaths.

Purpose: This article presents the outcomes of repairs of flexor tendon lacerations within digital sheaths performed more than 2 weeks after injury.

Methods: A retrospective review of 46 patients; 37 with finger lacerations involving a total of 54 severed tendons in 42 fingers and nine with thumb lacerations of the flexor pollicis longus (FPL). In those patients with finger lacera- tions, 30 lacerations were isolated to the flexor digitorum profundus (FDP; 17 in Zone I and 13 in Zone II), and 12 involved both FDP and flexor digitorum superficialis (FDS) for a total of 24 tendon lacerations.

Collateral Ligament Ruptures of the Thumb Metacarpophalangeal Joint A Review of 500 Surgical Cases.

A retrospective review was conducted of 500 consecutive patients who underwent surgery for complete collateral ligament ruptures of their thumb metacarpophalangeal (MP) joints comprising 362 ulnar collateral and 138 radial collateral ligaments. Complete rupture was confirmed in all cases at surgery. When surgery was carried out within 3 weeks of the injury, reinsertion of the ligament was pos- sible in 98% of cases.

Detecting Intra-Field Variation in Rice Yield With Unmanned Aerial Vehicle Imagery and Deep Learning.

Unmanned aerial vehicles (UAVs) equipped with multispectral sensors offer high spatial and temporal resolution imagery for monitoring crop stress at early stages of development. Analysis of UAV-derived data with advanced machine learning models could improve real-time management in agricultural systems, but guidance for this integration is currently limited. Here we compare two deep learning-based strategies for early warning detection of crop stress, using multitemporal imagery throughout the growing season to predict field-scale yield in irrigated rice in eastern Arkansas.