Transesophageal echocardiography monitoring for liver transplantation: where are we now?

Intraoperative hemodynamic monitoring is crucial for managing patients with end-stage liver disease (ESLD) undergoing orthotopic liver transplantation (OLT) due to their complex cardiovascular and pulmonary abnormalities. Traditionally, pulmonary artery catheterization (PAC) has been the standard for hemodynamic monitoring during OLT. However, the use of transesophageal echocardiography (TEE) has increased due to its real-time visualization of cardiac and vascular structures, which aids in managing hemodynamic instability during the three surgical phases of OLT: pre-anhepatic, anhepatic, and neo-hepatic.

Outcomes of Cochlear Implantation in Adolescents With Auditory Neuropathy Spectrum Disorder: Scoping Review and Case Report.

Objective: To assess outcomes of CI in adolescent patients with ANSD, a population which has not yet been comprehensively reviewed through a scoping review.

Methods: A scoping review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of MEDLINE, EMBASE, Cochrane DSR, Cochrane CENTRAL, CINAHL, and Web of Science was performed.

New Directions For Women's Health: Expanding Understanding, Improving Research, Addressing Workforce Limitations.

In the United States, the field of women's health faces critical challenges. This article, part of the National Academy of Medicine's Vital Directions for Health and Health Care: Priorities for 2025 initiative, emphasizes the need for a holistic, lifespan approach to women's health that considers biological sex, gender, and intersecting social factors. We identify three key challenges: broadening the understanding of women's health beyond reproductive issues, improving the research ecosystem, and addressing workforce limitations.

Translational Outcomes Project in Neurotrauma (TOP-NT) Pre-Clinical Consortium Study: A Synopsis.

Traumatic brain injury (TBI) has long been a leading cause of death and disability, yet research has failed to successfully translate findings from the pre-clinical, animal setting into the clinic. One factor that contributes significantly to this struggle is the heterogeneity observed in the clinical setting where patients present with injuries of varying types, severities, and comorbidities. Modeling this highly varied population in the laboratory remains challenging.

Decay in Physiologic Knowledge since Medical School among Critical Care Fellows (DIP Study).

Rapid accumulation of knowledge and skills by trainees in the intensive care unit assumes prior mastery of clinically relevant core physiology concepts. However, for many fellows, their foundational physiology knowledge was acquired years earlier during their preclinical medical curricula and variably reinforced during the remainder of their undergraduate and graduate medical training. We sought to assess the retention of clinically relevant pulmonary physiology knowledge among pulmonary and critical care medicine (PCCM) and critical care medicine (CCM) fellows.

Healthy Aging and the Gut Microbiome in People With and Without HIV.

Background: Aging-related comorbidities are more common in people with human immunodeficiency virus (HIV) compared to people without HIV. The gut microbiome may play a role in healthy aging; however, this relationship remains unexplored in the context of HIV.

Methods: 16S rRNA gene sequencing was conducted on stool from 1409 women (69% with HIV; 2304 samples) and 990 men (54% with HIV; 1008 samples) in the MACS/WIHS Combined Cohort Study.

Mechanisms and technologies in cancer epigenetics.

Cancer's epigenetic landscape, a labyrinthine tapestry of molecular modifications, has long captivated researchers with its profound influence on gene expression and cellular fate. This review discusses the intricate mechanisms underlying cancer epigenetics, unraveling the complex interplay between DNA methylation, histone modifications, chromatin remodeling, and non-coding RNAs. We navigate through the tumultuous seas of epigenetic dysregulation, exploring how these processes conspire to silence tumor suppressors and unleash oncogenic potential.

An Atypical Case of Herpes Simplex 1 Meningitis.

Herpes simplex virus (HSV) is well known to cause Central Nervous System (CNS) infections, ranging from more common HSV-2 viral meningitis to the more rare and severe HSV-1 encephalitis. Here we present an atypical case of aseptic meningitis due to HSV-1. Intriguingly, despite the potential severity of HSV-1 infections, the patient had an uncomplicated course with only mild symptoms that resolved with conservative management alone.

Neuropsychiatric Manifestations of Syphilis.

Neurosyphilis is a condition characterized by insidious onset of encephalopathy and delirium. The infrequency with which it is encountered makes neurosyphilis a formidable diagnostic challenge. We present a rare case of a 71-year-old male with ischemic cardiomyopathy, chronic obstructive pulmonary disease (COPD), undifferentiated arthritis and alcohol use disorder who was brought to the emergency department after he was found altered, confused, and paranoid.

Hidradenitis Suppurativa and Peripheral Ulcerative Keratitis.

The co-occurrence of inflammatory eye disease and hidradenitis suppurativa (HS) is uncommon; ocular involvement typically manifests as anterior uveitis. In this report, we present a unique case of peripheral ulcerative keratitis (PUK) where both infectious and rheumatological workup was negative, leading us to consider the possibility of an association between this condition and severe HS. As far as we are aware, there have only been six documented cases of PUK associated with HS.

Beneath the Surface: Diagnosing Gastric Linitis Plastica.

Gastric Linitis plastica is characterized by extensive infiltration of gastric wall by poorly differentiated tumor cells, creating a "leather-bottle stomach" appearance. We describe a case involving a 71-year-old male presenting with globus sensation, early satiety and weight loss. Recent EGD had revealed chronic gastritis with polypoid mucosa at the GE junction, and subsequent FDG-PET indicated asymmetric FDG localization.

A Review of Circulating Tumor DNA (ctDNA) in Pancreatic Cancer: Ready for the Clinic?

Pancreatic ductal adenocarcinoma is a devastating disease which is associated with an increase in cancer-related death in the USA. The minority of patients are cured by surgery alone and typically require adjuvant chemotherapy in order to improve clinical outcomes. Circulating tumor DNA (ctDNA) is an emerging technology whereby microscopic levels of minimal residual disease (MRD) can be detected in the bloodstream.

Ethnic-racial discrimination, identity, and out-group contact in context: A systematic review of daily process studies.

Objectives: Understanding how ethnicity and race shape individuals' everyday experiences in context is critical for advancing scientific rigor and addressing ethnic-racial inequities. Daily process studies (e.g.

How norms-shifting interventions foster community-level social and behavior change: new insights from a synthesis of realist evaluations of community-level interventions.

Social norms, the informal rules that influence behavior, play essential roles in shaping people's behavior. Community-based norms-shifting interventions (NSIs) identify gender and other social norms linked to unhealthy behaviors and implement activities to promote collective change by encouraging communities to reflect on and question these norms. Though NSIs are gaining international traction in social and behavior change programming for health promotion, how change occurs needs to be clearly understood in African and other contexts.

Dysplasia and Colorectal Cancer Surveillance in Ulcerative Colitis Patients in Latin America: Real-World Data.

Background: The prevalence of colorectal cancer (CRC) in patients with ulcerative colitis (UC) is higher than in the general population, in Latin America there is a progressive increase of UC, and information about CRC screening in inflammatory bowel disease (IBD) is scarce. The aim of this study was to analyze the findings of endoscopic surveillance of CRC in patients with IBD according to available technology.

Methods: Multicenter, cross-sectional, analytical study conducted in Latin American countries, in patients with UC, predominantly with more than 8 years of diagnosis and different degrees of disease activity.

Palovarotene in fibrodysplasia ossificans progressiva: review and perspective.

Introduction: Palovarotene is a retinoic acid receptor gamma agonist that was studied in phase-2 and phase-3 clinical trials for the inhibition of new heterotopic ossification (HO) in fibrodysplasia ossificans progressiva (FOP). Despite numerous setbacks and regulatory delays, palovarotene is now the first approved FOP treatment in the U.S.

Comparison of radiation exposure for interventional radiology vs urology-guided renal access for percutaneous nephrolithotomy.

Introduction: Radiation exposure during percutaneous nephrolithotomy (PCNL) can vary depending on the method used for renal access. This study aimed to compare fluoroscopy time and dose during PCNL when renal access is achieved via interventional radiology (IR) versus urology.

Methods: A retrospective review of patients who underwent unilateral PCNL between January 2020 and February 2023 was conducted.

N-Branched Tricyclic Guanidines as Novel Melanocortin-3 Receptor Agonists and Melanocortin-4 Receptor Antagonists.

The melanocortin receptors are a class of centrally and peripherally expressed G protein-coupled receptors, of which the MC3R and MC4R subtypes are implicated in the regulation of appetite and energy homeostasis and can serve as potential therapeutic targets for disorders such as obesity and cachexia. An unbiased high-throughput mixture-based library screen was implemented to identify novel ligands with an emphasis on the identification of nanomolar-potent agonists of the mouse melanocortin-3 receptor. This screen yielded the discovery of an N-branched tricyclic guanidine scaffold (TPI2408) that contained three nanomolar potent mMC3R agonists and additional compounds that possessed antagonism for the mMC4R.

Prospective Harmonization, Common Data Elements, and Sharing Strategies for Multicenter Pre-Clinical Traumatic Brain Injury Research in the Translational Outcomes Project in Neurotrauma Consortium.

Effective team science requires procedural harmonization for rigor and reproducibility. Multicenter studies across experimental modalities (domains) can help accelerate translation. The Translational Outcomes Project in NeuroTrauma (TOP-NT) is a pre-clinical traumatic brain injury (TBI) consortium charged with establishing and validating noninvasive TBI assessment tools through team science.

Glucocorticoids Alter Bone Microvascular Barrier via MAPK/Connexin43 Mechanisms.

Glucocorticoids (GCs) are standard-of-care treatments for inflammatory and immune disorders, and their long-term use increases the risk of osteoporosis. Although GCs decrease bone functionality, their role in bone microvasculature is incompletely understood. Herein, the study investigates the mechanisms of bone microvascular barrier function via osteoblast-endothelial interactions in response to GCs.