What's the bug?: An unusual cause of bacterial meningitis in a patient with history of transsphenoidal surgery.

Bacterial meningitis is an increasingly rare disease that carries significant morbidity and mortality. We describe the case of a 38-year-old male with a past medical history of pituitary macroadenoma with prior endonasal surgeries on prednisone therapy daily for resultant hypopituitarism and juvenile myoclonic epilepsy on lamotrigine daily who was transferred to an academic tertiary emergency department due to concern for developing pituitary apoplexy. At the outside emergency department, the patient presented complaining of sudden onset severe headache.

Impact of preoperative frailty status on decision regret following elective hernia repair.

Purpose: Decision regret following hernia repair is common, particularly for patients who experience complications. Frailty is a risk factor for complications, but whether frailty is independently associated with regret remains unknown.

Methods: We retrospectively reviewed the Michigan Surgical Quality Collaborative Core Optimization Hernia Registry, a representative sample of adult patients from > 70 hospitals across Michigan.

Challenges in Geographic Access to Specialized Pediatric Burn Care in the United States.

Background: Geographical access to pediatric burn centers in the US is not well described. Patients may receive care at American Burn Association (ABA)-verified burn centers, unverified burn centers, or non-burn centers. A recent study indicated that most US counties do not have an ABA-verified pediatric burn center within 100 miles.

Three-dimensional assessment of ascending aortic stiffness, motion, and growth in ascending thoracic aortic aneurysm.

Aims: Aortic wall stiffening in ascending thoracic aortic aneurysm (aTAA) is common. However, the spatial and temporal relationships between stiffness, aortic size, and growth in aTAA remain unclear.

Methods And Results: In this single-centre retrospective study, we utilized vascular deformation mapping to extract multi-directional aortic motion, aortic distensibility, and aortic growth in a multi-planar fashion from multi-phasic ECG-gated computed tomography angiograms.

NASCI case of the month: "pseudo normalization of T1 values in Anderson-Fabry disease".

Anderson-Fabry disease (AFD) is a X-linked lysosomal storage disorder that can result in cardiac dysfunction including left ventricular hypertrophy (LVH) and conduction abnormalities (Frontiers in cardiovascular medicine vol. 10) [1]. The manifestations of AFD in women may be isolated to one organ and occur late in life due to the random inactivation of the X chromosome.

Hiatus and pelvic floor failure patterns in pelvic organ prolapse: A 3D MRI study of structural interactions using a Level III conceptual model.

Background: A large urogenital hiatus in Level III results in a higher risk of developing pelvic organ prolapse after birth and failure after prolapse surgery. Deepening of the pelvic floor and downward rotation of the levator plate have also been linked to prolapse. Currently we lack data that evaluates how these measures relate to one another and to prolapse occurrence and size.

Overcoming Cultural Barriers and Building Healthcare Trust: A Mixed Methods Study on Cervical Cancer Prevention Among Arab American Women Across Major U.S. Cities.

Background: Understanding why Arab American women have lower adherence to cervical cancer screening compared to other racial/ethnic groups is important. The study aimed to understand attitudes and knowledge of cervical cancer prevention and HPV vaccination among Arab American women.

Methods: A mixed-method approach was employed, including nine focus groups and an online questionnaire.

Renal pelvis pressure and flowrate with a multi-channel ureteroscope: invoking the concept of outflow resistance.

Understanding renal pelvis pressure (P) during ureteroscopy (URS) has become increasingly important. High irrigation rates, desirable to maintain visualization and limit thermal dose, can increase P. Use of a multi-channel ureteroscope (m-ureteroscope) with a dedicated drainage channel is one strategy that may facilitate simultaneous low P and high flowrate.

Circulating metabolomic biomarkers of 5-year body weight and composition change in a biracial cohort of community-dwelling older adults.

Unintentional weight loss in older populations is linked to greater mortality and morbidity risks. This study aims to understand the metabolic mechanisms of unintentional weight loss and their relationship with body composition changes in older adults. We investigated plasma metabolite associations with weight and body composition changes over 5 years in 1335 participants (mean age 73.

Controlled Dynamic Microfluidic Culture of Murine, Bovine, and Human Embryos Improves Development: Proof-of-Concept Studies.

Classical preimplantation embryo culture is performed in static fluid environments. Whether a dynamic fluid environment, like the fallopian tube, is beneficial for embryo development remains to be determined across mammalian species. Objectives of these proof-of-concept studies were to determine if controllable dynamic microfluidic culture would enhance preimplantation murine, bovine, and human embryo development compared to static culture.

The impact of race, ethnicity, and socioeconomic status on early adolescent sleep disturbances for youth exposed to adverse childhood experiences.

Background: Adverse childhood experiences (ACEs) may increase the risk for adolescent sleep disturbances, though the impact of race, ethnicity, and socioeconomic status (SES) remains unclear.

Objective: We sought to determine the direct and moderating impact of race, ethnicity, family SES, and community SES on sleep disturbances across early adolescence for ACE-exposed youth.

Participants And Setting: This secondary analysis used longitudinal Adolescent Brain Cognitive Development Study® data (2016-2022) from youth who experienced ≥1 ACE by age 9-10 years.

Lost Work Due to Burn-Related Disability in a US Working Population.

Background: Burn injuries can require hospitalization, operations, and long-term reconstruction. Burn-injured patients can experience short- or long-term disability. We investigated lost workdays (LWDs), short-term disability (STD), and long-term disability (LTD) in the 12-month period following a burn injury.

Healthcare transition readiness of families of youth with cystic fibrosis during COVID-19: A correlational multicenter analysis.

Background: Enhancing family readiness for the healthcare transition (HCT) to adult-focused care can help adolescents and young adults (AYA) thrive in adulthood. We aimed to explore modifiable and non-modifiable individual, family, and healthcare factors associated with HCT readiness of AYA among families of AYA with cystic fibrosis (CF) during COVID-19.

Methods: A multi-site, cross-sectional design was used and an online survey was deployed among families and their AYA from three US pediatric CF centers.

Sarcomatous transformation of IDH-mutant astrocytoma matching to methylation class oligosarcoma following embolization, a case report.

The mesenchymal transformations of infiltrating gliomas are uncommon events. This is particularly true of IDH-mutant astrocytomas and oligodendrogliomas, in which mesenchymal transformation is exceedingly rare. oligosarcoma is a newly recognized methylation class (MC) that represents transformed 1p/19q co-deleted oligodendrogliomas, but recent studies indicate it may be non-specific.

From empiric anti-scabietic treatments to delusional infestation: A case report.

Chronic pruritus accounts for approximately 1 % of all physician visits, and providers are often confronted with how to treat patients with pruritus. Scabies is oftentimes a concern by both patients and providers, and anti-scabietic treatments are generally considered safe and effective. However, the pruritus will continue if there is an alternate etiology.

Patients with Autism Spectrum or Intellectual Disability in the Psychiatric Emergency Department: Findings from a 10-year Retrospective Review.

Purpose: There is a dearth of information about patients with autism spectrum disorder (ASD) or intellectual disability (ID) who seek emergency psychiatric care. Given this backdrop, this retrospective study aims to explore clinical, demographic, and disposition-related information about this patient population over a 10-year period.

Methods: This study includes individuals with ASD or ID (n = 1461) and had presented to a psychiatric emergency department between 2012 and 2021.

Data Verification and Respondent Validity for a Web-Based Sexual Health Survey: Tutorial.

Background: As technology continues to shape the landscape of health research, the utilization of web-based surveys for collecting sexual health information among adolescents and young adults has become increasingly prevalent. However, this shift toward digital platforms brings forth a new set of challenges, particularly the infiltration of automated bots that can compromise data integrity and the reliability of survey results.

Objective: We aimed to outline the data verification process used in our study design, which employed survey programming and data cleaning protocols.

MRI-Based Structural Failure Comparison between Chinese and American White Women With Prolapse: A Case-Control Study.

Introduction And Hypothesis: Although some evidence suggests that Chinese and white women might have different pelvic floor anatomy such as levator complex and connective tissue support for pelvic organs, it is unknown if these differences affect the mechanisms of pelvic organ prolapse. We sought to determine whether differences exist in MRI-based structural failure patterns between Chinese and American white women with prolapse.

Methods: This is a case-control study in different racial cohorts recruited in China and the USA.