Why is naloxone prescription not more common in emergency departments? A survey of physician practices and attitudes.

Objective: Emergency physicians (EPs) have a singular opportunity to prescribe naloxone and decrease fatal overdoses in opioid users. We surveyed EPs patterns of naloxone prescription and identified barriers to prescribing naloxone.

Design: Surveys were conducted at an emergency medicine conference from 2018 to 2019.

Chronic mild stress leads to anxiety-like behavior and decreased p70 S6K1 activity in the hippocampus of male mice.

Major affective disorders are highly prevalent, however, current treatments are limited in their effectiveness due to a lack of understanding of underlying molecular mechanisms. Recent studies have shown that reduced activity of p70 S6 kinase 1 (S6K1), a downstream target of the mechanistic target of rapamycin complex 1 (mTORC1), is linked to anxiety-like behavior in both humans and rodents. The purpose of this study was to investigate the relationship between S6K1 and anxiety-like behavior following chronic mild stress (CMS) and drug-induced inhibition of S6K1.

Feasibility and impact of a monoclonal antibody infusion program in reaching vulnerable underserved communities.

The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted Black, indigenous, and people of color (BIPOC). Equitable access to therapeutics is key to addressing health disparities. We established a monoclonal infusion program in the emergency department of a safety-net hospital.

Dehydrated human amnion/chorion membrane use in emergent craniectomies shows minimal dural adhesions.

Decompressive craniectomies (DCs) are routinely performed neurosurgical procedures to emergently treat increased intracranial pressure secondary to multiple aetiologies, such as subdural haematoma, epidural haematoma, or malignant oedema in the setting of acute infarction. The DC procedure typically induces epidural fibrosis post-cranial resection, resulting in adherence of the dura to both the brain internally and skin flap externally. This becomes especially problematic in the setting of skull flap replacement for cranioplasty as adherences can lead to bridging vein tear, damage to the underlying brain cortex, and other postoperative complications.

Dupilumab-Associated Sezary Syndrome.

Dupilumab is a monoclonal antibody that inhibits interleukin-4 (IL-4) and interleukin-13 (IL-13), approved for the treatment of adults with moderate-to-severe atopic dermatitis (AD). While recent reports have described cases of new-onset mycosis fungoides (MF) following treatment with dupilumab for AD, to our knowledge only one patient has been delineated with the progression to SS. We present an additional case of a patient who was diagnosed with SS following treatment with dupilumab for adult-onset AD and asthma.

Association Between Poor Sleep and Myocardial Infarction in Patients with Psoriasis: Findings from a Cross-Sectional Study with the National Psoriasis Foundation.

Background: Poor sleep quality occurs in patients with psoriasis at rates nearly twice that of the general population. Chronic sleep impairment is an independent risk factor for the development of cardiovascular disease. Here, we examine the association between sleep quantity and history of myocardial infarction in patients with psoriasis.

Treatment of Pediatric Pemphigus Foliaceus.

Pemphigus foliaceus (PF) is an autoimmune blistering disease limited to the superficial skin without mucosal involvement. It is clinically, histologically, and immunopathologically distinct from pemphigus vulgaris (PV). As data on pediatric PF is often merged with data on both pediatric and adult PV patients, isolating clinical outcomes in pediatric PF is not always possible.

A muscarinic, GIRK channel-mediated inhibition of inspiratory-related XII nerve motor output emerges in early postnatal development in mice.

In neonatal rhythmic medullary slices, muscarinic acetylcholine receptor (mAChR) activation of hypoglossal (XII) motoneurons that innervate the tongue has a net excitatory effect on XII inspiratory motor output. Conversely, during rapid eye movement sleep in adult rodents, XII motoneurons experience a loss of excitability partly due to activation of mAChRs. This may be mediated by activation of G-protein-coupled inwardly rectifying potassium (GIRK) channels.

Leveraging Machine Learning for Accurate Detection and Diagnosis of Melanoma and Nevi: An Interdisciplinary Study in Dermatology.

This study explores the application of machine learning and deep learning algorithms to facilitate the accurate diagnosis of melanoma, a type of malignant skin cancer, and benign nevi. Leveraging a dataset of 793 dermatological images from the Kaggle online platform (Google LLC, Mountain View, California, United States), we developed a model that can accurately differentiate between these lesions based on their distinctive features. The dataset was divided into training (80%), validation (10%), and testing (10%) sets to optimize model performance and ensure its generalizability.

A Pilot Study: Do Children Who Run Marathons Have More Osteoarthritis in the Lower Extremities as Adults.

Objective: To compare self-reported osteoarthritis of the knee and hip in adults who ran at least 1 marathon as a child with adults who ran high-school cross country (HSCC).

Design: Subject self-recall retrospective survey.

Setting: Electronic survey.

External Iliac Artery Endofibrosis: A Discussion on Two Unique Cases.

Iliac artery endofibrosis (IAE), as the name suggests, involves subintimal fibrosis of the iliac artery. IAE is most commonly associated with competitive athletics, particularly cycling, and remains a rather underappreciated diagnosis in the clinical setting. We present two unique and distinct presentations of IAE in competitive athletes.

Laser-Assisted In Situ Keratomileusis Surgery on a Patient with Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease or Neuromyelitis Optica Spectrum Disorder.

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and neuromyelitis optica spectrum disorder (NMOSD) are rare central demyelinating diseases that may affect refractive surgery outcomes. Optic neuritis and brainstem syndromes affecting cranial nerves are particularly relevant to corneal refractive surgery (CRS), such as laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy, or small incision lenticule extraction. There is currently no existing literature concerning the outcomes of CRS in patients with MOGAD or NMOSD.

High Fat High Sugar Diet Reduces Small Intestinal Secretion by Sex-Dependent Mechanisms.

Background/aims: The goal of this study was to determine the influence of high-fat high-sugar diet (Western diet) on intestinal function and subsequently to determine if there were any beneficial effects of exercise, genistein (a naturally occurring phytoestrogen) or both, on the intestine.

Methods: We measured transepithelial short circuit current (I), across freshly isolated segments of jejunum from male and female C57Bl/6J mice randomly assigned to one of the following groups for the 12-week study duration: high-fat high-sugar diet (HFS), HFS with genistein (Gen), HFS with exercise (Ex), or HFS with both genistein and exercise (Gen+Ex) and compared them to lean controls. Genistein concentration was 600 mg genistein/kg diet.

Does Preoperative Pharmacogenomic Testing of Patients Undergoing TKA Improve Postoperative Pain? A Randomized Trial.

Background: Pharmacogenomics is an emerging and affordable tool that may improve postoperative pain control. One challenge to successful pain control is the large interindividual variability among analgesics in their efficacy and adverse drug events. Whether preoperative pharmacogenomic testing is worthwhile for patients undergoing TKA is unclear.

Review of the use of radiomics to assess the risk of recurrence in early-stage non-small cell lung cancer.

Background And Objective: Radiomics is an emerging field of advanced image analysis that has shown promise as a non-invasive, companion diagnostic in predicting clinical outcomes and response assessments in solid tumors. Radiomics aims to extract high-content information from medical images not visible to the naked eye, especially in early-stage non-small cell lung cancer (NSCLC) patients. Although these patients are being identified by early detection programs, it remains unclear which patients would benefit from adjuvant treatment versus active surveillance.

Deep Learning Classification of Drusen, Choroidal Neovascularization, and Diabetic Macular Edema in Optical Coherence Tomography (OCT) Images.

Background Age-related macular degeneration (AMD), diabetic retinopathy (DR), drusen, choroidal neovascularization (CNV), and diabetic macular edema (DME) are significant causes of visual impairment globally. Optical coherence tomography (OCT) imaging has emerged as a valuable diagnostic tool for these ocular conditions. However, subjective interpretation and inter-observer variability highlight the need for standardized diagnostic approaches.

Meta-Analysis of Animal Fluency Performance in Amnestic Mild Cognitive Impairment and Cognitively Unimpaired Older Adults.

Animal fluency is a commonly used neuropsychological measure that is used in the diagnosis of amnestic mild cognitive impairment (aMCI) and Alzheimer disease. Although most individuals with aMCI have clinically normal scores on this test, several studies have shown that aMCI individuals' performance is significantly lower than that of cognitively unimpaired (CU) individuals. The aim of this meta-analysis was to characterize the effect size of animal fluency performance differences between aMCI and CU individuals.

Utilizing Deep Learning for X-ray Imaging: Detecting and Classifying Degenerative Spinal Conditions.

Background Degenerative spinal conditions (DSCs) involve a diverse set of pathologies that significantly impact health and quality of life, affecting many individuals at least once during their lifetime. Treatment approaches are varied and complex, reflecting the intricacy of spinal anatomy and kinetics. Diagnosis and management pose challenges, with the accurate detection of lesions further complicated by age-related degeneration and surgical implants.

Comparative anatomy of the felid brachial plexus reflects differing hunting strategies between Pantherinae (snow leopard, Panthera uncia) and Felinae (domestic cat, Felis catus).

The brachial plexus, a network of ventral rami providing somatic sensory and motor innervation to the forelimb, is of particular importance in felids. Large-bodied pantherines require powerful rotatory and joint stabilizing forelimb muscles to maintain secure holds on large prey, while smaller-bodied felines are small prey specialists reliant on manual dexterity. Brachial plexus dissections of two snow leopards (Panthera uncia) and two domestic cats (Felis catus) revealed that generally the morphology of the brachial plexus is quite conserved.

Glasgow Coma Scale Intubation Thresholds and Outcomes of Patients With Traumatic Brain Injury: The Need for Tailored Practice Management Guidelines.

Introduction: This study aims to re-evaluate the GCS threshold for intubation in patients presenting to the ED with a traumatic brain injury to optimize outcomes and provide evidence for future practice management guidelines.

Methods: We retrospectively reviewed the ACS-TQIP-Participant Use File (PUF) 2015-2019 for adult trauma patients 18 years and older who experienced a blunt traumatic head injury and received computerized tomography. Multivariable regressions were performed to assess associations between outcomes and GCS intubation thresholds of 5, 8, and 10.

Retrospective Study of EMS Scene Times and Mortality in Penetrating Trauma Patients: Improving Transport Standards and Patient Outcomes.

Background: This study aimed to determine the impact of emergency medical service (EMS) scene time variability on adult and pediatric trauma patient outcomes with moderate or severe penetrating injuries.

Methods: This retrospective study analyzed the American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) database between 2017 and 2020 to evaluate the relationship between EMS scene time on adult and pediatric patients with moderate to severe injuries. Primary outcomes included Dead on Arrival (DOA) to the Emergency Department (ED), ED mortality, 24-hour mortality, and in-hospital mortality.