Supra-Prophylactic Doses of Enoxaparin Reduces Fibrin Deposition Without Exacerbation of Intracerebral Hemorrhage in a Rat Model of Penetrating Traumatic Brain Injury.

Deep vein thrombosis and pulmonary embolism prophylaxis is an important part of trauma care. Despite an increased risk of thrombotic complications, the use of venous thrombosis chemoprophylaxis in penetrating traumatic brain injury (pTBI) patients is met with reluctance from neurosurgeons because of concern for the exacerbation of intracerebral hemorrhage. The objective of this study was to provide initial pre-clinical evidence of the effects of Lovenox (LVX) administration following pTBI with significant intracerebral hemorrhage.

Epigenetic signatures of asthma: a comprehensive study of DNA methylation and clinical markers.

Background: Asthma, a complex respiratory disease, presents with inflammatory symptoms in the lungs, blood, and other tissues. We investigated the relationship between DNA methylation and 35 clinical markers of asthma.

Methods: The Illumina Infinium EPIC v1 methylation array was used to evaluate 742,442 CpGs in whole blood from 319 participants from 94 families.

Neuropsychology's Role in Assessment of Medical Decision-Making Capacity, Home Safety, and Driving Ability.

Individuals with neurologic illness/injury often experience changes in their daily functioning. Clinical providers caring for these individuals are frequently called upon for input as patients and their families navigate challenging decisions to ensure safety. This article reviews 3 areas in which recommendations from clinicians are often requested: medical decision-making, home safety, and driving.

Antithrombotic Therapy for Heart Failure in Sinus Rhythm - A Concise Review.

Heart failure (HF) is a common disorder associated with significant morbidity and mortality. It can increase the risk of thromboembolic events, which subsequently lead to increased risk of stroke, ischemic heart disease, thromboembolism, and death. Antithrombotic therapy has been investigated as a potential management strategy for HF patients in sinus rhythm, but its efficacy remains uncertain.

The Epidemic of Congenital Syphilis in the Indigenous and Rural Populations of South Dakota.

From 2020 to 2023, South Dakota witnessed a substantial increase in cases of congenital syphilis (CS), with the highest rates identified in rural and Native American (NA) communities. Here, we discuss 3 severe cases of CS in premature infants born to NA individuals and communities in South Dakota with poor access to prenatal care. The infants in these 3 cases presented with varying clinical conditions, including respiratory failure, persistent pulmonary hypertension of the newborn, severe direct hyperbilirubinemia, feeding intolerance, and necrotizing enterocolitis.

Researching COVID to enhance recovery (RECOVER) pediatric study protocol: Rationale, objectives and design.

Importance: The prevalence, pathophysiology, and long-term outcomes of COVID-19 (post-acute sequelae of SARS-CoV-2 [PASC] or "Long COVID") in children and young adults remain unknown. Studies must address the urgent need to define PASC, its mechanisms, and potential treatment targets in children and young adults.

Observations: We describe the protocol for the Pediatric Observational Cohort Study of the NIH's REsearching COVID to Enhance Recovery (RECOVER) Initiative.

Genomic Considerations in the Treatment of Thyroid Carcinoma.

Highlighting genomically driven targeted therapies to improve outcomes in advanced thyroid carcinoma.

Using the Kirkpatrick model to evaluate a sepsis escape room for advanced pharmacy learners.

Background And Purpose: The purpose of this study was to use the first three levels of the Kirkpatrick Model to evaluate the effectiveness of a simulation center-based escape room activity designed to positively influence student learning.

Educational Activity And Setting: In this simulation, learners solve puzzles related to care of a critically ill patient. This activity was assessed via an assessment questionnaire (Kirkpatrick level 1), a pre/post learner knowledge quiz and learner self-assessment of skills and attitudes (Kirkpatrick level 2), and unstructured observation of learners upon return to the clinical environment (Kirkpatrick level 3).

Telemedicine in alcohol liver disease and transplantation care: Addiction therapy through video-conferencing-A case report.

Alcohol use disorder is a major public health concern, contributing to significant morbidity and mortality worldwide. Alcohol-associated liver disease is a major consequence of alcohol use disorder, with liver transplantation becoming the leading indication for this condition. This abstract describes a case study of a 39-year-old Native American man with severe alcohol-associated liver disease, illustrating the challenges and solutions in providing comprehensive care in a remote location.

A Retrospective Study Comparing the Effect of Conventional Coagulation Parameters Vs. Thromboelastography-Guided Blood Product Utilization in Patients With Major Gastrointestinal Bleeding.

Background: The use of thromboelastography (TEG) has demonstrated decreased blood product utilization in patients with specific etiologies of major gastrointestinal bleeding (GIB), such as variceal and non-variceal bleeding in cirrhosis patients; however, in a non-cirrhosis patient with GIB, there is far less evidence in the literature. Our retrospective study compares the effect of TEG-guided blood product utilization in patients with major GIB with all etiologies, including cirrhosis, admitted to medical intensive care unit (MICU).

Methods: A retrospective chart review was conducted on patients admitted to the MICU of a tertiary academic medical center diagnosed with GIB using ICD-9/10 codes from 2014 to 2018.

GWAS of Dizygotic Twinning in an Enlarged Australian Sample of Mothers of DZ Twins.

Female fertility is a complex trait with age-specific changes in spontaneous dizygotic (DZ) twinning and fertility. To elucidate factors regulating female fertility and infertility, we conducted a genome-wide association study (GWAS) on mothers of spontaneous DZ twins (MoDZT) versus controls (3273 cases, 24,009 controls). This is a follow-up study to the Australia/New Zealand (ANZ) component of that previously reported (Mbarek et al.

Primary Sclerosing Cholangitis: Epidemiology, Diagnosis, and Presentation.

Primary sclerosing cholangitis (PSC) is considered an immunologically mediated disease. However, some of its features are not consistent with the typical profile of autoimmune conditions. PSC is characterized by progressive biliary fibrosis that may ultimately result in the eventual development of cirrhosis.

Heart Failure Associated With Mycoplasma Pneumoniae Infection, A Case and Review of Literature.

is well known to cause pulmonary infection. However, it often has extrapulmonary manifestations as well. We diagnosed and treated a 41-year-old female who presented with symptoms of pneumonia along with multisystem involvement, including rash, acute hepatitis, and new onset heart failure that improved with steroids and doxycycline.

Pembrolizumab-Induced Broken Heart Syndrome, Pneumonitis, and Hypophysitis Occurring Concurrently; A Deadly Triad.

Immune checkpoint inhibitors are novel medications used to treat a wide range of solid organ tumors and work by stimulating the cellular immune response. With their increasing use, more and more multiorgan side effects are reported in the literature. Prompt recognition of these findings is vital for the safe clinical use of these agents.

Arrhythmogenic Left Ventricular Cardiomyopathy Associated With a Phospholamban Gene Mutation in a Young Female: A Case Report and Literature Review.

Arrhythmogenic cardiomyopathy (ACM) is a myocardium disease characterized by phenotypic features of myocardial scarring due to fibrofatty myocardial replacement often associated with global or regional ventricular dysfunction. For years after arrhythmogenic right ventricular cardiomyopathy (ARVC) was first described, the left ventricle (LV) was generally considered normal or minimally involved. In recent years, however, LV involvement has been recognized.

Reversible Cerebral Vasoconstriction Syndrome Associated With Oxybutynin Use; a Brief Review of Pathophysiology.

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by reversible vasospasm of the central nervous system vasculature. It usually presents as a classic thunderclap headache, but complications like a stroke, seizure, or intracranial hemorrhage may occur at the onset. Most cases are linked temporally to secondary agents.

Pakistan's Healthcare System: A Review of Major Challenges and the First Comprehensive Universal Health Coverage Initiative.

Each country's healthcare system has a different structure and functioning designed to meet the needs of its people utilizing the available resources. Due to ever-growing population needs and constantly emerging public health problems, it is vital for any healthcare system to be ready to adapt, recognize its limitations, and improve its flaws by learning from other healthcare models across the globe. In this article, we analyzed the significant challenges faced by Pakistan's healthcare system (PHS) and the first comprehensive initiative taken for universal health coverage in Pakistan.

A Case Presentation of Metastatic Hepatic Epithelioid Hemangioendothelioma: A Rare Vascular Tumor.

Epithelioid hemangioendothelioma (EHE) is an uncommon vascular tumor that can present in various organs, including the liver. Hepatic EHE (HEHE) may showcase with metastases at initial presentation, as patients have vague symptoms such as right upper quadrant pain leading to the risk of delayed diagnosis. There is no standard treatment.

Mediastinal Presentation of Testicular Embryonal Carcinoma.

Testicular embryonal carcinoma is a type of nonseminomatous germ cell tumor (NSGCT) that commonly presents with scrotal swelling due to testicular mass. About half of patients with NSGCTs will present with metastases at initial diagnosis. Rarely, testicular embryonal carcinoma can present primarily in the mediastinum.

More Than Results: The Clinical and Research Relationship in the Evolving Detection and Surveillance of SARS-CoV-2.

Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, real-time reverse transcription polymerase chain reaction (RT-PCR) became an essential tool for laboratories to provide high-sensitivity qualitative diagnostic testing for patients and real-time data to public health officials. Here we explore the predictive value of quantitative data from RT-PCR cycle threshold (Ct) values in epidemiological measures, symptom presentation, and variant transition.

Methods: To examine the association with hospitalizations and deaths, data from 74,479 patients referred to the Avera Institute for Human Genetics (AIHG) for COVID-19 testing in 2020 were matched by calendar week to epidemiological data reported by the South Dakota Department of Health.