Hospital admission of older patients with mild traumatic brain injury and traumatic intracranial hemorrhage: is it always necessary?

Background And Importance: Traumatic intracranial hemorrhage (tICH) after mild traumatic brain injury (mTBI) is not uncommon in the elderly. Often, these patients are admitted to the hospital for observation. The necessity of admission in the absence of clinically important intracranial injuries is however unclear.

The Continuous Fragility Index of Statistically Significant Findings in Studies Based on High Levels of Evidence Comparing Interventions for Femoroacetabular Impingement Syndrome.

Background: Critical analysis of studies with high level of evidence has relied on the significance set by the reported values. However, this strategy steers readers toward categorical interpretation of the data; therefore, a more comprehensive approach of data analysis is warranted. The continuous fragility index (CFI) allows for frailty interpretation of any given study's continuous outcome results.

Evaluation of an interprofessional education program involving medical and pharmacy students: a mixed-method study.

Background: Effective pharmacotherapy requires strong collaboration between physicians and pharmacists, highlighting the need for interprofessional education (IPE) in university curricula. This study evaluated the impact of an IPE program on medical and pharmacy students, focusing on their perceived development of interprofessional collaborative competencies, perceived learning outcomes, and clinical collaboration perceptions.

Methods: A mixed-method approach was employed to evaluate an IPE program that consisted of three mandatory activities with increased complexity and autonomy, that were integrated into the medical and pharmacy students' curricula.

Nebulized dexmedetomidine in the treatment of obstetric post-dural puncture headache: two case reports.

Post-dural puncture headache (PDPH) is a debilitating complication of neuraxial anesthesia, particularly prevalent in obstetric patients, usually characterized by a postural headache. PDPH is hypothesized to result from cerebrospinal fluid leakage through a dural puncture, triggering symptoms like neck stiffness and subjective hearing changes. While conservative measures are common for treatment, more refractory cases may require invasive interventions such as an epidural blood patch (EBP).

Evaluation of a context-aware chatbot using retrieval-augmented generation for answering clinical questions on medication-related osteonecrosis of the jaw.

The potential of large language models (LLMs) in medical applications is significant, and Retrieval-augmented generation (RAG) can address the weaknesses of these models in terms of data transparency and scientific accuracy by incorporating current scientific knowledge into responses. In this study, RAG and GPT-4 by OpenAI were applied to develop GuideGPT, a context aware chatbot integrated with a knowledge database from 449 scientific publications designed to provide answers on the prevention, diagnosis, and treatment of medication-related osteonecrosis of the jaw (MRONJ). A comparison was made with a generic LLM ("PureGPT") across 30 MRONJ-related questions.

Static Zygomatic Guides: Digital ZAGA Concept.

Guided zygomatic implant placement surgery has emerged as a promising solution for patients with severe maxillary bone loss, offering precise implant placement and predictable outcomes. This article provides a comprehensive review of the current state-of-the-art techniques, advantages, challenges, and future directions in guided zygomatic implant surgery.

Axial spondyloarthritis.

Axial spondyloarthritis manifests as a chronic inflammatory disease primarily affecting the sacroiliac joints and spine. Although chronic back pain and spinal stiffness are typical initial symptoms, peripheral (ie, enthesitis, arthritis, and dactylitis) and extra-musculoskeletal (ie, uveitis, inflammatory bowel disease, and psoriasis) manifestations are also common. Timely and accurate diagnosis is challenging and relies on identifying a clinical pattern with a combination of clinical, laboratory (HLA-B27 positivity), and imaging findings (eg, structural damage on pelvic radiographs and bone marrow oedema on MRI of the sacroiliac joints).

C5 complement inhibition versus FcRn modulation in generalised myasthenia gravis.

Background: Myasthenia gravis (MG) is an autoimmune disorder affecting neuromuscular junctions, leading to fluctuating muscle weakness. While many patients respond well to standard immunosuppression, a substantial subgroup faces ongoing disease activity. Emerging treatments such as complement factor C5 inhibition (C5IT) and neonatal Fc receptor (FcRn) antagonism hold promise for these patients.

Gut microbiome dysbiosis is not associated with portal vein thrombosis in patients with end-stage liver disease: a cross-sectional study.

Background: Portal vein thrombosis (PVT) is a common complication in patients with end-stage liver disease (ESLD). The portal vein in ESLD patients is proposedly an inflammatory vascular bed due to translocation of endotoxins and cytokines from the gut. We hypothesized that a pro-inflammatory gut microbiome and elevated trimethylamine N-oxide (TMAO), a driver of thrombosis, may contribute to PVT development.

Accurate evaluation of factor VIII activity of efanesoctocog alfa in the presence of emicizumab.

Background: Efanesoctocog is a B-domain-deleted, Fc-fusion FVIII linked to the D'D3 domain of VWF and two XTEN polypeptides, designed for an ultra-extended half-life for prophylaxis in hemophilia A, but also aiding in managing acute bleeding or surgery in patients on long-term emicizumab. However, no current laboratory method accurately measures FVIII levels in the presence of emicizumab. We hypothesized that the chromogenic (CSA) FVIII assay, specifically calibrated for efanesoctocog using bovine coagulation factors, could provide an accurate assessment of efanesoctocog activity.

Students' perspective on the Dutch National Pharmacotherapy Assessment, a national survey study among final-year medical students.

Introduction: The Dutch National Pharmacotherapy Assessment (DNPA) was introduced in 2013 to improve clinical pharmacology and therapeutics (CPT) education. This study investigated final-year medical students' perceived motivation and level of preparation for the DNPA in different scenarios: mandatory vs. non-mandatory, and traditional high-stakes assessment programme vs.

The impact of summative, formative or programmatic assessment on the Dutch National Pharmacotherapy Assessment: a retrospective multicentre study.

Background: The Dutch National Pharmacotherapy Assessment (DNPA), which focuses on assessing medication safety and essential drug knowledge, was introduced to improve clinical pharmacology and therapeutics education in the Netherlands. This study investigated how the performance of final-year medical students on the DPNA was affected by the assessment programme (traditional with summative or formative assessment, and programmatic assessment).

Methods: This multicentre retrospective longitudinal observation study (2019-2023) involved final-year medical students from four medical schools in the Netherlands.

Use of continuous glucose monitoring and point-of-care glucose testing in hospitalized patients with diabetes mellitus in non-intensive care unit settings: A systematic review and meta-analysis of randomized controlled trials.

The benefits of using continuous glucose monitoring (CGM) in hospitalized patients with diabetes remain uncertain. Point-of-care (POC) glucose testing is the standard of care in this setting. We compared the effect of adding CGM to POC testing versus POC testing alone on glycemic outcomes in this population.

The 24-hour physical activities in adults with cerebral palsy and their adherence to the 24-hour movement guideline.

Objective: To describe 24-hour physical activities (sleep and physical activity) in adults with cerebral palsy (CP), explore potential influencing factors and compare 24-hour physical activities with controls.

Design: Cross-sectional, observational internet study involving adults with CP and a convenience sample of adults without CP.

Setting: Individuals residing in the Netherlands Participants: 110 adults with CP (median age 42, range 28-77 years; 64 (58%) ambulant; 40% male) and 89 adult controls (median age 43, range 18-78 years; 29% male).

Left-Right Brain-Wide Asymmetry of Neuroanatomy in the Mouse Brain.

Left-right asymmetry of the human brain is widespread through its anatomy and function. However, limited microscopic understanding of it exists, particularly for anatomical asymmetry where there are few well-established animal models. In humans, most brain regions show subtle, population-average regional asymmetries in thickness or surface area, alongside a macro-scale twisting called the cerebral petalia in which the right hemisphere protrudes anteriorly past the left.

Maternal postpartum mental health negatively affects infants' health related quality of life.

Objectives: To assess the association of early and late postpartum maternal mental health with infants' health related quality of life (HRQoL).

Methods: The study was embedded within the POST-UP trial (n = 1843). Infants' HRQoL was assessed with the Infant and Toddler Quality of Life Questionnaire Short Form-47 at ages 1 month (1 m), and 12 m.

DNA-binding affinity and specificity determine the phenotypic diversity in BCL11B-related disorders.

BCL11B is a Cys2-His2 zinc-finger (C2H2-ZnF) domain-containing, DNA-binding, transcription factor with established roles in the development of various organs and tissues, primarily the immune and nervous systems. BCL11B germline variants have been associated with a variety of developmental syndromes. However, genotype-phenotype correlations along with pathophysiologic mechanisms of selected variants mostly remain elusive.