Galantamine-Memantine Combination in the Treatment of Parkinson's Disease Dementia.

Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects over 1% of population over age 60. It is defined by motor and nonmotor symptoms including a spectrum of cognitive impairments known as Parkinson's disease dementia (PDD). Currently, the only US Food and Drug Administration-approved treatment for PDD is rivastigmine, which inhibits acetylcholinesterase and butyrylcholinesterase increasing the level of acetylcholine in the brain.

Long-Term Outcomes of Acute Temporal Bone Fractures.

Objective(s): To compare the incidence of acute and chronic complications of temporal bone fractures, and identify predictors for post-injury, audiometrically confirmed hearing loss.

Methods: Retrospective cohort analysis of patients with acute temporal bone fractures who underwent both in-hospital and outpatient follow-up Otolaryngology evaluation at an academic, tertiary-care institution from January 2002 to January 2023. Otologic outcomes were compared between initial and follow-up evaluations.

Magnetic Resonance Imaging Prior Authorizations for Orthopaedic Care Are Negatively Affected by Medicaid Insurance Status.

Background: Magnetic resonance imaging (MRI) has revolutionized musculoskeletal care. However, its high costs and high utilization has prompted many insurance payors to require a prior authorization. This process remains burdensome and results in delays to patient care.

Comparison of positive BioFire FilmArray meningitis/encephalitis (ME) panels, CSF cultures, CSF parameters, clinical presentation and in-patient mortality among patients with bacterial and fungal meningitis.

Unlabelled: The BioFire FilmArray meningitis/encephalitis panel (MEP) was brought to the University of Kentucky in 2016 to aid in the identification of community-acquired meningitis and encephalitis (ME). This panel has shown variable performance with some institutions showing high sensitivity and specificity for many pathogens but others seeing false positives during clinical use. We evaluated the panel's performance using retrospective chart review of patients at the University of Kentucky from October 2016 to September 2022, including 7,551 MEP results.

An Unusual Presentation of Cutaneous Bullous Lupus.

Drug-induced lupus erythematosus (DILE) is an autoimmune reaction that results in symptoms of polyarthralgia, fever, and cutaneous lesions and other manifestations. Several drugs have been documented to cause this disease, including procainamide, isoniazid, methyldopa, penicillamine, and hydralazine. Systemic lupus erythematosus (SLE) manifestations often occur after the patient has been taking the drug without complications for months to years.

Enteral Midodrine for Intravenous Vasopressor Weaning in Acute Traumatic Spinal Cord Injury Patients.

Enteral vasopressor therapies have been used to facilitate the weaning of intravenous (IV) vasopressors in critically ill patients. Studies have shown mixed results in the medically critically ill population; however, this practice is still common. The use of enteral vasopressors in the acute traumatic spinal cord injury is less well-described.

Long-Term Follow-Up and Overall Survival in NRG258, a Randomized Phase III Trial of Chemoradiation Versus Chemotherapy for Locally Advanced Endometrial Carcinoma.

This randomized phase III trial aimed to determine whether treatment with cisplatin and volume-directed radiation followed by carboplatin and paclitaxel for four cycles (chemoradiotherapy [C-RT]) increased recurrence-free survival (RFS) and overall survival (OS) when compared with carboplatin and paclitaxel for six cycles (chemotherapy [CT]) in locally advanced endometrial cancer (UC). Previously reported results showed that C-RT did not improve RFS compared with CT. Here we report the final OS analysis.

Modern tools for optimizing fluid management in dialysis patients: a comprehensive review.

Maintaining optimal fluid balance is crucial for patients with end-stage renal disease on dialysis, as both fluid overload and excess removal can lead to poor outcomes. Traditional approaches such as physical exam and chest X-ray have limitations when assessing volume status. This review carefully examines the tools that provide more precise options, including lung ultrasound, echocardiography, Venous Excess Ultrasound (VEXUS), bioimpedance analysis (BIA), and passive leg raise (PLR).

Primary anorectal mammary-like adenocarcinoma: a potential diagnostic pitfall with conventional colorectal adenocarcinoma.

Anogenital mammary-like glands (AGMLGs) are present in the anogenital region that bear striking morphologic and protein-expression similarities to mammary glands in the breast. AGMLGs can give rise to both benign and malignant lesions which mimic primary breast lesions. Herein, we report two mammary-type adenocarcinomas arising from AGMLGs, including one in the previously unreported site of the rectum.

Pectoralis I and Serratus Anterior Plane Block Analgesia for Bilateral Mastectomy: A Case Series.

Background: Poorly controlled acute breast surgery postoperative pain is associated with delayed recovery, increased morbidity, impaired quality of life, and prolonged opioid use during and after hospitalization. Recently, ultrasound-guided pectoralis nerve (PECS) I block and serratus anterior plane (SAP) block, together or individually, have emerged as a potential method to relieve pain, decrease opioid requirements, and improve patient outcomes.

Objective: The aim of this study was to assess if the addition of a PECS I/SAP block in patients undergoing bilateral mastectomies provides more effective perioperative analgesia compared to standard analgesia.

Risk Factors in Optimal Management of Hypertension in Elderly Patients Following 2017 American College of Cardiology-American Heart Association Guidelines.

Introduction/objectives: The 2017 American Heart Association hypertension management guidelines recommended optimal control of blood pressure under 130/80 mmHg. We aimed to study the factors associated with suboptimal and uncontrolled hypertension in the elderly patients.

Methods: We performed a retrospective review of suburban outpatient records of patients with hypertension, aged 65 years and older, and grouped into optimally controlled (OC; BP <130/80 mmHg), sub-optimally controlled (SOC; BP 130-139/80-89 mmHg), and uncontrolled (UC; BP≥140/90 mmHg) groups; and compared the associations of variables.

Average Age of Resuscitation Blood Products Is not Associated With In-Hospital Mortality Among Trauma Patients: A Retrospective Cohort Study.

Introduction: Transfusion of packed red blood cells (PRBC) or low-titer group O whole blood (LTOWB) has become standard practice in trauma patients with significant blood loss. As blood ages, it undergoes metabolic and structural changes. This study aimed to test the association between age of PRBC/LTOWB and mortality among adult trauma patients.

Stop The Falls! A framework for injury prevention outreach for older adults presented by the American Association for the Surgery of Trauma Geriatric Trauma and Injury Prevention Committees.

With the increasing age of the population in the USA, fall prevention events to target older patients are imperative. The American Association for the Surgery of Trauma hosted a fall prevention event at the host city of the 2023 Annual Meeting. We review the planning and implementation of this "Stop the Falls" event, in hopes that other institutions may benefit and sustainably effectuate fall prevention events for an increasingly geriatric population.

Child outcomes after prenatal exposure to platinum and taxane-based chemotherapy: an unplanned interim analysis of the international network on cancer, infertility, and pregnancy study.

Background: Platina and taxanes are frequently used chemotherapeutic agents to treat cancer, also when diagnosed during pregnancy. This report presents an interim analysis of the largest series of children prenatally exposed to platinum and/or taxane agents and aims to determine their physical health and neurocognitive outcomes.

Methods: As part of a multicentre, prospective cohort study (ClinicalTrials.

Pretreatment factors associated with symptomatic stroke in Moyamoya disease patients: A multicenter study.

Objectives: Moyamoya disease (MMD) is a cerebrovascular disorder marked by the progressive steno-occlusion of the bilateral internal carotid arteries and the formation of abnormal collateral vessel networks at the base of the brain. Previous studies have attempted to identify risk factors predictive of postoperative complications to improve patient management. This study aims to identify pretreatment factors associated with post-bypass symptomatic strokes in MMD patients.

Minimally invasive treatment with radiofrequency ablation and kyphoplasty for avascular necrosis of the spine in sickle cell disease: illustrative case.

Background: Avascular necrosis (AVN) of the spine is a rare sequela of chronic sickle cell disease (SCD) in which the shape of the sickled red blood cells interfere with the normal vascular supply of vertebral bodies. In this report, the authors describe a case of progressive spinal AVN treated with radiofrequency ablation (RFA) and kyphoplasty for the patient's persistent lower back pain.

Observations: A 38-year-old male with long-standing spinal AVN due to SCD had been managed conservatively with hydroxyurea and oral opioid analgesics for several years until breakthrough episodes of low-back pain began to occur with an inability to perform activities of daily life.

Frontal Lobe Epilepsy: Bermuda's Triangle.

Despite great progress in imaging, genetics, surgery, and therapeutics, frontal lobe epilepsy (FLE) continues to be a challenge for neurologists and epileptologists. This manuscript summarizes the latest advancements in FLE discussed at the 2023 Epilepsy Specialist Symposium during the American Epilepsy Society Annual meeting. Correlation between stereoelectroencephalography and clinical symptoms has reinvigorated symptomatology literature in FLE, allowing for more precise aura anatomical localization.

A case study on development of a spiral oral health curriculum for medical students.

Inadequate oral healthcare remains a critical public health issue in children and adults in the US affecting adverse social, psychological, economic, and health outcomes. Medical clinicians have a clear role in addressing oral health issues and improving outcomes. Oral health guidelines for health profession schools were developed by the Association of American Medical Colleges (AAMC) oral health core competencies, and the newer Center for Integration of Primary Care and Oral Health's (CIPCOH) Entrustable Professional Activities (EPAs).

Association of Atrial Fibrillation with Insomnia in the Elderly Population.

Introduction/objectives: Insomnia is a common sleep disorders that affects most individuals in the United States, and worldwide. Insomnia is linked with an increased risk of atrial fibrillation (AF) in adults, although the strengths of association were weak, especially in the elderly population. AF is estimated to affect approximately 3 to 6 million people in the United States.

An Efficiency Model for Decreasing Operative Room Turnover Time for Total Joint Arthroplasties.

Objectives: Despite an increased demand for total joint arthroplasty (TJA), rising health-care costs and bundling of payments by payers have shifted the focus to improving operating room (OR) efficiency. This study aimed to assess the efficacy of an efficiency model that optimized instrument trays on decreasing OR turnover time (TOT) and the benefits made possible by this improved efficiency.

Methods: All primary TJA procedures performed by a single fellowship-trained surgeon from January 2022 to August 2023 were reviewed.