Concurrent Hospice in a Veteran's Affairs Dialysis Unit: A Single Center Experience and Lessons Learned over 4 Years.

End stage kidney disease (ESKD) patients until recently have been effectively excluded from receiving hospice benefits unless they withdraw from renal replacement therapy. Policy change has allowed select populations to receive concurrent hospice and hemodialysis. We conducted a retrospective analysis of all deaths occurring from 2019 to 2022 among outpatient hemodialysis patients at our VA medical center.

Informed consent in assisted reproductive technology: Implications for pediatric clinicians.

After conceiving through assisted reproductive technologies (ART), parents may present to their pediatrician with concerns related to their child's neurodevelopment, including whether their child's health may be related to their use of ART. Pediatricians may be unfamiliar with the ART process and what the families endured up to this point, resulting in difficulty counseling parents through these discussions. Before presentation to the pediatrician, parents have undergone extensive evaluation with reproductive endocrinologists.

A Review of Dextromethorphan-Quinidine for the Treatment of Agitation in Dementia.

To provide an updated summary of the literature on dextromethorphan quinidine for the treatment of agitation in dementia. PubMed, Medline, APA PsycINFO, Embase, and Cochrane Collaboration were searched from inception to January 7, 2024 using the keywords , , and . The search was limited to the English language and human subjects.

Technical Note: Neural Network Architectures for Self-Supervised Body Part Regression Models with Automated Localized Segmentation Application.

The advancement of medical image deep learning necessitates tools that can accurately identify body regions from whole-body scans to serve as an essential pre-processing step for downstream tasks. Typically, these deep learning models rely on labeled data and supervised learning, which is labor-intensive. However, the emergence of self-supervised learning is revolutionizing the field by eliminating the need for labels.

Laboratory and clinical haemostatic aberrations in primary dermatologic disease: A review.

Inflammatory dermatologic diseases have long been viewed as a "skin limited" disease process. Current literature on inflammatory dermatologic diseases investigates their relationship and influence on thromboembolic states and thromboembolic complications and the understanding of their pathophysiology and molecular mechanisms.Studies specifically discuss known inflammatory skin diseases including alopecia areata, vitiligo, psoriasis, hidradenitis suppurativa, atopic dermatitis, chronic spontaneous urticaria, and autoimmune bullous diseases, and their effects on systemic inflammation, associated cardiovascular comorbidities, and thromboembolic or hypercoagulable states.

Delayed Onset Perinasal Mucocele Cyst in a Patient With Remote History of Orofacial Cleft Repair.

Nasoalveolar cysts are rare, nonodontogenic cysts with a subtle course that can lead to nasal deformity and, uncommonly, nasal airway obstruction. Herein the authors present the case of a 28-year-old male who presented with a recurrent left-sided nasoalveolar cyst. Upon presentation, this cyst had formed a significant alar defect and was obstructing the left nasal airway.

Development and validation of a predictive scoring model for complications following endoscopic endonasal skull base surgery.

Objective: The endoscopic endonasal approach (EEA) has evolved into an established technique in skull base surgery. The authors previously examined 1002 EEA procedures and reported factors associated with postoperative complications. Here they report the development and validation of a scoring model based on risk factors to better predict complications following EEA.

Assessing Changes in Corneal Densitometry in Patients After Small Incision Lenticule Extraction (SMILE).

Purpose: The aim is to assess for any lasting changes in corneal densitometry (CD) in patients who underwent small incision lenticule extraction (SMILE) and developed early transient postoperative corneal haze.

Methods: This retrospective chart review analyzed 98 eyes from 49 patients who underwent SMILE at the Hoopes Vision Clinic and had one-year postoperative Pentacam CD (Oculus Optikgeräte GmbH, Wetzlar, Germany). These were compared to 78 eyes from 42 unoperated myopic control patients with documented CD measurements.

Implication of vasopressin receptor genes (AVPR1A and AVPR1B) in the susceptibility to polycystic ovary syndrome.

Background: Polycystic ovary syndrome (PCOS) is a complex heterogenous disorder manifesting with various reproductive, endocrine, and metabolic derangements such as insulin resistance and hyperglycemia. The arginine vasopressin peptide (AVP), also called or antidiuretic hormone (ADH), modulates metabolic functions such as glucose hemostasis, insulin sensitivity, and lipid metabolism via binding to two central and peripheral receptors (AVPR1A and AVPR1B). In the present study, we aimed to detect whether the AVPR1A and AVPR1B genes confer risk for PCOS.

Recent developments in non-invasive methods for assessing metabolic dysfunction-associated fatty liver disease.

The prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) is increasing, affecting over one-third of the global population and contributing to significant morbidity and mortality. Diagnosing MAFLD, especially with advanced fibrosis, remains challenging due to the limitations of liver biopsy, the current gold standard. Non-invasive tests are crucial for early detection and management.

BubR1 and SIRT2: Insights into aneuploidy, aging, and cancer.

Aging is a significant risk factor for cancer which is due, in part, to heightened genomic instability. Mitotic surveillance proteins such as BubR1 play a pivotal role in ensuring accurate chromosomal segregation and preventing aneuploidy. BubR1 levels have been shown to naturally decline with age and its loss is associated with various age-related pathologies.

Molecular specializations underlying phenotypic differences in inner ear hair cells of zebrafish and mice.

Introduction: Hair cells (HCs) are the sensory receptors of the auditory and vestibular systems in the inner ears of vertebrates that selectively transduce mechanical stimuli into electrical activity. Although all HCs have the hallmark stereocilia bundle for mechanotransduction, HCs in non-mammals and mammals differ in their molecular specialization in the apical, basolateral, and synaptic membranes. HCs of non-mammals, such as zebrafish (zHCs), are electrically tuned to specific frequencies and possess an active process in the stereocilia bundle to amplify sound signals.

Cost-Effectiveness of Total Neoadjuvant Therapy With Selective Nonoperative Management for Locally Advanced Rectal Cancer: Analysis of Data From the Organ Preservation for Rectal Adenocarcinoma Trial.

Purpose: The clinical efficacy of total neoadjuvant therapy (TNT) followed by selective nonoperative management (NOM) for locally advanced rectal cancer (LARC) was examined in the Organ Preservation for Rectal Adenocarcinoma (OPRA) trial. We investigated the cost and quality-of-life implications of adopting this treatment approach.

Methods: We analyzed clinical, cost, and quality-of-life outcomes for TNT with selective NOM in comparison with chemoradiotherapy (CRT)-surgery-adjuvant chemotherapy (standard of care [SOC]) using data from OPRA, prospective cohorts, and published studies.

Epidemiology of Acute Compartment Syndrome After Pediatric Tibial Tubercle and Tibial Shaft Fractures.

Background: While acute compartment syndrome (ACS) is a well-reported complication after pediatric tibial shaft fractures, prior literature has suggested that pediatric patients with tibial tubercle fractures may be at increased risk of ACS due to the proximity of the tibial tubercle to the anterior tibial recurrent artery. However, this theory was largely based on a series of early case reports without substantiation in larger-scale studies.

Hypothesis/purpose: The purpose of this study is to conduct a population-level analysis of the incidence and risk factors of acute compartment syndrome following pediatric tibial tubercle and tibial shaft fractures.

Effects of 3D ultrasonography and 3D printed images on maternal-fetal attachment and its correlation with overall smoking within pregnancy: a pilot study.

Background: Smoking in pregnancy continues to cause significant morbidity to mothers and babies and contributes to tremendous costs to society. Maternal-fetal attachment (MFA) may differentiate smokers who quit or pregnant smokers from non-smokers. Researchers have recommended utilizing interventions that improve MFA to help decrease smoking within pregnancy.

Standard of care treatment for stage IVB cervical cancer: A systematic review and meta-analysis.

Objective: Our aim was to perform a systematic review and meta-analysis evaluating the efficacy of standard treatment for stage IVB cervical cancer.

Method: Databases were searched for Phase III trials evaluating stage IVB CC patients according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Systematic review included Phase III trials evaluating first-line treatment of stage IVB cervical cancer (CC).

Consequences of Legal Infractions on the General Surgery Residency Application Process.

Objective: Alcohol and drug-related legal infractions are common among college and medical students. The objective of this work is to quantify the influence of these legal infractions on program directors (PDs) when making decisions on applicants to general surgery residencies.

Design: A convenience sample of 72 PDs with publicly accessible email addresses were electronically sent a previously piloted survey tool.