Evaluating the use of sublingual sufentanil in patients with buprenorphine treatment who are undergoing ambulatory surgery: A Prospective Case Report.

Introduction: Opioid use disorder is a chronic illness with significant morbidity and mortality. Opioid agonists, like buprenorphine, are commonly used to prevent relapse. Recent changes in buprenorphine legislation are expected to increase prescription and guidelines recommend its continuation during the perioperative period for many patients.

Patient and Tumor Factors on Overall Survival in Spindle Cell Melanoma.

Introduction: Spindle cell melanoma (SCM) is a rare melanoma subtype characterized histologically by atypical, spindled, malignant melanocytes. SCM often presents in older patients and lacks typical cytologic markers, complicating diagnosis and frequently leading to advanced disease upon presentation. While some studies have documented SCM incidence, none have thoroughly examined the demographic, socioeconomic, and treatment factors influencing survival outcomes.

Persistent Risk of Pulmonary Embolism in Acute Pancreatitis Despite Prophylactic Anticoagulation.

Acute pancreatitis, a sudden inflammatory condition, can lead to a hypercoagulable state resulting in complications such as deep vein thrombosis (DVT) or pulmonary embolism (PE). This case report discusses a unique presentation of a massive PE in a patient with acute pancreatitis despite being on appropriate prophylactic anticoagulation. A 27-year-old man presented with acute abdominal pain, nausea, and vomiting.

Trends in heart failure-related mortality among middle-aged adults in the United States from 1999-2022.

Introduction: Heart failure (HF) represents a significant contributor to morbidity and mortality. Heart failure mortality trends among the middle aged have not been fully characterized into the years of the COVID-19 pandemic. Our objective was to analyze the trends in mortality related to heart failure across various demographic and geographic categories-including gender, race, and census region-spanning from 1999 to 2022, with particular attention paid to the effect of the COVID-19 pandemic on HF mortality.

Prenatal Tobacco Exposure, Brain Subcortical Volumes, and Gray-White Matter Contrast.

Importance: Maternal tobacco use during pregnancy (MTDP) remains a major public health challenge. However, the complete spectrum of effects of MTDP is not fully understood.

Objectives: To examine the longitudinal associations of MTDP and children's brain morphometric subcortical volume and gray-white matter contrast (GWC) development.

Light adjustable lens in eyes with a history of radial keratotomy.

Purpose: To evaluate visual and refractive outcomes in eyes with a history of radial keratotomy (RK) implanted with the second-generation light-adjustable lens (LAL).

Setting: Private practice, multiple locations.

Design: Retrospective, consecutive case series.

Markedly Exophytic Hypertrophic Lichen Planus in a Patient With Ichthyosis Vulgaris.

Hypertrophic lichen planus (HLP) is an idiopathic inflammatory condition characterized by hyperkeratotic plaques or nodules, typically occurring bilaterally on the wrists, ankles, or lower extremities. This variant of lichen planus is more common among African-American patients and occupies a broad differential with other keratotic skin conditions, some of which are malignant, making recognition and accurate diagnosis essential. We present an unusual case of a 49-year-old African-American woman with four markedly exophytic, horn-like lesions on her shins, ultimately diagnosed as HLP.

Diagnosis and management of dilated cardiomyopathy: a systematic review of clinical practice guidelines and recommendations.

Dilated cardiomyopathy (DCM) is extensively discussed in numerous expert consensus documents and international guidelines, with differing recommendations. To support clinicians in daily practice and decision-making, we conducted a systematic review of key guidelines and recommendations concerning the diagnosis and clinical management of DCM. Our research encompassed MEDLINE and EMBASE databases for relevant articles published, as well as the websites of relevant scientific societies.

Clinical Outcomes Following Optical Coherence Tomographic Versus Intravascular Ultrasound-Guided Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Controlled Trials.

Background: Optical coherence tomography (OCT) and intravascular ultrasound (IVUS) are adjunctive intracoronary imaging modalities used to optimize coronary stent implantation. However, the impact of OCT versus IVUS on clinical outcomes and periprocedural complications is unclear.

Aims: To perform a meta-analysis of all vetted randomized controlled trials comparing OCT-guided versus IVUS-guided percutaneous coronary intervention.

A Case of Pneumocephalus Due to an Untreated Atrial-Esophageal Fistula Post-Left Atrial Ablation Therapy.

Air embolisms can be caused by trauma, barotrauma, or due to surgical procedures in neurosurgery, vascular surgery, and cardiac surgery. An atrial-esophageal fistula (AEF) is a life-threatening complication that can occur following left atrial ablation therapy, which is used to treat refractory atrial fibrillation (Afib). AEF, if left untreated, can lead to serious neurological complications such as pneumocephalus.

Evaluating the Realism of a Task Trainer and the Impact on Residents' Confidence in Managing Massive Upper Gastrointestinal Bleeding Among Emergency Medicine Residents.

Objective Hemodynamically unstable upper gastrointestinal bleeding (UGIB) represents a life-threatening emergency that often lacks adequate high-fidelity training in the insertion of balloon tamponade devices. To address this gap, we developed an affordable task trainer that provides real-time feedback to enhance the training experience for emergency medicine residents. This study aims to evaluate the realism of the task trainer and its impact on residents' confidence in managing massive UGIB.

Lung Transplant Outcomes in Recipients of Advanced Age: Are Two Always Better Than One?

Background: Lung transplantation has become more common in patients aged 65 years and older. We aimed to examine outcomes across age groups and identify risk factors for decreased survival.

Methods: United Network for Organ Sharing data for all primary lung transplants from 1/1/2006 to 3/8/2023 was retrospectively reviewed.

SARS-CoV-2 Prevalence in a Delivering Refugee Population: Refugee Status, Payor Type, Race, and Vaccination Status.

Underserved communities were disproportionately affected during the coronavirus (COVID-19) pandemic. Limited data exist on the impact of COVID-19 among refugee populations because refugee status is not often classified in electronic medical record (EMR) systems, unlike race or primary language. The study aim was to evaluate the PCR-based prevalence of SARS-CoV-2 in a delivering population over the first 2 years of the pandemic by refugee status, ethnicity, insurance, and vaccination status.

Prevalence and Incidence of Type 1 Brugada Pattern: A 30-Year Experience at Mayo Clinic.

Objective: To identify the incidence and prevalence of type 1 Brugada pattern at Mayo Clinic during 30 years.

Methods: We retrospectively reviewed the electronic medical records from 1992 to 2021 at Mayo Clinic Enterprise. Patients with type 1 Brugada pattern electrocardiogram (ECG) were identified by a systematic keyword search.

Finite Element Analysis of Mechanical Ocular Sequelae from Badminton Shuttlecock Projectile Impact.

Purpose: With the growing popularity of badminton worldwide, the incidence of badminton-related ocular injuries is expected to rise. The high velocity of shuttlecocks renders ocular traumas particularly devastating, especially with the possibility of permanent vision loss. This study investigated the mechanism behind ocular complications through simulation analyses of mechanical stresses and pressures upon shuttlecock impact.

Omega-3 and Risk of atrial fibrillation: Vagally-mediated double-edged sword.

Objective: Studies regarding effects of omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on risk of atrial fibrillation (AF) have reported discordant results. The aim of this review is to clarify effects of marine omega-3 intake on risk of AF.

Patients And Methods: A PubMed search was performed using terms: atrial fibrillation, omega-3, EPA, DHA, vagal tone.

Characteristics and Risks of Endophthalmitis Following 25-gauge Vitrectomy Surgery over a 14-year period.

Purpose: To analyze endophthalmitis characteristics and risks following a 25-gauge vitrectomy or microincision vitrectomy surgery (MIVS).

Design: Retrospective.

Subjects: Post-MIVS endophthalmitis patients.

The radiological perspective of juvenile nasopharyngeal angiofibroma: A case report.

Juvenile nasopharyngeal angiofibroma (JNA) is a rare, locally aggressive, highly vascularized benign tumor classically found in males from 13 to 20 years old. The most common clinical presentations are recurrent epistaxis and nasal congestion. Imaging plays a significant role in differentiating and determining the extension of nasopharyngeal lesions.

Integrating Radioprotective Agents into Post-Mastectomy Radiotherapy: Optimization of Reconstructive Outcomes in Breast Cancer.

Surgical intervention utilizing various approaches is a cornerstone in the management of breast cancer. The surgical approaches include lumpectomy, mastectomy, axillary lymph node dissection, and primary or delayed reconstruction. Post-mastectomy radiotherapy is frequently recommended in cases of advanced tumors and extensive lymph node involvement.

IdopNetwork as a genomic predictor of drug response.

Despite being challenging, elucidating the systematic control mechanisms of multifactorial drug responses is crucial for pharmacogenomic research. We describe a new form of statistical mechanics to reconstruct informative, dynamic, omnidirectional, and personalized networks (idopNetworks), which cover all pharmacogenomic factors and their interconnections, interdependence, and mechanistic roles. IdopNetworks can characterize how cell-cell crosstalk is mediated by genes and proteins to shape body-drug interactions and identify key roadmaps of information flow and propagation for determining drug efficacy and toxicity.