Developing a Green Nursing Practice in a Profession That Contributes to Climate Change: One Nurse's Journey.

The health care industry accounts for 5% of global greenhouse gas emissions, with hospitals being the largest contributor. Critical care units create 3 times the greenhouse emissions of other hospital patient care units. Health care contributions to environmental harm include medical waste disposal, toxicant exposure, and pollutants.

A Case of Triple Respiratory Coinfection: COVID-19, Enterovirus, and Parainfluenza.

We report a case of a 34-year-old female who presented to the emergency department with fever, nausea, vomiting, and diarrhea following a suspected foodborne illness. She tested positive for COVID-19, human parainfluenza virus type 4, and enterovirus/rhinovirus in the hospital. She subsequently developed hypoxia, hypotension, and sepsis.

"Increasing body mass index is associated with intensive care unit admission and severe maternal morbidity".

Objective: This study aimed to assess the relationship between increased body mass index (BMI) with severe maternal morbidity (SMM).

Study Design: We obtained data for a retrospective cohort of singleton live births using an electronic birth certificate database from 2010 to 2022 in Central New York. Institutional review board exemption was obtained.

American Geriatrics Society position statement: Making medical treatment decisions for unrepresented older adults.

This paper is an official position statement of the American Geriatrics Society (AGS) and updates the 2017 AGS position statement, Making Medical Treatment Decisions for Unbefriended Older Adults. In this updated position statement, the term "unbefriended" is replaced by "unrepresented" as a term that is more value-neutral, more accurately describes the circumstance in which a person without medical decision-making capacity does not have recognized surrogate representation, and better aligns with increasingly preferred terminology as reflected in recent medical literature. We define unrepresented older adults as those who (1) lack decisional capacity to provide informed consent for a particular medical treatment, (2) have not executed an advance directive that addresses the medical treatment at hand and lack capacity to do so, and (3) lack representation from a surrogate decision-maker (i.

"Pardon My Language": The Curious Case of a Bloody Sandwich and the John Cunningham Virus Reactivation in the Era of Immunomodulatory Drugs.

Progressive multifocal leukoencephalopathy (PML) is a rare diagnosis associated with high mortality in different clinical settings. PML has been attributed to the reactivation of the John Cunningham (JC) virus (JCV). JCV typically affects patients with HIV/AIDS, solid organ and hematological malignancies, and those under treatment with immunomodulatory drugs (IMiDs) like pomalidomide.

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.

Management of recurrent end-stage achalasia with robotic-assisted esophagectomy: a case report and literature review.

Introduction And Importance: Achalasia, an uncommon esophageal motility disorder, presents therapeutic challenges, especially in refractory cases with a history of multiple surgeries. Here, we present a complex case illustrating the dilemmas and multidisciplinary approach required in managing such patients. This case underscores the relevance of newer techniques like robotic-assisted esophagectomy in refractory achalasia management.

SRY+ Derivative X Chromosome in a Female With Apparently Typical Sexual Development.

Background: When the SRY gene is present in a 46,XX fetus, some degree of testicular development is expected. Our laboratory performed prenatal genetic testing for a fetus that had screened positive for Y chromosome material by noninvasive prenatal screening (NIPS) but that had apparently typical female development by ultrasound imaging. The aim of this study was to determine the clinical relevance of the NIPS results.

SARS-CoV-2 seroprevalence and associated factors among outpatient attendees at health facilities in different provinces in Chad.

Background: Chad with 7,698 confirmed cases of infection and 194 deaths since the beginning of the COVID-19 pandemic, is one of the African countries with the lowest reported case numbers. However, this figure likely underestimates the true spread of the virus due to the low rate of diagnosis. The high rate of asymptomatic infections reflects the reality of SARS-CoV-2 transmission in Chad.

Leveraging Implementation Factors and Policy to Improve the Effectiveness of Naloxone.

More than 50 years of high-quality data demonstrate that naloxone is an efficacious and cost-effective overdose reversal agent. Intranasal naloxone is now available in the United States as an over-the-counter and generic medication for the first time since the start of the overdose crisis more than 20 years ago. As the overdose crisis continues to contribute to substantial loss of life, there is an historic opportunity for jurisdictions to expand equitable and sustained access to intranasal naloxone.

Efficacy and safety of teclistamab in relapsed or refractory multiple myeloma: a systematic review and meta-analysis.

To synthesize the evidence on the efficacy and safety of teclistamab in treating relapsed/refractory multiple myeloma (RRMM). A systematic search for records published from inception until June 2024 was conducted on PubMed, Web of Science, EMBASE, and Google Scholar databases. Five studies with 661 RRMM patients were included in the analysis.

Sump syndrome: Diagnosis dilemmas and therapeutic approaches-A case series.

Key Clinical Message: It is important to consider the diagnosis of Sump syndrome in patients with a history of open cholecystectomy, particularly in those who migrate from developing countries where alternative biliary interventions may be limited. The presentation may range from acute severe, mimicking acute ascending cholangitis, to chronic recurrent abdominal pain without evidence of inflammation. Management is a case-by-case decision, with principal management aims to decompress the biliary tract and address any underlying sepsis.

Comparative Outcomes of Unilateral vs Bilateral Revascularization in Moyamoya Disease: A Multicenter Retrospective Study.

Background And Objectives: Moyamoya disease (MMD) is characterized by progressive steno-occlusion of the internal carotid arteries, leading to compensatory collateral vessel formation. The optimal surgical approach for MMD remains debated, with bilateral revascularization potentially offering more comprehensive protection but involving more extensive surgery compared to unilateral revascularization. This study aims to compare bilateral revascularization and unilateral revascularization short-term safety profile in the treatment of MMD.

Assessment of awareness and knowledge of Good Samaritan Law in the general literate population - A cross-sectional study in Telangana.

Introduction: Road traffic injuries are the eighth leading cause of death in India. The Law Commission of India report says that 50% of the victims who died of preventable injuries could have been saved had they received the medical care on time. To protect the people who help road accident victims, Good Samaritan Law was enacted.

Assessing Student and Physician Fertility Awareness Utilizing the Fertility and Infertility Treatment Knowledge Score (FIT-KS).

Introduction: Medical trainees are delaying childbearing due to competing demands of career, financial constraints, and limited parental leave. Delaying childbearing increases the risk of obstetric complications, with up to one-quarter of female physicians facing infertility. Education on family planning and fertility is rarely discussed among medical trainees, and research on medical trainees' knowledge of fertility and infertility is minimal.

Novel Clinical Practice Assessments: Informational Statements by the Musculoskeletal Tumor Society.

Musculoskeletal oncology involves rare diseases. As a result, there is a paucity of literature to guide practitioners. Studies are often clinical experience, retrospective reviews, noncomparative studies, and involve small numbers of patients.

Hemorrhaging Uterine Fibroid Leading to Emergent Early Term Cesarean Delivery: A Case Report.

 The incidence of uterine leiomyomas, or fibroids, affecting pregnant individuals is estimated to be 10%, but there are no guidelines or recommendations for fetal or maternal surveillance in pregnancies affected by them. Risks associated with fibroids during pregnancy include potential for pain, preterm birth, fetal growth restriction, higher cesarean delivery rate, fetal malpresentation, placenta abruption, and postpartum hemorrhage.  This case describes a 26-year-old gravida 1 para 0 who presented at early term for severe abdominal pain and was found to have acute abdomen accompanied by a nonreassuring fetal heart rate tracing.

Short- and Long-Term Outcomes of Prenatally Identified Congenital Aqueductal Stenosis by Fetal MRI.

Objective: Providing accurate prenatal prognostication for expectant parents is challenging due to limited literature on factors impacting outcomes in children with congenital aqueductal stenosis (CAS). This study stratified CAS patients into isolated or complex categories (presence of additional intra- or extra-cranial anomalies or genetic syndromes) and evaluated both short- and long-term outcomes. Additionally, the role of ventricular rupture was assessed.

Cesarean scar niche: comparison of transvaginal ultrasound findings and uterine tissue samples after hysterectomy.

Background: The cesarean scar niche, a consequence of incomplete wound healing, can lead to gynecological complications and affect future pregnancies. While internal niches have been well-studied, external and bidirectional niches are also important.

Objective: We aimed to conduct a comparative analysis of the prevalence and measurements of different types of niches.