Exertional Compartment Syndrome Strategies for Evaluation and Management.

Objective: The exertional compartment syndrome (ECS) is often a delayed diagnosis. Compartment pressure measurements (CPM) confirm the diagnosis. Herein we present our algorithm for the evaluation and management (E&M) of ECS.

CpG island methylator phenotype classification improves risk assessment in pediatric T-cell Acute Lymphoblastic Leukemia.

Current intensive treatment of pediatric T-cell acute lymphoblastic leukemia (T-ALL) has substantial side-effects, highlighting a need for novel biomarkers to improve risk stratification. Canonical biomarkers such as genetics and immunophenotype are largely not used in pediatric T-ALL stratification. This study aimed to validate the prognostic relevance of DNA methylation CpG island methylator phenotype (CIMP) risk stratification in two pediatric T-ALL patient cohorts: the Nordic NOPHO ALL2008 T-ALL study cohort (n=192) and the Dutch DCOG ALL-10/ALL-11 validation cohorts (n=156).

Development of the Incompatible Insect Technique targeting : introgression of a wild nuclear background restores the performance of males artificially infected with .

The bacterium is increasingly studied for its potential use in controlling insect vectors or pests due to its ability to induce Cytoplasmic Incompatibility (CI). CI can be exploited by establishing an opportunistic infection in a targeted insect species through trans-infection and then releasing the infected males into the environment as sterilizing agents. Several host life history traits (LHT) have been reported to be negatively affected by artificial infection.

Association of mental health treatment receipt with cancer screening among US adults with a history of anxiety or depression.

Background: Low participation in cancer screening contributes to a disproportionate burden of cancer morbidity and mortality among adults with mental health (MH) disorders like depression and anxiety. It is unknown whether MH treatment affects screening participation in this population.

Methods: Using the 2019 and 2021 National Health Interview Survey, data from screening-eligible respondents with a history of depression or anxiety were analyzed.

Attractor Landscape Analysis Reveals a Reversion Switch in the Transition of Colorectal Tumorigenesis.

A cell fate change such as tumorigenesis incurs critical transition. It remains a longstanding challenge whether the underlying mechanism can be unraveled and a molecular switch that can reverse such transition is found. Here a systems framework, REVERT, is presented with which can reconstruct the core molecular regulatory network model and a reversion switch based on single-cell transcriptome data over the transition process is identified.

[How to report the end-of-life decisions in the clinical record? Proposal of an "ABCD".].

Coping with the end of life decision making process in ICU, its complexity adds a challenge for the healthcare team: how to report in the medical record the events and reasoning that led to withholding or withdrawing treatments shifting from intensive to palliative care. Each healthcare team must select the best approach for managing the decision-making process and the necessary rules to ensure a correct clinical history narrative, indicating who must write and what has to be written. Taking into account the team organization, the report may be written not necessarily by the ICU director, but also by a staff physician as a spokesperson in the individual case.

Prevalence of Peri-Implant Diseases in a Private Practice and Potential Risk Indicators.

Purpose: The purpose of this study was to evaluate the occurrence of peri-implant diseases and their potential risk indicators in a private practice setting.

Materials And Methods: This cross-sectional study evaluated data from 390 subjects (mean age 55.8 ± 11.

Supervision of Pediatric Anesthesia After-Hours: A Survey of Pediatric Anesthetists in Australia and New Zealand.

Background: After-hours pediatric anesthesia may pose increased risks, with a heightened potential for sudden cardio-respiratory decline. While mortality rates are low in Australia and New Zealand, critical events and morbidity occur more frequently and present ongoing challenges. However, little is known about how trainees are supervised during these high-risk periods.

The weight of multiple hits: how TBI and infectious encephalitis co-modulate adverse outcomes.

Background: Chronic neurologic deficits from traumatic brain injury (TBI) and subsequent infectious encephalitis are poorly characterized.

Methods: Using TriNetX database we queried patients 18 years or older with a confirmed diagnosis of encephalitis between 2016 and 2024. Patient cohorts included those with a diagnosis of TBI at least one month before encephalitis ( = 1,038), those with a diagnosis of a TBI anytime before encephalitis ( = 1,886), and those with encephalitis but no TBI, ( = 45,210;  = 45,215).

Orbital and Ocular Venous Congestion: A Rare Manifestation of Hypervascular Paget Disease of the Bone.

A 73-year-old male with a history of incidentally diagnosed Paget disease of bone affecting the skull and left orbit 2 years prior presented with 3 months of vision loss, proptosis, and periorbital swelling of the OS. Examination showed best-corrected Snellen visual acuity of 20/150 in the affected eye, intact motility, 7 mm of relative proptosis, significant dilated and tortuous "corkscrew" conjunctival vessels, serous choroidal and retinal detachments, optic nerve hyperemia, and venous tortuosity and dilation. Although the bony lesions in the left orbit were stable from 1 year prior on imaging, the diagnostic angiogram demonstrated osseous blush and hypervascularity of the lesion.

Lacrimal Sac CLL: A Review of Clinical Features, Investigations, and Management.

Purpose: This study reviews all reported cases of lacrimal gland chronic lymphocytic leukemia (CLL) to identify patterns in clinical presentation, diagnosis, and management to aid in early recognition and treatment of this uncommon occurrence.

Methods: A comprehensive search of medical literature databases was performed to identify studies reporting lacrimal sac involvement in CLL from 1970 to 2024. Data were extracted regarding demographics, symptoms, diagnostic methods, treatment, and outcomes.

An outbreak of Shiga toxin-producing serotype O103:H2 associated with unpasteurized soft cheese, England and Wales, 2022.

In July 2022, a genetically linked and geographically dispersed cluster of 12 cases of Shiga toxin-producing (STEC) O103:H2 was detected by the UK Health Security Agency using whole genome sequencing. Review of food history questionnaires identified cheese (particularly an unpasteurized brie-style cheese) and mixed salad leaves as potential vehicles. A case-control study was conducted to investigate exposure to these products.

Early and Late Outcomes of Transcatheter Aortic Valve Replacement in Patients With Prior Chest Radiation: A Systematic Review and Meta-Analysis.

Background: Patients with prior history of chest or mediastinal radiation are deemed high risk for surgical AVR. Transcatheter aortic valve replacement (TAVR) has emerged as a promising alternative for these patients, however, this patient population was underrepresented in prior TAVR trials.

Aims: To compare the outcomes of TAVR in patients with versus without a history of prior chest or mediastinal radiation.

Association of prostate-specific antigen density with prostate cancer mortality after a benign systematic prostate biopsy result.

Objective: To assess the association between prostate-specific antigen (PSA) density (PSAD) and prostate cancer mortality after a benign result on systematic transrectal ultrasonography (TRUS)-guided prostate biopsy.

Patients And Methods: This retrospective study used data from the Finnish Randomised Study of Screening for Prostate Cancer (FinRSPC) collected between 1996 and 2020. We identified men aged 55-71 years randomised to the screening arm with PSA ≥4.

The relationship between primate distal fibula trabecular architecture and arboreality, phylogeny and size.

The fibula, despite being traditionally overlooked compared to the femur and the tibia, has recently received attention in primate functional morphology due to its correlation with the degree of arboreality (DOA). Highlighting further fibular features that are associated with arboreal habits would be key to improving palaeobiological inferences in fossil specimens. Here we present the first investigation on the trabecular bone structure of the primate fibula, focusing on the distal epiphysis, across a vast array of species.

Ischemic Area-Targeting and Self-Monitoring Nanoprobes Ameliorate Myocardial Ischemia/Reperfusion Injury by Scavenging ROS and Counteracting Cardiac Inflammation.

Precise and effective management of myocardial ischemia/reperfusion injury (MIRI) is still a formidable challenge in clinical practice. Additionally, real-time monitoring of drug aggregation in the MIRI region remains an open question. Herein, a drug delivery system, hesperadin and ICG assembled in PLGA-Se-Se-PEG-IMTP (HI@PSeP-IMTP), is designed to deliver hesperadin and ICG to the MIRI region for in vivo optical imaging tracking and to ameliorate MIRI.

Trends, Characteristics and Outcomes in Breast Cancer Survivors With STEMI.

Breast cancer is the most common malignancy among women. While advances in detection and treatment have improved survival, breast cancer survivors face an increased risk of cardiovascular disease. However, limited data exist on cardiac outcomes after ST-elevation myocardial infarction (STEMI) in this population.

A Case Study of a Female Infant With Primary Hypertrophic Osteoarthropathy Demonstrates That Early Initiation of Celecoxib Slows but Does Not Prevent Symptom Progression.

Primary Hypertrophic Osteoarthropathy (PHOAR1) is characterized by autosomal recessive loss of function variants in 15-hydroxyprostaglandin dehydrogenase (HPGD) leading to digital clubbing, periostosis, pachydermia, and severe hyperhidrosis. HPGD catalyzes the first step of prostaglandin E2 (PGE2) degradation. Selective COX-2 inhibitors have proved beneficial in adults, though it is unknown if early initiation of COX-2 inhibitors can alter the natural history of PHOAR1.

Evidence-Based Application of Natriuretic Peptides in the Evaluation of Chronic Heart Failure With Preserved Ejection Fraction in the Ambulatory Outpatient Setting.

Background: Plasma NT-proBNP (N-terminal pro-B-type natriuretic peptide) is commonly used to diagnose heart failure with preserved ejection fraction (HFpEF), but its diagnostic performance in the ambulatory/outpatient setting is unknown because previous studies lacked objective reference standards.

Methods: Among patients with chronic dyspnea, diagnosis of HFpEF or noncardiac dyspnea was determined conclusively by exercise catheterization in a derivation cohort (n=414), multicenter validation cohort 1 (n=560), validation cohort 2 (n=207), and a nonobese Japanese validation cohort 3 (n=77). Optimal NT-proBNP cut points for HFpEF rule out (optimizing sensitivity) and rule in (optimizing specificity) were derived and tested, stratified by obesity and atrial fibrillation.

FFR-Negative Nonculprit High-Risk Plaques and Clinical Outcomes in High-Risk Populations: An Individual Patient-Data Pooled Analysis From COMBINE (OCT-FFR) and PECTUS-obs.

Background: Despite fractional flow reserve (FFR)-guided deferral of revascularization, recurrent events in patients with diabetes or after myocardial infarction remain common. This study aimed to assess the association between FFR-negative but high-risk nonculprit lesions and clinical outcomes.

Methods: This is a patient-level pooled analysis of the prospective natural-history COMBINE (OCT-FFR) study (Optical Coherence Tomography Morphologic and Fractional Flow Reserve Assessment in Diabetes Mellitus Patients) and PECTUS-obs study (Identification of Risk Factors for Acute Coronary Events by OCT After STEMI and NSTEMI Patients With Residual Non- Flow Limiting Lesions).

Extensive Inactive Neurocysticercosis: A Case Report in Mbeya, Southern Highlands of Tanzania.

Background: Neurocysticercosis (NCC) and Acquired Human Immunodeficiency Syndrome (AIDS) are both highly prevalent in Africa. Clinical presentation of NCC ranges from asymptomatic to manifestations, including epileptic seizures, severe progressive headache, and focal neurological deficits. It is influenced by the number, size, location, and stage of the cysts, as well as the parasite's potential to cause inflammation and the immunological response of the host.

Severe Ethylene Glycol Toxicity: Multidisciplinary Management and Long-Term Renal Implications.

Ethylene glycol (C₂H₆O₂), a toxic alcohol commonly found in automotive antifreeze, de-icing solutions, and industrial coolants, can cause severe toxicity when ingested. Due to its sweet taste, it is often consumed accidentally or intentionally, leading to life-threatening consequences such as metabolic acidosis, acute kidney injury (AKI), and mortality. Prompt diagnosis and early treatment with antidotes such as fomepizole or ethanol, combined with hemodialysis, are essential in preventing severe outcomes.

Dual Viral Infections and Para-Pneumonic Effusion in a Pediatric Patient: A Case of Respiratory Syncytial Virus and COVID-19 Complication.

Para-pneumonic effusion in children is often associated with bacterial infections; however, dual viral infections, including respiratory syncytial virus (RSV) and COVID-19, can also lead to severe respiratory complications, as demonstrated in this case. This case report presents the clinical course of a pediatric patient with both RSV and COVID-19 infections, leading to para-pneumonic effusion.  A three-year-old girl with a history of asthma and prior febrile convulsions presented to the Emergency Department with fever, cough, vomiting, and fatigue.

A Case of Fournier's Gangrene in a Patient with Human Immunodeficiency Syndrome.

Fournier's gangrene (FG) is a type of necrotizing fasciitis affecting the abdomen or perineum. It is a polymicrobial infection that progresses to an obliterating endarteritis, causing thrombosis and subsequent tissue necrosis, allowing pathogenic invasion of interfacial planes.Patients with Fournier's gangrene typically have underlying systemic conditions that cause vascular insufficiencies or immunosuppression.

Clinical Insights on My Acute Ischemic Stroke Caused by a Carotid Web.

Acute ischemic stroke, a medical emergency caused by reduced cerebral blood flow, results in brain cell damage. While commonly associated with older individuals, strokes can also occur in young and middle-aged adults, posing significant socio-economic and health challenges due to the long-term impact of the condition. This poses significant socio-economic and health challenges because stroke is a leading cause of disability and mortality.