A 7-year-old with new-onset seizures, behavior disturbance, and encephalitis.

Refractory seizures are common in pediatric neurology; consideration of whether seizures are acutely symptomatic of an underlying disease process is critical. In this case, a previously healthy 7-year-old patient presented with intractable focal seizures in the setting of a viral prodrome and headache. This case highlights a comprehensive work up of new-onset refractory seizures in a patient with features of encephalitis and describes a diagnostic quandary that ultimately led to a rare unifying diagnosis.

Beyond the Exam Room: Teaching Intervisit Care to Internal Medicine Residents.

Introduction: Intervisit care, asynchronous care provided between patient visits, represents an essential part of patient care. Despite the importance of intervisit care, residency programs have not traditionally taught residents how to effectively manage intervisit care within the formal curriculum. We aimed to improve resident preparedness in providing intervisit care with an intervisit workshop.

Primary sclerosing cholangitis in children with inflammatory bowel disease: An ESPGHAN position paper from the Hepatology Committee and the IBD Porto group.

Objective: We aimed to provide an evidence-supported approach to diagnose, monitor, and treat children with inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC).

Methods: The core group formulated seven PICO-structured clinical questions. A systematic literature search from inception to December 2022 was conducted by a medical librarian using MEDLINE and EMBASE.

Polygenic score distribution differences across European ancestry populations: implications for breast cancer risk prediction.

Background: The 313-variant polygenic risk score (PRS) provides a promising tool for clinical breast cancer risk prediction. However, evaluation of the PRS across different European populations which could influence risk estimation has not been performed.

Methods: We explored the distribution of PRS across European populations using genotype data from 94,072 females without breast cancer diagnosis, of European-ancestry from 21 countries participating in the Breast Cancer Association Consortium (BCAC) and 223,316 females without breast cancer diagnosis from the UK Biobank.

Patterns of diuretic titration during inpatient management of acute decompensated heart failure.

Introduction: Hospitalization rates for acute decompensated heart failure (ADHF) have increased, resulting in 6.5 million hospital days annually. Despite this, optimal diuretic strategies for managing ADHF remain unclear, highlighting the need to analyze diuretic practice patterns in ADHF treatment.

Adjustable Phonatory PEEP to Treat Dysphonia: A Preliminary Investigation of Progressive Masked Voice Exercises (PMVE).

The Progressive Masked Voice Exercises (PMVE) with an innovative semioccluded ventilation mask fitted and adjustable positive end-expiratory pressure (PEEP) valve was evaluated. This study aimed to compare the effectiveness of the PMVE with the PEEP device and the Vocal Function Exercise (VFE) program on acoustic, auditory-perceptual, aerodynamic, and self-report measures. Twenty-five participants diagnosed with voice disorders met the criteria.

Mammography Among Women Residing in Urban Versus Rural Utah: Breast Cancer Survival.

Background: Annual or biennial breast cancer screenings are recommended for women 40 and older. Women residing in rural areas have worse breast cancer survival rates than urban women, but no study has focused on rural versus urban residence in Utah regarding breast cancer screening and mortality.

Methods: Cases (n = 14,516) were women aged > 39 diagnosed with a first primary invasive breast cancer between 1998 and 2017 in Utah.

A genome-wide association meta-analysis links hidradenitis suppurativa to common and rare sequence variants causing disruption of the Notch and Wnt/β-catenin signaling pathways.

Background: The contributions of genetic and environmental risk factors to hidradenitis suppurativa (HS) are both poorly understood.

Objective: To identify sequence variants that associate with HS and determine the contribution of environmental risk factors and inflammatory diseases to HS pathogenesis.

Methods: A genome-wide association meta-analysis of 4814 HS cases (Denmark: 1977; Iceland: 1266; Finland: 800; UK: 569; and US: 202) and 1.

Guideline concordant care for acute low back pain: A mixed-methods analysis of determinants of implementation.

Introduction: We conducted an explanatory, sequential mixed-methods study to measure variation in the use of imaging and physical therapy (PT) for acute low back pain (LBP) and to identify implementation determinants that might explain variation in use across 22 EDs and 27 urgent cares in urban and rural locations within a community-based health system.

Methods: We described the patient population and measured concordance with LBP guideline recommendations on imaging and PT referral from January-June 2023. We conducted key informant interviews with physicians and advanced practice providers (APPs), n = 30, from these 49 sites between July - September 2023 and performed content analysis to identify implementation determinants to guideline concordance.

The single-cell spatial landscape of stage III colorectal cancers.

We conducted a spatial analysis using imaging mass cytometry applied to stage III colorectal adenocarcinomas. This study used multiplexed markers to distinguish individual cells and their spatial organization from 52 colorectal cancers. We determined the landscape features of cellular spatial features in the CRC tumor microenvironment.

Exploring COX-Independent Pathways: A Novel Approach for Meloxicam and Other NSAIDs in Cancer and Cardiovascular Disease Treatment.

As a fundamental process of innate immunity, inflammation is associated with the pathologic process of various diseases and constitutes a prevalent risk factor for both cancer and cardiovascular disease (CVD). Studies have indicated that several non-steroidal anti-inflammatory drugs (NSAIDs), including Meloxicam, may prevent tumorigenesis, reduce the risk of carcinogenesis, improve the efficacy of anticancer therapies, and reduce the risk of CVD, in addition to controlling the body's inflammatory imbalances. Traditionally, most NSAIDs work by inhibiting cyclooxygenase (COX) activity, thereby blocking the synthesis of prostaglandins (PGs), which play a role in inflammation, cancer, and various cardiovascular conditions.

Capturing Chemotherapy and Radiotherapy Dose Among Breast Cancer Patients With the Utah All-Payer Claims Database Compared With Gold-Standard Abstraction.

Objective: To evaluate the validity of the Utah statewide All-Payer Claims Database (APCD), we compared breast cancer-specific treatments and dosages with gold-standard abstraction of medical records.

Study Design: In this pilot study, breast cancer treatments were abstracted by a certified tumor registrar at the Utah Cancer Registry (UCR) for patients diagnosed in 2013 with breast cancer. The abstraction of medical records was the gold standard for comparison with treatments identified in the APCD.

Quantitatively assessing the impact of the quality of SNOMED CT subtype hierarchy on cohort queries.

Objective: SNOMED CT provides a standardized terminology for clinical concepts, allowing cohort queries over heterogeneous clinical data including Electronic Health Records (EHRs). While it is intuitive that missing and inaccurate subtype (or is-a) relations in SNOMED CT reduce the recall and precision of cohort queries, the extent of these impacts has not been formally assessed. This study fills this gap by developing quantitative metrics to measure these impacts and performing statistical analysis on their significance.

Plain language review: the safety of relugolix combination therapy for advanced prostate cancer.

What Is This Summary About?: Advanced prostate cancer is a cancer that began in the prostate (a part of the male body) and has spread to other parts of the body. This is a review of two clinical research studies of patients with advanced prostate cancer who were treated with relugolix combination therapy. Relugolix is a medicine taken by mouth that lowers a male sex , called testosterone.

Responsive Neurostimulation in Pediatric and Young Adult Patients With Drug-Resistant Focal, Multifocal, and Generalized Epilepsy: A Single-Center Experience.

Background: Responsive neurostimulation (RNS) is used off-label in pediatric patients with drug-resistant epilepsy (DRE). Our study aims to assess the safety and efficacy of RNS in pediatric and young adult patients with focal, multifocal, and generalized DRE.

Methods: All patients who underwent RNS implantation at Primary Children's Hospital in Salt Lake City, UT, between December 2017 and 2022.