Challenges of Treating a C2 Odontoid Fracture in an Elderly Patient With Multiple Comorbidities: A Case Report.

An 88-year-old male with a history of cervical spondylosis (status post laminectomy of C2-C3 and laminoplasty of C4-C5), chronic congestive heart failure (CHF), pulmonary embolism, and lumbar spinal stenosis presented to an outpatient sports medicine clinic with neck pain following a fall five days prior due to loss of balance. He reported pain on the left side worsened by movement and accompanied by neck "clicking." A physical exam showed severe limitation in cervical spine extension limited by pain and loss of lordotic curve and a neurologic exam demonstrated weakness in the left leg secondary to a previous back surgery.

Surgical Obliteration of a Filum Terminale Arteriovenous Fistula Following Aborted Endovascular Embolization: Illustrative Case Report and Literature Review.

Arteriovenous fistulas of the filum terminale are rare vascular malformations that predominantly affect males and can present with various neurological symptoms. In this study, we indexed previously published cases of filum terminale arteriovenous fistulas demonstrating that endovascular and microsurgical management are both proven to be appropriate and successful treatment modalities with low complication rates. Endovascular treatment is far less invasive; however, it is associated with higher failure rates, which need to be managed surgically.

Quantifying the Diagnostic Odyssey Burden Among Persons with Inborn Errors of Immunity.

Purpose: Patients with inborn errors of immunity (IEI) have lifelong health complications including severe infections and physical impairments. Previous studies show that a patient's perception of their health is an important predictor of health outcomes. The purpose of this study was to understand factors related to patient reported health status.

Hormonal Fluctuation and Ankle Instability in Women-Is There a Correlation?

Background: With higher incidences of ankle sprains and chronic ankle instability in women, it has been postulated that hormonal modulation and ligamentous laxity influences injury propensity. The purpose of this study is to investigate the impact of hormonal fluctuation on ankle stability and ligamentous laxity and their potential contribution to injury propensity in the female athlete.

Methods: In November 2023, a systematic review of the MEDLINE, Embase, and Cochrane Library databases was performed following PRISMA guidelines.

Disparities in Diagnosis, Access to Specialist Care and Treatment for Inborn Errors of Immunity.

Inborn errors of immunity represent a rapidly expanding group of genetic disorders of the immune system. Significant advances have been made in recent years in diagnosis, including using genetic testing and newborn screening; treatment, including precision therapies, gene therapy and hematopoietic stem cell transplant; and development of patient registries to inform prevalence, understand morbidity of these disorders and guide the development of clinical trials. However, significant disparities due to age, race, ethnicity, socioeconomic status, or geographic location exist in all aspects of care of patients with inborn errors of immunity, beginning with delays in diagnosis and further compounded by impaired access to specialist care and treatment, leading to a notable impact on outcomes including morbidity and mortality.

Differences in Religious Commitment and Harm Reduction Attitudes Among US Medical Students by Sex Assigned at Birth: A Pilot Study.

Harm reduction emphasizes positive change by working with individuals without judgment, coercion, discrimination, or requiring abstinence from drugs to receive support. This study examines how religious commitment and medical student attitudes toward harm reduction approaches for substance use differ based on sex assigned at birth. Participants from a US osteopathic medical school completed the revised Harm Reduction Acceptability Scale and the Belief into Action Scale.

Racemose neurocysticercosis of the basal arachnoid cisterns: illustrative case.

Background: Neurocysticercosis is a parasitic infection of the central nervous system caused by the helminth Taenia solium. Racemose neurocysticercosis is a rare form of the disease that specifically involves cerebrospinal fluid-filled spaces in the brain and carries a high rate of complications and mortality.

Observations: This report describes the case of a 37-year-old man who developed headaches and nausea, which were found to be secondary to racemose neurocysticercosis.

From Deworming to Cancer Therapy: Benzimidazoles in Hematological Malignancies.

Drug repurposing is a strategy to discover new therapeutic uses for existing drugs, which have well-established toxicity profiles and are often more affordable. This approach has gained significant attention in recent years due to the high costs and low success rates associated with traditional drug development. Drug repositioning offers a more time- and cost-effective path for identifying new treatments.

Dissecting Secondary Immunodeficiency: Identification of Primary Immunodeficiency within B-Cell Lymphoproliferative Disorders.

Distinguishing between primary (PID) and secondary (SID) immunodeficiencies, particularly in relation to hematological B-cell lymphoproliferative disorders (B-CLPD), poses a major clinical challenge. We aimed to analyze and define the clinical and laboratory variables in SID patients associated with B-CLPD, identifying overlaps with late-onset PIDs, which could potentially improve diagnostic precision and prognostic assessment. We studied 37 clinical/laboratory variables in 151 SID patients with B-CLPD.

Use of Hypoglossal Nerve Stimulation for Treating OSA in Military Patient Populations.

Background: Failure to effectively treat obstructive sleep apnea (OSA) and its symptoms is incompatible with military readiness. Continuous positive airway pressure (PAP) is the gold standard treatment for OSA, but it is impractical in austere environments. Another OSA treatment, hypoglossal nerve stimulation (HGNS), which is implanted, could have advantages for military patients but is unclear whether HGNS is efficacious.

The inferior sacral iliac line as a horizontal reference plane in paediatric pelvic radiographs.

Background: While often used, Hilgenreiner's line may not always be a reliable reference plane following triple innominate pelvic osteotomy or trauma to the triradiate cartilage. The inferior sacral-iliac line is a horizontal line connecting the sclerotic corners of the inferior sacral-iliac joints. This is a consistent landmark in the ossifying infant pelvis as well as the fully developed adult pelvis.

Psychodynamic Insights into Treatment-Resistant Pharmacotherapy: A Case Study Exploring Patient-Physician Dynamics and Adherence to Evidence-Based Practices.

Background: Pharmacological resistance in severe recurrent mood and anxiety disorders remains a significant challenge in modern biological psychiatry. This case report investigates the intricate decision-making process employed by physicians when managing patients resistant to conventional pharmacotherapy.

Methods: Informed consent was obtained from the patient.

Utility of Handheld Ultrasound in Identifying Millimeter-Sized Vasculature in Living and Cadaveric Subjects.

Objective This study aims to investigate the utility of handheld, Bluetooth-capable ultrasound in identifying millimeter-sized vasculature in both living and cadaveric subjects. Methods Using handheld, linear ultrasound probes, the carpal tunnel of 87 living individuals (174 forearms) was assessed for the presence of a persistent median artery (PMA). Radial, ulnar, and persistent median arterial diameters were measured, along with forearm circumference.

Two ventral midline penile lesions in a young adult.

Traumatic neuromas are benign nerve sheath tumors resulting in overgrowth of nerve fibers of severed ends in which the axons to Schwann cell fascicles approaches a near 1:1 ratio. They occur when the nerve has been injured and continuity cannot be reestablished. Traumatic neuromas that arise in the penis are rare and are difficult to differentiate from condylomata without histopathologic analysis.

Acute Primary Small Bowel Volvulus in a Male With Loeys-Dietz Syndrome.

Loeys-Dietz syndrome (LDS) is a connective tissue disorder with features including, but not limited to, aortic dissections, skeletal abnormalities, and craniofacial defects. However, considering its relatively recent discovery, there are still many unknowns about LDS. The extent of a connective tissue disorder like LDS is yet to be defined throughout the various organ systems, including the gastrointestinal system.

Human Lung Mast Cells as a Possible Reservoir for Coronavirus: A Novel Unrecognized Mechanism for SARS-CoV-2 Immune-Mediated Pathology.

The pathogenic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global health concern. Cell entry of SARS-CoV-2 depends on viral spike (S) proteins binding to cellular receptors (ACE2) and their subsequent priming by host cell proteases (TMPRSS2). Assessing effects of viral-induced host response factors and determining which cells are used by SARS-CoV-2 for entry might provide insights into viral transmission, add clarity to the virus' pathogenesis, and possibly reveal therapeutic targets.

Exploring Choke Holds in Brazilian Jiujitsu Athletes: A Demographic Study.

Introduction Brazilian jiujitsu is a relatively new sport that has grown exponentially in popularity along with the growth of the Ultimate Fighting Championship (UFC). In jiujitsu, there are a variety of submissions with a choke hold being one of the most popular. There is a subset of athletes in jiujitsu who believes chokes are safe.

Is Revision Arthroscopic Bankart Repair a Viable Option? A Systematic Review of Recurrent Instability following Bankart Repair.

: Recurrent shoulder instability following Bankart lesion repair often necessitates surgical revision. This systematic review aims to understand the failure rates of arthroscopic revision Bankart repair. : Following the PRISMA guidelines and registered on PROSPERO, this systematic review examined twenty-five articles written between 2000 and 2024.

Clinical Analysis of Postpartum Preeclampsia After an Uncomplicated Pregnancy.

Preeclampsia is a rare complication of pregnancy and can cause maternal death. This case report serves to increase awareness of the range and severity of symptoms in postpartum preeclampsia and highlights a stepwise approach to provide prompt management. The cause of preeclampsia is not fully understood but is correlated with many placental and maternal factors.

A Second Slice of FPIES: A Single-Center Reappraisal of Pediatric FPIES.

Background: Food protein-induced enterocolitis syndrome (FPIES) is being increasingly recognized as a non-IgE-mediated food allergy; however, it remains unclear if and how the presentation, diagnosis, and management of this disease has changed in recent years.

Objective: To reappraise the FPIES cohort at a large US pediatric tertiary referral center.

Methods: We performed a retrospective chart review of pediatric patients with FPIES (International Classification of Diseases, Tenth Revision code K52.

Identifying delay in glymphatic clearance of labeled protons post-acute head trauma utilizing 3D ASL MRI (arterial spin labeling): a pilot study.

This study correlated mild traumatic brain injury (mTBI) cognitive changes with ASL-MRI glymphatic clearance rates (GCRs) and recovery with GCR improvement. mTBI disrupts the blood brain barrier (BBB), reducing capillary mean transit time and GCRs. mTBI is clinically diagnosed utilizing history/examination findings with no physiologic biomarkers.