The intersection of race and sex on the clinical and cognitive progression of multiple sclerosis.

Objective: Black populations show increased incidences of diagnosis, worse disease severity, and earlier likelihood of mortality due to MS. Clinical outcomes are also linked to biological sex and as with Black individuals, MS characteristics between sexes have also shifted overtime. This study examined whether clinical disease progression differed by race and sex for patients with MS.

Managing Menopause: The Evolving Role of Estrogens, Selective Serotonin Reuptake Inhibitors, and Phytoestrogens in Balancing Hormonal Fluctuations.

Menopause is characterized by the cessation of menstruation for 12 consecutive months. In this narrative review, we describe the transitional stages of menopause, clinical presentation, pharmacological management of symptoms, and effects on fluctuating hormone levels. To standardize the stages of menopause, the Stages of Reproductive Aging Workshop + 10 (STRAW+10) system was designed with five distinct categories corresponding to symptom presentation and numerical years.

Type-1-to-type-2 transition of brain microvascular pericytes induced by cytokines and disease-associated proteins: Role in neuroinflammation and blood-brain barrier disruption.

While the concept of pericyte heterogeneity in the brain microvasculature is becoming more widely accepted, little is known about how they arise, or their functional contributions to the blood-brain barrier (BBB). We therefore set out to examine the distribution of subtypes of pericytes at the BBB and sought to elucidate some of their functional characteristics by examining their unique mRNA expression patterns. We demonstrate that type-1 pericytes (PC1) that are associated with young healthy brains and BBB homeostasis, can transition into type-2 pericytes (PC2) that are associated with disease and BBB breakdown, both in vitro and in vivo, in the presence of both endogenous and disease associated ligands.

Delays in Treatment for Temporal Encephaloceles and Cerebrospinal Fluid Leaks.

Objective: Lateral skull base defects (LSBD) pose a diagnostic challenge; however, early recognition and treatment are important to avoid sequelae. This study examines the impact of health care disparities associated with time to diagnosis and treatment for patients with LSBD.

Study Design, Setting, Patients, Intervention, Outcome Measures: Multi-institutional retrospective cohort study at four U.

Periodontal health in a large cohort of Ugandans living with HIV: a cross-sectional study.

Background: The impact of periodontitis on large populations of people living with HIV (PLHIV) in resource-constrained settings remains largely un-investigated. This study aims to address this knowledge gap by providing a comprehensive description of the periodontal health status among a sizable cohort of Ugandans living with HIV.

Methods: This was a cross-sectional study with 4,449 participants who were over 18-years old with data captured on their reported age, gender, tobacco use, length of time on HAART and alcohol use.

Hematopoietic Cell Transplant compared with Standard Care in Adolescents and Young Adults with Sickle Cell Disease.

Disease-modifying therapies are standard of care (SOC) for sickle cell disease (SCD), but hematopoietic cell transplantation (HCT) has curative potential. We compared outcomes prospectively through 2-years after biologic assignment to a Donor or No Donor (SOC) Arm based on the availability of an HLA-matched sibling or unrelated donor (BMTCTN 1503; NCT02766465). A donor search was commenced after eligibility confirmation.

State Variation in Medicare Reimbursement for the Top 100 Cardiothoracic Surgery Procedures, 2013-2022.

Objective We analyzed changes in reimbursement rates for cardiothoracic surgery procedures from 2013 to 2022 to identify interstate variance and compare changes in reimbursement between procedural groups. Methods The Center for Medicare and Medicaid Services database was analyzed to find the 100 highest-grossing cardiothoracic surgery CPT codes from 2013 to 2022. Medicare Administrative Contractor codes were utilized to identify reimbursement for each state.

Hepatitis Delta Virus Testing and Prevalence Among Chronic Hepatitis B Patients Across Three U.S. Safety-net Health Systems.

Background & Aims: Despite a high prevalence of risk factors associated with hepatitis delta virus (HDV) infection among safety-net populations, data evaluating HDV testing and prevalence are limited. We aim to evaluate HDV testing practices and HDV prevalence among an ethnically diverse, multi-center cohort of safety-net patients with chronic hepatitis B (CHB).

Methods: We retrospectively evaluated 13,218 patients with CHB (54.

Trends in Phototherapy Utilization, Payments, and Geographic Distribution: An Analysis of United States Medicare Part B From 2000 to 2021.

Background: Trends in phototherapy utilization in the context of new therapeutics have not been evaluated.

Objective: This study aimed to evaluate phototherapy utilization, payments, and geographic distribution for Medicare beneficiaries from 2000 to 2021.

Patients/methods: A longitudinal analysis of the Medicare Part B National Summary Data Files was conducted to obtain phototherapy utilization and payment amounts.

Thoracic Radiofrequency Ablation in a Patient With Von Willebrand's Disease: A Case Report.

Congenital bleeding disorders involve specific deficiencies in factors that can alter hemostasis, increasing the risk of bleeding. This case report describes a patient with Von Willebrand's disease who was diagnosed with severe thoracic facet arthritis with pain scores of 9/10. An antihemophilic factor (vWF, Humate-P) injection was administered by a hematologist just before thoracic medial branch blocks.

Dendritic Spines of Layer 5 Pyramidal Neurons of the Aging Somatosensory Cortex Exhibit Reduced Volumetric Remodeling.

Impairments in synaptic dynamics and stability are observed both in neurodegenerative disorders and in the healthy aging cortex, which exhibits elevated dendritic spine turnover and decreased long-term stability of excitatory connections at baseline, as well as an altered response to plasticity induction. In addition to the discrete gain and loss of synapses, spines also change in size and strength both during learning and in the absence of neural activity, and synaptic volume has been associated with stability and incorporation into memory traces. Furthermore, intrinsic dynamics, an apparently stochastic component of spine volume changes, may serve as a homeostatic mechanism to prevent stabilization of superfluous connections.

A Comparative Analysis of Zip Code Discordance in Pediatric Gunshot Wounds.

Introduction: With the rate of pediatric gun violence rising, it is imperative to investigate current trauma intervention strategies. For example, previous trauma studies have used zip codes of residence as a proxy for the zip code of injury. This study aims to look at relationships between zip codes of injury and residence specifically in pediatric patients with gunshot wounds.

Systematic Review of the Profunda Artery Perforator Free Flap for Head and Neck Reconstruction.

Objective: The profunda artery perforator (PAP) flap has gained popularity in head and neck reconstruction with a favorable donor site providing a relatively hidden scar and the ability to harvest a large amount of pliable tissue with consistent vascular anatomy. The primary aim of this study is to evaluate the safety and efficacy of this PAP flap in head and neck reconstruction.

Data Sources: PUBMED, EMBASE, Web of Science, Google Scholar (January 1948-February 2022).

Dopamine D-Like Receptor-Mediated Insurmountable Blockade of the Reinforcing Effects of Cocaine in Rats.

Previous studies indicated differing effects of dopamine D-like and D-like receptor (DR and DR, respectively) agonists on cocaine self-administration. Leftward shifts by DR agonists in the cocaine self-administration dose-effect function contrast with decreases by DR agonists in maximal cocaine self-administration without rightward or leftward displacement. Whether the effects of the DR agonists are due to actions at DRs has not been determined, possibly due to the difficulty in separating the blockade by a DR antagonist of the effects of the DR agonists and those of cocaine.

Personalization of primary prevention: Exploring the role of coronary artery calcium and polygenic risk score in cardiovascular diseases.

Personalized healthcare is becoming increasingly popular given the vast heterogeneity in disease manifestation between individuals. Many commonly encountered diseases within cardiology are multifactorial in nature and disease progression and response is often variable due to environmental and genetic factors influencing disease states. This makes accurate early identification and primary prevention difficult in certain populations, especially young patients with limited Atherosclerotic Cardiovascular Disease (ASCVD) risk factors.

The Impact of Mentoring on Academic Career Success in Surgical Subspecialties: A Systematic Review.

Introduction: As of 2019, women comprise 52.4% of medical school matriculants, make up more than one-third of the active physician workforce, and nearly half of residents and fellows. Although the number of women physicians continues to increase, many surgical subspecialities, including orthopaedic surgery, have not seen a substantial increase in the percentage of women physicians.