A Tale of 102,726 Messages: Characterizing the Modern Urologist's Portal Message Burden After Common Urologic Surgeries.

Introduction: We aimed to characterize patient portal messaging use after urologic surgery to identify administrative burden and evaluate postoperative clinical associations.

Methods: Epic was queried for all urologic surgeries performed at the Mayo Clinic enterprise between 2019 and 2022. Data from the highest volume procedures were extracted including patient-generated portal messages to their provider and emergency department (ED) visits within 6 months of surgery.

Early Renal Outcomes Following Heart Transplantation Using Organs Procured After Circulatory Death.

Background: Transplantation using hearts obtained through donation after circulatory death (DCD) is increasing, but data on recipient renal outcomes are limited.

Methods And Results: Patients at a single institution who underwent heart transplantation using organs procured through DCD or donation after brain death (DBD) from April 2016 to August 2022 were included in this retrospective cohort study. Hemodynamic measures were collected via right heart catheterization performed 1 week after transplantation.

Education Research: EEG Education in Child Neurology and Neurodevelopmental Disabilities Residencies: A Survey of US and Canadian Program Directors.

Background And Objectives: In the United States, many child neurologists (CNs) and neurodevelopmental disability (NDD) specialists who read EEGs in clinical practice had no additional EEG training other than what was received during residency. This practice highlights the importance of ensuring that CN/NDD residents achieve EEG competence before graduation. However, prior survey-based evidence showed that roughly a third of graduating CN residents in the United States do not feel confident interpreting EEGs independently.

Proposed Nutrition Competencies for Medical Students and Physician Trainees: A Consensus Statement.

Importance: In 2022, the US House of Representatives passed a bipartisan resolution (House of Representatives Resolution 1118 at the 117th Congress [2021-2022]) calling for meaningful nutrition education for medical trainees. This was prompted by increasing health care spending attributed to the growing prevalence of nutrition-related diseases and the substantial federal funding via Medicare that supports graduate medical education. In March 2023, medical education professional organizations agreed to identify nutrition competencies for medical education.

Development of an Automated Triage System for Longstanding Dizzy Patients Using Artificial Intelligence.

Objective: To report the first steps of a project to automate and optimize scheduling of multidisciplinary consultations for patients with longstanding dizziness utilizing artificial intelligence.

Study Design: Retrospective case review.

Setting: Quaternary referral center.

Traumatic Brain Injury.

Advances in trauma care have allowed persons with traumatic brain injury to survive at increasingly greater rates. However, they commonly go on to experience complex symptoms including changes in cognitive, emotional, and behavioral functioning that together limit functioning and quality of life. Clinical neuropsychology is uniquely skilled to work together with other rehabilitation professionals, using a patient centered approach, evidence-based treatments, and increasingly using emerging technology while adhering to ethical principles of respect, beneficence, and justice.

Consensus recommendations for clinical assessment tools for the diagnosis of posterior cortical atrophy syndrome from the Atypical AD PIA of ISTAART.

Introduction: Delay in diagnosis of posterior cortical atrophy (PCA) syndrome is common, and the lack of familiarity with assessment tools for identifying visual cortical dysfunction is a contributing factor. We propose recommendations for the approach to the evaluation of PCA clinical features during the office visit, the neuropsychological evaluation, and the research setting. A recommended screening battery for eye clinics is also proposed.

The impact of internet connectivity when conducting a virtual clinical trial with participants living in rural areas.

Aim: The purpose of this secondary analysis was to describe issues related to internet connections during a virtual randomized clinical trial (v-RCT) that included family caregiver participants living in rural areas.

Background: Success of v-RCTs depends on reliable, high-quality internet access, which can be problematic in rural areas.

Methods: Interventionists documented connectivity issues and corrections made to address connectivity in a narrative note after each virtual visit with family caregivers enrolled in a v-RCT.

Baseline multimodal imaging to predict longitudinal clinical decline in atypical Alzheimer's disease.

There are recognized neuroimaging regions of interest in typical Alzheimer's disease which have been used to track disease progression and aid prognostication. However, there is a need for validated baseline imaging markers to predict clinical decline in atypical Alzheimer's Disease. We aimed to address this need by producing models from baseline imaging features using penalized regression and evaluating their predictive performance on various clinical measures.

Posterior subcapsular cataract in a patient with Straatsma syndrome.

Straatsma syndrome is an uncommon ocular condition generally comprised of myelinated retinal nerve fiber layer, myopia, and amblyopia. Associated ocular disorders include strabismus, nystagmus, optic nerve hypoplasia, and iris heterochromia. We report the case of a 6-year-old girl with unilateral Straatsma syndrome and an acquired cataract that required surgical extraction.

Natural history and complications of normocalcemic hyperparathyroidism: a retrospective cohort study.

Normocalcemic hyperparathyroidism (NHPT) is variably defined, and information regarding complications and natural history are scarce. We aimed to describe the phenotype of NHPT in relation to hypercalcemic hyperparathyroidism (PHPT) and controls, to determine risk of progression, and to develop a predictive model for progression to PHPT. This is a retrospective chart review of 232 patients at a tertiary medical center, comparing 75 controls, 73 patients with NHPT, and 84 with PHPT.

Effects of intermittent fasting and caloric restriction on inflammatory biomarkers in individuals with obesity/overweight: A systematic review and meta-analysis of randomized controlled trials.

Introduction: Obesity is characterized by chronic low-grade inflammation. This study presents an updated systematic review and meta-analysis on the effect of caloric restriction (CR) and intermittent fasting (IF) on plasma inflammatory biomarkers (C-reactive protein [CRP], tumor necrosis factor [TNF]-alpha, and interleukin [IL]-6) in individuals with obesity/overweight compared with unrestricted or ad libitum feeding.

Methods: PubMed, Web of Science, and SCOPUS databases were searched for randomized controlled trials (RCTs) reporting inflammatory biomarkers after at least 8 weeks of intervention.

When Oxybutynin Becomes a Decoy for Oxycodone: A Case Report of Diversion Through Substitution.

This case report describes the novel use of oxybutynin and acetaminophen as a substitution for oxycodone for the express purpose of diverting oxycodone in a hospital-based post-anesthesia care unit (PACU). The report outlines how the physical properties and pharmacologic effects of non-controlled medications in the PACU, like oxybutynin, can be visually mistaken and even mimic the side effects of controlled substances like oxycodone. Substituting oxybutynin for controlled substances can circumvent diversion surveillance software.

Incidence and presenting clinical features of pediatric keratoconus in a US population.

Purpose: To report both the incidence of pediatric keratoconus (PKC) in a population-based cohort and the risk for undergoing corneal surgery over a 20-year period at a single institution.

Methods: The medical records of all patients <19 years of age diagnosed with keratoconus while residing in Olmsted County, Minnesota, from January 1, 1975, through December 31, 2019, were retrospectively reviewed. The records of patients <19 years with keratoconus examined at our institution from January 1, 2001, through December 31, 2020, were also reviewed.

Distinct plasma lipids predict axonal injury and multiple sclerosis activity.

Background: Lipids are of particular interest for the study of neuroinjury and neuroinflammation as structural lipids are major components of myelin, and a variety of lipid species modulate inflammation. In this study, we performed an in-depth lipidomics analysis to identify lipids associated with injury and disease activity.

Methods: Plasma samples were collected from paediatric-onset multiple sclerosis (MS) cases within 4 years of disease onset from 17 sites.

Quality-of-life outcomes from NRG Oncology NSABP B-39/RTOG 0413: whole-breast irradiation vs accelerated partial-breast irradiation after breast-conserving surgery.

Background: NRG Oncology NSABP B-39/RTOG 0413 compared whole-breast irradiation (WBI) to accelerated partial-breast irradiation (APBI). APBI was not equivalent to WBI in local tumor control. Secondary outcome was quality of life (QOL).