Barriers and facilitators to treat-to-target in axial spondyloarthritis in clinical practice: a mixed methods study.

This study aimed to explore the perceptions of patients and rheumatologists about a treat-to-target (T2T) strategy in axial spondyloarthritis (axSpA) and identify the barriers and facilitators to its implementation in clinical practice. A mixed methods design was applied. Patients with axSpA who visited the outpatient clinic with active disease (AxSpA Disease Activity Score [ASDAS] ≥ 2.

Question and answers on long-acting therapy with cabotegravir and rilpivirine in people with HIV.

Modern ART is evolving, allowing the use of new drug formulations and alternative routes of administration to oral therapy. Long-acting (LA) cabotegravir and rilpivirine, the first fully injectable antiretroviral regimen approved for clinical use, is a test case for this new route of administration, and an innovation with implications for the quality of life of people with HIV (PWH). However, its use requires a reorganization of outpatient clinics and outpatient services, and a number of issues remain to be defined regarding the management of PWH on LA drugs, including the correct selection of people who can be treated with LA cabotegravir and rilpivirine.

T2-low severe asthma clinical spectrum and impact: The Greek PHOLLOW cross-sectional study.

Background: Data on type 2 (T2)-low severe asthma (SA) frequency is scarce, resulting in an undefined unmet therapeutic need in this patient population. Our objective was to assess the frequency and characterize the profile and burden of T2-low SA in Greece.

Methods: PHOLLOW was a cross-sectional study of adult SA patients.

Ovarian function in adolescents and young adults undergoing cancer treatment: biochemical and ultrasound marker analysis.

Objective: Gonadal dysfunction is a major late complication after cancer diagnosis and treatment. We aimed to study the prevalence of premature ovarian insufficiency (POI) and the potential reduction of ovarian reserve in a cohort of adolescent and young adult (AYA) patients undergoing cancer treatments, evaluating ovarian function and reserve markers. We also aimed to analyze how these markers are related to each other and to treatment-related risk factors.

Diagnostic changes in a specialized psychiatric outpatient clinic for migrants: An observational study.

Culture significantly influences the understanding, presentation, diagnosis, and treatment of mental disorders, particularly among migrant patients. This observational study examines the frequency and timing of diagnostic changes among migrant patients in a specialized psychiatric outpatient clinic. Furthermore, the study includes a qualitative sub-study to provide insights into the diagnostic process.

Time to regional surgical care in rural South Africa.

Background: District hospitals in South Africa have limited surgical capacity and regional hospitals treat most essential surgical conditions. This study aimed to describe the pathway and time to regional hospital surgical care for persons with general surgery conditions (PSC) in South Africa.

Methods: This was a retrospective audit of all persons referred on the Vula Mobile App to the general surgery service at Worcester Regional Hospital (WRH) from 1 January 2019 to 31 December 2019.

Case report: Detection and treatment of a rare submucosal gland duct adenoma of the esophagus.

This article reports a rare case of esophageal submucosal gland duct adenoma (ESGDA). The patient was found to have this tumor after undergoing endoscopy in an outpatient clinic due to occasional tingling while eating. White light endoscopy revealed the tumor as a dumbbell-shaped bulge, and ultrasound endoscopy revealed it as a hypoechoic mass located in the submucosal layer.

Baseline Ultrasound Assessment Improves the Response to Apremilast in Patients with Psoriatic Arthritis: Results from a Multicentre Study.

Background: Psoriatic arthritis (PsA) phenotypes show different responses to the many available drugs. For a tailored medicine, it is important to choose the most effective treatment according to patients' characteristics. Apremilast is recommended in PsA with moderate activity.

Anatomic site distribution of in men who have sex with men attending a tertiary care hospital in North India.

Background And Objectives: Anorectal and pharyngeal infections with (NG) are common in men who have sex with men (MSM). However, they are often asymptomatic and found in the absence of reported risk behavior and concurrent genital infection. These serve as a hidden reservoir for ongoing transmission and may cause complications.

Impacts of a multipronged initiative with community HIV clinics to support retention and re-engagement in HIV care.

Background: Despite advances in HIV treatment, gaps in care retention threaten the individual health of people with HIV (people) and public health efforts to end the HIV epidemic.

Objective: This project aimed to identify and address gaps in retention and support re-engagement in care.

Methods: A multipronged initiative at five community HIV clinics and community-based organizations (CBOs) included patient, healthcare professional (HCP), and community-focused interventions.

Tooth vitality and periapical healing: is Biodentine at par with MTA in regenerative endodontics?

Design: The study is a prospective, double-blinded randomised control trial that compares the mineral trioxide aggregate (MTA) and Biodentine as the pulp space barrier material after induction of a periapical blood clot by over-instrumentation for endodontic regeneration in single-rooted mature permanent anterior tooth (closed apex) with apical periodontitis (periapical pathology of more than 3 mm) and having necrosed pulp. A total of 36 patients were included in the study and after randomisation were allocated equally to both the groups out of which 31 patients returned for follow-up over an 18-month period. The treatment protocol consisted of two separate appointments.

Exploring the link between dietary inflammatory index, inflammatory biomarkers, and sleep quality in adults with obesity: a pilot investigation.

Objective: Obesity is known to be associated with inflammation and impaired sleep quality. In addition, the anti-inflammatory properties of the daily diet provide positive effects on health. The aim of this study was to investigate the relationship between the inflammatory index of the diet consumed by people with obesity and inflammatory biomarkers and sleep quality.

A Randomized, Double-Blind, Two-Way Cross-over Study to Evaluate the Efficacy of Liraglutide Treatment in Patients Undergoing Transoral Outlet Reduction Endoscopy for Weight Regain Post Roux-en-Y Gastric Bypass.

Background: Transoral outlet reduction endoscopy (TORe) and glucagon-like peptide-1 agonist, liraglutide, have individually shown promise in managing weight regain after Roux-en-Y gastric bypass. However, combined effects of adjunctive liraglutide to TORe remain unexplored. A cross-over design was utilized to evaluate the efficacy of liraglutide treatment when initiated immediately post-TORe or 1 year post-TORe.

Switching between anti-cgrp monoclonal antibodies in migraine prophylaxis.

Introduction: When a first anti-CGRP monoclonal antibody (anti-CGRP mAb) fails, switching to a different anti-CGRP mAb is an option often considered, despite this approach is not yet systemically studied.

Methods: We present the findings of a systematic review conducted according to the PRISMA recommendations on published studies - of any design - investigating the clinical outcomes after switching for any reason to different anti-CGRP mAbs.

Results: The literature search retrieved 76 records, while 19 papers were eventually reviewed.

The Minority Tax: Stories from Family Physicians.

The minority tax has been defined as a set of disparities that those who are underrepresented in medicine face in addition to clinical care, education, and research responsibilities. These taxes include systemic racism, diversity efforts, clinical and promotion disparities, lack of faculty development, and isolation. Much has been added to the literature to better define and characterize the minority tax and propose suggestions for mitigations.

Health Care Delivery and Financial Considerations in Amyotrophic Lateral Sclerosis Clinics: A Survey of Clinic Directors.

Background And Objectives: Clinical care for people living with amyotrophic lateral sclerosis (PLWALS) is directed at slowing disease progression and symptom management. The American Academy of Neurology recommends a multidisciplinary approach to providing ALS health care because observational studies show that multidisciplinary clinics (MDCs) extend survival and improve quality of life. However, providing multidisciplinary care is a challenging financial proposition.

A cross-sectional study on the assessment of adherence to cardiovascular medications in Sudan heart center.

Background: Non-adherence to cardiovascular medications is a global problem with clinical, economic, and humanistic consequences. Investigation of this problem may open the road for proper management of cardiovascular diseases.

Objective: Our objectives were to assess the level of adherence to, and to examine factors influencing adherence to, cardiovascular medications in subjects visiting a heart center in Sudan.

The association of muscle weakness with functional disability in older patients with Diabetes mellitus: Measured by three different grip strength thresholds.

The association of muscle weakness with poor outcomes is well defined in general older population, but there is insufficient data on the association of muscle weakness with functionality in older patients with diabetes mellitus (DM). We aimed to investigate the predictivity of muscle weakness defined as low grip strength thresholds determined by EWGSOP2, and two regional thresholds in older patients with DM for functional disability. Activities of Daily Living (ADL), Instrumental ADL (IADL), grip strength, comorbidities, anthropometric and biochemical data from outpatient clinic medical records were screened retrospectively.

Low-volume transanal irrigation (TAI) in the treatment of functional faecal incontinence in children: a cohort study.

Purpose: Functional faecal incontinence (FFI) is a stigmatising condition for a child and parents and can be a challenge to treat even in tertiary centres. Transanal irrigation (TAI) is an emerging treatment with great success in refractory cases. We performed TAI with a substantially decreased amount of water used (low-volume TAI), yet no previous evidence exists on this treatment in children.

Putting the Puzzle Together: Case Report of Parinaud Syndrome in a Pediatric Patient.

Parinaud syndrome, also known as dorsal midbrain syndrome, is a condition affecting the dorsal midbrain region of the brainstem that presents with a triad of ophthalmic clinical findings, including upgaze paresis, convergence retraction nystagmus, and light-near dissociation. This case report will discuss the clinical presentation of Parinaud syndrome in a four-year-old patient who was seen in an out-patient clinic for intermittent exotropia 5 months after a suboccipital craniotomy resection of a pineal mass and ventriculoperitoneal (VP) shunt placement for associated hydrocephalus. Current literature is relatively sparse regarding the presentation of Parinaud syndrome in the pediatric population, with little known about prognosis and potential for recovery.

Effects of an Organizational Implementation Strategy on Sustainment of Measurement-Based Care in Community Mental Health.

Objective: Little is known about how to sustain evidence-based interventions with fidelity in community mental health settings. Phase 1 of the Working to Implement and Sustain Digital Outcome Measures (WISDOM) trial showed that an organizational strategy improved the implementation of measurement-based care (MBC) in mental health services for youths 1-12 months after clinician MBC training. The authors report results from phase 2 of the trial, in which the strategy's effects on MBC sustainment 13-26 months after clinician MBC training were examined.

Alpha/beta values in pediatric medulloblastoma: implications for tailored approaches in radiation oncology.

Background: Medulloblastoma is the most common malignant pediatric brain tumor, typically treated with normofractionated craniospinal irradiation (CSI) with an additional boost over about 6 weeks in children older than 3 years. This study investigates the sensitivity of pediatric medulloblastoma cell lines to different radiation fractionation schedules. While extensively studied in adult tumors, these ratios remain unknown in pediatric cases due to the rarity of the disease.

Outcomes of functional tics in adolescents: a single-centre tertiary study.

Objective: To investigate the prognosis and co-occurring disorders, including functional neurological symptoms, in adolescents diagnosed with functional tic-like behaviour (FTLB).

Design: This was a single-centre tertiary study in the UK. A structured clinical interview was administered to 43 parents or carers of adolescents assessed with FTLB at their previous outpatient clinic appointment.

Outcomes of Anesthesia-Supported versus Endoscopist-Driven Sedation Modalities: A retrospective cohort study.

Background And Aims: Anesthesia involvement has become commonplace in many procedural settings. The goal of this study is to compare sedation modalities utilized by endoscopists and anesthesiologists in the endoscopy suite, particularly with respect to recovery time and adverse events.

Methods: We conducted a retrospective cohort study including adults (≥18) undergoing outpatient EGD and/or colonoscopy at Mayo Clinic in Jacksonville, Florida between October 1, 2018 through December 31, 2022.

[Diagnostic utility of the MTA-Score depending on age and cerebral microangiopathy in times of automated volumetry].

  To investigate the diagnostic value of the MTA score according to age, cerebral small vessel disease and in times of automated volumetry.  Retrospective analysis of patients with subjective cognitive decline (SCD), amnestic mild cognitive impairment (aMCI), Alzheimer's disease (AD) and mixed dementia (MD) who presented to our outpatient dementia clinic between February 2018 and October 2020. Patients underwent cranial magnetic resonance imaging (MRI) including specific MRI sequences needed for automated volumetry.