Asymptomatic Primary Hyperparathyroidism: A Misnomer.

Primary hyperparathyroidism (PHPT) is an endocrine disorder marked by elevated secretion of parathyroid hormone (PTH), which results in hypercalcemia and may cause complications in the kidneys and bones. Diagnosing this condition involves ruling out secondary causes and understanding the complexities of the laboratory values associated with PHPT. The disease has become more recognizable to clinicians in an earlier phase thanks to updated screening guidelines.

Emergency department management of opioid use disorder in pediatric patients.

Opioid use disorder (OUD) has emerged as a significant public health crisis affecting individuals across all age groups. However, there remains a critical gap in understanding the specific nuances and challenges associated with OUD in pediatric populations. This article provides a comprehensive review of the epidemiology, definition of OUD, screening recommendations for OUD, and evidence-based management strategies for OUD in pediatric patients.

A rare case of non-lupus full house nephropathy in a transplanted kidney, case report.

Key Clinical Message: Non-lupus full house nephropathy is a rare entity that is still poorly understood. It can complicate post-transplant kidneys and result in a de novo process. Treatment is difficult but can be possibly achieved with optimization of immune suppression.

Acute opioid overdose in pediatric patients.

Recent increases in pediatric and adolescent opioid fatalities mandate an urgent need for early consideration of possible opioid exposure and specific diagnostic and management strategies and interventions tailored to these unique populations. In contrast to adults, pediatric methods of exposure include accidental ingestions, prescription misuse, and household exposure. Early recognition, appropriate diagnostic evaluation, along with specialized treatment for opioid toxicity in this demographic are discussed.

Associations between obesity severity and medical comorbidities for children with obesity in low intensity hospital intervention.

Background: Childhood obesity has increased dramatically in the United States. Most available research has followed obesity prevalence with little attention to medical comorbidities, which could guide prevention and intervention.

Methods: A retrospective chart review examined 2038 children referred to a Pediatric Weight Management Clinic providing low intensity (<26 contact hours) intervention.

Interplay of Objective Sleep Duration and Cardiovascular and Cerebrovascular Diseases on Cause-Specific Mortality.

Background Cardiovascular and cerebrovascular diseases (CBVDs) and cancer are leading causes of death. Short sleep is a potential contributor to health; however, its role in predicting mortality associated with cardiometabolic risk factors (CMRs) and CBVD remains poorly understood. We tested whether objective short sleep duration increases the risk of mortality associated with CMRs and CBVD.

Arterial Properties as Determinants of Left Ventricular Mass and Fibrosis in Severe Aortic Stenosis: Findings From ACRIN PA 4008.

Background The role of arterial load in severe aortic stenosis is increasingly recognized. However, patterns of pulsatile load and their implications in this population are unknown. We aimed to assess the relationship between the arterial properties and both (1) left ventricular remodeling and fibrosis and (2) the clinical course of patients with severe aortic stenosis undergoing aortic valve replacement ( AVR ).

Predictors of Waitlist Mortality in Portopulmonary Hypertension.

Background: The current Organ Procurement Transplantation Network policy grants Model for End-Stage Liver Disease (MELD) exception points to patients with portopulmonary hypertension (POPH), but potentially important factors, such as severity of liver disease and pulmonary hypertension, are not included in the exception score, and may affect survival. The purpose of this study was to identify significant predictors of waitlist mortality in patients with POPH.

Methods: We performed a retrospective cohort study of patients in the Organ Procurement and Transplantation Network database with hemodynamics consistent with POPH (defined as mean pulmonary arterial pressure >25 mm Hg and pulmonary vascular resistance [PVR] ≥240 dynes·s·cm) who were approved for a POPH MELD exception between 2006 and 2014.

A Prospective Evaluation of an Outpatient Assessment of Postural Instability to Predict Risk of Falls in Patients with Parkinson's Disease Presenting for Deep Brain Stimulation.

Background: Postural instability (PI) and falls, major causes of morbidity in patients with PD, are often overlooked. DBS is a mainstay therapy for Parkinson's disease (PD) and has been purported to both worsen and improve PI. An effective PI evaluation that can predict fall risk in patients with PD presenting for DBS is needed.

The epidemic investigation of serum 25-hydroxy vitamin D levels in the adults in Qujing area of Yunnan province in China.

Objective: To investigate the levels of serum 25-hydroxy vitamin D(25-OHD) and its related influence factors in the adults in Qujing area of Yunnan Province in China.

Method: 25-OHD levels in the sera were detected with a 25-hydroxy vitamin D kit and read with LIAISON XL chemiluminescence analyzer. Data was statistically analyzed with software SPSS17.

A voxelwise approach to determine consensus regions-of-interest for the study of brain network plasticity.

Despite exciting advances in the functional imaging of the brain, it remains a challenge to define regions of interest (ROIs) that do not require investigator supervision and permit examination of change in networks over time (or plasticity). Plasticity is most readily examined by maintaining ROIs constant via seed-based and anatomical-atlas based techniques, but these approaches are not data-driven, requiring definition based on prior experience (e.g.

Transient unilateral brachial plexopathy and partial Horner's syndrome following spinal anesthesia for cesarean section.

A healthy 21-year-old primigravida presented for elective cesarean section. At 45 min after intrathecal (IT) injection of bupivacaine, morphine and fentanyl she developed dysphagia, right sided facial droop, ptosis and ulnar nerve weakness. This constellation of signs and symptoms resolved 2 h later.

Overview and Long-term Outcomes of Patients Born With Twin-to-Twin Transfusion Syndrome.

Twin-to-twin transfusion syndrome (TTTS) results from a disproportionate blood supply between two (or more) fetuses that share a single placenta. Multiple complications can occur as a result of the syndrome, including intrauterine growth restriction in the donor twin, cardiomyopathies in recipients, and neurodevelopmental morbidities in survivors. Studies indicate that patients with TTTS have higher incidences of congenital heart disease compared with the unaffected population, and even when compared with uncomplicated monochorionic diamniotic twins.