Palovarotene in fibrodysplasia ossificans progressiva: review and perspective.

Introduction: Palovarotene is a retinoic acid receptor gamma agonist that was studied in phase-2 and phase-3 clinical trials for the inhibition of new heterotopic ossification (HO) in fibrodysplasia ossificans progressiva (FOP). Despite numerous setbacks and regulatory delays, palovarotene is now the first approved FOP treatment in the U.S.

Prospective study on time-to-tertiary care in alcohol-associated hepatitis: space-time coordinates as prognostic tool and therapeutic target.

Background And Aims: Alcohol-associated hepatitis (AH) frequently triggers acute decompensation (AD) in cirrhosis, with severe AH linked to high short-term mortality, especially in acute-on-chronic liver failure. Current corticosteroid treatments have limited efficacy, highlighting the need for new therapies. We hypothesized that severe AH outcomes are influenced by early specialized care; thus, we examined the impact of time-to-tertiary care (TTTc).

Variation in lipoprotein(a) response to potent lipid lowering: The role of apolipoprotein (a) isoform size.

Background: Lipoprotein(a) [Lp(a)] is a driver of residual cardiovascular risk. Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) decrease Lp(a) with significant heterogeneity in response. We investigated contributors to the heterogeneous response.

New onset refractory status epilepticus: Long-term outcomes beyond seizures.

We propose and prioritize important outcome domains that should be considered for future research investigating long-term outcomes (LTO) after new onset refractory status epilepticus (NORSE). The study was led by the international NORSE Institute LTO Working Group. First, literature describing the LTO of NORSE survivors was identified using a PubMed search and summarized to identify knowledge gaps.

Discovery of a DNA methylation profile in individuals with Sifrim-Hitz-Weiss syndrome.

Pathogenic heterozygous variants in CHD4 cause Sifrim-Hitz-Weiss syndrome, a neurodevelopmental disorder associated with brain anomalies, heart defects, macrocephaly, hypogonadism, and additional features with variable expressivity. Most individuals have non-recurrent missense variants, complicating variant interpretation. A few were reported with truncating variants, and their role in disease is unclear.

Sudden Vision Loss: A Diagnostic Approach.

Vision loss affects more than 7 million Americans and impacts quality of life, independence, social functioning, and overall health. Common and dangerous conditions causing sudden vision loss include acute angle-closure glaucoma, retinal detachment, retinal artery occlusion, giant cell arteritis, and optic neuritis. Acute angle-closure glaucoma features ocular pain, headache, and nausea; treatment includes pilocarpine eye drops, oral or intravenous acetazolamide, and intravenous mannitol.

Without visual feedback voluntary torque is overestimated during muscle potentiation despite similar motor unit firing rate and perception of exertion.

The purpose was to assess whether visual feedback of torque contributes to motor unit (MU) firing rate reduction observed during post-activation potentiation (PAP) of skeletal muscle. From 15 participants 23 MUs were recorded with intramuscular fine-wire electrodes from the tibialis anterior during isometric dorsiflexion contractions at 20% of maximum, with and without both PAP and visual feedback of torque. A 5s maximal voluntary contraction (MVC) was used to induce PAP, and evoked twitch responses were assessed before and after.

Assessing the subarachnoid space anatomy on clinical imaging: utilizing normal and pathology to understand compartmentalization of the subarachnoid space.

Background: The goal of the study is to use CT imaging in patients with aSAH to evaluate the anatomic distribution of hemorrhage and compartmentalization of subarachnoid space to investigate potential in vivo visualization of recently discovered layer named subarachnoid lymphatic-like membrane (SLYM).

Methods: We conducted a retrospective cohort study of cases with aneurysmal SAH (aSAH) at our institution between January 2015 and June 2022. Subarachnoid hemorrhage distribution into superficial and deep subarachnoid spaces was classified based on proximity to the dural or pial surfaces, respectively, as seen on multiplanar CT head.

The association between physician sex and patient outcomes: a systematic review and meta-analysis.

Background: Some prior studies have found that patients treated by female physicians may experience better outcomes, as well as lower healthcare costs than those treated by male physicians. Physician-patient sex concordance may also contribute to better patient outcomes. However, other studies have not identified a significant difference.

Gender trends in orthopedic surgical residency programs in Canada over 20 years.

Background: Gender disparities exist in several surgical specialties, particularly in orthopedic surgery. The purpose of this study was to determine the current trends in gender diversity among orthopedic surgical residents in Canada over the last 20 years.

Methods: We analyzed gender distribution data for orthopedic trainees from the Canadian Resident Matching Service (CaRMS) for 2013-2022 and the Canadian Post-MD Education Registry for 2000-2022 using linear and quadratic regressions.

Effects of Acute Aerobic Exercise on Skeletal Muscle and Liver Glucose Metabolism in Male Rodents with Type 1 Diabetes.

Aerobic exercise (AE) is associated with a significant hypoglycemia risk in individuals with type 1 diabetes mellitus (T1DM). However, the mechanisms in the liver and skeletal muscle governing exercise-induced hypoglycemia in T1DM are poorly understood. This study examined the effects of a 60-minute bout of AE on hepatic and muscle glucose metabolism in T1DM rats.

Parallel EEG-fNIRS assessments of covert cognition in behaviorally non-responsive ICU patients: A multi-task feasibility study in a case of acute motor sensory axonal neuropathy.

Background: Repeat neurological assessment is standard in cases of severe acute brain injury. However, conventional measures rely on overt behavior. Unfortunately, behavioral responses may be difficult or impossible for some patients.

Cross-cultural adaptation and evidence of validity of the interprofessional collaboration scale (IPC-BR) for Brazil.

We aimed to perform cross-cultural adaptation of the Interprofessional Collaboration Scale (IPC-BR) and to evaluate evidence of its validity for the Brazilian hospital context. The research consisted of six steps: translation of the instrument into the new language, synthesis of the translated versions, back-translation, synthesis of the versions in the original language, evaluation of the syntheses by an expert committee, and pilot testing or pretesting and validation of the internal structure of the items of the instrument. The pilot testing involved 4 translators, 14 judges, and 30 healthcare professionals; the validation of the internal structure involved 686 professionals including nurses, physicians and physiotherapists.

Transcatheter edge-to-edge repair in severe mitral regurgitation following acute myocardial infarction - aetiology-based analysis.

Aims: To evaluate the association between transcatheter edge-to-edge repair (TEER) and outcomes in patients with significant mitral regurgitation (MR) following acute myocardial infarction (MI), focusing on the aetiology of acute post-MI MR in high-risk surgical patients.

Methods And Results: The International Registry of MitraClip in Acute Mitral Regurgitation following Acute Myocardial Infarction (IREMMI) includes 187 patients with severe MR post-MI managed with TEER. Of these, 176 were included in the analysis, 23 (13%) patients had acute papillary muscle rupture (PMR) and 153 (87%) acute secondary MR.

Heterogeneous knowledge of childhood seizures and epilepsy care in Canadian healthcare Providers: Identifying the gaps.

Epilepsy is the most common chronic neurological condition in children. Many barriers exist in early recognition which cause delay in care and impact quality of life. Some of these children require advanced treatments which are underutilized due to lack of education, awareness and referrals.

Trends in female applicants to Canadian ophthalmology residency programs from 1998-2020.

Background: Ophthalmology has historically been a male-dominated specialty. Despite there being a higher proportion of females in Canadian medical schools since the early 2000s, it is unknown if trends in female applicants and those accepted to ophthalmology have followed suit. This study aims to evaluate trends in gender representation of ophthalmology applicants to Canadian residency programs from 1998 to 2020 and to compare those trends to other surgical specialties.

Evaluating the Podcast as an Equity, Diversity and Inclusion resource: a cross-sectional survey analysis.

Background: Equity-deserving groups are communities marginalized from institutional power by oppressive forces (e.g., racism, sexism, homophobia, ableism).

Children and divorce: A rapid review targeting cognitive dissonance, in the context of narrative therapy.

Today, for divorcing parents, the social norms of "good" parenting appear to impose obligations to "fight" for shared custody of their children. However, this may intensify conflicts experienced by their children in the form of cognitive dissonance. Authors conducted a rapid review to explore children's experiences of divorce (ages three to 12 years old) in the context of narrative therapy, in order to uncover the mechanism of cognitive dissonance.

Age-associated differences in FIRES: Characterizing prodromal presentation and long-term outcomes via the web-based NORSE/FIRES Family Registry.

Febrile infection-related epilepsy syndrome (FIRES) is a rare clinical presentation of refractory status epilepticus following a febrile infection. This study analyzes data from the NORSE/FIRES Family Registry, an international web-based registry available in six languages with data entered by patients, families, and clinicians to explore clinical presentations, survivorship, and long-term outcomes in adult and pediatric FIRES patients. We characterize and examine differences in demographics, prodromal symptoms, seizure frequency, anti-seizure medications (ASMs), quality of life, cognition, mood, and anxiety in adults vs pediatric populations with FIRES.

Risk of stroke with reduced dose direct oral anticoagulants vs standard dose anticoagulation after cardioversion of atrial fibrillation: A systematic review and meta-analysis.

Background: There is consensus on the safety of standard dose direct oral anticoagulants (DOACs) for stroke prevention in patients undergoing cardioversion of atrial fibrillation (AF), but outcomes of reduced dose DOACs in this setting remain unclear.

Objective: This systematic review and meta-analysis aimed to compare the rate of cardioversion-associated thromboembolic events between patients taking reduced dose DOACs and those receiving standard dose anticoagulation.

Methods: A systematic search was conducted for studies published between January 1, 2009, and February 16, 2024 in PubMed, Embase, and Cochrane Central Register of Controlled Trials.

The impact of hypertension prevention and modification on dementia burden: A systematic review of economic studies.

Aim: Neurological disorders account for the largest proportion of disability-adjusted life years globally, with dementia being the third leading cause. Hypertension has been identified as a priority, targetable risk factor for dementia. This study aimed to systematically review economic studies that examine the impact of hypertension prevention and control on the costs and outcomes of dementia.