Double the Diagnosis: A Case Report of Dizygotic Twins With Meningomyelocele.

The formation of neural tube defects, such as a meningomyelocele, is often sporadic and more common in monozygotic twin gestations but can be associated with folic acid deficiency and rarely occurs in dizygotic twins. In this case report, we present dizygotic twins born in the United States with meningomyeloceles. In addition, their neural tube defects were complicated by hydrocephalus and decreased muscle tone and movement in the lower extremities.

Intractable Belching as a Psychiatric Consequence: A Case Report.

Background: Belching is a common physiological occurrence, but it becomes bothersome when it occurs excessively and disrupts one's quality of life. It is hypothesized that psychiatric diagnoses may be an etiology and exacerbation for intractable belching.  Case presentation: We present a case report of a female in her 70s with a psychiatric history of major depressive disorder (MDD) and generalized anxiety disorder (GAD) with symptoms of intractable belching.

Unraveling Palisaded Encapsulated Neuroma: A Case Report and Diagnostic Challenges.

Palisaded encapsulated neuroma (PEN), also known as solitary circumscribed neuroma, is a rare, benign tumor of neuronal origin, often located on the head or neck. We present a case involving a 77-year-old Middle Eastern woman with a slowly enlarging, slightly symptomatic lesion on her upper lip. Histopathological analysis following a shave biopsy revealed the lesion to be a PEN.

A Rare Case of Hemodialysis as an Extracorporeal Treatment for Severe Phenytoin Overdose.

Phenytoin is a well-known anticonvulsant medication that is useful in the management of most seizure disorders. Given the narrow therapeutic index of 10-20 mg/mL, acute phenytoin overdose can occur with either oral or intravenous administration. There is no distinct antidote to phenytoin, and therefore supportive care is the treatment of choice.

Design and Development of Virtual Reality Application Implementing Age-Friendly Care and the 4Ms: A Quality Improvement Project.

Introduction: With an increase in the aging population, the application of evidence-based practice in geriatric education can strengthen knowledge, skills, and clinical experience for healthcare students caring for older adults. The Age-Friendly Health System (AFHS) is one of the frameworks founded on providing evidence-based and low-risk care centered on what matters most to older adults, their families, and caregivers. Virtual reality (VR) platforms are gaining popularity due to their ability to provide an immersive, hands-on learning experience resembling an actual medical practice or care setting.

Synergistic pH-responsive MUC-1 aptamer-conjugated Ag/MSN Janus nanoparticles for targeted chemotherapy, photothermal therapy, and gene therapy in breast cancer.

Drug resistance in cancer treatment, primarily attributed to the overexpression of the multidrug resistance (MDR) gene, significantly hampers the effectiveness of chemotherapy. This mechanism, driven by the increased production of P-glycoprotein (P-gp) efflux pumps, highlights the urgent need for innovative strategies to combat drug resistance in cancer patients. This study explores the application of antisense technology to suppress MDR gene expression, while addressing the challenges of instability and limited cellular uptake associated with antisense oligonucleotides.

Increased tobacco taxation associated with decreased consumption and bladder cancer incidence.

Purpose: The temporal relationship between smoking exposure and bladder cancer (BC) diagnosis remains ill-defined. This study aims to cross-correlate and temporally associate changes in United States (US) tobacco tax and consumption with BC incidence.

Methods: US tobacco consumption, tobacco tax data, and BC incidence rates from 1975-2019 were retrieved.

Digital Flexible Ureteroscope: Evaluating Factors Responsible for Damage and Implementing a Mandatory Certification Program for Usage.

Digital flexible ureteroscopes (DFUs) play a crucial role in endourological procedures, and scope breakages are often avoidable with proper measures in place. We aimed to evaluate the effect of mandatory training on DFU durability and to assess the influence of various factors on instrument damage. Mandatory training involving instructional videos on DFU care was introduced for all processing and operating room staff handling DFUs.

Can Artificial Intelligence Fool Residency Selection Committees? Analysis of Personal Statements by Real Applicants and Generative AI, a Randomized, Single-Blind Multicenter Study.

Introduction: The potential capabilities of generative artificial intelligence (AI) tools have been relatively unexplored, particularly in the realm of creating personalized statements for medical students applying to residencies. This study aimed to investigate the ability of generative AI, specifically ChatGPT and Google BARD, to generate personal statements and assess whether faculty on residency selection committees could (1) evaluate differences between real and AI statements and (2) determine differences based on 13 defined and specific metrics of a personal statement.

Methods: Fifteen real personal statements were used to generate 15 unique and distinct personal statements from ChatGPT and BARD each, resulting in a total of 45 statements.

Going P(u)BLIQ: Successfully Transitioning Undergraduate Medical Students from Problem-Based Learning to Inquiry Case Learning Through a Novel Hybrid Approach.

Purpose: Problem-based learning (PBL) is an established learning method in medical education that uses small groups to address a "problem" in the form of a patient's medical condition. Compared to lectures, there is compelling evidence that PBL performs better in numerous areas including student basic knowledge and satisfaction. Inquiry case (IQ) learning is a modified form of PBL, which can be described as faster-paced and requires more student responsibility.

Interstitial Cystitis Chatter: A Qualitative Evaluation of Bladder Instillation Online.

Objective: To qualitatively assess the perception and experiences of bladder instillation for interstitial cystitis among women on Reddit, a widely used anonymous social media platform.

Methods: "r/interstitialcystitis," a Subreddit with >27,000 subscribers, was queried for bladder instillation among women with interstitial cystitis in November 2023. Posts were analyzed qualitatively by 3 independent researchers.

Three-Year Effects of Motivational Interviewing-Enhanced Behavior Therapy for Adolescents With Attention-Deficit/Hyperactivity Disorder: A Randomized Community-Based Trial.

Objective: This study reports 3-year effects of a parent-teen cognitive/behavioral treatment for adolescent attention-deficit/hyperactivity disorder (ADHD), blended with Motivational Interviewing (Supporting Teens' Autonomy Daily [STAND]), vs Usual Care (UC) in 4 community clinics.

Method: This was a randomized clinical trial with double randomization of adolescents and therapists to STAND vs UC. Participants were 278 culturally diverse adolescents diagnosed with DSM-5 ADHD and 82 community therapists.

Assessment of the therapeutic potential of salubrinal for ME/CFS and long-COVID.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic debilitating condition with no cure that shares commonality with long-COVID. This review examines current understanding of long-COVID symptoms, characteristics of the affected population, the connection with ME/CFS, and the potential for salubrinal, an agent known for its influence on cellular stress pathways, to mitigate these disorders It also describes the historical development and mechanism of action of salubrinal, to mitigate endoplasmic reticulum (ER)/cellular stress responses, that could potentially contribute to symptom improvement in both ME/CFS and long-COVID patients. Further research and clinical trials are warranted to advance our understanding of the potential role of salubrinal in improving the quality of life for individuals with long-COVID-related ME/CFS symptoms as well as ME/CFS patients.

Perspectives of osteopathic medical students on preclinical urology exposure: a single institution cross-sectional survey.

Context: There is an increasing number of medical school graduates opting for surgical specialties, and the osteopathic applicant match rate for urology is lower than that of allopathic applicants. Factors influencing this may include a lack of interest, perceived challenges in matching into urology, insufficient urology mentorship, limited research opportunities, and inadequate osteopathic representation in urology.

Objectives: The objective of this survey is to assess osteopathic medical students' perspectives on pursuing urology and enhancing preclinical exposure to and knowledge of urology.

Purine and pyrimidine synthesis differently affect the strength of the inoculum effect for aminoglycoside and β-lactam antibiotics.

Unlabelled: The inoculum effect has been observed for nearly all antibiotics and bacterial species. However, explanations accounting for its occurrence and strength are lacking. Previous work found that the relationship between [ATP] and growth rate can account for the strength and occurrence of the inoculum effect for bactericidal antibiotics.

Career duration and later-life health conditions among former professional American-style football players.

Objectives: Career duration is often used as a metric of neurotrauma exposure in studies of elite athletes. However, as a proxy metric, career length may not accurately represent causal factors, and associations with health outcomes may be susceptible to selection effects. To date, relationships between professional American-style football (ASF) career length and postcareer health remain incompletely characterised.

Patient Satisfaction and QoL in SUI: Results With Single-Incision or Full-Length Slings.

Importance: Understanding treatment impact on quality of life of patients with stress urinary incontinence (SUI) in the short- and long-term is vital to optimizing treatment success.

Objectives: This study aimed to report 36-month patient satisfaction and quality of life results from a 522 study of single-incision and full-length slings in SUI.

Study Design: This was a secondary analysis of the Altis 522 study, a prospective, multicenter, nonrandomized, noninferiority cohort study comparing the Altis single-incision sling to full-length slings for the treatment of SUI.

Current Patient Management for Bacterial Meningitis Simultaneously Affected by Stroke.

Bacterial meningitis (BM) is a critical central nervous system infection characterized by increased risks of complications and potentially fatal outcomes. The chances of full recovery are significantly reduced in the presence of concomitant neurovascular complications such as ischemic and hemorrhagic strokes, intracerebral hemorrhage, and cerebral sinus thrombosis. Effective treatment of BM requires a targeted approach that simultaneously addresses the causative pathogen and manages the neurologically related complications.

The Role of Intravascular Ultrasound in Limb Salvage: A Systematic Review and Meta-Analysis.

Purpose: The purpose of this study was to review the current literature of intravascular ultrasound (IVUS) use in real world cohorts inclusive of chronic limb threatening ischemia (CLTI) patients and compare the outcomes to patients imaged by angiography alone.

Methods: The systematic review was registered in Research Registry. A literature search was performed across 4 databases: PubMed, Medline/Embase, Cochrane Review, and Web of Science for eligible comparative studies.

Topical Therapies for Periorbital Dyschromia: A 30-Year Review of the Literature.

Background: Periorbital dyschromia (POD) is a prevalent dermatologic problem with multifactorial etiology, making treatment outcomes inconsistent and unclear.

Objective: To evaluate and compose a comprehensive review of topical ingredients proven to be effective in the treatment of POD.

Materials And Methods: Scopus, PubMed, and OVID databases were searched in a span of 30 years through December 31, 2023, to identify articles with original findings of topical therapies for the treatment of POD.