Risk Profile and Prognostic Implications of Premature Advanced Coronary Atherosclerotic Disease Among Young to Early Middle-aged Adults: The Coronary Artery Calcium Consortium.

Introduction: Premature advanced subclinical coronary atherosclerosis among young adults is an under-recognized and unique disease phenotype that has not been well characterized.

Methods: We used data from 44,047 participants with no prior CVD history (59.8% male) from the Coronary Artery Calcium (CAC) Consortium.

Low serum serotonin is associated with functional decline, mild behavioural impairment and brain atrophy in dementia-free subjects.

Brain serotonin dysregulation is associated with dementia and neuropsychiatric symptomology. However, the prognostic utility of circulating serotonin levels in detecting features of prodromal dementia including functional decline, cognitive impairment, mild behavioural impairment and brain atrophy remains unclear. In this prospective study of memory clinic subjects followed-up for ≤5 years, dementia-free subjects, classified as having no cognitive impairment or cognitive impairment, no dementia at baseline, underwent annual neuropsychological assessments including Montreal Cognitive Assessment, Global Cognition scores and Clinical Dementia Rating Scale Global Scores (where a ≥ 0.

Can ChatGPT play a significant role in anatomy education? A scoping review.

Purpose: We performed a scoping review to explore if ChatGPT, an artificial intelligence platform, can play a significant role in anatomy education.

Methods: PubMed, SCOPUS, ERIC and Cochrane databases were searched for articles which included anatomical questions asked to ChatGPT. From each article, we extracted the following data: authors, type of study (qualitative or quantitative), presence or not of comparison of ChatGPT with other platforms or humans, type of questions asked to ChatGPT and evaluation of the answers to these questions.

Clinical utility of plasma p-tau217 in identifying abnormal brain amyloid burden in an Asian cohort with high prevalence of concomitant cerebrovascular disease.

Introduction: Using an Asian cohort with high prevalence of concomitant cerebrovascular disease (CeVD), we evaluated the performance of a plasma immunoassay for tau phosphorylated at threonine 217 (p-tau217) in detecting amyloid beta positivity (Aβ+) on positron emission tomography and cognitive decline, based on a three-range reference, which stratified patients into low-, intermediate-, and high-risk groups for Aβ+.

Methods: Brain amyloid status (Aβ- [n = 142] vs Aβ+ [n = 73]) on amyloid PET scans was assessed along with the plasma ALZpath p-tau217 assay to derive three-range reference points for PET Aβ+ based on 90% sensitivity (lower threshold) and 90% specificity (upper threshold).

Results: Plasma p-tau217 (area under the curve [AUC] = 0.

Nuclear Magnetic Resonance (NMR)-Based Lipidomics Reveal the Association of Altered Red Blood Cell (RBC) Membrane Lipidome with the Presence and the Severity of Coronary Artery Stenosis.

Coronary heart disease (CHD) is the leading cause of morbidity and mortality worldwide despite significant improvements in diagnostic modalities. Emerging evidence suggests that erythrocytes, or red blood cells (RBCs), are one of the most important contributors to the events implicated in atherosclerosis, although the molecular mechanisms behind it are under investigation. We used NMR-based lipidomic technology to investigate the RBC lipidome in patients with CHD compared to those with normal coronary arteries (NCAs), all angiographically documented, and its correlation with coronary artery stenosis.

Fear of Fragility: A Case of Osteoporosis-Triggered Takotsubo Cardiomyopathy.

We present a case of a 73-year-old woman with a medical history significant for hyperlipidemia, on pravastatin, who developed Takotsubo cardiomyopathy following a diagnosis of osteoporosis. She presented to the Emergency Department with acute transient left arm pain that resolved spontaneously. Investigations revealed elevated troponin levels, non-specific electrocardiographic changes, no significant coronary artery disease on angiography, and left ventricular systolic dysfunction, findings consistent with Takotsubo cardiomyopathy.

Overground robotic exoskeleton vs conventional therapy in inpatient stroke rehabilitation: results from a pragmatic, multicentre implementation programme.

Background: Despite the reported efficacy of overground robotic exoskeleton (ORE) for rehabilitation of mobility post-stroke, its effectiveness in real-world practice is still debated. We analysed prospectively collected data from Improving Mobility Via Exoskeleton (IMOVE), a multicentre clinical implementation programme of ORE enrolling participants with various neurological conditions and were given options to choose between 12 sessions of ORE or conventional therapy (control).

Methods: This is analysis of participants under IMOVE who fulfilled the following criteria (i) primary diagnosis was stroke (ischemic, hemorrhagic; first or recurrent), (ii) onset of stroke was within 9 months and (iii) the intervention was during inpatient stay.

Treatment of oropharyngeal cancer during the COVID-19 lockdown - outcomes for patients treated during the pandemic.

Background: The onset of the coronavirus disease 2019 (COVID-19) outbreak caused major interruptions to the entire healthcare network affecting referral, diagnosis and treatment pathways with the potential to affect cancer treatment outcomes. In Ireland a national lockdown was initiated in March 2020 involving a stay-at-home order with a limitation on travel, social interactions and closure of schools, universities and childcare facilities. We designed a retrospective study comparing treatment outcomes for patients with oropharyngeal cancer treated before and during the COVID pandemic.

Impact of initial jugular vein insertion site selection for central venous catheter placement on hemodialysis catheter complications.

Purpose: This study evaluated the impact of choosing the right versus left internal jugular vein (IJV) for initial central venous catheter (CVC) placement on hemodialysis catheter-related outcomes in critically ill patients.

Materials And Methods: Medical records from the University of Maryland Medical Center were reviewed for adult critical care patients who received an IJV CVC between January 1, 2019, and December 31, 2022, and later required an additional temporary hemodialysis catheter.

Results: The study included 214 patients, with 100 (46.

The relationship between symptoms and regurgitant severity in primary mitral regurgitation: a cardiovascular magnetic resonance study.

In the ACC/AHA guidelines, the presence of symptoms plays a central role in determining timing surgery in primary mitral regurgitation (MR). Studies have shown a disconnect between the severity of MR and symptoms. The purpose of this study is to assess risk factors for symptoms in patients with chronic primary MR.

Neuroblastoma Masquerading as Constipation: Reducing Diagnostic Error With the Pediatric Abdominal Point-of-Care Ultrasound Survey.

Abdominal pain is a common pediatric complaint in the emergency department and other clinical settings. While most causes are benign, dangerous and time-sensitive conditions may be present. Point-of-care ultrasound (POCUS) is a diagnostic modality that can help more thoroughly explore the differential diagnosis at a relatively low cost, without exposure to ionizing radiation, and in a timely manner.

On-Table Virtual Reality to Reduce Anxiety/Distress during Radiation Treatments: A Pilot Randomized Trial.

We report the first randomized trial of a virtual reality (VR) headset used on-table during external beam radiation therapy (RT) treatments to reduce anxiety/distress during receipt of RT. A small pilot study was conducted among 10 patients, with VR randomized to start in the first week ("immediate VR") versus the second week ("delayed VR") of treatment. All patients (100%) in the immediate VR group had declines in measured distress scores after their first radiation treatment, compared to only 1 patient (16.

Comparative Effects of Rosuvastatin and Atorvastatin Loading Doses on Immediate Post-percutaneous Coronary Intervention (PCI) Thrombolysis in Myocardial Infarction (TIMI) Flow in ST-Segment Elevation Myocardial Infarction (STEMI) Patients.

Background: Primary percutaneous coronary intervention (PCI) is crucial in managing acute ST-segment elevation myocardial infarction (STEMI), emphasizing the importance of optimal myocardial reperfusion.

Objective: The goal of this research was to determine how loading doses of rosuvastatin and atorvastatin affected the flow rate of thrombolysis in myocardial infarction (TIMI) immediately post-perfusion thrombolysis in patients undergoing primary PCI.

Methodology: This prospective, comparative study was carried out over a one-year period (January 2023 to December 2023) in Pakistan.

Combined Neoadjuvant-Adjuvant Immunotherapy and Abdominoperineal Resection for a Primary Anorectal Melanoma: A Case Report.

Anorectal melanoma (ARM) is a rare entity with aggressive biological behavior and poor prognosis. Clinically, ARM presents with atypical symptoms, such as anal pain and bleeding, thus often being misdiagnosed as a benign anorectal pathology and leading to delayed diagnosis. We present a case of a 73-year-old female patient with stage I ARM, treated successfully with a combination of neoadjuvant-adjuvant immunotherapy (nivolumab, an anti-PD-1 monoclonal antibody) and abdominoperineal resection.

Ultrahypofractionated Adjuvant Breast Radiation Therapy (± Boost) and Virtual Consultations: Patient Perspectives at 1 Year.

Purpose: In March 2020, a 1-week ultrahypofractionated adjuvant breast radiation therapy schedule, 26 Gy in 5 fractions, and telehealth were adopted to reduce the risk of COVID-19 for staff and patients. This study describes real-world 1-year late toxicity for ultrahypofractionation (including a sequential boost) and patient perspectives on this new schedule and telehealth workflows.

Methods And Materials: Consecutive patients were enrolled between March and August 2020.

Managing Epiglottitis in Adults: A Comprehensive Case Study.

Epiglottitis is an inflammatory condition involving the epiglottis and surrounding tissues. While it can develop at any age, it was traditionally more common in children, largely due to infections with type B (Hib). Since the introduction of the Hib vaccine, the incidence in children has significantly decreased, while cases in adults have become more prevalent.

A Case of Amyand's Hernia.

Inguinal hernias are the most prevalent type of abdominal wall hernia. While many cases are uncomplicated, some variant forms can pose a heightened risk of severe complications. We report the case of a 46-year-old male who arrived at the emergency department with a two-day history of diffuse abdominal pain, with an otherwise negative review of systems, an unremarkable medical and surgical history, and normal laboratory results.

An "Expanded Zone" Concept for Soft Tissue Coverage of the Upper Extremity: Upper Extremity "Expanded Zones".

Vascularized soft tissue coverage of open wounds of the lower extremity has long been predicated on the zone of injury and the available local flap donor site options found therein. A hypothesis was presented decades ago in this journal that attempted to extend a similar approach to simplify upper extremity coverage as well, but appears to have long been forgotten. However, with the emergence of the fasciocutaneous flap and its offspring the perforator flap, now a plethora of additional local flap options within the upper extremity may justify this idea being further considered.

Inflammatory Pseudotumor of the Spleen in a Patient With Psoriatic Arthritis: A Diagnostic Challenge in the COVID-19 Era.

The baseline inflammatory microenvironment in various organs of patients, which is shaped by pre-existing conditions and circulating drugs at the time before viral antigen exposure, may affect the severity of coronavirus disease-19 (COVID-19) infection and the nature of its complications. Inflammatory pseudotumor (IPT) of the spleen may represent one such complication that merits further investigation. We describe the case of a patient, who was under long-term treatment with a tumor necrosis factor inhibitor (TNFi), for psoriatic arthritis (PsA) and developed an inflammatory mass in the spleen, accompanied by systemic manifestations.

Preoperative gastric retention in endoscopic retrograde cholangiopancreatography.

We comment on the article by Jia , in the . We focus mainly on the factors that impair gastric motility and cause gastric retention in the pre-operative setting of endoscopic retrograde cholangiopancreatography (ERCP). ERCP is a complex endoscopic therapeutic procedure, which demands great skill from the endoscopist but also has recognized complications.

The Presence of Type Va Double Common Bile Duct in a Male Patient: A Case Report.

Double common bile duct (DCBD) is a rare congenital anomaly of the biliary system, characterized by the presence of two common bile ducts. The condition can be classified into five distinct types. Type Va DCBD is one of the rare congenital variations where both bile ducts open separately into the duodenum: one opens normally at the major duodenal papilla, and the second opens independently into the duodenum at a different site, usually proximal to the major duodenal papilla.