Successful Treatment of Plasma Cell-Rich Acute Rejection Using Bortezomib: A Case Report.

Plasma cell-rich acute rejection (PCAR), a relatively rare subtype of acute allograft rejection, is usually associated with a significantly lower treatment response rate and a higher graft failure rate. PCAR is characterized by the presence of more than 10% of plasma cells out of all graft infiltrating cells, with approximately 40%-60% of PCAR resulting in graft failure within a year. Currently, there is no gold standard for the effective treatment of PCAR.

Once-weekly insulin efsitora alfa versus once-daily insulin degludec in adults with type 1 diabetes (QWINT-5): a phase 3 randomised non-inferiority trial.

Background: Insulin efsitora alfa (efsitora) is a once-weekly basal insulin. This phase 3 study aimed to assess the efficacy and safety of efsitora compared with insulin degludec (degludec) in adults with type 1 diabetes.

Methods: This randomised, 52-week, parallel-design, open-label, treat-to-target non-inferiority study conducted at 82 global health-care centres, randomly assigned (1:1) adults (ie, those aged ≥18 years) with type 1 diabetes glycated haemoglobin A (HbA) 7·0-10·0% (53·0-85·8 mmol/mol) to efsitora (n=343) or, degludec (n=349), both in combination with insulin lispro.

Endoscopic Through-the-Scope X-Tack Helix Suturing System for Complete Closure of a Large Full-Thickness After Surgical Gastric Perforation.

Gastric perforation is considered a surgical emergency managed operatively; however, endoscopic repair techniques have gained popularity as they are cost-effective, improve mortality, and decrease hospital stay and recurrence. With increased prevalence of gastric defects postoperatively and after invasive endoscopic procedures, various endoscopic techniques were developed over the years, but special consideration should be given to the defect type, size, and location. Our case highlights the use of X-Tack through-the-scope suturing for closing a large, full-thickness gastric perforation in a difficult location where OverStitch is not feasible.

FHOD-1 and profilin protect sarcomeres against contraction-induced deformation> in .

Formin HOmology Domain 2-containing (FHOD) proteins are a subfamily of actin-organizing formins important for striated muscle development in many animals. We showed previously that absence of the sole FHOD protein, FHOD-1, from results in thin body wall muscles with misshapen dense bodies that serve as sarcomere Z-lines. We demonstrate here that mutations predicted to specifically disrupt actin polymerization by FHOD-1 similarly disrupt muscle development, and that FHOD-1 cooperates with profilin PFN-3 for dense body morphogenesis, and with profilins PFN-2 and PFN-3 to promote body wall muscle growth.

Brief Psychotic Episodes and Depressed Mood in a Patient With Borderline Personality Disorder and Antiphospholipid Syndrome.

Psychiatric disorders are reported to be associated with systemic inflammatory conditions and autoimmune diseases. Antiphospholipid syndrome (APS) is a rare condition with poorly understood prevalence and incidence in the general population. Case reports have described co-occurrences of psychiatric conditions and APS.

Hematopoietic Growth Factors Regulate the Entry of Monocytes into the Adult Brain via Chemokine Receptor CCR5.

Monocytes are circulating macrophage precursors generated from bone marrow hematopoietic stem cells. In adults, monocytes continuously replenish cerebral border-associated macrophages under physiological conditions. Monocytes also rapidly infiltrate the brain in pathological settings.

Choroid Plexitis and Obstructive Hydrocephalus Secondary to Cryptococcal Meningoencephalitis in an Immunocompetent Individual With Remarkable Imaging Findings: A Case Report.

is an invasive and opportunistic fungus usually associated with immunocompromised individuals. Invasion of the choroid plexus by is rare. This report presents the radiologic findings of a previously healthy male with bilateral choroid plexus invasion complicated by obstructive hydrocephalus.

Single-Session Endoscopic Ultrasound-Directed Transgastric Endoscopic Retrograde Cholangiopancreatography and Simultaneous Endoscopic Ultrasound-Guided Transmural Gallbladder Drainage in Choledocholithiasis and Acute Cholecystitis After Unsuccessful Laparoscopic Cholecystectomy.

In patients considered high risk of laparoscopic cholecystectomy, percutaneous gallbladder drainage is traditionally considered first-line treatment option. Recent evidence supports endoscopic gallbladder drainage as a safe and feasible alternate option. We describe a case of Roux-en-Y gastric bypass surgery patient with acute cholecystitis and choledocholithiasis with unsuccessful laparoscopic cholecystectomy because of difficult operative field, underwent successful single-session endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography and endoscopic ultrasound-guided transmural gallbladder drainage at our institution.

Achieving Equity in Transportation for Radiotherapy.

Transportation is a significant social determinant of health and a barrier to treatment for many patients. Cancer patients are disproportionately affected, and it can be especially salient for patients undergoing several weeks of daily radiation treatment. A prospective survey pilot study at our institution examining financial toxicity related to transportation for patients undergoing radiation treatment showed a correlation between high transportation costs and financial stress.

The impact of storage, handling, and treatment on nutritional quality and safety of animal milk: A protocol for the systematic review and meta-analysis.

Objectives: Human milk has been shown to reduce severe morbidity in preterm/low-birth-weight infants and is therefore the recommended nutritional source. When infants cannot receive maternal milk, donor human milk (DHM) is recommended. The use of human milk banking facilities is increasing to meet the need for DHM.

The impact of donating milk on the health of milk donors and their infants: A systematic review and meta-analysis protocol.

Objectives: Breast milk is the recommended nutritional source for newborns and has been associated with decreased morbidity in low-birth-weight and preterm infants. In situations where breast milk is not available, donor breast milk is an alternative. Milk banking is becoming increasingly common worldwide to meet this need.

Anomalous Right Coronary Artery From Pulmonary Artery Presenting as Inferior Wall Ischemia: A Case Report.

We illustrate the case of a 62-year-old man with a symptomatic anomalous right coronary artery from pulmonary artery (ARCAPA). Our patient had presented with dyspnea on exertion with electrocardiogram showing pronounced inferior Q waves and marked inferolateral ST-T wave changes. The patient had a nuclear stress test which showed inferior wall ischemia.

Ascertainment of Infection and Eradication Treatment Using a Nationwide Electronic Health Record Database.

Background And Aims: There are limited contemporary population-based data on epidemiology and outcomes in the United States. Our primary aim was to create a validated cohort of veterans with testing or treatment using Veterans Health Administration data.

Methods: Using Veterans Health Administration structured and unstructured data, we developed and validated 4 algorithms for infection (3 algorithms) and treatment status (1 algorithm).

Pulse Pressure as a Hemodynamic Parameter in Preeclampsia with Severe Features Accompanied by Fetal Growth Restriction.

: Modern management of preeclampsia can be optimized by tailoring the targeted treatment of hypertension to an individual's hemodynamic profile. Growing evidence suggests different phenotypes of preeclampsia, including those with a hyperdynamic profile and those complicated by uteroplacental insufficiency. Fetal growth restriction (FGR) is believed to be a result of uteroplacental insufficiency.

Dynamical forces drive organ morphology changes during embryonic development.

Organs and tissues must change shape in precise ways during embryonic development to execute their functions. Multiple mechanisms including biochemical signaling pathways and biophysical forces help drive these morphology changes, but it has been difficult to tease apart their contributions, especially from tissue-scale dynamic forces that are typically ignored. We use a combination of mathematical models and experiments to study a simple organ in the zebrafish embryo called Kupffer's vesicle.

Navigating Unique Diagnostic and Therapeutic Challenges in Premenstrual Dysphoric Disorder: A Case Report.

Premenstrual dysphoric disorder (PMDD) is a disabling form of premenstrual syndrome affecting females of reproductive age in the premenstrual period. The presentation may vary from severe mood lability to extreme attempts to end life, usually within a week before menstruation resulting in considerable stress, functional impairment, and interpersonal conflicts. We present an interesting case of a 19-year-old sexually active girl who presented with a polysubstance overdose owing to her cyclical episodes of severe mood symptoms including irritability and uncontrolled aggression.

Single-Cell RNA Sequencing Reveals Immunomodulatory Effects of Stem Cell Factor and Granulocyte Colony-Stimulating Factor Treatment in the Brains of Aged APP/PS1 Mice.

Alzheimer's disease (AD) leads to progressive neurodegeneration and dementia. AD primarily affects older adults with neuropathological changes including amyloid-beta (Aβ) deposition, neuroinflammation, and neurodegeneration. We have previously demonstrated that systemic treatment with combined stem cell factor (SCF) and granulocyte colony-stimulating factor (G-CSF) (SCF+G-CSF) reduces the Aβ load, increases Aβ uptake by activated microglia and macrophages, reduces neuroinflammation, and restores dendrites and synapses in the brains of aged APPswe/PS1dE9 (APP/PS1) mice.

Myelin basic protein mRNA levels affect myelin sheath dimensions, architecture, plasticity, and density of resident glial cells.

Myelin Basic Protein (MBP) is essential for both elaboration and maintenance of CNS myelin, and its reduced accumulation results in hypomyelination. How different Mbp mRNA levels affect myelin dimensions across the lifespan and how resident glial cells may respond to such changes are unknown. Here, to investigate these questions, we used enhancer-edited mouse lines that accumulate Mbp mRNA levels ranging from 8% to 160% of wild type.