Chronic Khat Usage as a Cause of Chronic Hypertensive Encephalopathy and Vascular Dementia: A Case Report.

Khat is a native plant of Eastern Africa that is widely utilized for its stimulant-like effects. It is known to have effects similar to those of amphetamine and has a comparable side effect profile, including tachycardia, hypertension, and insomnia. In this case report, we present a 45-year-old Somali gentleman with a history of more than eight years of chronic Khat use, presenting with progressive cognitive decline.

Plasma Matrix Metalloproteinase-9 Predicts Intraoperative Experience and Extent of Resection in Vestibular Schwannoma Surgery.

Objective: To evaluate the predictive value of plasma matrix metalloproteinase-9 (MMP-9) level in determining the extent of tumor resection (EOR) and tumor adherence in vestibular schwannoma (VS) surgery.

Study Design: Prospective cohort study.

Setting: Academic referral center.

Long-term Postural Stability Changes After Correction of Spinal Deformity: A prospective, controlled pilot study.

Study Design: Prospective cohort study.

Objective: This study aimed to investigate the durability of postural stability after ASD correction surgery and its' association with clinical outcomes.

Summary Of Background Data: The prevalence of symptomatic adult spinal deformity (ASD) necessitates surgical intervention, aiming to correct global spinal balance and spinopelvic parameters.

Up-front resection for hepatocellular carcinoma: Assessing futility in the preoperative setting.

Objective: We sought to develop a predictive model to preoperatively identify patients with hepatocellular carcinoma (HCC) at risk of undergoing futile upfront liver resection (LR).

Methods: Patients undergoing curative-intent LR for HCC were identified from a large multi-institutional database. Futile LR was defined by death or disease recurrence within six months postoperatively.

Matching Into Integrated Plastic Surgery: The Impact of USMLE Step 1 Transition to Pass/Fail: Did the 2019 Predictions Come True in 2024?

Background: The first class of integrated plastic surgery residency applicants with pass/fail (P/F) step 1 assessments occurred during the 2023-2024 Match cycle. This study analyzes the results of a 2024 postmatch survey to program directors (PDs) regarding the impact of the conversion to P/F step 1 scoring and compares the results to the 2019 survey that attempted to predict how this conversion would influence decision-making when it was initially announced.

Methods: A 26-item survey evaluating PDs' perspectives on applicant characteristics and the application process following P/F step 1 scoring was distributed March 2024.

Diagnosing Hypoparathyroidism, Sensorineural Deafness, and Renal Dysplasia Syndrome and a Novel Variant.

Hypoparathyroidism (hypoPTH), sensorineural deafness, and renal dysplasia (HDR) syndrome is a rare autosomal dominant condition with approximately 200 cases published. HDR syndrome is caused by variants of GATA binding protein 3 gene (), which encodes a transcription factor, with multiple types of variants reported. We present the case of a 76-year-old woman who was diagnosed with hypoPTH when she was aged 40 years and transferred care to our institution.

Renal Physiology Education via Podcast: Channel Your Enthusiasm.

Renal physiology is considered one of the most challenging medical disciplines to understand and to teach. Eight academic nephrologists have come together to produce a podcast devoted to helping learners at any level improve their understanding of this difficult topic. Using Dr Burton D.

Impact of Disability on Postoperative Outcomes After Gastrointestinal Cancer Surgery.

Introduction: Approximately 61 million individuals in the United States have a disability and face unique challenges, resulting in healthcare disparities.

Objective: We aimed to evaluate the impact of disability on postoperative outcomes and number of healthy days at home (HDAH).

Methods: Patients who underwent surgery for gastrointestinal (GI) cancer between 2017 and 2020 were identified using the Medicare database.

Utilizing objective performance indicators to assess resident autonomy during robotic cholecystectomy.

Background: The current evaluation of surgical resident operative autonomy consists primarily of self-report and is prone to bias. Objective performance indicators (OPIs) generated from the da Vinci Surgical System capture objective intraoperative data providing an opportunity to evaluate the intraoperative resident experience more accurately. This study investigates the ability of OPIs to describe resident autonomy during robotic cholecystectomy.

Liraglutide mitigates dexamethasone-induced fatty acid synthase (FASN) and the cluster of differentiation36 (CD36) expression: a potential treatment for glucocorticoid-induced non-alcoholic fatty liver disease (NAFLD).

The clinical use of dexamethasone (DXM) is associated with the development of non-alcoholic fatty liver disease (NAFLD). However, the mechanisms by which DXM-induced NAFLD is still incompletely known. Therefore, the current study aims to test the hypothesis that DXM-induced NAFLD is mediated by dysregulation of key genes involved in lipid metabolism and liraglutide (LG) can ameliorate these effects.

Investigative genetic genealogy practices warranting policy attention: Results of a modified policy Delphi.

A technique known as investigative genetic genealogy (IGG) was first introduced to criminal investigations in 2018, and it has since been used by U.S. law enforcement to help identify hundreds of criminal perpetrators and unidentified human remains.

Real-world outcomes of first-line maintenance niraparib monotherapy in patients with epithelial ovarian cancer.

Aims: To assess real-world progression-free survival (rwPFS) and time to next treatment (rwTTNT) among patients with epithelial ovarian cancer (EOC) who received first-line maintenance (1LM) niraparib monotherapy.

Patients & Methods: In this US-nationwide, electronic health record-derived, deidentified database study, eligible patients with EOC initiated 1LM niraparib monotherapy (1 January 2017-1 December 2022) following first-line platinum-based chemotherapy. Median rwPFS and rwTTNT were estimated with Kaplan-Meier methodology overall and in a homologous recombination-deficient (HRd) subgroup (further stratified as wild-type [wt] or -mutated [m]).

The Impact of Antibiotics on Latency When Given at the Time of Membrane Rupture Prior to Viability.

Background: It is well established that antibiotics administered in preterm prelabor rupture of membranes increases latency to delivery. While data is limited for membrane rupture prior to viability, antibiotics may also increase latency in this population.

Objective: To assesses the effect of prophylactic antibiotics on the duration of latency in individuals with previable prelabor rupture of membranes.

Therapeutic doses of efzofitimod demonstrate efficacy in pulmonary sarcoidosis.

Background: In a phase 1b/2a clinical trial of efzofitimod in patients with corticosteroid-requiring pulmonary sarcoidosis, treatment resulted in dose-dependent improvement in key end-points. We undertook a analysis pooling dose arms that achieved therapeutic concentrations of efzofitimod (Therapeutic group) those that did not (Subtherapeutic group).

Methods: Peripheral blood mononuclear cells incubated with tuberculin-coated beads were exposed to varying concentrations of efzofitimod in an assay to determine concentrations that inhibited granuloma formation.

Expert Clinical Management of Inflammatory Immune-Related Arthritis in Patients with Cancer Receiving Immune Checkpoint Inhibitors.

Introduction: Treatment guidelines for immune-related inflammatory arthritis (irAE-IA) in patients with cancer receiving immune checkpoint inhibitors (ICIs) are vague with respect to the use of specific agents. Patients are usually referred to rheumatologists for treatment. We conducted a survey of expert rheumatologists to determine current practices.

Incidence of bradycardia with the use of remdesivir for coronavirus disease of 2019 and risk factor analysis.

Background: Remdesivir is commonly used for inpatient treatment of coronavirus disease of 2019 (COVID-19) and may be associated with bradycardia. The objective is to investigate the incidence of bradycardia in patients with COVID-19 receiving remdesivir and evaluate potential risk factors associated with bradycardia.

Methods: This single-center, retrospective, cohort study evaluated the incidence of bradycardia during and up to 48 h after remdesivir administration in adults admitted to the medical center for treatment of COVID-19.

Targeting the Type I Interferon Pathway in Glomerular Kidney Disease: Rationale and Therapeutic Opportunities.

Type I interferons (IFNs) are immunostimulatory molecules that can activate the innate and adaptive immune systems. In cases of immune dysfunction, prolonged activation of the type I IFN pathway has been correlated with kidney tissue damage in a wide range of kidney disorders, such as lupus nephritis (LN) and focal segmental glomerulosclerosis (FSGS). Genetic mutations, such as risk variants in conjunction with elevated type I IFN expression, are also associated with higher rates of chronic kidney disease in patients with LN and collapsing FSGS.

Determinants of Racial and Ethnic Differences in Maternal Cardiovascular Health in Early Pregnancy.

Background: Suboptimal cardiovascular health (CVH) in pregnancy is associated with adverse maternal and offspring outcomes. To guide public health efforts to reduce disparities in maternal CVH, we determined the contribution of individual- and neighborhood-level factors to racial and ethnic differences in early pregnancy CVH.

Methods: We included nulliparous individuals with singleton pregnancies who self-identified as Hispanic, non-Hispanic Black (NHB), or non-Hispanic White (NHW) and participated in the nuMoM2b cohort study (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be).

Eruptive keratoacanthoma secondary to immune checkpoint inhibitors: a narrative review.

The use of immunotherapy is an emerging treatment option for advanced malignancies. Cutaneous adverse events following cancer immunotherapy are well-documented in the literature. The rarer cutaneous adverse effects are less characterized, including eruptive keratoacanthomas (KA).

Impact of Academic Medical Centers on Surgical Outcomes of Neighboring Non-Academic Medical Centers.

Introduction: We aimed to investigate the geographic variation of Academic Medical Centers (AMCs) across different healthcare markets and the impact on surgical outcomes in nearby non-AMCs.

Methods: Patients who underwent major surgery between 2016 and 2021 were identified from the Medicare Standard Analytic Files. Healthcare markets were delineated using Dartmouth Atlas hospital referral regions.

Household Exposure to Substance Abuse and the Risk of New Persistent Opioid Use After Cancer Surgery.

Background: Household-level factors may also influence the risk of new persistent opioid use (NPOU). We sought to assess the risk of NPOU among individuals with household exposure to substance abuse.

Methods: Opioid-naïve individuals who underwent oncological procedures were identified using the IBM MarketScan database.

Genomic Profiling of Biliary Tract Cancers: Comprehensive Assessment of Anatomic and Geographic Heterogeneity, Co-Alterations and Outcomes.

Background: Biliary tract cancers (BTCs) represent distinct biological and genomic entities. Anatomic and geographic heterogeneity in genomic profiling of BTC subtypes, genomic co-alterations, and their impact on long-term outcomes are not well defined.

Methods: Genomic data to characterize alterations among patients with BTCs were derived from the AACR GENIE registry (v15.