Changing paradigms in asthma management.

Asthma is a complex clinical syndrome characterized by airway inflammation that can cause variable, usually reversible airway obstruction and bronchial hyperreactivity. This illness has a spectrum from intermittent to persistent that has mild, medium or severe intensity. As our understanding of the underling inflammatory pathway grows, so too does our catalogue of advanced treatments (such as monoclonal antibodies), opening the path for treatment individually curated for patients.

Cajal body formation is regulated by coilin SUMOylation.

Cajal bodies (CBs) are membraneless organelles whose mechanism of formation is still not fully understood. Many proteins contribute to the formation of CBs, including Nopp140 (NOLC1), WRAP53 and coilin. Coilin is modified on multiple different lysine residues by SUMO, the small ubiquitin-like modifier.

Back to the Anatomy Lab to Redefine the Pulley System of the Thumb: Is There an A0 Pulley?

Background: There are various anatomical descriptions of the pulley system of the fingers and thumb. The A0 pulley, often referred to as palmar aponeurosis of the fingers, is of keen interest, especially regarding surgical release of the A1 pulley for trigger finger; however, there has been no anatomical description of the A0 pulley in the thumb.

Methods: Twenty-four cadaveric thumbs were dissected to expose the entire pulley system.

A Hearing Intervention and Health-Related Quality of Life in Older Adults: A Secondary Analysis of the ACHIEVE Randomized Clinical Trial.

Importance: Health-related quality of life is a critical health outcome and a clinically important patient-reported outcome in clinical trials. Hearing loss is associated with poorer health-related quality-of-life in older adults.

Objective: To investigate the 3-year outcomes of hearing intervention vs health education control on health-related quality of life.

: a commentary on the eternal dilemma of endometrial cancer screening in postmenopausal asymptomatic women. Is it time to team up?

Introduction: The diagnostic workflow for endometrial carcinoma in postmenopausal asymptomatic women remains an ongoing dilemma. Whereas an ultrasonographic endometrial thickness greater than 4.0 or 5.

Coronary drug-coated balloons: A comprehensive review of clinical applications and controversies.

Drug-coated balloons have emerged as a promising therapeutic option in the treatment of cardiovascular disease. This review article provides an overview of the concept of drug-coated balloons and their clinical applications in both de novo and treated coronary artery disease. A summary of key clinical trials and registry studies evaluating drug-coated balloons is presented for reference.

Inflammatory pathways in patients with post-acute sequelae of COVID-19: The role of the clinical immunologist.

As the SARS-CoV-2 pandemic progressed, some survivors noted prolonged symptoms after acute infection, termed post-acute sequelae of COVID-19 (PASC) or "long COVID." PASC is a significant clinical and public health concern that adversely affects patients' quality of life, income, and health care expenses. Moreover, PASC symptoms are highly heterogeneous, the most common being fatigue and cognitive impairment, and they likely reflect a spectrum of clinical phenotypes.

Left Main Coronary Artery Disease: A Contemporary Review of Diagnosis and Management.

Significant left main coronary artery disease is a very high-risk subgroup of coronary artery disease that is a crucial indicator of heightened morbidity and mortality rates. Despite its clinical significance, uncertainties persist regarding the optimal management strategy for patients, particularly given its phenotypic variations. Existing evidence-based guidelines offer insights into revascularization options, yet questions remain regarding long-term prognoses and clinical outcomes when comparing percutaneous coronary intervention to coronary artery bypass grafting.

Tricuspid valve infective endocarditis in disseminated gonococcal infection (DGI).

SummaryWe describe a case of culture-negative infective endocarditis due to , where the application of metagenomics shotgun sequencing in blood played a pivotal role in elucidating the underlying aetiology, guiding targeted therapy and ultimately resulting in the patient's complete recovery. Beyond its immediate clinical impact, prompt treatment bears significant implications for public health. The utilisation of molecular testing emerges as a valuable strategy to enhance diagnostic accuracy, particularly in cases involving fastidious organisms that are infrequently associated with infective endocarditis.

Residual Kidney Function in Hemodialysis: Its Importance and Contribution to Improved Patient Outcomes.

Individuals afflicted with advanced kidney dysfunction who require dialysis for medical management exhibit different degrees of native kidney function, called residual kidney function (RKF), ranging from nil to appreciable levels. The primary focus of this manuscript is to delve into the concept of RKF, a pivotal yet under-represented topic in nephrology. To begin, we unpack the definition and intrinsic nature of RKF.

Implementation of an Enhanced Recovery After Surgery Protocol for Cleft Palate Repair.

Objective: This study examines an Enhanced Recovery After Surgery (ERAS) protocol for patients with cleft palate and hypothesizes that patients who followed the protocol would have decreased hospital length of stay and decreased narcotic usage than those who did not.

Design: Retrospective cohort study.

Setting: The study takes place at a single tertiary children's hospital.

Barriers to Remote Burn Care Delivery: An Analysis of Burn Center Proximity and Access to Critical Telehealth Infrastructure.

Mounting evidence supports the use of telehealth to improve burn care access and efficiency. However, barriers to telehealth use remain throughout the United States and may disproportionately affect specific populations, such as rural and non-English-speaking patients. This study analyzes the association between physical proximity to burn care and determinants of telehealth access.

Plastic Surgery Outreach Clinics Expand Access to Cleft and Craniofacial Care in Mississippi.

Accessing treatment at ACPA (American Cleft Palate-Craniofacial Association)-approved centers is challenging for individuals in rural communities. This study aims to assess how pediatric plastic surgery outreach clinics impact access for patients with orofacial cleft and craniosynostosis in Mississippi. An isochrone map was used to determine mean travel times from Mississippi counties to the sole pediatric hospital and the only ACPA-approved team in the state.

Be the Qualitative Researcher: A Team-Based, Active Learning Strategy Using Popular Music Lyrics.

A team-based, active learning activity was created to facilitate undergraduate nursing students' understanding of qualitative research concepts. Working in small groups, students utilized the full-text lyrics of albums by recording artist Taylor Swift to analyze phrasing, create a qualitative coding scheme, code the data, and create a content and thematic analysis. The students then collaboratively created a Google Slide to present their findings for the class.

Simulation Training for Emergency Sternotomy in the Cardiovascular Intensive Care Unit.

Background: Emergency resternotomy in the intensive care unit for a patient who has undergone cardiac surgery can be daunting for surgeons and critical care staff. Clinicians involved are often unfamiliar with the surgical instruments and techniques needed.

Local Problem: After an emergency intensive care unit resternotomy resulted in suboptimal performance and outcome, protocols for emergency resternotomy were established and improved.

Patients Requiring Multiple Surgeries for Velopharyngeal Insufficiency: Findings From a 10-Year Retrospective Review.

This study analyzed patients undergoing multiple surgeries for velopharyngeal insufficiency (VPI) and reviewed their preoperative evaluations and techniques selected for subsequent surgeries. A retrospective chart review was performed including patients having undergone multiple surgeries for VPI at the authors' institution between 2012 and 2022. All patients were evaluated and managed at the author's institution under the direction of 4 senior surgeons.

Posterior Vault Distraction in the Acute Setting.

Posterior vault distraction osteogenesis (PVDO) has been shown to resolve acute intracranial hypertension (AIH) while carrying an acceptable perioperative morbidity profile. PVDO has been associated with symptomatic improvement and fewer surgeries in those requiring ventriculoperitoneal shunts. The authors' experience using PVDO as an acute intervention is presented, demonstrating its safety and efficacy for management of AIH.

Mandibular Distraction in Patients With Pierre Robin Sequence: A Multisurgeon Experience.

Objective: Mandibular distraction osteogenesis (MDO) is rapidly becoming a standard of care for management of patients with severe Pierre Robin sequence. The tongue is brought forward to alleviate airway obstruction. This study will look at an institutional, multisurgeon experience with MDO over 10 years.