Intraoperative Anesthetic Care During Emergent/Urgent Craniotomy or Craniectomy for Intracranial Hypertension or Herniation: A Systematic Review.

This systematic review aimed to identify and describe best practice for the intraoperative anesthetic management of patients undergoing emergent/urgent decompressive craniotomy or craniectomy for any indication. The PubMed, Scopus, EMBASE, and Cochrane databases were searched for articles related to urgent/emergent craniotomy/craniectomy for intracranial hypertension or brain herniation. Only articles focusing on intraoperative anesthetic management were included; those investigating surgical or intensive care unit management were excluded.

Inhibition of Unc-51-like-kinase is mitoprotective during infection in corneal epithelial cells.

(PA) is an opportunistic gram-negative pathogen that can infect the cornea, leading to permanent vision loss. Autophagy is a cannibalistic process that drives cytoplasmic components to the lysosome for degradation and/or recycling. Autophagy has been shown to play a key role in the removal of intracellular pathogens and, as such, is an important component of the innate immune response.

Pain Coping Skills Training for Patients Receiving Hemodialysis: The HOPE Consortium Randomized Clinical Trial.

Importance: Chronic pain is common among individuals with dialysis-dependent kidney failure.

Objective: To evaluate the effectiveness of pain coping skills training (PCST), a cognitive behavioral intervention, on pain interference.

Design, Setting, And Participants: This multicenter randomized clinical trial of PCST vs usual care was conducted across 16 academic centers and 103 outpatient dialysis facilities in the US.

Non-selective b adrenergic receptor inhibitors impair hematopoietic regeneration in mice and humans after hematopoietic cell transplants.

Peripheral nerves promote mouse bone marrow regeneration by activating b2 and b3 adrenergic receptor signaling, raising the possibility that non-selective b blockers could inhibit engraftment after hematopoietic cell transplants (HCTs). We observed no effect of b blockers on steady-state mouse hematopoiesis. However, mice treated with a non-selective b blocker (carvedilol), but not a b1-selective inhibitor (metoprolol), exhibited impaired hematopoietic regeneration after syngeneic or allogeneic HCTs.

Clinical Conundrum: Climbing at the Extremes of High Elevation with Nonischemic Cardiomyopathy.

Cornwell, William, Aaron L Baggish, Christoph Dehnert, Benjamin D Levine, and Andrew M Luks. Clinical Conundrum: Climbing at the Extremes of High Elevation with Nonischemic Cardiomyopathy. 00:00-00, 2024.

Efficacy of Revisional Endoscopic Sleeve Gastroplasty After Laparoscopic Sleeve Gastrectomy.

Background: Recurrent weight gain after laparoscopic sleeve gastrectomy (LSG) is common. Revisional endoscopic sleeve gastroplasty (r-ESG) has been shown to be a promising endoscopic bariatric therapy (EBT) to treat weight recurrence after LSG. However, to date, weight loss outcomes beyond 1-year follow-up are unknown.

Standardizing the reporting of cholangiocarcinoma: the society of abdominal radiology disease focused panel on cholangiocarinoma lexicon.

In March 2023, the Society of Abdominal Radiology (SAR) Disease Focused Panel (DFP) on Cholangiocarcinoma (CCA) was formed. One of its initial tasks was for creation of a lexicon specific for CCA to complement the terms related to the Liver Imaging Reporting and Data System (LI-RADS) category M. A committee was formed and vetted 15 unique terms for CCA.

Learning from Hindsight: Examining Autonomic, Inflammatory, and Endocrine Stress Biomarkers and Mental Health in Healthy Terrorism Survivors Many Years Later.

Introduction: Terrorism and trauma survivors often experience changes in biomarkers of autonomic, inflammatory and hypothalamic-pituitary-adrenal (HPA) axis assessed at various times. Research suggests interactions of these systems in chronic stress.

Study Objective: This unprecedented retrospective study explores long-term stress biomarkers in three systems in terrorism survivors.

Neuronal cell type specific roles for Nprl2 in neurodevelopmental disorder-relevant behaviors.

Loss of function in the subunits of the GTPase-activating protein (GAP) activity toward Rags-1 (GATOR1) complex, an amino-acid sensitive negative regulator of the mechanistic target of rapamycin complex 1 (mTORC1), is implicated in both genetic familial epilepsies and Neurodevelopmental Disorders (NDDs) (Baldassari et al., 2018). Previous studies have found seizure phenotypes and increased activity resulting from conditional deletion of GATOR1 function from forebrain excitatory neurons (Yuskaitis et al.

Transforming grayscale MRI images to color utilizing generative artificial intelligence to better understand multiple sclerosis.

Multiple sclerosis (MS) falls within the spectrum of central nervous system (CNS) demyelinating diseases that may lead to permanent neurological disability. Fundamental to the diagnosis and clinical surveillance is magnetic resonance imaging (MRI) that allows for the identification of T2-hyperintensities associated with autoimmune injury that demonstrate distinct spatial distribution patterns. Here, we describe the clinical experience of a 31-year-old, right-handed, White man seen in consultation at The University of Texas Southwestern Medical Center in Dallas, Texas, following complaints of headaches that began after head trauma related to military service.

The impact of oral contraceptive pill use on sympathetic transduction at rest in young females.

Although previous work has demonstrated that oral contraceptive pill (OCP) use does not affect resting muscle sympathetic nerve activity (MSNA), growing evidence indicates that it attenuates neurogenic vasoconstriction. Despite these advances, it remains unknown how OCP use affects the ability of MSNA to dynamically control vascular tone and arterial blood pressure (BP) on a beat-by-beat basis. Thus, we tested the hypothesis that, compared with naturally menstruating females (MC), those using OCPs will exhibit attenuated sympathetic vascular transduction at rest.

Factors in Initial Anticoagulation Choice in Hospitalized Patients With Pulmonary Embolism.

Importance: Despite guideline recommendations to use low-molecular-weight heparins (LMWHs) or direct oral anticoagulants in the treatment of most patients with acute pulmonary embolism (PE), US-based studies have found increasing use of unfractionated heparin (UFH) in hospitalized patients.

Objective: To identify barriers and facilitators of guideline-concordant anticoagulation in patients hospitalized with acute PE.

Design, Setting, And Participants: This qualitative study conducted semistructured interviews from February 1 to June 3, 2024, that were recorded, transcribed, and analyzed in an iterative process using reflexive thematic analysis.

Education Research: The Neurohumanities in Training: Integrating a Humanities Curriculum Within Neurology Residency Programs.

Background And Objectives: Perhaps stemming from the central role of detailed examinations and a focus on the subjective sphere that grounds their clinical practice, neurologists have frequently opined on experiences traditionally a province of humanities. The increasingly technological focus on medical education and care can be seen to devalue the subjective aspects of medicine. As a counter to this, we report on the existence of neurohumanities curricula within neurology residency training.

Clinical Perspectives on the Pathophysiology of Facial Synkinesis: A Narrative Review.

Importance: Facial synkinesis refers to pathologic cocontraction and baseline hypertonicity of muscles innervated by the facial nerve, commonly attributed to the aberrant regeneration of nerve fibers following injury. The pathomechanism and optimal treatment of facial synkinesis remain unclear. The goal of this review is to highlight current understanding of the epidemiology, pathophysiology, clinical presentation, assessment, and treatment of facial synkinesis.

Lung cancer-intrinsic SOX2 expression mediates resistance to checkpoint blockade therapy by inducing Treg cell-dependent CD8+ T-cell exclusion.

Tumor cell-intrinsic signaling pathways can drastically affect the tumor immune microenvironment, promoting tumor progression and resistance to immunotherapy by excluding immune-cell populations from the tumor. Several tumor cell-intrinsic pathways have been reported to modulate myeloid-cell and T-cell infiltration creating "cold" tumors. However, clinical evidence suggests that excluding cytotoxic T cells from the tumor core also mediates immune evasion.

Treatment strategies to reduce cardiovascular risk in persons with chronic kidney disease and Type 2 diabetes.

Chronic kidney disease (CKD) is a prevalent and progressive condition associated with significant mortality and morbidity. Diabetes is a common cause of CKD, and both diabetes and CKD increase the risk of cardiovascular disease (CVD), the leading cause of death in individuals with CKD. This review will discuss the importance of early detection of CKD and prompt pharmacological intervention to slow CKD progression and delay the development of CVD for improving outcomes.

Promotora intervention for metabolic and mental health to reduce type 2 diabetes risk: a pilot randomized controlled trial.

The objective of this study was to develop and evaluate a novel behavioral intervention (PRIME2) that integrates evidence-based approaches for reducing diabetes risk and perceived stress. We conducted a pilot randomized controlled trial of the 16-session PRIME2 intervention vs. usual care among 40 Spanish-speaking Latinx adults with prediabetes and body mass index (BMI) ≥ 25 kg/m.

Faster and better than a physician?: Assessing diagnostic proficiency of ChatGPT in misdiagnosed individuals with neuromyelitis optica spectrum disorder.

Background: Neuromyelitis optica spectrum disorder (NMOSD) is a commonly misdiagnosed condition. Driven by cost-consciousness and technological fluency, distinct generations may gravitate towards healthcare alternatives, including artificial intelligence (AI) models, such as ChatGPT (Generative Pre-trained Transformer). Our objective was to evaluate the speed and accuracy of ChatGPT-3.

Incidental neutropenia: An emergency medicine focused approach.

Introduction: Neutropenia is defined as an absolute neutrophil count (ANC) < 1500 cells/microL and may be discovered incidentally in an asymptomatic, afebrile patient.

Objective: This narrative review provides an approach to the afebrile emergency department patient with incidental neutropenia.

Discussion: Neutropenia is an ANC < 1500 cells/microL, with mild neutropenia defined as an ANC ≥ 1000 to <1500 cells/microL, moderate ≥500 to <1000 cells/microL, severe <500 cells/microL, and agranulocytosis <200 cells/microL.

Adults With Head and Neck Burns Experience Worse Long-Term Outcomes and Require More Reconstructive Surgeries: A Burn Model System Study.

Background: Adults living with head and neck burn injuries experience psychosocial consequences due to scarring as well as functional disabilities. However, the impact of head and neck burns on long-term self-reported psychosocial outcomes, return to work, and need for reconstructive surgery has not been well described. This study investigates the unique longitudinal problems in psychosocial and functional recovery faced by adults with head and neck burn injuries.

Relationship Between Sleep Disturbances and Chronic Pain: A Narrative Review.

Sleep disturbances and chronic pain are prevalent and interrelated conditions that have significant impact on individuals' quality of life. Understanding the intricate dynamics between sleep and pain is crucial for developing effective treatments that enhance the well-being of affected individuals and reduce the economic burden of these debilitating conditions. This narrative review examines the complex relationship between sleep disturbances and chronic pain.

Pancreaticoduodenectomy in trauma patients with grade IV-V duodenal or pancreatic injuries: a post hoc analysis of an EAST multicenter trial.

Introduction: The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries.

Methods: This is a retrospective, multicenter analysis from 35 level 1 trauma centers from January 2010 to December 2020.

Beyond cholangiocarcinoma: imaging features of mimicking pathologies in the biliary tract.

Cholangiocarcinoma (CCA) is the second most common primary malignancy of the hepatobiliary system and presents as a heterogeneous disease with three distinct morphological subtypes: mass-forming, periductal-infiltrating, and intraductal-growing, each characterized by distinguishing imaging features. Accurate diagnosis of CCA is challenging due to the overlap of imaging findings with a broad range of benign and malignant conditions. Therefore, it is essential for radiologists to recognize these mimickers and offer a reasonable differential diagnosis, as this has a significant impact on patient management.