Disseminated Chickenpox Following Live Varicella Vaccination in a Crohn's Disease Patient on Combination Immunosuppression.

Novel therapeutics used in the treatment of inflammatory bowel disease pose an increased risk of viral reactivation in patients. We present a case of a patient with refractory Crohn's disease (CD) who developed primary varicella (chickenpox) of a vaccine-viral strain after receiving combination immunosuppression with high-dose corticosteroids, tumor necrosis factor inhibitor (TNFi), and a Janus kinase inhibitor (JAKi) in the hospital. While this patient recovered and did not experience long term adverse effects, her case provides an opportunity for improvement.

Unusual presentation of medication-induced atrial fibrillation: A case report.

This case highlights that atrial fibrillation can occur as an adverse effect of tamsulosin even in younger patients at lower doses, challenging the conventional understanding that this complication primarily affects older individuals on higher doses. Clinicians should remain vigilant for this potential side effect across all patient demographics to ensure prompt identification and management.

Analytical Validation of Wrist-Worn Accelerometer-Based Step-Count Methods during Structured and Free-Living Activities.

Introduction: Wrist-worn accelerometers can capture stepping behavior passively, continuously, and remotely. Methods utilizing peak detection, threshold crossing, and frequency analysis have been used to detect steps from wrist-worn accelerometer data, but it remains unclear how different approaches perform across a range of walking speeds and free-living activities. In this study, we evaluated the performance of four open-source methods for deriving step counts from wrist-worn accelerometry data, when applied to data from a range of structured locomotion and free-living activities.

Multiscale Analysis of Alzheimer's Disease Using Feature Fusion in Cognitive and Sensory Brain Regions.

Introduction: This research is focused on early detection of Alzheimer's disease (AD) using a multiscale feature fusion framework, combining biomarkers from memory, vision, and speech regions extracted from magnetic resonance imaging and positron emission tomography images.

Methods: Using 2D gray level co-occurrence matrix (2D-GLCM) texture features, volume, standardized uptake value ratios (SUVR), and obesity from different neuroimaging modalities, the study applies various classifiers, demonstrating a feature importance analysis in each region of interest. The research employs four classifiers, namely linear support vector machine, linear discriminant analysis, logistic regression (LR), and logistic regression with stochastic gradient descent (LRSGD) classifiers, to determine feature importance, leading to subsequent validation using a probabilistic neural network classifier.

Chronic Severe Neutropenia Associated With Intravenous Immunoglobulin for Multifocal Motor Neuropathy.

Intravenous immunoglobulin (IVIG) is an immunomodulatory therapy derived from pooled donor immunoglobulins and used for treatment of various autoimmune conditions. Here we report the diagnosis and management of IVIG-induced chronic severe neutropenia with absolute neutrophil count <0.5×10/µL in a patient with multifocal motor neuropathy.

Current Concepts in the Prevention of Perioperative Myocardial Injury.

Perioperative myocardial injury is frequently caused by tachycardia from excessive sympathetic nervous system activity resulting from the surgical stimulation (type 2) rather than by rupture of atherosclerotic plaques with superimposed thrombosis (type 1). The elevated sympathetic nervous system activity results in tachycardia that induces demand ischemia within the myocardium and damages the heart muscle. A rise in troponin has been shown to be a reliable predictor of adverse cardiovascular events when measured in a population at risk.

Defining and responding to the contextual drivers for implementation of antimicrobial stewardship in 14 neonatal units in South Africa.

Background: Research on the contextual drivers of antimicrobial stewardship (AMS) programme interventions in neonatal units is limited.

Methods: As part of a prospective mixed-methods multidisciplinary neonatal AMS (NeoAMS) interventional study in 14 South African hospitals, we applied a three-phased process to assess implementation barriers and contextual drivers experienced by participating health professionals. The study included: (Phase one; P1) a survey of pre-intervention barriers and enablers; (P2) written feedback during the study intervention phase; and (P3) semi-structured exit interviews.

Standardized naming convention and classification system for critical loads of nitrogen and sulfur deposition.

Critical loads (CLs) of atmospheric deposition have been used for multiple decades to assess the impacts of air pollutants on terrestrial and aquatic ecosystems. However, these CLs have been developed by different researchers, at different times, using different methods, and are named in different ways with varying levels of information and levels of specificity. In this study, we identified the elements that describe CLs and used them to develop and test a standardized CL naming convention and a complementary CL classification system applicable to all CLs.

Seminoma Diagnosed by Multicancer Detection Testing: A Case Report.

A 67-year-old male with positive signals for neuroendocrine and head/neck cancer on a commercially available multicancer detection test underwent an extensive negative diagnostic workup at a local hospital. Referred to our medical center for advanced imaging and endoscopic procedures ultimately led to the diagnosis of an early-stage seminoma with eventual orchiectomy. This case highlights challenges in evaluating positive multicancer detection results, emphasizing the need for a broader understanding of how to interpret these testing results to fully evaluate complex cases, as well as the need for protocolized follow-up approaches to a positive multicancer detection test.

Re-sheathing failure with Navitor during transcatheter aortic valve implantation: a case report.

Background: Self-expanding valves used in transcatheter aortic valve implantation (TAVI) are designed to allow recapture and repositioning, facilitating optimal placement and mitigating conduction disturbances and paravalvular leakage. Here, we present a rare case in which the Navitor (Abbott Structural Heart, Santa Clara, CA, USA) could not be recaptured.

Case Summary: An 81-year-old Japanese woman with very severe aortic stenosis and a massively calcified nodule at the non-coronary cusp (NCC) underwent TAVI with a 25 mm Navitor valve.

A Hybrid Rehabilitation Program for Adults with Peripheral Artery Disease (HY-PAD): A Pre-Post Intervention Study to Assess Its Feasibility.

Background: Supervised exercise programs improve walking impairment and quality of life (QoL) in patients with peripheral artery disease (PAD). However, such programs are underutilized, due to their limited accessibility. A feasible and effective exercise program is needed.

Pharmaco-Invasive Strategy Vs Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction in Latin America: A Meta-Analysis.

Background: Primary percutaneous coronary intervention (PCI) is the established treatment for ST-segment elevation myocardial infarction (STEMI), but often it is not readily available in low-resource settings. We assessed the safety and efficacy of the pharmaco-invasive strategy compared to primary PCI for STEMI in Latin America.

Methods: MEDLINE, Embase, and Latin American and Caribbean Health Sciences Literature (LILACS) were searched for the period from their inception to September 2023, for studies that compared a pharmaco-invasive strategy vs primary PCI in Latin America.

Ten tips in lupus nephritis management.

Lupus nephritis is an important cause of severe glomerulonephritis, and a leading cause of kidney failure in young adults. While the disease can lead to rapid destruction of nephrons if untreated, there are effective therapies to reverse the severe acute kidney injury and prevent the lifetime risk of kidney failure. Early diagnosis and timely intervention are therefore of critical importance.

Differential Cardiopulmonary Effects of Isoprene- versus Toluene-generated Photochemically-Aged Smog in Rats.

Photochemical smog is a complex mixture of primary and secondary air pollutants including secondary organic aerosols (SOA), ozone and reactive aldehydes which has been linked to increased risk of adverse cardiovascular and pulmonary responses. The components and related health effects of smog are thought to be determined both by the precursor chemicals and reaction conditions. Here we examined the difference between isoprene- (IS-) and toluene- (TS) generated smog in causing cardiopulmonary effects in rats.

Inferring and evaluating satellite-based constraints on NO emissions estimates in air quality simulations.

Satellite observations of tropospheric NO columns can provide top-down observational constraints on emissions estimates of nitrogen oxides (NO ). Mass-balance-based methods are often applied for this purpose but do not isolate near-surface emissions from those aloft, such as lightning emissions. Here, we introduce an inverse modeling framework that couples satellite chemical data assimilation to a chemical transport model.

What role does wealth play in the racial health gap in the United States? Examining differences among African Americans, Latinos, and non-Hispanic Whites.

Wealth resources has received little attention when studying how socioeconomic status shapes health outcomes. In the United States (USA), there is a growing body of evidence acknowledging a widening racial/ethnic wealth gap. However, little is known about wealth's role in shaping health inequity.

Erratum: Publisher Correction: Development and evaluation of a bovine lung-on-chip (bLOC) to study bovine respiratory diseases.

[This corrects the article DOI: 10.1007/s44164-022-00030-z.].

Erratum: Publisher Correction: Neurovascular models for organ-on-a-chips.

[This corrects the article DOI: 10.1007/s44164-022-00015-y.].

New Mediastinal and Hilar Lymphadenopathy After Adjuvant Pembrolizumab in a Patient With Stage III Clear Cell Renal Cell Carcinoma.

The advent of immune checkpoint inhibitors (ICIs) has transformed the management of advanced and high-risk renal cell carcinoma (RCC). In the adjuvant setting, ICIs, such as pembrolizumab, aim to reduce the risk of recurrence following potentially curative nephrectomy. However, this therapeutic approach introduces unique challenges, particularly related to immune-related adverse events (irAEs).

Overcoming Anatomical Challenges: Epidural Blood Patch and Plica Mediana Dorsalis Case Report.

The efficacy of epidural blood patch (EBP) is highly variable, and often, clinicians are unable to identify the underlying reasons for treatment failure. A 36-year-old parturient underwent a "blind" epidural blood patch (EBP) without image guidance but failed to obtain relief from a postural headache related to the labor epidural. During the second EBP, an intact plica mediana dorsalis (PMD) was visualized in the anterior-posterior fluoroscopic view after injection of contrast, and autologous blood was injected on both sides of the PMD, leading to the complete resolution of headache symptoms.

Therapeutic Antithrombotic Agent Use and Bleeding Risk in Retrobulbar Anesthesia for Outpatient Ophthalmic Surgery.

Background and objective Retrobulbar block is commonly used for providing effective anesthesia and akinesia for ophthalmic surgery. It can, however, lead to sight-threatening retrobulbar hemorrhage in very rare cases. The aim of this study was to evaluate retrobulbar block quality, to determine the prevalence of retrobulbar hemorrhage associated with these blocks, and to assess whether the use of antithrombotic agents in patients undergoing retrobulbar block for ophthalmic surgery was associated with retrobulbar hemorrhage.

The Perils of Pregnancy: A Case Report of Subglottic Stenosis​.

Subglottic stenosis (SGS) presents a rare, yet challenging condition characterized by airway obstruction below the glottis, with diverse etiologies ranging from congenital to acquired factors like intubation or autoimmune diseases. Diagnosis and management of SGS during pregnancy are particularly complex due to limited literature and diagnostic consensus. This article presents a case of a 26-year-old pregnant woman presenting with escalating dyspnea and stridor attributed to SGS, most likely secondary to idiopathic etiology.

A Scoping Review of Pakistani Healthcare Simulation: Insights for Lower-Middle-Income Countries.

Healthcare simulation has gained global recognition in health professions education, yet its adoption in Pakistan, a lower-middle-income country (LMIC), remains limited. This scoping review aimed to explore how simulation is integrated into healthcare education in Pakistan, highlighting challenges and opportunities to inform similar LMICs. Pakistan serves as a critical case study for LMICs due to its unique challenges, including uneven access to simulation technologies and limited faculty training, which are shared by many similar resource-constrained settings.