National survey of financial burden and experience among patients with cancer and autoimmune disease receiving charitable copay assistance.

Background: Little is known about the role that charitable copay assistance (CPA) plays in addressing access to care and financial distress. The study sought to evaluate financial distress and experience with CPA among patients with cancer and autoimmune disease.

Methods: This is a national cross-sectional self-administered anonymous electronic survey conducted among recipients of CPA to cover the costs of a drug for cancer or autoimmune disease.

β3 accelerates microtubule plus end maturation through a divergent lateral interface.

β-tubulin isotypes exhibit similar sequences but different activities, suggesting that limited sequence divergence is functionally important. We investigated this hypothesis for TUBB3/β3, a β-tubulin linked to aggressive cancers and chemoresistance in humans. We created mutant yeast strains with β-tubulin alleles that mimic variant residues in β3 and find that residues at the lateral interface are sufficient to alter microtubule dynamics and response to microtubule targeting agents.

Impact of Frailty on Surgical Outcomes of Patients With Cushing Disease Using the Multicenter Registry of Adenomas of the Pituitary and Related Disorders Registry.

Background And Objectives: Despite growing interest in how patient frailty affects outcomes (eg, in neuro-oncology), its role after transsphenoidal surgery for Cushing disease (CD) remains unclear. We evaluated the effect of frailty on CD outcomes using the Registry of Adenomas of the Pituitary and Related Disorders (RAPID) data set from a collaboration of US academic pituitary centers.

Methods: Data on consecutive surgically treated patients with CD (2011-2023) were compiled using the 11-factor modified frailty index.

Vesalius and His Manikin: An Enduring Influence on Modern Anatomic Teaching.

Anatomic teaching has long informed surgical knowledge, experience, and skills. One tool for teaching that emerged during the Renaissance was the fugitive anatomic sheet, which used flap layers to reveal different levels of anatomy. In 1538, Vogtherr introduced the first fugitive sheets, which included illustrations of male and female figures with a torso paper flap that, when lifted, revealed the internal organs in a cartoonish style.

Recurrence Patterns and Management after Pleurectomy Decortication for Pleural Mesothelioma.

Objective: We hypothesize that recurrence following pleurectomy decortication (PD) is primarily local. We explored factors associated with tumor recurrence patterns, disease-free interval (DFI), and post-recurrence survival (PRS).

Summary Background Data: Tumor recurrence is a major barrier for long-term survival after pleural mesothelioma (PM) surgery.

High-Resolution OCT Reveals Age-Associated Variation in the Region Posterior to the External Limiting Membrane.

Purpose: To evaluate visibility of a sub-band posterior to the external limiting membrane (ELM) and assess its age-associated variation.

Methods: In a retrospective cross-sectional study, normal eyes were imaged using a high-resolution spectral-domain optical coherence tomography (SD-OCT) prototype (2.7-µm axial resolution).

Exploring the Complex Relationship Between Psychosocial Stress and the Gut Microbiome: Implications for Inflammation and Immune Modulation.

There is growing interest in understanding the complex relationship between psychosocial stress and the human gastrointestinal microbiome (GIM). This review explores the potential physiological pathways connecting these two and how they contribute to a pro-inflammatory environment that can lead to the development and progression of the disease. Exposure to psychosocial stress triggers the activation of the sympathetic nervous system (SNS) and hypothalamic-pituitary axis (HPA), leading to various physiological responses essential for survival and coping with the stressor.

Mpox primer for clinicians: what makes the difference in 2024?

Purpose Of Review: The 2024 mpox outbreak, primarily driven by the possibly more virulent clade Ib strain, prompted the WHO declaring it a public health emergency of international concern (PHEIC) on August 14, 2024. This review provides essential guidance for clinicians managing mpox cases, as it contrasts the features of the 2024 outbreak with those of the 2022 epidemic to support better clinical decision-making.

Recent Findings: The review highlights significant differences between the 2024 and 2022 outbreaks, including total case numbers, demographic distribution, and fatality rates.

Cannabinoid-based Pharmacology for the Management of Substance Use Disorders.

In the last two decades, the endocannabinoid system has emerged as a crucial modulator of motivation and emotional processing. Due to its widespread neuroanatomical distribution and characteristic retrograde signaling nature, cannabinoid type I receptors and their endogenous ligands finely orchestrate somatic and axon terminal activity of dopamine neurons. Owing to these unique features, this signaling system is a promising pharmacological target to ameliorate dopamine-mediated drug-seeking behaviors while circumventing the adverse side effects of, for instance, dopaminergic antagonists.

Outcomes and complications of vertebral body tethering by patient gender.

Purpose: Non-fusion surgical options for pediatric scoliosis management such as vertebral body tethering (VBT) offer an alternative to spinal fusion. With this study, we aim to evaluate the postoperative outcomes in boys versus girls who have undergone VBT. Our hypothesis is that girls and boys will have similar outcomes by 2-year follow-up.

Analysis of Urinary Metanephrines Using Liquid Chromatography Tandem Mass Spectrometry.

Metanephrines (metanephrine [MN] and normetanephrine [NMN]) are O-methylated metabolites derived from the catecholamines, epinephrine, and norepinephrine, respectively. High concentrations of metanephrines have been observed in individuals with pheochromocytoma, a neuroendocrine tumor. Measurement of metanephrines in urine is used to screen for the tumor.

Quality Assurance in Metabolomics and Metabolic Profiling.

Metabolic profiling (untargeted metabolomics) aims for a global unbiased analysis of metabolites in a cell or biological system. It remains a highly useful research tool used across various analytical platforms. Incremental improvements across multiple steps in the analytical process may have large consequences for the end quality of the data.

Decontamination of DNA sequences from a Streptomyces genome for optimal genome mining.

Despite meticulous precautions, contamination of genomic DNA samples is not uncommon, which can significantly compromise the analysis of microorganisms' whole-genome sequencing data, thus affecting all subsequent analyses. Thanks to advancements in software and bioinformatics techniques, it is now possible to address this issue and prevent the loss of the entire dataset obtained in a contaminated whole-genome sequencing, where the DNA of another bacterium is present. In this study, it was observed that the sequencing reads from Streptomyces sp.

Carbon-dot pequi-nut in the development of immunosensor to detect pathogenic bacteria.

Carbon dots in biosensing have advanced significantly, adding improvements to different detection techniques. In this study, an amperometric immunosensor for Salmonella Thyphimurium was designed using antibodies labeled with carbon dots (Cdots) from pequi almond (Caryocar brasiliensis). Cdots were synthesized by pyrolysis and characterized by FTIR, UV/fluorescence, electrochemistry, zeta potential, and transmission electron microscopy (TEM).

Restorative Neurostimulation Therapy Compared to Optimal Medical Management: A Randomized Evaluation (RESTORE) for the Treatment of Chronic Mechanical Low Back Pain due to Multifidus Dysfunction.

Introduction: Many interventional strategies are commonly used to treat chronic low back pain (CLBP), though few are specifically intended to target the distinct underlying pathomechanisms causing low back pain. Restorative neurostimulation has been suggested as a specific treatment for mechanical CLBP resulting from multifidus dysfunction. In this randomized controlled trial, we report outcomes from a cohort of patients with CLBP associated with multifidus dysfunction treated with restorative neurostimulation compared to those randomized to a control group receiving optimal medical management (OMM) over 1 year.

Guidance for Prescribing Oral Antihypertensive Medications in the Emergency Department.

Purpose Of Review: To review the most current recommendations regarding assessment and treatment of asymptomatic hypertension treatment in the emergency department (ED) and to provide guidance for prescribing oral antihypertensive therapy for ED providers.

Recent Findings: There are varying management strategies for the treatment of asymptomatic hypertension in the ED likely due to a lack of direct guidelines for treatment. There is an increasing body of evidence for the safety of initiating therapy to treat chronic asymptomatic hypertension in the ED.

Right ventricular subclinical dysfunction in high-burden idiopathic outflow tract premature ventricular contraction population.

Background: The relationship between premature ventricular contractions (PVC) and right ventricular (RV) function is not widely known. Left ventricular (LV) dysfunction due to PVC is known as PVC-induced cardiomyopathy (PIC) and suppressing the PVC substrate would improve LV function. The effect of PVC ablation on changes in RV function in patients with subtle RV subclinical dysfunction remains unknown.

Vascular outflow reconstruction in right lobe living donor liver transplantation with and without middle hepatic vein.

Although living donor liver transplantation has evolved, small-for-size syndrome remains a feared complication. Achieving optimal outflow for the graft with limited donor risk is possible with an experienced team and different techniques. Here we describe the technical aspects of living donor liver transplantation using a right lobe graft, including the different types of grafts, venous reconstructions and the importance of preoperative workup.

HIV Prevention in Syringe Service Programs Since the Start of COVID-19: Where Do We Go From Here?

Purpose: This narrative review addresses post-2020, specific, complex challenges for use of and adherence to pre-exposure prophylaxis (PrEP) for HIV prevention among out-of-treatment people who use drugs (PWUD) at syringe services programs (SSPs).

Recent Findings: The COVID-19 pandemic and its associated changes to the provision of healthcare have significantly impacted HIV prevention, especially for PWUD. Through a synthesis of literature and clinical experience, we (1) characterize the operational changes imposed by the pandemic on SSPs that shaped the current HIV prevention landscape; (2) describe three levels of current challenges for PWUD, including consumer attitudes, non-medical and medical provider attitudes, and structural and scalability barriers; (3) characterize current models for PrEP in SSPs; and (4) offer practical recommendations for HIV prevention in harm reduction programs.

Functional Magnetic Resonance Imaging of Post-Traumatic Headache: A Systematic Review.

Purpose Of Review: To evaluate existing functional magnetic resonance imaging (fMRI) studies on post-traumatic headache (PTH) following traumatic brain injury (TBI).

Recent Findings: We conducted a systematic search of PubMed and Embase databases from inception to February 1, 2024. Eligible fMRI studies were required to include adult participants diagnosed with acute or persistent PTH post-TBI in accordance with any edition of the International Classification of Headache Disorders.

Opioid Prescriptions for Low Back Pain among Military-Connected Older Adults Across Multiple Care Systems.

Background: Untreated low back pain (LBP) in older adults can lead to disability and development of chronicity. Due to the potential development of medical comorbidities and negative risks associated with pharmacological use, chronic LBP management for older adults requires a responsive approach.

Methods: The objective of this study is to evaluate the probability of (1) opioid prescription receipt and (2) opioid-sedative coprescription, in a sample of military-service-connected patients enrolled in the Veterans Health Administration (VHA) or TRICARE, ages 30-85 years, receiving care in three systems: VHA, Military Health System (MHS), and nonfederal (civilian) healthcare facilities.

Evaluating the prognostic role of glucose-to-lymphocyte ratio in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors in first line: a study by the Turkish Oncology Group Kidney Cancer Consortium (TKCC).

Purpose: Identifying prognostic indicators for risk stratification in metastatic renal cell carcinoma (mRCC) is crucial for optimizing treatment strategies and follow-up plans. This study aims to investigate the prognostic role of the glucose-to-lymphocyte ratio (GLR) in patients with mRCC receiving tyrosine kinase inhibitors (TKIs) as first-line therapy.

Methods: A retrospective cohort study was conducted using data from the Turkish Oncology Group Kidney Cancer Consortium Database.

Quantification of Particle-Associated Viruses in Secondary Treated Wastewater Effluent.

Viruses can interact with a broad range of inorganic and organic particles in water and wastewater. These associations can protect viruses from inactivation by quenching chemical disinfectants or blocking ultraviolet light transmission, and a much higher dosage of disinfectants is required to inactivate particle-associated viruses than free viruses. There have been only few studies of the association of viruses with particles in wastewater, particularly in secondary treated effluent.

Hematuria in the ER patient: optimizing detection of upper tract urothelial - A pictorial essay.

Upper tract urothelial carcinoma (UTUC) is a rare and challenging subset of the more frequently encountered urothelial carcinomas (UCs), comprising roughly 5-7% of all UCs and less than 10% of all renal tumors. Hematuria is a common presenting symptom in the emergency setting, often prompting imaging to rule out serious etiologies, with UTUC especially posing as a diagnostic challenge. These UTUC lesions of the kidney and ureter are often small, mimicking other pathologies, and are more aggressive than typical UC of the bladder, emphasizing the importance of timely and accurate diagnosis.

Translation, cross-cultural adaptation and psychometric evaluation of the Serbian Ankylosing Spondylitis Quality of Life (ASQoL) Questionnaire (refers to r-axSpA) and its relations with disease activity and functional status indices.

Objectives: To translate, cross-culturally adapt and validate the Serbian Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, e.g. according to the new nomenclature Radiographic-Axial Spondyloarthritis (r-axSpA), and to relate it to disease activity and functional status domains.