Cancer History, Antiphospholipid Syndrome, and Lupus Anticoagulant: A Perfect Storm for Thrombosis.

Cancer and antiphospholipid syndrome (APS) independently increase thrombotic risk, and their coexistence can create a particularly hazardous prothrombotic state. This case report aims to highlight the complex challenges in managing concurrent thrombotic and hemorrhagic events in patients with a history of cancer and APS. The combination of these conditions presents a rare and difficult clinical scenario, requiring careful consideration in anticoagulation management.

Refined Approach to the Treatment of Caseous Calcification of the Mitral Annulus: A Case Report.

Caseous calcification of the mitral annulus (CCMA) is a rare variant of mitral annular calcification (MAC), in which the core of the calcification undergoes a caseous transformation. CCMA can cause dysfunction of the mitral valve or embolization of caseous material, requiring surgery. There is currently no clear consensus on the optimal treatment strategy for CCMA.

Neurodivergence and Threat: A Case Study on the Risk of Violent Fixations in Autism Spectrum Disorder.

Mass shootings have increasingly captured public attention in recent decades, prompting closer examination of the mental health of those responsible. This scrutiny often focuses on individuals with neurodevelopmental disorders, such as autism spectrum disorder (ASD). While epidemiological evidence is mixed on whether these individuals are more likely to commit acts of violence than the general public, certain behavioral characteristics may make them more vulnerable to extremist ideations.

Granulomatous Tubulointerstitial Nephritis as a Rare Cause of Allograft Failure: A Case Report.

Although granulomatous interstitial nephritis (GIN) is a rare histological finding in kidney transplants, the joint occurrence of GIN and focal segmental glomerulosclerosis (FSGS) has not, to our knowledge, been reported in the literature. We report a case of GIN and de novo FSGS in kidney transplant recipients leading to allograft failure. A 69-year-old male with a history of end-stage renal disease (ESRD) of unknown etiology, as well as liver failure from hepatitis B and C co-infection, initially had a living unrelated kidney transplant (LURT) in 2007 and subsequently received both liver and kidney transplants (SLKTs) in 2017.

The Impact of Patient-Centered, Structured Interdisciplinary Bedside Rounds on Medical Staff Satisfaction, Education, and Experience.

Background Daily interdisciplinary rounds in hospitals are becoming standardized to maximize the multidisciplinary approach to hospitalized patient care. We hypothesize that structured Interdisciplinary Bedside Rounds (IDRs) increase the satisfaction, education, and experience of medical staff and thus detail actionable recommendations for IDR implementation or delineate measurable long-term impacts. Methods This observational study was performed in a 300-bed community hospital.

Mechanical Thrombectomy in Africa: A Challenging Future.

Mechanical thrombectomy (MT) has revolutionized the management of proximal large vessel occlusions (LVOs) in patients with acute ischemic stroke (AIS), improving long-term outcomes compared to standard treatments. However, despite its success in high-income countries, the widespread implementation of MT in Africa remains limited. With Africa experiencing one of the highest stroke burdens globally, this study examines the barriers impeding the adoption of MT in the region.

Assessment of Contributing Risk Factors Leading to Heart Failure in Patients Who Are Methamphetamine Users.

Background: Methamphetamine abuse is a public health problem across the world, and the cardiovascular system experiences a significant effect on the myocardium over time. Methamphetamine is a common cause of heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). The prevalence and risk factors for HFpEF and HFrEF in this patient population remain unclear.

A Comparison of the Accuracy of Two Non-dental 3D Printers and a Standard Dental 3D Printer for Printing Dental Models: An In Vitro 3D Analysis.

Background: While the majority of dentists and lab techs recommend dental-specific desktop printers, many of them use cheaper, more affordable 3D printers in their practice. The study aimed to compare the accuracy of two commercial non-dental stereolithography (SLA) 3D printers with a dental 3D printer for diagnostic dental casts.  Methods: A prototype stereolithographic (Standard Triangle/Tessellation Language (STL)) model of a dentoform was used as a master model to be printed by three 3D printers (n=10 for each printer).

Predictors of No-Shows After an Endoscopic Mucosal Resection in Veterans: A Retrospective Analysis.

Introduction Endoscopic mucosal resection (EMR) is a common intervention for large colorectal polyps, but its long-term success depends heavily on post-procedure surveillance to detect recurrence. Despite the critical importance of follow-up appointments, some patients fail to attend these crucial visits. This study aims to identify demographic, clinical, and socioeconomic factors that predict missed follow-up appointments after EMR.

Natural variation in MdNAC5 contributes to fruit firmness and ripening divergence in apple.

Fruit firmness is an important trait for characterizing the quality and value of apple. It also serves as an indicator of fruit maturity, as it is a complex trait regulated by multiple genes. Resequencing techniques can be employed to elucidate variations in such complex fruit traits.

Management of Labral Tears in the Hip: A Consensus Statement.

Background: Inconsistencies in the workup of labral tears in the hip have been shown to result in a delay in treatment and an increased cost to the medical system.

Purpose: To establish consensus statements among Canadian nonoperative/operative sports medicine physicians via a modified Delphi process on the diagnosis, nonoperative and operative management, and rehabilitation and return to play (RTP) of those with labral tears in the hip.

Study Design: A consensus statement.

Evaluation of Thigh Muscle Strength in Adolescent Patients After Anterior Cruciate Ligament Reconstruction With Lateral Extra-articular Tenodesis or Anterolateral Ligament Reconstruction.

Background: There has been increased interest in lateral extra-articular procedures, such as anterolateral ligament reconstruction (ALLR) or lateral extra-articular tenodesis (LET), to reduce anterolateral rotation instability of the knee after anterior cruciate ligament reconstruction (ACLR). Despite promising surgical outcomes with these techniques, their impact on knee strength recovery is unknown.

Hypothesis: Patients undergoing lateral extra-articular procedures at the time of ACLR would have impaired thigh muscle strength at 6 to 9 months after surgery.

Increasing Incidence of Pickleball Injuries Presenting to US Emergency Departments: A 10-year Epidemiologic Analysis of Mechanisms and Trends.

Background: Pickleball is one of the fastest-growing sports in the United States. It is popular among seniors but has recently grown across all age groups. As pickleball has gained interest, its corresponding injury burden has also increased.

Characterizing hole trap production due to proton irradiation in germanium cross-strip detectors.

We present an investigation into the effects of high-energy proton damage on charge trapping in germanium cross-strip detectors with the goal of accomplishing three important measurements. First, we calibrated and characterized the spectral resolution of a spare COSI-balloon detector in order to determine the effects of intrinsic trapping, finding that electron trapping due to impurities dominates over hole trapping in the undamaged detector. Second, we performed two rounds of proton irradiation of the detector in order to quantify, for the first time, the rate at which charge traps are produced by proton irradiation.

Adversity in Adolescence: Modeling risk for different purposes.

Policymakers and practitioners are increasingly leveraging research on the links between adversity and wellbeing in childhood and adolescence. However, conceptualizations and analytical approaches focused on these connections vary across disciplines, with implications for empirical results, interpretation of findings, and how those findings guide policy and practice. This article demonstrates the importance of researchers matching study aims to analytic approach when modeling relations between adversity and problems signifying poor outcomes.

Clinical, immunophenotypic, and genomic findings of acute myeloid leukemia with RAM immunophenotype: Comparison with other CD56-positive acute leukemias.

Background: Acute myeloid leukemia (AML) with RAM immunophenotype is a newly recognized high-risk AML immunophenotypic subcategory characterized by blasts with bright expression of CD56 and weak to absent expression of CD45, HLA-DR, and CD38, as first described by the Children's Oncology Group (COG). The relationship between AML-RAM and other CD56-positive acute leukemias is unclear. The goal of this study is to characterize the clinicopathological characteristics of AML with RAM phenotype and compare them with other CD56 co-expressing acute leukemias.

CD58 expression does not impact response to inotuzumab ozogamicin in patients with B-cell acute lymphoblastic leukemia.

Background: CD58 loss has been described as a mechanism of resistance to blinatumomab and chimeric antigen receptor T-cell therapy, functioning as a modulator of response to T-cell activation.

Methods: Using flow cytometry, we evaluated the impact of CD58 mean fluorescence intensity (MFI) on the probability of achieving measurable residual disease (MRD) negativity in patients with B-cell acute lymphoblastic leukemia treated with inotuzumab ozogamicin (InO).

Results: The odds ratio of achieving MRD negativity was 1.

Pneumonia in patients with chronic lymphocytic leukemia treated with venetoclax-based regimens: A real-world analysis of Polish Adult Leukemia Group (PALG).

Background: Patients with chronic lymphocytic leukemia (CLL) are susceptible to infections that can affect their clinical outcomes.

Aims: To assess: (1) the incidence of pneumonia in CLL patients treated with venetoclax-based regimens in a real-world setting, (2) the risk factors for event-free survival (EFS), and (3) overall survival (OS).

Methods: This multicenter study included 322 patients from eight centers.

Erythrocytapheresis as a strategy to manage anemia and iron overload in nondeletional hemoglobin H disease.

Hemoglobin H (HbH) disease is associated with anemia, ineffective erythropoiesis, and iron overload. We report a case of a patient with HbH/Hb Constant Spring disease, who was maintained on chronic transfusions as an adult due to symptomatic anemia. Over time, he developed iron overload and was started on chelation therapy but did not have an adequate response to chelation.

Factors related to mean corpuscular volume in p.C282Y homozygotes.

Introduction: The aim of this study was to define the relationships between factors other than transferrin saturation (TS) to mean corpuscular volume (MCV) and macrocytosis (MCV > 100 fL) in p.C282Y (rs1800562) homozygotes.

Methods: We studied white post-screening participants with p.

Recurrent Poorly Differentiated Thyroid Cancer Successfully Treated With Radiation and Immunotherapy.

A 65-year-old patient presented with recurrent, locally advanced poorly differentiated thyroid cancer despite 2 neck surgeries, and with newly diagnosed brain and skull base metastases. He was treated with palliative stereotactic radiosurgery to the brain and skull base lesions. Thereafter, as no targetable genetic alteration was identified and antiangiogenic multikinase inhibitors were deemed at high risk of hemorrhagic complications, off-label systemic therapies were considered.

Metastatic Insulinoma Managed With Continuous Glucose Monitoring in a Young Female Patient.

Insulinomas are rare neuroendocrine neoplasms and causes of hypoglycemia. They present with neuroglycopenic symptoms, including confusion and seizures. Suspected diagnosis must be confirmed through bloodwork and imaging.