Corneal Refractive Surgery Considerations in Patients with Anorexia Nervosa.

Anorexia nervosa (AN) is a psychiatric eating disorder characterized by body mass index (BMI) ≤ 18.5, fear of gaining weight, and a distorted perception of body weight. With increasing rates of myopia, there is a population of patients who concurrently develop AN and may seek corneal refractive surgery.

Comparative Analysis of Effective Lens Position and Refractive Outcomes in Scleral-Fixated versus Intracapsular Intraocular Lenses.

Purpose: To evaluate the outcomes of scleral-fixated intraocular lenses (IOLs) implanted using either Yamane technique or Gore-Tex suture fixation, in comparison to intracapsular lens fixation, and to assess the efficacy of various lens formulas in achieving predicted refractive targets.

Patients And Methods: This study included 45 eyes from 44 patients with scleral-fixated IOLs, comprising 37 Yamane eyes and 8 Gore-Tex eyes. Preoperative refractive predictions from various formulae were compared with final postoperative refraction.

Association between cannabis use and clinical outcomes in patients with solid malignancies receiving immune checkpoint inhibitors.

Background: Cannabis (CAN) use has risen significantly over the last few decades. CAN has potent immunosuppressive properties, which could antagonize the effect of immunotherapy (IO). The impact of CAN use on clinical cancer outcomes remains unclear.

Navigating the Dynamic Nature of Mitral Regurgitation With the Use of Multimodality Imaging in a Young Woman.

The mechanism and severity of mitral valve (MV) regurgitation (MR) play a critical role in guiding treatment decisions. Transthoracic echocardiography (TTE) is the primary diagnostic modality for evaluating MV disease. Discordant findings on TTE can be further quantified through transesophageal echocardiography (TEE).

Silent Inflammation: A Case of Blurry Vision Raising Diagnostic Challenges in an Elderly Patient.

Giant cell arteritis (GCA) is a large vessel vasculitis with cranial and extracranial vessel involvement. Clinicians suspect GCA when a patient exhibits symptoms or exam findings of temporal headache with sudden vision loss, jaw or tongue claudication, scalp tenderness, abnormal temporal artery exam, and diagnostic findings, including elevated inflammatory markers. We present a case, which highlights that, despite established diagnostic measures, challenges persist.

Sunset Sign Due to Intraventricular Tension Pneumocephalus: A Key Clue to Evaluating Delayed Emergence After General Anesthesia.

Prompt emergence from general anesthesia is crucial after neurosurgical procedures, such as craniotomies, to facilitate timely neurological evaluation for identification of intraoperative complications. Delayed emergence can be caused by residual anesthetics, metabolic imbalances, and intracranial pathology, for which an eye examination can provide early diagnostic clues. The sunset sign (or setting sun sign), characterized by a downward deviation of the eyes, can be an early indicator of raised intracranial pressure (ICP) or midbrain compression, as is commonly observed in states of hydrocephalus or periaqueductal or tectal plate dysfunction.

Iris Avulsion During Corneal Wound Hydration After Uneventful Cataract Extraction.

We report a case of spontaneous total iris avulsion that occurred during corneal wound hydration following an uneventful phacoemulsification procedure. An 86-year-old woman underwent cataract surgery on her right eye, during which a single-piece acrylic intraocular lens (Bausch and Lomb Akreos Adapt Advanced Optics, Bausch and Lomb Incorporated, Rochester, NY, USA) was implanted in the bag, and the viscoelastic material was removed. During corneal wound hydration, total iris avulsion was observed, with the iris prolapsing out of the anterior chamber through the main wound.

A Rare Case of Tissierella praeacuta Bacteremia in the Context of Lower Extremity Cellulitis.

()is a gram-variable obligate anaerobe. In this case report, we describe the first documented case of bacteremia in a patient with sepsis resulting from lower extremity cellulitis without concomitant osteomyelitis. During the inpatient course, the patient was treated with IV vancomycin, cefepime, and ertapenem, in addition to surgical debridement and incision and drainage of his foot wound.

Monitoring Response Using Circulating Tumor DNA in Undifferentiated Pleomorphic Sarcoma: A Case Report.

Circulating tumor DNA (ctDNA) can be used to assess treatment response in patients with undifferentiated pleomorphic sarcoma (UPS). The importance of this is explored in our case of a 75-year-old man who was diagnosed with UPS of the right kidney. After a right nephrectomy and tumor resection, the patient was recovering well with initially undetectable, and then slightly elevated, circulating tumor DNA.

Bridging the Gap: Promoting Interventional Pain Medicine as a Future for Family Physicians.

The use of interventional pain medicine (IPM) has been growing over the past few years, offering relief to patients suffering from acute and chronic pain who have failed conservative therapies. Pain is one of the top complaints that family physicians encounter, yet there is no official pain medicine (PM) fellowship or recognized training program that favors family medicine graduates. Although family medicine residency programs allot a certain amount of time to teaching trainees in PM, this is considerably insufficient and does not dedicate ample time for procedural treatments.

Esophageal Perforation Resulting From Nonaccidental Trauma in a Neonate: A Case Report.

Esophageal perforation (EP) resulting from nonaccidental trauma in a neonate is extremely rare. We report a previously healthy 12-day-old neonate presenting with stridor, respiratory distress, and bloody vomitus. Clinical, radiographic, and endoscopic evaluations confirmed the diagnosis of EP.

Diagnosing Porphyria in a Female Patient With Diffuse Pelvic Pain: A Case Study.

Porphyria is a rare and often underdiagnosed metabolic disorder that leads to abdominal pain, pelvic pain, changes in neurological states, and digestive issues due to a buildup of porphyrins in the body. Diagnosis can be especially difficult in young women, where symptoms of porphyria often overlap with gynecological conditions. We present a case of a 37-year-old female patient who was experiencing persistent lower abdominal and pelvic pain, brain fog and confusion, and a rash after long sun exposure.

Acute Intermittent Porphyria in an Adolescent Patient: Diagnostic and Treatment Challenges.

Acute intermittent porphyria (AIP) is a rare inherited metabolic disorder caused by decreased activity of the enzyme porphobilinogen deaminase in the heme synthesis pathway. This leads to the accumulation of toxic porphyrin precursors, such as porphobilinogen and δ-aminolevulinic acid. Clinical manifestations typically include episodic bouts of severe neurovisceral pain and autonomic dysfunction.

Knowledge, Perception, and Practices of Hand Hygiene Among Medical and Paramedical Students at a Tertiary Care Institute in Uttarakhand.

Background: Healthcare-associated infections or nosocomial infections are considered to be one of the leading causes of increased morbidity and mortality in patients. Hand hygiene is one of the simplest and most effective infection control measures to prevent nosocomial infections. Medical and paramedical students are the foundation of any healthcare system.

Seizing the Teachable Moment: A Pilot Study of Preventive Lifestyle Education in the Emergency Department.

Background Preventive measures are critical in avoiding and limiting the severity of diseases. Key lifestyle behaviors include sleep hygiene, habitual exercise, a healthy diet, and avoidance of risky substances, particularly the use of tobacco. The transtheoretical model (TTM) of change suggests that patients can move towards healthful changes through education.

Leptospirosis Causing Severe Acute Kidney Injury, Hyperbilirubinemia, and Thrombocytopenia: A Case Report.

Leptospirosis, an infection caused by the spirochete Leptospira and commonly attributed to the underdeveloped world, is frequently under-diagnosed in the United States. This report discusses the case of a 79-year-old male with no significant medical history who presented to the ED with recurrent falls. Initial laboratory results demonstrated severe acute kidney injury, hyperbilirubinemia, and thrombocytopenia.

Establishment of Biobank and Patient-Derived Xenograft of Soft Tissue and Bone Tumors.

Soft tissue and bone tumors are rare, and their low frequency and diverse histological types make conducting large-scale clinical trials challenging. Patient-derived xenografts (PDX), entailing implantation of cancer specimens in immunocompromised mice, are emerging as a valuable translational model because PDX keeps the original tumors' character and drug sensitivity. We sequentially transplanted 166 surgical and biopsy specimens from orthopedic surgeries, including 138 soft tissue and bone tumors (81 malignant, 23 intermediate, and 34 benign), 16 metastatic bone tumors, 9 hematological malignancies, and 3 non-tumor tissues.

Iliofemoral Venous Thrombectomy and Angioplasty in a Patient Following Simultaneous Pancreas-Kidney Transplant: A Case Report.

Simultaneous pancreas-kidney (SPK) transplantation is a recognized treatment for patients with insulin-dependent diabetes and advanced chronic kidney disease or end-stage renal disease (ESRD), offering significant survival benefits. However, it is associated with a higher risk of venous thrombosis, which can jeopardize the survival of the pancreaticoduodenal graft. This case report describes a patient with type 2 diabetes, hypertension, and ESRD who developed acute, occlusive deep vein thrombosis (DVT) involving the right common femoral, profunda femoral, and greater saphenous veins on postoperative day 1 (POD1) following a deceased donor SPK transplant, despite systemic prophylactic anticoagulation.

Standardized protocol for labor induction: a type I hybrid effectiveness-implementation trial.

Background: Cesarean delivery remains the most common obstetrical procedure with more than 250,000 patients in the US undergoing cesarean following labor induction annually. Here, we evaluated the impact of prospectively implementing a standardized labor induction protocol on cesarean delivery rates.

Methods: This multi-site type I hybrid effectiveness-implementation study compared 2 years before (PRE) and 2 years after (POST) implementation of a standardized labor induction protocol at two hospitals within the University of Pennsylvania Health System (2018-2022).

Social context modulates active avoidance: Contributions of the anterior cingulate cortex in male and female rats.

Actively avoiding danger is necessary for survival. Most research on active avoidance has focused on the behavioral and neurobiological processes when individuals learn to avoid alone, within a solitary context. Therefore, little is known about how social context affects active avoidance.

Lipidomic analysis of plant-derived extracellular vesicles for guidance of potential anti-cancer therapy.

Plant-derived extracellular vesicles (PEVs) have been regarded as a superior source for nanomedicine and drug delivery systems. Nevertheless, their clinical translation is hindered by the lack of clarity and even contradiction in their biomedical applications. Herein, we conducted a comprehensive compositional analysis of four commonly used PEVs to fully understand their functional lipid contents and assess their potential therapeutic applications.

Elementary flow mapping across life cycle inventory data systems: A case study for data interoperability under the Global Life Cycle Assessment Data Access (GLAD) initiative.

Purpose: Limited availability of life cycle assessment (LCA) data poses a significant challenge to its mainstream adoption, rendering it a central issue within the LCA community. The Global LCA Data Access (GLAD) network aims to increase the accessibility and interoperability of LCA data and offers benefits for different use cases. GLAD is an intergovernmental collaboration involving different stakeholders organized into working groups.

Orthologs of and impact sleep in mice.

Model organisms such as are powerful tools to study the genetic basis of sleep. Previously, we identified the genes and using selective breeding for long and short sleep duration in an outbred population of . is a transcription factor that is part of the epidermal growth factor receptor signaling pathway, while is involved in proline and arginine metabolism.

Epidemiology, patient characteristics, and treatment patterns of patients with narcolepsy in Sweden: a non-interventional study using secondary data.

Study Objectives: To estimate the prevalence and incidence and evaluate the treatment patterns of patients diagnosed with narcolepsy in specialist care in Sweden.

Methods: This non-interventional retrospective longitudinal study used Swedish register data from 2010 to 2020 and included patients diagnosed with narcolepsy (either type 1 or type 2), recorded in specialist outpatient and inpatient care from January 2015 to December 2019. All patients received an index date corresponding to the date of the first narcolepsy diagnosis.