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.

Elbow Ulnar Collateral Ligament Repair With Suture Tape Augmentation Versus Reconstruction Should Be Determined Using Precise Imaging and Indications.

Current surgical treatment options for ulnar collateral ligament injury of the elbow include both reconstruction and repair. A growing amount of research has evaluated the outcomes of these various techniques in a variety of study designs. Large national database assessment indicates that overall failure rates are low and complication rates are similar between UCL reconstruction and UCL repair techniques.

The impact of ACOG's 39-week rule on fetal death rates in the United States: A systematic review.

Objective: The "39-week rule," implemented in August 2009, strongly discouraged early term deliveries before 39 weeks without accepted ACOG delivery indications. In this study, we evaluated fetal death rates before and after the 39-week rule in the United States (US) by review of published series.

Study Design: Systematic literature searches were performed in PubMed, Cochrane Central Register of Controlled Trials, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and Scopus databases (January 2009-June 2023).

Exploring the presence and roles of humility when experiencing situations of uncertainty.

Background: Uncertainty is a pervasive challenge in clinical practice. Whereas the importance of humility in navigating uncertainty has been discussed, empirical research on how humility is practiced or expressed (i.e.

Enhancing the Immunogenicity of Nivolumab plus Ipilimumab with Live Bacterial Supplementation in Metastatic Renal Cell Carcinoma.

Dysbiosis may hinder effective tumor immunity and reduce the efficacy of therapies such as immune checkpoint blockade (ICB) in renal cell carcinoma (RCC). CBM588, a product containing live Clostridium butyricum, has shown promise in enhancing ICB effectiveness in metastatic RCC in terms of response rates and progression-free survival. Further research to confirm these findings should take factors such as diet and microbiome composition into account and include predictive biomarkers for patient selection.

Malnutrition and risks of atrial fibrillation recurrence after catheter ablation.

Background: Recent data showed an association between malnutrition and increased all-cause mortality and thromboembolic risk in patients with atrial fibrillation (AF). However, the impact of malnutrition on the clinical outcomes for patients undergoing catheter ablation for AF is still debated. Our study aimed to examine this relationship using all existing available data.

Incidental granular cell tumor at the ileocecal junction mimicking a lymph node metastasis in a patient with history of neuroendocrine tumor of the right colon.

Granular cell tumors are rare neoplasms originating from Schwann cells found in various organs. GCTs are seldom reported in the gastrointestinal tract. Pre-operative detection and diagnosis of colonic GCTs is challenging since the tumors are mainly asymptomatic, small, slow-growing, and submucosal.

Factors affecting waiting times to enter opioid use disorder treatment in the United States with a particular focus on potential biological sex disparity.

Aim: Opioid use disorder (OUD) is the problematic use of licit or illicit opioids. Thus far, the literature on biological sex differences in accessing treatment is scarce. Hence, we hypothesize that biological sex has a moderating effect on OUD treatment accessibility.

Feasibility, validity, and normative data for the remote Uniform Data Set neuropsychological battery at the University of Pennsylvania Alzheimer's Disease Research Center.

Introduction: We investigated the feasibility and validity of the remotely-administered neuropsychological battery from the National Alzheimer's Coordinating Center Uniform Data Set (UDS T-Cog).

Methods: Two hundred twenty Penn Alzheimer's Disease Research Center participants with unimpaired cognition, mild cognitive impairment, and dementia completed the T-Cog during their annual UDS evaluation. We assessed administration feasibility and diagnostic group differences cross-sectionally across telephone versus videoconference modalities, and compared T-Cog to prior in-person UDS scores longitudinally.

Patient-Reported Outcome Measures for Mohs Reconstruction: A Systematic Review.

Objective: Mohs micrographic surgery (MMS) and subsequent reconstructive procedures for the treatment of facial nonmelanoma skin cancers (NMSCs) significantly impact quality of life (QoL). A validated patient-reported outcome measure (PROM) for patients who undergo Mohs reconstruction is not yet established. This study aims to systematically assess the quality of existing PROMs to determine their effectiveness in capturing the challenges faced after Mohs reconstruction for facial NMSC.

Complex Hemodynamic Responses to Trans-Vascular Electrical Stimulation of the Renal Nerve in Anesthetized Pigs.

The objective of this study was to characterize hemodynamic changes during trans-vascular stimulation of the renal nerve and their dependence on stimulation parameters. We employed a stimulation catheter inserted in the right renal artery under fluoroscopic guidance, in pigs. Systolic, diastolic and pulse blood pressure and heart rate were recorded during stimulations delivered at different intravascular sites along the renal artery or while varying stimulation parameters (amplitude, frequency, and pulse width).

The effects of rain and drought on incidence of enteric disease in Pennsylvania (2010-2019).

Background: Campylobacter, nontyphoidal Salmonella, Cryptosporidium, and Giardia cause an estimated 1 million cases of domestically acquired waterborne diseases annually in the United States. Acute symptoms can include diarrhea and vomiting; however, these illnesses can result in longer term complications such as reactive arthritis, Guillan Barré syndrome and death, particularly in immunocompromised individuals. Precipitation and drought can plausibly increase the risk of enteric infections, but consensus in the literature is lacking.

REAL-TIME RECURSIVE ESTIMATION OF, AND UNCERTAINTY QUANTIFICATION FOR, BREATH ALCOHOL CONCENTRATION VIA LQ TRACKING CONTROL-BASED INVERSE FILTERING OF TRANSDERMAL ALCOHOL BIOSENSOR SIGNALS.

The utility of newly developed wearable biosensors for passively, non-invasively, and continuously measuring transdermal alcohol levels in the body in real time has been limited by the fact that raw transdermal alcohol data does not consistently correlate (quantitatively or temporally) with interpretable metrics of breath and blood across individuals, devices, and the environment. A novel method using a population model in the form of a random abstract hybrid system of ordinary and partial differential equations and linear quadratic tracking control in Hilbert space is developed to estimate blood or breath alcohol concentration from the biosensor-produced transdermal alcohol level signal. Using human subject data in the form of 270 drinking episodes, the method is shown to produce estimates of blood or breath alcohol concentration that are highly correlated and thus good predictors of breath analyzer measurements.

Pathways From Socioeconomic Factors to Major Cardiovascular Events Among Postmenopausal Veteran and Nonveteran Women: Findings From the Women's Health Initiative.

Background: Cardiovascular disease (CVD) remains a leading cause of death for women in the United States, with veterans being at potentially higher risk than their nonveteran counterparts due to accelerated aging and distinct biopsychosocial mechanisms. We examined pathways between selected indicators of socioeconomic status (SES) such as education, occupation, household income, and neighborhood SES and major CVD events through lifestyle and health characteristics among veteran and nonveteran postmenopausal women.

Methods And Results: A total of 121 286 study-eligible WHI (Women's Health Initiative) participants (3091 veterans and 118 195 nonveterans) were prospectively followed for an average of 17 years, during which 16 108 major CVD events were documented.

Guideline-Directed Medical Therapy After Hospitalization for Acute Heart Failure: Insights From the CONNECT-HF.

Background: Significant gap remains in the implementation of guideline-directed medical therapy (GDMT) in patients with heart failure after a hospitalization. We aimed to evaluate the use and titration of GDMT at discharge and over a 12-month period after hospital discharge and to identify factors associated with GDMT use and titration.

Methods And Results: The CONNECT-HF (Care Optimization Through Patient and Hospital Engagement Clinical Trial for Heart Failure) trial evaluated the effect of a hospital and postdischarge quality improvement intervention in participants with heart failure with reduced ejection fraction.

A Pilot Study of a Novel Dietary Intervention Targeting Ultra-Processed Food Intake.

Background: Ultra-processed foods (UPFs) are harmful to health but ubiquitous in the modern food environment, comprising almost 60% of the average American diet. This study assessed the feasibility, acceptability, and preliminary efficacy of a novel behavioral intervention designed to reduce UPF intake.

Methods: Fourteen adults participated in an 8-week pilot intervention, which consisted of weekly group sessions, individual meal planning sessions, and financial support.

New role of calcium-binding fluorescent dye alizarin complexone in detecting permeability from articular cartilage to subchondral bone.

Osteoarthritis (OA) is a chronic degenerative joint disorder characterized by the progressive deterioration of articular cartilage and concomitant alterations in subchondral bone architecture. However, the precise mechanisms underlying the initiation and progression of OA remains poorly understood. In the present study, we explored whether the calcification in the articular cartilage occurred in the early stage of mouse OA model, generated by the surgery destabilization of the medial meniscus (DMM), via the intra-articular injection of alizarin complexone due to its anionic nature for binding calcium-containing crystals.

Comorbidity profiles and pulmonary embolism risk assessment: Leveraging the Charlson Comorbidity Index for improved prognostication in a national data set.

Current risk assessment of pulmonary embolism (PE) stratifies patients based on hemodynamic stability, clinical parameters of severity, right ventricular dysfunction and cardiac injury but fails to integrate a wide variety of comorbid conditions. The Charlson Comorbidity Index (CCI) predicts mortality based on patients' diseases and provides a system to quantify disease burden. The National Inpatient Sample (NIS) database (2016-2018) was used to identify patients with PE and calculate CCI score groups of 0, 1-2, 3-5, and ≥6 and stratify them by outcome.

at Scientific Sessions 2023: Moving Toward Social Justice in Cardiovascular Health in the United States.

Attention to social justice is essential to improving cardiovascular health outcomes. In the absence of social justice, equitable cardiovascular health is impossible. This viewpoint provides a brief synopsis of the 2023 -sponsored session titled "Moving Towards Social Justice in Cardiovascular Health.

Mechanisms of extracellular vesicle uptake and implications for the design of cancer therapeutics.

The translation of pre-clinical anti-cancer therapies to regulatory approval has been promising, but slower than hoped. While innovative and effective treatments continue to achieve or seek approval, setbacks are often attributed to a lack of efficacy, failure to achieve clinical endpoints, and dose-limiting toxicities. Successful efforts have been characterized by the development of therapeutics designed to specifically deliver optimal and effective dosing to tumour cells while minimizing off-target toxicity.

General emergency physician perceptions of caring for children: A qualitative interview study.

Background: Emergency physicians care for most children presenting to U.S. emergency departments (EDs).

Revolutionizing healthcare and medicine: The impact of modern technologies for a healthier future-A comprehensive review.

The increasing integration of new technologies is driving a fundamental revolution in the healthcare sector. Developments in artificial intelligence (AI), machine learning, and big data analytics have completely transformed the diagnosis, treatment, and care of patients. AI-powered solutions are enhancing the efficiency and accuracy of healthcare delivery by demonstrating exceptional skills in personalized medicine, early disease detection, and predictive analytics.