Ketamine Infusion for Complex Regional Pain Syndrome Treatment: A Narrative Review.

Purpose Of Review: Complex Regional Pain Syndrome (CRPS) is a neuropathic pain disorder characterized by pain disproportionate to the inciting event that is constant for an extended duration. Numerous treatment options for this condition have been explored with unsatisfactory results in many cases. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist typically used as an anesthetic and analgesic, presents a promising potential treatment for CRPS in patients who fail to respond to traditional therapies.

Cardiometabolic Multimorbidity and Dementia Onset among Middle-aged and Older Adults: Differences by Race/Ethnicity.

Background: Racial/ethnic minoritized groups in the U.S. have higher prevalence of cardiometabolic multimorbidity and experience higher risk of dementia.

Evaluation of an AI-Based Voice Biomarker Tool to Detect Signals Consistent With Moderate to Severe Depression.

Purpose: Mental health screening is recommended by the US Preventive Services Task Force for all patients in areas where treatment options are available. Still, it is estimated that only 4% of primary care patients are screened for depression. The goal of this study was to evaluate the efficacy of machine learning technology (Kintsugi Voice, v1, Kintsugi Mindful Wellness, Inc) to detect and analyze voice biomarkers consistent with moderate to severe depression, potentially allowing for greater compliance with this critical primary care public health need.

Subcutaneous Panniculitis-Like T-Cell Lymphoma Presenting as a Targetoid Plaque in a Pediatric Patient: A Case Report and Review of Literature.

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare type of non-Hodgkin lymphoma characterized by subcutaneous nodules, indurated plaques, erythema, and cellular infiltrates in the subcutaneous fat. Biopsies show neoplastic cells expressing cytotoxic T-cell markers and displaying moderate cytologic atypia while sparing the dermis and epidermis and showing variable degrees of necrosis, hemorrhage, and inflammatory changes. We describe a pediatric case of SPTCL in a 6-year-old boy, presenting with an unusual targetoid plaque and systemic symptoms, who showed significant improvement on systemic immunosuppressants without chemotherapy.

Amino Acid Supplementation May Help Prevent Muscle Wasting After Orthopedic Surgery, but Additional Studies Are Warranted: A Systematic Review of Randomized Clinical Trials.

Essential amino acid (EAA) supplementation, including conditionally essential amino acid (CEAA) and branched-chain amino acids (BCAA) supplementation, has been suggested as a mechanism to optimize patient outcomes by counteracting the atrophy associated with orthopedic procedures. We sought to investigate the effect of EAA supplementation in the perioperative period on patients undergoing orthopedic and spine surgery, specifically whether it is associated with (1) reductions in postoperative muscle atrophy and (2) improved postoperative function including range of motion, strength, and mobility. We conducted a systematic review of the literature.

Changes in Physical Activity and Cardiovascular Disease Risk in Cancer Survivors: A Nationwide Cohort Study.

Background: Cancer survivors face an elevated risk of cardiovascular disease, with physical inactivity after cancer treatment potentially worsening this risk.

Objectives: The aim of this study was to investigate the association between physical activity before and after a cancer diagnosis and the risk for heart disease.

Methods: A nationwide cohort of 269,943 cancer survivors (mean age 56.

β-alanine supplementation in adults with overweight and obesity: a randomized controlled feasibility trial.

Objective: Overweight and obesity are characterized by excess adiposity and systemic, chronic, low-grade inflammation, which is associated with several metabolic disorders. The aim of this study was to assess the feasibility and tolerability of β-alanine supplementation and to explore the effects on cardiometabolic health and cardiovascular, hepatic, and renal function in adults with overweight and obesity.

Methods: A total of 27 adults (44% female; mean [SD], age: 58 [10] years, BMI: 31.

Factors Contributing to Opioid Overprescribing at Surgical Discharge.

Introduction: Opioids remain the gold standard for treating acute pain, whereas overprescribing occurs regularly in the postoperative setting with little clinical guidance. The objective of this study is to examine whether the length of surgery is an independent risk factor for opioid overprescribing at discharge.

Methods: We conducted a retrospective case-control study to determine if there is an association between the length of surgery and overprescribed opioids.

Physical Activity Amid a Pandemic: How Socioeconomic and Demographic Factors Shaped Behaviors During COVID-19.

The COVID-19 pandemic led to significant shifts in societal norms and individual behaviors, including changes in physical activity levels. This study examines the relationship between socioeconomic and sociodemographic factors and changes in physical activity levels during the pandemic compared to pre-pandemic levels among adult Arkansans. Survey data were collected from 1,205 adult Arkansans in July and August 2020, capturing socioeconomic and sociodemographic characteristics and information on physical activity changes since the onset of the pandemic.

The pleiotropic effects of PCSK9 in cardiovascular diseases beyond cholesterol metabolism.

Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality globally, with elevated low-density lipoprotein cholesterol (LDL-C) levels being a major risk factor. Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays a critical role in regulating LDL-C levels by promoting the degradation of hepatic low-density lipoprotein receptors (LDLR) responsible for clearing LDL-C from the circulation. PCSK9 inhibitors are novel lipid-modifying agents that have demonstrated remarkable efficacy in reducing plasma LDL-C levels and decreasing the incidence of CVD.

Iron Chelation Prevents Age-Related Skeletal Muscle Sarcopenia in Klotho Gene Mutant Mice, a Genetic Model of Aging.

Background: A decline in skeletal muscle mass and function known as skeletal muscle sarcopenia is an inevitable consequence of aging. Sarcopenia is a major cause of decreased muscle strength, physical frailty and increased muscle fatigability, contributing significantly to an increased risk of physical disability and functional dependence among the elderly. There remains a significant need for a novel therapy that can improve sarcopenia and related problems in aging.

Endoscopic Ultrasound-Guided Treatments for Pancreatic Cancer: Understanding How Endoscopic Ultrasound Has Revolutionized Management of Pancreatic Cancer.

Pancreatic cancer is associated with high rates of morbidity and mortality. Endoscopic ultrasound (EUS)-guided biopsy has become the standard diagnostic modality per the guidelines. The use of EUS has been growing for providing various treatments in patients with pancreatic cancers: biliary and gallbladder drainage for those with malignant biliary obstruction, gastroenterostomy for malignant gastric outlet obstruction, celiac plexus/ganglia neurolysis for pain control, radiofrequency ablation, placement of fiducial markers, and injection of local chemotherapeutic agents.

Hypertension: A Continuing Public Healthcare Issue.

Hypertension is a cardiovascular disease defined by an elevated systemic blood pressure. This devastating disease afflicts 30-40% of the adult population worldwide. The disease burden for hypertension is great, and it greatly increases the risk of cardiovascular morbidity and mortality.

The Association Between Dietary Supplement Use and COVID-19 Symptoms.

The scientific evidence supporting recommendations for dietary supplement use to prevent or treat coronavirus disease 2019 (COVID‑19) is not well‑established. This cohort study investigates the relationship between dietary supplement usage and COVID‑19 symptoms among 27,181 adults tested for COVID‑19. Using data from surveys following COVID‑19 testing, conducted by the University of Arkansas for Medical Sciences, associations between dietary supplement usage, symptomatology, and COVID‑19 status were explored.

A Rare Case of Congenital Buccal Lipoblastoma in a Term Neonate.

A lipoblastoma is a benign tumor of adipocytes originating from embryonic white fat and occurs in the pediatric population. Congenital lipoblastomas, however, are rare, and the incidence of these tumors in neonates is unknown. Due to their rare presentation, congenital oral lipoblastomas can, firstly, pose diagnostic challenges for the pediatrician and must be differentiated from the more commonly seen oral lesions in the newborn and other rare malignant growths.

Expert Rater Agreement for Symptoms and Diagnosis of Bipolar Disorder in Youth.

The diagnosis of bipolar disorder (BD) in young children has been a topic of debate, in part owing to varied interpretation of manic-like symptoms. We examined how expert academic clinicians participating in the pediatric bipolar biobank varied in their interpretation and application of Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria and diagnoses. Study co-investigators reviewed 12 standardized narratives and for each marked a visual analog scale with their confidence in the presence of manic episodes and criteria.

Vaccine hesitancy or hesitancies? A latent class analysis of pediatric patients' parents.

Vaccine hesitancy is an attitude of indecision toward vaccination that is related to but not determinative of vaccination behaviors. Although theories of vaccine hesitancy emphasize it is often vaccine-specific, we do not know the extent to which this is true across sociodemographic groups. In this study, we asked: What latent classes of vaccine hesitancy might exist when examining parents' attitudes toward vaccines in general and COVID-19 and human papillomavirus (HPV) vaccination specifically? Which sociodemographic, health access, and health-related variables are predictive of membership in those classes? To answer those questions, we analyze online survey data from parents of pediatric patients recruited through eight clinics within the University of Arkansas for Medical Sciences Rural Research Network.

Options for pediatric heart valve replacement.

Heart valve replacement is indicated for children with irreparable heart valve disease. These replacements come in a variety of forms including mechanical, xenograft tissue, allograft tissue, and autograft tissue valves. These options each have unique benefits and risks profiles.

Fluorescent identification of axons, dendrites and soma of neuronal retinal ganglion cells with a genetic marker as a tool for facilitating the study of neurodegeneration.

This study characterizes a fluorescent -tdTomato neuronal reporter mouse line with strong labeling of axons throughout the optic nerve, of retinal ganglion cell (RGC) soma in the ganglion cell layer (GCL), and of RGC dendrites in the inner plexiform layer (IPL). The model facilitated assessment of RGC loss in models of degeneration and of RGC detection in mixed neural/glial cultures. The tdTomato signal showed strong overlap with >98% cells immunolabeled with RGC markers RBPMS or BRN3A, consistent with the ubiquitous presence of the vesicular glutamate transporter 2 (VGUT2, SLC17A6) in all RGC subtypes.

A National Assessment of Pediatric Surgical Critical Care Fellowship Structure: Defining the Training Experience.

Background: Pediatric Surgical Critical Care (PSCC) is a unique specialty incorporating fundamental principles of surgical, neonatal, and pediatric critical care. This study aims to characterize the current landscape of PSCC training to identify opportunities for educational standardization and improvement.

Methods: An anonymous electronic survey-based assessment was distributed to the program directors (PDs) of all current ACGME-accredited PSCC fellowships (n = 14).

Investigating the origins of the mutational signatures in cancer.

Most of the risk factors associated with chronic and complex diseases, such as cancer, stem from exogenous and endogenous exposures experienced throughout an individual's life, collectively known as the exposome. These exposures can modify DNA, which can subsequently lead to the somatic mutations found in all normal and tumor tissues. Understanding the precise origins of specific somatic mutations has been challenging due to multitude of DNA adducts (i.