Weight and metabolic changes with long-acting cabotegravir and rilpivirine or bictegravir/emtricitabine/tenofovir alafenamide.

Background: Modest weight and lipid changes have been observed in cabotegravir plus rilpivirine long-acting (CAB+RPV LA) Phase 3/3b studies. The SOLAR study included standardized evaluations of weight and metabolic changes in people living with HIV switching to CAB+RPV LA dosed every 2 months (Q2M) vs. continuing bictegravir/emtricitabine/tenofovir (BIC/FTC/TAF).

Efficiency and Completeness in Outpatient Visits Using the Scientific Method and Analog Scales.

The relationship between the scientific method and clinical practice was discussed in an earlier column. Another column described the application of analog scales to clinical practice. This column will discuss how the combination of these 2 strategies can be used to increase the efficiency and completeness of outpatient psychiatric management.

Challenges and Opportunities of Pediatric Mental Health Practice in Rural America.

Youth living in Rural America have increased rates of mental illness and inadequate resources to address their mental health concerns. Programs and systems are currently available to build capacity in pediatric clinicians to care for youth with mental illness and to recruit and support rural clinicians. Such programs should continue to be supported with federal and state funding and additional novel programs aimed at addressing the youth mental health crisis in North America should be developed and funded.

Electronic Monitoring of Mom's Schedule (eMOMS™): A Feasibility Randomized Controlled Trial Targeting Postpartum Weight Retention and Breastfeeding Duration Among Populations With Overweight/Obesity.

Background: Globally, rising trends in gestational diabetes and body mass index contribute to maternal and neonatal morbidity and mortality. Lifestyle modifications and breastfeeding may reverse this effect, although few studies combine these into one intervention.

Research Aims: To measure postpartum weight retention, breastfeeding duration, hemoglobin A1C, and mean arterial blood pressure at 6 months postpartum among women with elevated pre-pregnancy body mass index.

Making surgical education intuitive: A surgical robotics primer for pre-clinical medical students.

Background: As robotic surgeries increase nationwide, residency programs are implementing commensurate curriculum. Medical student exposure and comfort with these surgeries, however, is lagging. This program sought to improve student interest and confidence through additional robotic exposure.

Outcomes of Mucous Cystectomy and Osteophytectomy Using a Random Nonadvancement Flap Technique.

Background: The purpose of this study was to determine the clinical outcomes of mucous cystectomy and osteophytectomy using a random nonadvancement flap technique.

Methods: This was a therapeutic outcomes study of patients who underwent mucous cystectomy under local anesthesia by 1 of 2 hand fellowship-trained surgeons between 2012 and 2022. The key features of the surgical technique include designing a random nonadvancement flap with the cyst at its base; transecting the cyst pedicle as the flap is elevated; resecting the cyst wall from the undersurface of the reflected flap; decompressing the distal joint by removing marginal osteophytes; and insetting the flap without advancement.

A 40-week phase 2B randomized, multicenter, double-blind, placebo-controlled study evaluating the safety and efficacy of memantine in amyotrophic lateral sclerosis.

Introduction: Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease with no known cure, limited treatment options with minimal benefits, and significant unmet need for disease modifying therapies.

Aims: This study investigated memantine's impact on ALS progression, with an additional focus on the effects of memantine on cognitive and behavioral changes associated with the disease.

Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted from December 2018 to September 2020.

Perceptions and attitudes toward artificial intelligence among frontline physicians and physicians' assistants in Kansas: a cross-sectional survey.

Objective: This survey aims to understand frontline healthcare professionals' perceptions of artificial intelligence (AI) in healthcare and assess how AI familiarity influences these perceptions.

Materials And Methods: We conducted a survey from February to March 2023 of physicians and physician assistants registered with the Kansas State Board of Healing Arts. Participants rated their perceptions toward AI-related domains and constructs on a 5-point Likert scale, with higher scores indicating stronger agreement.

A False-positive Diagnosis of a Lethal Serotonin Syndrome Based on Postmortem Whole-blood Levels of Sertraline: How Forensic Detective Work Uses Medical Knowledge and Clinical Pharmacology to Solve Cases.

This column is the third in a 3-part series describing cases in which general medical knowledge, including psychiatric and clinical pharmacology, was instrumental in determining whether dereliction was the direct cause of damages in a malpractice suit. This case illustrates how not taking into account the following variables can result in a false-positive diagnosis of a lethal serotonin syndrome: (a) the time course of treatment, (b) the time course of symptoms, (c) the difference between antemortem plasma and postmortem whole-blood levels of highly protein bound and highly lipophilic drugs. The case also illustrates how taking those 3 variables into account led to the conclusion that there was no dereliction in the care of the patient that was the direct cause of his death, and hence, there was no medical malpractice.

Assessment of clinician agreement with and knowledge of evidence-based obesity treatment in the primary care setting.

Introduction: Effective, evidence-based obesity treatment is needed, which often involves use of anti-obesity medications (AOMs). Data on the breadth and quality of guideline-directed obesity treatment implementation in primary care remain limited. This study aimed to assess primary care clinicians' agreement with and knowledge of guideline-directed obesity treatment, as well as to assess the health status of persons with obesity and their use of AOMs.

Outcomes of internal fixation with Femoral Neck System (FNS) for intracapsular femoral neck fractures.

Background: Internal fixation of hip fractures is associated with high reoperation rates. This study investigated the reoperation rates after internal fixation with the femoral neck system (FNS).

Materials And Methods: A single-institution cohort study was conducted on patients aged 18 years or older who sustained intracapsular femoral neck fractures and underwent internal fixation with a fixed-angle implant.

Systemic steroids and bronchopulmonary dysplasia: a systematic review and meta-analysis.

Importance: It is unclear if systemic steroids decrease the risk of Bronchopulmonary Dysplasia (BPD) while increasing the risk of neurodevelopmental impairment (NDI).

Objective: Conduct a systematic review of randomized controlled trials of systemic steroids to evaluate the risk of BPD, mortality, and NDI in premature infants ≤30 weeks.

Data Sources: MEDLINE, EBSCOhost, Web of Science, Cochrane Library, Embase, and CINAHL.

Valproate-Induced Thrombocytopenia: A Case Report.

Despite its effectiveness in treating a variety of neurologic and psychiatric conditions, valproate carries many clinically significant adverse effects that are sometimes life-threatening. Due to the potentially severe nature of these adverse effects, providers must communicate these risks to patients and maintain close follow-up, especially during the first six months following drug initiation or dose increase. We present a case of a 64-year-old male with schizoaffective disorder who developed thrombocytopenia following the initiation of valproate.

Vaginal Cuff Dehiscence after Robotic Hysterectomy in Endometrial Cancer vs. Non-Cancer Patients.

Introduction: Vaginal cuff dehiscence (CD) after hysterectomy is a rare but serious complication of robotic-assisted laparoscopic total hysterectomy (RLTH). The authors of this study aimed to compare the incidence and risk factors of CD following RLTH among patients with and without endometrial cancer.

Methods: This retrospective study included women aged 18 years or older who underwent RLTH by two surgeons at a single institution from 2013 to 2018.

Evaluating the Long-Term Neurologic Sequelae Among Trauma Patients who Received Flexion-Extension Radiographs.

Introduction: This study evaluated the presence of neurologic sequelae among trauma patients after flexion-extension (F/E) radiographs.

Methods: Authors of the study conducted a retrospective review of patients (age ≥ 14 years) with a Glasgow Coma Score of 15 who sustained a blunt traumatic injury and received F/E radiographs. Radiographic scans were defined as positive, negative, inconclusive, or incomplete.