The impact of volatile anesthetics and propofol on phosphatidylinositol 4,5-bisphosphate signaling.

Phosphatidylinositol 4,5-bisphosphate (PIP), as well as other anionic phospholipids, play a pivotal role in various cellular processes, including ion channel regulation, receptor trafficking, and intracellular signaling pathways. The binding of volatile anesthetics and propofol to PIP leads to alterations in PIP-mediated signaling causing modulation of ion channels such as ɣ-aminobutyric acid type A (GABA) receptors, voltage-gated calcium channels, and potassium channels through various mechanisms. Additionally, the interaction between anionic phospholipids and G protein-coupled receptors plays a critical role in various anesthetic pathways, with these anesthetic-induced changes impacting PIP levels which cause cascading effects on receptor trafficking, including GABA receptor internalization.

Communities organizing to promote equity: engaging local communities in public health responses to health inequities exacerbated by COVID-19-protocol paper.

Background: The COVID-19 pandemic has disproportionately impacted rural and under-resourced urban communities in Kansas. The state's response to COVID-19 has relied on a highly decentralized and underfunded public health system, with 100 local health departments in the state, few of which had prior experience engaging local community coalitions in a coordinated response to a public health crisis.

Methods: To improve the capacity for local community-driven responses to COVID-19 and other public health needs, the University of Kansas Medical Center, in partnership with the Kansas Department of Health and Environment, will launch Communities Organizing to Promote Equity (COPE) in 20 counties across Kansas.

Aflibercept to treat retinopathy of prematurity: need for more research.

Until recently, the standard care for retinopathy of prematurity (ROP) was destructive treatment of the peripheral avascular retina, most often using laser therapy. Now, intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents have been included in recommendations for treatment-warranted ROP. The three anti-VEGF agents used to treat ROP are bevacizumab, ranibizumab, and aflibercept and clinical trials using, a variety of treatment strategies, have shown all three are efficacious and easy to administer.

Advancements in AMA Guides Musculoskeletal Impairment Evaluations: Improved Reliability and Ease of Use.

Objective: Describe and evaluate methodological improvements in AMA Guides to the Evaluation of Permanent Impairment ( Guides ) Sixth Edition 2024, including an updated sequential method and enhanced diagnosis-based impairment tables, compared to the Guides Sixth 2008.

Methods: Three physician experts and 3 premedical students, respectively, completed 2 rounds of impairment ratings using the AMA Guides Sixth 2008 versus 2024 methods. Impairment values and completion times using each method were compared for both groups.

Total Shoulder Arthroplasty Versus Reverse Shoulder Arthroplasty in Primary Glenohumeral Osteoarthritis With Intact Rotator Cuffs: A Meta-Analyses.

Traditional practice favors total shoulder arthroplasty (TSA) for the treatment of primary glenohumeral osteoarthritis (PGHO) with an intact rotator cuff; however, the indications for reverse shoulder arthroplasty (RSA) have expanded to include PGHO. The purpose of this systematic review is to compare the mean differences in the range of motion and patient-reported outcomes between the TSA and RSA with an intact rotator cuff and to analyze the subgroup of the Walch type B2 glenoid. This IRB-exempt, PROSPERO-registered systematic review strictly followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines.

The Role of Telemedicine in Rural Specialty Care: Priorities and Recommendations From Rural Primary Care Physicians.

Introduction: The study goal was to understand telemedicine's role in improving access to rural specialty care. Other outcomes included assessing specialty availability and frequency of referrals at rural sites.

Methods: This mixed methods study included surveys and semi-structured interviews of rural primary care physicians (PCPs).

Emerging Trends in Atherosclerosis: Time to Address Atherosclerosis From a Younger Age.

Over the past two decades, research efforts into cardiovascular disease (CVD) have uncovered findings that fundamentally challenge our understanding of CVD, particularly atherosclerosis. Atherosclerosis was primarily attributed to the well-described abnormal lipid accumulation theory, involving plaque growth with subsequent plaque hemorrhage resulting in acute vessel thrombosis that may or may not rupture. This perspective has now evolved to encompass more complex pathways, wherein the accumulation of abnormal products of oxidation and inflammation is the most likely factor mediating atherosclerotic plaque growth.

Storylines of family medicine III: core principles-primary care, systems and family.

is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'III: core principles-primary care, systems, and family', authors address the following themes: 'Continuity of care-building therapeutic relationships over time', 'Comprehensiveness-combining breadth and depth of scope', 'Coordination of care-managing multiple realities', 'Access to care-intersectional, systemic, and personal', 'Systems theory-a core value in patient-centered care', 'Family-oriented practice-supporting patients' health and well-being', 'Family physician as family member' and 'Family in the exam room'. May readers develop new understandings from these essays.

Cardamonin inhibits osteogenic differentiation by downregulating Wnt/beta-catenin signaling and alleviates subchondral osteosclerosis in osteoarthritic mice.

Osteoarthritis (OA) is a common degenerative joint disease, and subchondral osteosclerosis is an important pathological change that occurs in its late stages. Cardamonin (CD) is a natural flavonoid isolated from Alpinia katsumadai that has anti-inflammatory activity. The objectives of this study were to investigate the therapeutic effects and potential mechanism of CD in regulating OA subchondral osteosclerosis at in vivo and in vitro settings.

A Systematic Review of the Single-Item Burnout Question: Its Reliability Depends on Your Purpose.

Background: Surveillance of burnout by the gold-standard Maslach Burnout Inventory (MBI) is hindered by cost and length. The validity and benchmarking of the commonly recommended and used single-item burnout question (SIBOQ) are unknown. We sought to (1) derive an equation for predicting the gold standard MBI from the SIBOQ and (2) measure the correlation of the SIBOQ with the full MBI and its subscales.

Snapping Wrist From Bowstringing of the Digital Flexors After Carpal Tunnel Release: A Case Report.

Symptomatic bowstringing of digital flexor tendons is a rare complication of carpal tunnel release (CTR). Two weeks after open CTR, a 47-year-old man with severe carpal tunnel syndrome had relief of his preoperative median paresthesia but complained of new-onset painful snapping of the wrist and transient ulnar paresthesia occurring with wrist dorsiflexion and concomitant digital flexion. Physical examination localized the audible snapping to the hook of hamate (HOH) where manual pressure eliminated the wrist motion-induced snapping and the associated ulnar paresthesia.

Transcarotid versus transthoracic transcatheter aortic valve replacement: A systematic review and meta-analysis.

Background: Transthoracic approaches may be contraindicated in some patients and may be associated with poorer outcomes. Therefore other alternative access routes are increasingly being performed. We conducted a systematic review of the literature on Transcarotid transcatheter aortic valve replacement (TC-TAVR) and meta-analysis comparing outcomes of TC-TAVR and other access routes.

Short and Long-Term Success of a Surgery Residency Prep Course.

Introduction: This study aimed to assess the feasibility of evaluating the short-term and long-term effectiveness of a surgery residency prep course throughout the intern year.

Methods: The authors offered a surgery residency prep course to graduating medical students. We used an anonymous survey to assess the perceived confidence in medical knowledge, clinical skills and surgical skills pre-course, post-course, and at six months into residency.

B-Lymphoblastic Lymphoma Isolated to the Testes: A Case Report and Review of Literature.

Isolated testicular involvement in pediatric lymphoma is rare and poses diagnostic challenges. In this study, the case of an isolated testicular B-lymphoblastic lymphoma in a 9-year-old boy is discussed with an emphasis on the difficulties in diagnosing and treating such an unusual presentation. This example illustrates the importance of considering lymphoblastic lymphoma in the differential diagnosis of an unidentified source of testicular enlargement.

The Essential Parallels Between Clinical Practice and the Scientific Method.

This column presents a way of conceptualizing the clinical practice of medicine including psychiatry within the framework of the scientific method. The goal is to aid practicing clinicians as well as trainees. This conceptual framework will improve the care of patients as it applies a discipline relative to giving time-limited trials of the various treatments available and then an assessment of whether the treatment worked adequately or not and what to do in the latter case.

'Just the Way it Was': Perspectives on Sexual Harassment in Medical School and #MeToo of Women Graduating Prior to 1975.

Introduction: The purpose of this study was to assess gender-based mistreatment during medical education recalled by women who attended medical school between 1948 and 1975 and their perspectives on the #MeToo movement.

Methods: Methods included a qualitative analysis of video-recorded structured interviews.

Results: The 37 participants graduated in classes of 2-20% women.