Gender Differences in Self-Assessment Among Clerkship Medical Students Despite Equivalent Academic and Clinical Performance.

Objective: The authors aimed to determine if medical students' self-assessment of abilities and performance differed by gender during the psychiatry clerkship and if these differences were reflected objectively in test scores or clinical evaluations from educators.

Methods: Data from mid-clerkship self-assessments completed during the psychiatry core clerkship were reviewed from two classes of medical students. Students rated their performance on 14 items across five domains: knowledge/clinical reasoning, differential diagnosis, data presentation, studying skills, and teamwork as "below," "at," or "above expected level.

Current Stroke Solutions Using Artificial Intelligence: A Review of the Literature.

Introduction: In recent years, artificial intelligence (AI) has emerged as a transformative tool for enhancing stroke diagnosis, aiding treatment decision making, and improving overall patient care. Leading AI-driven platforms such as RapidAI, Brainomix, and Viz.ai have been developed to assist healthcare professionals in the swift and accurate assessment of stroke patients.

Identifying Factors that Influence Pediatric Echo Lab Image Quality: Development and Validation of a New Assessment Tool.

No method of evaluating transthoracic echocardiograms (TTE) image quality (IQ) has been validated. Furthermore, structural echo lab elements impacting IQ are unknown. We sought to develop and validate a TTE IQ grading tool and determine patient and echo lab features associated with IQ.

Potential Process Control Issues with Vasopressin.

The University of Kentucky's Drug Quality Task Force (DQTF) conducted a study to perform consumer-level quality assurance screening of vasopressin injections used in their healthcare pharmacies. The primary objective was to identify potential quality defects by examining intralot and interlot variability using Raman spectrometry and statistical analyses. Raman spectra were collected noninvasively and nondestructively from vasopressin vials (n=51) using a Thermo Scientific Smartraman DXR3 Analyzer.

Pharmacotherapy adjuncts for traumatic brain injury: A narrative review of evidence and considerations in the emergency department.

Traumatic Brain Injury (TBI) remains a significant global health concern with significant impact on morbidity and mortality. This narrative review explores adjunctive pharmacologic agents to be employed by emergency medicine clinicians during Advanced Trauma Life Support (ATLS) in patients presenting with a TBI. Pharmacologic agents are commonly employed for the management of rapid sequence intubation and post-intubation analgosedation, hemodynamics, intracranial pressure, coagulopathy, seizure prophylaxis, and infection.

Linaclotide Use for the Treatment of Constipation and Gastrointestinal Symptoms in People With Cystic Fibrosis.

Introduction: Cystic Fibrosis (CF) is a multisystem autosomal recessive disease characterized by thick, sticky mucus which causes lung disease, pancreatic insufficiency, and many other manifestations. Constipation is a common complication in CF and few advances in treatment have been made until recent years. Linaclotide is a treatment approved for chronic idiopathic constipation and irritable bowel syndrome with constipation.

Timing of anticoagulation for patients with atrial fibrillation after acute ischemic stroke: Systematic review and meta-analysis.

Background: Patients with acute ischemic stroke (AIS) in the setting of atrial fibrillation (Afib) will need to start/resume anticoagulation (AC) as it is the mainstay for secondary stroke prevention. Several studies have compared the safety and outcomes of starting/resuming AC in early or late start windows (ESW or LSW) but there is no consensus in clinical practice on the optimal timing of anticoagulation. This meta-analysis aims to compare the safety and outcome measures after resuming AC in the ESW versus LSW in patients with Afib after AIS.

The Validation of Digital PCR-Based Minimal Residual Disease Detection for the Common Mutations in IDH1 and IDH2 Genes in Patients with Acute Myeloid Leukemia.

Accurate monitoring of minimal residual disease (MRD) is crucial for effective management of patients with acute myeloid leukemia (AML). This study aims to validate MRD detection of the seven most common IDH1 and IDH2 mutations in patients with AML using a QuantStudio 3D digital PCR platform. This assay demonstrated a high concordance for the variant allele frequencies between digital PCR and next-generation sequencing assays.

Pancreas transplant outcomes in patients with human immunodeficiency virus infection.

There is limited information on access and outcomes of patients living with human immunodeficiency virus (HIV) (PLWH) who have undergone pancreas transplantation. We conducted a retrospective cohort study analyzing data from the United Network for Organ Sharing from July 1, 2001, to June 30, 2021. Recipients of pancreas transplant were stratified by HIV serostatus.

Dream of the Endless: Special Considerations in Procedural Sedation.

Procedural sedation and analgesia (PSAA) is integral to facilitating painful and anxiety-inducing medical procedures in the emergency department (ED). Optimal PSAA enhances procedural success and improves both patient and provider satisfaction. The selection of appropriate sedative and analgesic agents, routes, and dosages, which depend on various patient- and procedure-specific factors is a complex process.

Significant Within-Individual Variability in VCTE Liver Stiffness Measurements at Two Intercostal Spaces in Subjects with MASLD: Implications for Evaluating Improvement in Liver Fibrosis After Weight-Loss or Liver-Directed Therapy.

Introduction: Studies have compared the group-averages of liver stiffness measures (LSMs) from multiple rib spaces by vibration-controlled transient elastography (VCTE) to stage liver fibrosis. No previous study has assessed within-individual liver stiffness variation from two rib spaces in individuals with metabolic-dysfunction associated steatotic liver disease (MASLD).

Methods: We evaluated within-individual LSM variation according to body weight classification and its clinical implication.

A novel strategy for resource reduction in the wake of yet another sterile fluid shortage.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Cephalosporins for Outpatient Pyelonephritis in the Emergency Department: COPY-ED Study.

Study Objective: The primary objective of our study was to compare the effectiveness of oral cephalosporins versus fluroquinolones and trimethoprim/sulfamethoxazole (TMP-SMX) for the treatment of pyelonephritis in patients discharged home from the emergency department (ED).

Methods: This was a multicenter, retrospective, observational cohort study of 11 geographically diverse US EDs. Patients aged ≥18 years diagnosed with pyelonephritis and discharged home from the ED between January 1, 2021 and October 31, 2023 were included.

Perceptions of Pharmacy Educators Regarding the NAPLEX Pass Rate Puzzle.

Objective: Identify perceptions from pharmacy faculty across the Academy concerning factors that may be influencing North American Pharmacist Licensure Examination (NAPLEX) first-time pass rates to highlight potential focused areas of further research based on common experiences.

Methods: An anonymous 43-item Qualtrics questionnaire was distributed to faculty members from the American Association of Colleges of Pharmacy. Questions were predominantly 5-point Likert scale items (5 = very large impact) and encompassed 6 domains: pharmacy school factors, COVID-19 educational modifications, testing factors, standardized testing, applicant preparedness, and student factors.

VCTE Overestimates Liver Fibrosis due to Abdominal-Truncal Adiposity and Not Hepatic Steatosis: A Case Report.

Vibration-controlled transient elastography (VCTE) is used for the noninvasive assessment of liver fibrosis. We present a case of significant weight loss over 1 year, resulting in a marked improvement in liver stiffness suggesting a decrease in liver fibrosis from stage 4 (cirrhosis) to stage 2 (moderate fibrosis) notably without a change in the grade of hepatic steatosis. The improvement in two stages of fibrosis over this short time frame is due to the overestimation of liver stiffness in a subject with class 3 obesity and not due to the resolution of fibrosis.

Safety and efficacy of intravenous thrombolytic therapy in the extended window up to 24 hours: A systematic review and meta-analysis.

Objective: About 25% of patients with acute ischemic stroke (AIS) present within the intravenous thrombolytic (IVT) therapeutic window of <4.5 h. This study is to elucidate the safety and efficacy of IVT in the extended therapeutic window (ETW) in patients with AIS.

Azithromycin Exposure in a 10-Day Window of Myocardial Infarction and Short- and Long-Term Outcomes.

Background: The U.S. Food and Drug Administration warned in 2012 that azithromycin (AZM) can cause potentially fatal irregular heart rhythm, particularly in patients with known cardiac risk factors.

3-Factor prothrombin complex concentrate versus 4-factor prothrombin complex concentrate for the reversal of oral factor Xa inhibitors.

Multiple agents exist for the reversal of oral Factor Xa inhibitor (FXa) associated bleeding, including Coagulation FXa Recombinant, Inactivated zhzo (andexanet alfa) and 4-factor prothrombin complex concentrate (4F-PCC). While classified as a 3F-PCC product, Profilnine contains up to 35 IU of Factor VII (per 100 IU of Factor IX) in addition to therapeutic levels of Factors II, IX, and X, and has demonstrated a similar impact on prothrombin time and blood product usage in non-warfarin related bleeding. This was a retrospective, multicenter study at four medical centers of adult patients who presented with major bleeding associated with oral FXa inhibitors and received either 4F-PCC (n = 64) or 3F-PCC (n = 61).

Comparison of Machine Learning Models to a Novel Score in the Identification of Patients at Low Risk for Diabetic Retinopathy.

Purpose: To develop an easily applicable predictor of patients at low risk for diabetic retinopathy (DR).

Design: An experimental study on the development and validation of machine learning models (MLMs) and a novel retinopathy risk score (RRS) to detect patients at low risk for DR.

Subjects: All individuals aged ≥18 years of age who participated in the telemedicine retinal screening initiative through Temple University Health Systems from October 1, 2016 through December 31, 2020.

Standardized Data Elements for Patients With Acute Pulmonary Embolism: A Consensus Report From the Pulmonary Embolism Research Collaborative.

Recent advances in therapy and the promulgation of multidisciplinary pulmonary embolism teams show great promise to improve management and outcomes of acute pulmonary embolism (PE). However, the absence of randomized evidence and lack of consensus leads to tremendous variations in treatment and compromises the wide implementation of new innovations. Moreover, the changing landscape of health care, where quality, cost, and accountability are increasingly relevant, dictates that a broad spectrum of outcomes of care must be routinely monitored to fully capture the impact of modern PE treatment.

Transition From Epstein-Barr Virus (EBV)-Positive Rectal Hodgkin Lymphoma to Diffuse Large B-Cell Lymphoma in the Lung.

We report a distinctive case of sequential lymphomas in a 72-year-old male, initially diagnosed with Epstein-Barr virus (EBV)-positive rectal classic Hodgkin lymphoma (cHL), followed by the development of diffuse large B cell lymphoma (DLBCL) in the lung. This rare progression underscores the complexity of lymphomas associated with EBV infection and their unpredictable clinical courses. The patient's journey began with symptoms of intractable diarrhea, low appetite, and significant weight loss, leading to the diagnosis of stage 4B cHL, managed initially with brentuximab/doxorubicin, vinblastine, dacarbazine (AVD) chemotherapy.