Impact of initial jugular vein insertion site selection for central venous catheter placement on hemodialysis catheter complications.

Purpose: This study evaluated the impact of choosing the right versus left internal jugular vein (IJV) for initial central venous catheter (CVC) placement on hemodialysis catheter-related outcomes in critically ill patients.

Materials And Methods: Medical records from the University of Maryland Medical Center were reviewed for adult critical care patients who received an IJV CVC between January 1, 2019, and December 31, 2022, and later required an additional temporary hemodialysis catheter.

Results: The study included 214 patients, with 100 (46.

Group-Based Trajectory Modeling Identifies Distinct Patterns of Sympathetic Hyperactivity Following Traumatic Brain Injury.

Background: Paroxysmal sympathetic hyperactivity (PSH) occurs with high prevalence among critically ill patients with traumatic brain injury (TBI) and is associated with worse outcomes. The PSH-Assessment Measure (PSH-AM) consists of a Clinical Features Scale and a diagnosis likelihood tool (DLT) intended to quantify the severity of sympathetically mediated symptoms and the likelihood that they are due to PSH, respectively, on a daily basis. Here, we aim to identify and explore the value of dynamic trends in the evolution of sympathetic hyperactivity following acute TBI using elements of the PSH-AM.

Ring Fixator Bone Transport is Associated With Fewer Unplanned Major Reoperations than Masquelet in the Treatment of Segmental Bone Defects of the Tibia.

Objective: To determine whether bone transport or Masquelet results in higher rates of major unplanned reoperations for the treatment of segmental tibial bone defects ≥4 cm in length.

Methods: Design: Retrospective cohort.

Setting: Level I trauma center.

INCREASED CITRULLINATED HISTONE H3 LEVELS AND ACCELERATED THROMBIN KINETICS IN TRAUMA PATIENTS WHO DEVELOP VENOUS THROMBOEMBOLISM.

Background: Neutrophil extracellular traps (NETs), and its formation and release, known as NETosis, may play a role in the initiation of thrombin generation (TG) in trauma. The objective of this study was to assess whether trauma patients, who develop symptomatic venous thromboembolism (VTE), have increased levels of plasma citrullinated histone H3 (CitH3) and accelerated TG kinetics.

Methods: Patients presenting to a Level I Trauma Center as trauma activations had samples collected within 12 hours of time of injury (TOI), alongside healthy volunteers (HV).

International Consensus Guidance for the Management of Glucocorticoid Related Complications in Neuromuscular Disease.

Introduction/aims: Glucocorticoid (GC)-related adverse reactions and risks are commonly seen during the treatment of immune-mediated and inflammatory neuromuscular disorders. There is wide variation in the management of associated complications. The aim of this study is to develop international consensus guidance on the management of GC-related complications in neuromuscular disorders.

Topical Netarsudil in Childhood Glaucoma: A Systematic Review.

Purpose: To evaluate the effectiveness and safety of topical netarsudil 0.02% in managing childhood glaucoma.

Methods: A literature search in the electronic databases of PubMed CENTRAL, Google Scholar, EMBASE, the Register of Controlled Trials, and Ovid MEDLINE from January 2017 to August 2023 using one or a combination of the following terms: "netarsudil," "rhopressa," "Rho-kinase," "pediatric glaucoma," "childhood glaucoma," "intraocular pressure" was conducted.

Revisiting the Defeatist Performance Belief Scale in Adults With Schizophrenia and Youth at Clinical High-Risk for Psychosis: A Comprehensive Psychometric Analysis.

Background And Hypothesis: In accordance with the Cognitive Model of Negative Symptoms, defeatist performance beliefs (DPBs) are an important psychosocial mechanism of negative symptoms in schizophrenia-spectrum groups. DPBs are also mediators of negative symptom improvement in clinical trials. Despite the clinical significance of DPBs and their inclusion as a mechanism of change measure in clinical trials, the psychometric properties of the DPB scale have not been examined in any schizophrenia-spectrum group.

What Is Diagnostic Stewardship?

Background: Diagnostic stewardship is a set of clinically based changes to the ordering, processing, and reporting of diagnostic tests designed to improve patient outcomes (through decreased inappropriate testing, and reduced patient harm from wrong, delayed, or missed diagnosis). It shares a common philosophy with laboratory stewardship but has some key differences.

Content: Laboratory stewardship focuses primarily on pre- and post-analytical components of the testing process.

Education Research: Utilization of Simulation in Residency Programs: A Survey of Adult Neurology Residency Program Directors.

Background And Objectives: Previous research has demonstrated that simulation-based medical education (SBME) can improve neurology trainees' confidence, knowledge, and competence. However, a general needs assessment and review of current SBME used within neurology are needed to guide SBME curriculum development. The objective of this study was to describe the current use of SBME in resident education and to assess perceived barriers to expanding SBME interventions.

Case Study Analysis of a Decision Coaching Intervention for Young Adults with Early Psychosis.

Young adults with early psychosis often disengage from essential early intervention services (i.e., Coordinated Specialty Care or CSC in the United States).

Dorsomedial Striatum CB1R signaling promotes Pavlovian devaluation sensitivity in male Long Evans rats and reduces DMS inhibitory synaptic transmission in both sexes.

Cannabinoid receptor-1 (CB1R) signaling in the dorsal striatum regulates the shift from flexible to habitual behavior in instrumental outcome devaluation. Based on prior work establishing individual, sex, and experience-dependent differences in Pavlovian behaviors, we predicted a role for dorsomedial striatum (DMS) CB1R signaling in driving rigid responding in Pavlovian autoshaping and outcome devaluation. We trained male and female Long Evans rats in Pavlovian Lever Autoshaping (PLA).

Managing obesity in adults with type 1 diabetes.

As the prevalence of obesity has reached epidemic proportions, its prevalence has also increased among adults living with type 1 diabetes mellitus. Unlike the pathophysiologic relationship between obesity and type 2 diabetes mellitus, the relationship between obesity and type 1 diabetes mellitus, and management of obesity in the setting of type 1 diabetes mellitus, have not been well reviewed. In this article, we discuss the comprehensive management of obesity in adults with type 1 diabetes mellitus, focusing on medical nutrition therapy and adjunct therapies such as weight loss-promoting medications and metabolic/bariatric surgery.

Elucidating Metabolite and pH Variations in Stroke through Guanidino, Amine and Amide CEST MRI: A Comparative Multi-Field Study at 9.4T and 3T.

This study aims to investigate the variations in guanidino (Guan), amine and amide chemical exchange saturation transfer (CEST) contrasts in ischemic stroke using permanent middle cerebral artery occlusion (pMCAO) and transient MCAO (tMCAO) models at high (9.4T) and clinical (3T) MRI fields. CEST contrasts were extracted using the Polynomial and Lorentzian Line-shape Fitting (PLOF) method.

18F-5-fluoro-aminosuberic acid PET/CT imaging of oxidative-stress features during the formation of DEN-induced rat hepatocellular carcinoma.

The role of oxidative stress metabolism during hepatocellular carcinoma (HCC) formation potentially allows for positron emission tomography (PET) imaging of oxidative stress activity for early and precise HCC detection. However, there is currently limited data available on oxidative-stress-related PET imaging for longitudinal monitoring of the pathophysiological changes during HCC formation. This work aimed to explore PET-based longitudinal monitoring of oxidative stress metabolism and determine the sensitivity of [18F]-5-fluoroaminosuberic acid ([18F]FASu) for assessing pathophysiological processes in diethylnitrosamine (DEN) induced rat HCC.

JHU-2545 preferentially shields salivary glands and kidneys during PSMA-targeted imaging.

Purpose: Prostate-specific membrane antigen (PSMA) radioligand therapy is a promising treatment for metastatic castration-resistant prostate cancer (mCRPC). Several beta or alpha particle-emitting radionuclide-conjugated small molecules have shown efficacy in late-stage mCRPC and one, [[177Lu]Lu]Lu-PSMA-617, is FDA approved. In addition to tumor upregulation, PSMA is also expressed in kidneys and salivary glands where specific uptake can cause dose-limiting xerostomia and potential for nephrotoxicity.

Discordant Susceptibilities of Enterobacterales to Different Tetracycline Classes.

When bacteria are tetracycline- or doxycycline-resistant, the ability of these bacteria to be susceptible to the other tetracyclines is not well defined. Consequently, gaining knowledge about the ability to infer Enterobacterales susceptibility to minocycline and third-generation tetracycline antibiotics from surrogates is vital. In this study, we show that tigecycline may be a reasonable surrogate from which clinicians can infer omadacycline and eravacycline susceptibilities, even in the presence of doxycycline and tetracycline resistance.

Peripheral Intravenous Catheter-Associated Injuries in Neonates: Monitoring, Diagnosis, Management, and Complications.

Advances in neonatal medicine over the last several decades have led to improvements in survival for the most fragile and critically ill infants. A mainstay of supporting the health needs of hospitalized infants involves use of peripheral intravenous (PIV) catheters to administer medications, parenteral nutrition, and blood products. However, PIV catheters are not without risks and complications such as infiltration and extravasation.

A core glycolipid vaccine elicits cross-reactive antibodies against Salmonella spp. and protects against invasive nontyphoidal Salmonella disease in mice.

Background: Enteric fever caused by Salmonella enterica serovars Typhi and Paratyphi A in addition to gastroenteritis and invasive disease, predominantly attributable to nontyphoidal Salmonella serovars Typhimurium and Enteritidis, are major causes of death and disability across the globe. A broad-spectrum vaccine that protects against disease caused by typhoidal and nontyphoidal serovars of Salmonella is not available for humans but would prevent a considerable burden of disease worldwide.

Methods: We previously developed a broad-spectrum vaccine for Gram-negative bacteria that is based on the inner core domain of detoxified Escherichia coli O111, Rc (J5) mutant lipooligosaccharide, a highly conserved antigen across Gram-negative bacteria, complexed with an outer membrane protein of group B Neisseria meningitidis.

Oxidized phospholipid and transcriptomic signatures of THC-related vaping associated lung injury.

E-cigarette/vaping-associated lung injury (EVALI) is strongly associated with vitamin E acetate and often occurs with concomitant tetrahydrocannabinol (THC) use. To uncover pathways associated with EVALI, we examined cytokines, transcriptomic signatures, and lipidomic profiles in bronchoalveolar lavage fluid (BALF) from THC-EVALI patients. At a single center, we prospectively enrolled mechanically ventilated patients with EVALI from THC-containing products (N = 4) and patients with non-vaping acute lung injury and airway controls (N = 5).

Diabetic Ketoacidosis Without Diabetes Mellitus in Acute Pancreatitis.

Background/objective: Diabetic ketoacidosis (DKA) is typically but not exclusively seen in patients with a history of diabetes mellitus.

Case Report: This is a case of 39 year-old male who was diagnosed with acute pancreatitis based on characteristic symptoms and positive CT findings on presentation. Laboratory testing revealed elevated serum glucose 251 mg/dL, low serum bicarbonate 8 mmol/L, increased anion gap 21, and elevated serum beta-hydroxybutyrate 9.