Impact of BMI Category on Recurrence and Progression of Nonmuscle Invasive Bladder Cancer Prognosis.

Objective: To assess the association of being overweight or obese with Nonmuscle invasive bladder cancer (NMIBC) recurrence, stage progression, and grade progression.

Methods: Patients with NMIBC were included and categorized into 3 groups based on their body mass index (BMI): normal weight, overweight, and obese. Recurrence was defined as any histologically proven bladder cancer on subsequent transurethral resection of bladder tumor (TURBT).

Chest Feminization and Masculinization Surgery: Part Two of the Plastic Surgeon's Perspective of Gender-Affirming Surgery.

Transgender individuals commonly feel significant distress and discomfort, termed gender dysphoria, as a result of the discrepancy between their gender assigned at birth and their gender identity. A major source of gender dysphoria stems from distinct anatomical differences between the male and female chest. Gender-affirming mastectomy of transmasculine patients and breast augmentation for chest feminization of transfeminine patients, also referred to as top surgery, are often the first surgical interventions and most commonly pursued physical modifications for the treatment of gender dysphoria among this patient population.

Venous thromboembolism in transfer trauma patients: A global problem.

Background: As air travel and immobility are risk factors for venous thromboembolism, we aimed to test the hypothesis that internationally transferred trauma patients have a high incidence of venous thromboembolism on arrival.

Methods: A prospectively maintained registry of all international transferred trauma patients who presented to our level I trauma center from January 2023 to June 2024 was retrospectively reviewed. Patients with either lower extremity venous duplex ultrasound or computed tomography scan of the chest with contrast on arrival were included.

Chemoimmunotherapy-Resistant Ocular Surface Squamous Neoplasia Managed With I-125 Brachytherapy.

Purpose: The purpose of this study was to report the management of chemoimmunotherapy-resistant ocular surface squamous neoplasia (OSSN) with iodine-125 (I-125) brachytherapy.

Methods: A 36-year-old man presented to the clinic with biopsy-proven OSSN that covered ∼70% of the corneal surface and extended to the 6 o'clock position of the inferior limbus of the OS. The visual acuity was 20/20 in the OD and 20/40 in the affected OS.

More Than Body Parts: A New Ethos of Anatomy Education.

A new ethos of anatomy education goes beyond the learning of body parts in the traditional curriculum. In the traditional curriculum, the focus of only providing information on the structure of the human body left certain learning opportunities overlooked, marginalized, or dismissed as irrelevant; thus, opportunities to foster and shape professional attributes in health care learners were lost. Furthermore, changes in curricula structures and reductions in anatomy teaching hours have necessitated a transformation in how anatomy education is perceived and delivered.

Colo-cutaneous fistula in the setting of complicated sigmoid diverticulitis previously managed with percutaneous drainage: a case report.

Colo-cutaneous fistulas are a rare complication of diverticular disease. Percutaneous drainage offers a promising alternative to surgical intervention in the management of complicated diverticular disease with abscess formation. Recent case studies and literature reviews support its efficacy in achieving abscess resolution and reducing the need for surgery.

Health impacts of asphalt emissions: Examining neurological risks and the need for long-term exposure mitigation.

Asphalt, widely used in infrastructure, emits complex chemical mixtures throughout its service life, posing significant risks to human health and the environment. This expanded understanding extends the concern from a construction-related hazard to a broader public health issue, especially affecting vulnerable populations like children who play on blacktop surfaces. Despite increased awareness, the specific mechanisms behind asphalt emissions, their impact on asphalt deterioration, and their effects on the human nervous system remain poorly understood.

Topiramate treatment of pediatric metabolic dysfunction-associated steatotic liver disease: A descriptive cohort study.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common disease in children. Lifestyle modification is the primary treatment but difficult to achieve and maintain. Topiramate is a component of an approved weight loss medication (topiramate-phentermine) in children aged 12 years and older but is more commonly used as a single agent, off-label, for pediatric obesity.

Ischemic Stroke Prevention in Patients Atrial Fibrillation and a Recent Ischemic Stroke, TIA, or Intracranial Hemorrhage; a World Stroke Organisation (WSO) Scientific Statement.

Background: Secondary stroke prevention in patients with atrial fibrillation (AF) is one of the fastest growing areas in the field of cerebrovascular diseases. This Scientific statement from the World Stroke Organization Brain & Heart Task Force provides a critical analysis of the strength of current evidence this topic, highlights areas of current controversy, identifies knowledge gaps, and proposes priorities for future research.

Methods: We select topics with the highest clinical relevance and perform a systematic search to answer specific practical questions.

Pediatric endoscopic sinus surgery: Revisited 35 years later.

Over the past 35 years, pediatric endoscopic sinus surgery (PESS) has significantly evolved from its inception as a novel intervention to become a cornerstone in the management of pediatric sinus disorders. This evolution is reflective of a broader shift towards a more nuanced understanding and treatment of pediatric chronic rhinosinusitis (PCRS), marked by the introduction of comprehensive guidelines and the refinement of surgical indications. Recent literature and the extensive experience of the senior author, who has been at the forefront of utilizing PESS since its inception, highlight a noticeable shift in the procedure's utilization.

DEK::AFF2 Fusion Sinonasal and Skull Base Nonkeratinizing Squamous Cell Carcinoma: A Clinical Outcome Study Compared With Conventional Sinonasal Squamous Cell Carcinoma.

DEK::AFF2 fusion nonkeratinizing squamous cell carcinoma (NKSCC) is an emerging entity in the sinonasal tract, temporal bone, and skull base. However, the clinical behavior of these tumors has not been well studied. Here, we report the largest cohort of DEK::AFF2 carcinomas to determine if morphology, mitotic rate, and/or Ki-67 IHC are associated with patient outcomes, including a comparison with high-risk human papillomavirus (HPV)-associated and independent patients.

Association Between Sleep Duration and Cardiovascular Disease Among Asian Americans.

Background: Cardiovascular disease (CVD) prevalence varies widely among Asian American adults. The American Heart Association added healthy sleep to its metrics to define ideal cardiovascular health. Little is known about the association between sleep and CVD prevalence among Asian subgroups.

Clarifying thresholds for defining levels of physical function and pain interference using bookmarking in orthopaedics.

Purpose: Bookmarking is a qualitative method used to assign descriptive labels to ranges of patient-reported outcome (PROM) scores. We aimed to evaluate variability between bookmarking samples and test score ranges where there was variability in expert opinion in previous studies.

Methods: We conducted two bookmarking sessions with patients who experienced orthopaedic fractures (n = 11) and one session with orthopaedic clinicians (n = 10).

Does cognitive intra-individual variability predict change in everyday functioning performance in women with and without HIV in the Women's Interagency HIV Study?

This study examined the association between cognitive intra-individual variability (IIV), a non-mean-based indicator of underlying neuropathology, and self-reported everyday functioning of 1,086 women with HIV (WWH) and 494 socio-demographically similar women without HIV (WWoH). Objective cognitive performance across seven domains and the self-rated Lawton & Brody scale of Instrumental Activities of Daily Living (IADL) were assessed among participants of the Women's Interagency HIV Study. Two types of cognitive IIV were calculated by taking the standard deviation across seven cognitive domains to calculate dispersion: 1) intra-individual standard deviation (denoted as IIV) and 2) coefficient of variation (denoted as IIV).

The onset presentation of multiple sclerosis differs in Hispanic/Latinx Americans compared with non-Hispanic White Americans.

Background: Little is known about how multiple sclerosis (MS) presents in Hispanic/Latinx (HL) people with MS (pwMS).

Objective: Compare age at onset (AAO) and onset severity between HL versus non-Hispanic White (NHW) pwMS.

Methods: A cross-sectional study leveraged the MS PATHS registry spanning seven US tertiary care institutions.

Evaluating the effect of a virtual reality digital therapeutic on maternal stress among expectant and postpartum Black and Latina mothers: a protocol paper.

Background: Maternal mental health is vital to overall well-being, particularly among expectant and postpartum Black and Latina women who experience higher stress levels and mental health challenges. Traditional healthcare systems often fail to meet these needs, underscoring the need for innovative and accessible interventions. NurtureVR, a digital maternal mental health and educational program, leverages virtual reality to offer mindfulness, relaxation, and guided imagery to support these women.

SARS-CoV-2 Spike S1 subunit triggers pericyte and microvascular dysfunction in human pancreatic islets.

The COVID-19 pandemic has profoundly affected human health, yet the mechanisms underlying its impact on metabolic and vascular systems remain incompletely understood. Clinical evidence suggests that SARS-CoV-2 directly disrupts vascular homeostasis, with perfusion abnormalities observed in various tissues. The pancreatic islet, a key endocrine mini-organ reliant on its microvasculature for optimal function, may be particularly vulnerable.

Social and Polygenic Risk Factors for Time to Comorbid Diagnoses in Individuals with Substance Use Disorders: A Phenome-Wide Survival Analysis.

Importance: Persons with substance use disorders (SUD) often suffer from additional comorbidities, including psychiatric conditions and physical health problems. Researchers have explored this overlap in electronic health records (EHR) using phenome wide association studies (PheWAS) to characterize how different indicators are related to all conditions in an individual's EHR. However, analyses have been largely cross-sectional in nature.

Improving HIV Outcomes in Miami's Black populations with clinic-based community health workers protocol: The integrated navigation and support for treatment adherence, counseling, and research (INSTACARE) randomized controlled trial.

Miami-Dade is an HIV epicenter where Black populations experience excess AIDS-related deaths due to poor medication adherence, which prevents achieving an undetectable HIV viral load (VL). A promising approach to improving HIV outcomes in Black populations has been the use of community health workers (CHWs). Evidence shows CHWs trained in motivational interviewing (MI) may further improve outcomes, however little data exists about Black CHWs trained in MI who support Black patients with HIV.

Examination of MGMT as a risk gene for dementia in the Amish.

Introduction: Recently, the O-6-methylguanine-DNA methyltransferase (MGMT) locus was proposed as influencing the risk of Alzheimer's disease (AD) in women who did not carry the apolipoprotein E ε4 allele. We examined an Amish founder population for any influence of genetic variation in and around the MGMT locus on the risk for dementia.

Methods: Genetic association was performed for single nucleotide polymorphisms (SNPs) surrounding the MGMT locus.

Optimized monitoring for immune checkpoint inhibitor induced myocarditis using high-sensitivity troponin-T.

Background: Immune checkpoint inhibitor (ICI)-induced Myocarditis (irMyocarditis) is a rare adverse event with a high mortality rate of 40-50 % and which is mostly not diagnosed until clinical symptoms emerge.

Objectives: This study aims to screen patients for irMyocarditis using high-sensitivity cardiac troponin-T (hs-TnT) before and regularly during therapy with ICI.

Methods: A cohort of 280 cancer patients were prospectively screened for levels of hs-TnT at baseline and prior to every ICI infusion.

Does the treatment modality affect nosocomial pneumonia and other in-hospital outcomes in patients with combined injuries to the ribs and clavicle? A propensity score weighted analysis of a retrospective cohort.

Objective: What is the effect of surgical or conservative treatment on the in-hospital outcomes of patients with combined fractures of the clavicle and ribs?

Design: Retrospective cohort study.

Setting: Two level-1 trauma centers and academic teaching hospitals in Boston, Massachusetts.

Patients: All adult patients with a clavicle fracture and ≥3 rib fractures admitted from 2016 to 2021.