Back to Basics: The Utility of History and Physical in the Workup of Geriatric Ground-Level Falls.

Introduction: Falls account for nearly ¾ of all trauma in the geriatric population. We hypothesized that history and physical could reliably identify elderly patients with ground-level falls (GLF) who require head and cervical spine imaging.

Materials And Methods: Patients of age >65 y with GLF from January, 2018 to December, 2021 at a level 1 trauma center were retrospectively reviewed.

Awake, endoscopic lumbar interbody spinal fusion: 10 years of experience with the first 400 cases.

Objective: Awake, endoscopic spinal fusion has been utilized as an ultra-minimally invasive surgery technique to accomplish the goals of spinal fixation, fusion, and disc height restoration. While many techniques exist for this approach, this series represents a single institution's experience with a large cohort and the evolution of this method.

Methods: The medical records of a consecutive series of 400 patients treated over a 10-year period were retrospectively reviewed.

"Due to These Restrictions, Girls Think of Themselves as Nothing": A Qualitative and Quantitative Description of Menstrual Restrictions and Stigma Among Adolescent Girls Across Religious and Other Sociocultural Contexts.

Introduction: Girls in Tanzania often experience menstrual restrictions (i.e., expectations about behaviors prohibited during menstruation) and menstrual stigma (i.

Late corneal guttae recurrence in bilateral penetrating keratoplasty grafts.

Background: To describe a case of guttae recurrence in bilateral corneal grafts in a patient with a known diagnosis of Fuchs endothelial dystrophy, more than three decades following penetrating keratoplasty.

Methods: Case Report.

Results: A 79-year-old White woman presented with declining vision, right eye worse than the left.

The Role of Myeloid Cells on the Development of Hepatic Metastases in Gastrointestinal Cancer.

The development of hepatic metastases is the leading cause of mortality in gastrointestinal (GI) cancers and substantial research efforts have been focused on elucidating the intricate mechanisms by which tumor cells successfully migrate to, invade, and ultimately colonize the liver parenchyma. Recent evidence has shown that perturbations in myeloid biology occur early in cancer development, characterized by the initial expansion of specific innate immune populations that promote tumor growth and facilitate metastases. This review summarizes the pathophysiology underlying the proliferation of myeloid cells that occurs with incipient neoplasia and explores the role of innate immune-host interactions, specifically granulocytes and neutrophil extracellular traps, in promoting hepatic colonization by tumor cells through the formation of the "premetastatic niche".

Collaboration encourages innovation: setting new standards in wound care with the Wound Care Collaborative Community expert panel consensus Recommendations.

Background: The Wound Care Collaborative Community (WCCC) assesses shortcomings and unmet needs in wound care by partnering with key stakeholders, such as the National Institutes of Health, the US Food and Drug Administration (FDA), industry leaders, and expert health care providers and researchers, to advance the study of wound healing. Through this work, the WCCC has identified a few key barriers to innovation in wound care. The WCCC aims to accelerate the development of science-based, patient-centered solutions and address public policy challenges related to ensuring patients receive early access to innovative treatment options.

Human organoids for rapid validation of gene variants linked to cochlear malformations.

Developmental anomalies of the hearing organ, the cochlea, are diagnosed in approximately one-fourth of individuals with congenital. The majority of patients with cochlear malformations remain etiologically undiagnosed due to insufficient knowledge about underlying genes or the inability to make conclusive interpretations of identified genetic variants. We used exome sequencing for the genetic evaluation of hearing loss associated with cochlear malformations in three probands from unrelated families deafness.

Acoustic Radiation Force Optical Coherence Elastography of the Crystalline Lens: Safety.

Purpose: To assess the safety of acoustic radiation force optical coherence elastography in the crystalline lens in situ.

Methods: Acoustic radiation force (ARF) produced by an immersion single-element ultrasound transducer (nominal frequency = 3.5 MHz) was characterized using a needle hydrophone and used for optical coherence elastography (OCE) of the crystalline lens.

The impact of deep response to ursodeoxycholic acid in primary biliary cholangitis - should it be the new clinical standard?

Purpose Of Review: This review explores the emerging concept of "deep response" in primary biliary cholangitis (PBC), defined by the normalization of biochemical markers, particularly alkaline phosphatase and bilirubin. It examines its potential as a new standard for disease management and its implications for long-term patient outcomes, health policies, and clinical decision-making.

Recent Findings: Recent studies suggest that achieving a deep response significantly improves long-term outcomes in some patients with PBC.

Long-Acting Injectable Prep for People Who Inject Drugs at a Syringe Services Program: A Qualitative Acceptability and Feasibility Study.

Although people who inject drugs (PWID) are at high risk of acquiring HIV, knowledge and uptake of pre-exposure prophylaxis (PrEP) for HIV prevention among this population remain low due to numerous psychosocial and structural barriers. Multiple implementation strategies have been proposed to address this gap, notably providing long-acting injectable (LAI) formulations of PrEP and offering PrEP at syringe services programs (SSPs). This qualitative study explores the acceptability and feasibility of offering LAI-PrEP for PWID at risk for HIV at Florida's first legal SSP.

Germ cell tumors in children.

Pediatric germ cell tumors represent a rare but biologically diverse group of neoplasms arising from pluripotent primordial germ cells. The 2022 edition of the WHO Classification of Pediatric Tumors introduced the first organ independent classification of germ cell tumors, reflecting advances in molecular biology, histopathology, and clinical practice. This review highlights the key changes, including the refined distinctions between the different subtypes.

Aseptic meningitis from herpes simplex virus proctitis.

Sexually transmitted proctitis, a prevalent concern among men who have sex with men (MSM) is frequently caused by a range of pathogens, including herpes simplex virus (HSV), and While HSV-associated proctitis typically presents with visible lesions, cases without external manifestations remain evasive. We report the case of an MSM in his early 30s presenting with dyschezia and perineal discomfort after unprotected anoreceptive intercourse. Despite initial inconspicuous findings, rectal swabs revealed HSV-2 infection.

A Small-Molecule Inhibitor of Gut Bacterial Urease Protects the Host from Liver Injury.

Hyperammonemia is characterized by the accumulation of ammonia within the bloodstream upon liver injury. Left untreated, hyperammonemia contributes to conditions such as hepatic encephalopathy that have high rates of patient morbidity and mortality. Previous studies have identified gut bacterial urease, an enzyme that converts urea into ammonia, as a major contributor to systemic ammonia levels.

Management of hidradenitis suppurativa in the inpatient setting: a clinical guide.

Hidradenitis suppurativa (HS) is a chronic inflammatory disease that affects the axilla, inframammary folds, buttocks, inner thighs, and anogenital regions. Patients with moderate to severe HS often seek care in the emergency department and may require hospitalization; however, the lack of clear admission criteria and management guidelines presents significant challenges. To address these issues, we conducted a clinical review aimed at hospitalists and consulting dermatologists considering hospital admission for patients experiencing severe HS flares.

Skin and Soft Tissue Infection Complicated by Sepsis in an Immunocompromised Patient: A Rare Case Report.

Physicians should consider non-O1, non-O139 (NOVC) in the differential diagnosis of cellulitis complicated by sepsis, especially in immunocompromised patients when potential exposure exists. Due to the pathogen's potential for severe infections and rising incidence from environmental changes, we emphasize the need for increased awareness and appropriate treatment guidelines.

Red cell microparticles produced using high-pressure extrusion enhance both primary and secondary hemostasis.

Background: Current therapies to treat excessive bleeding are associated with significant complications, which may outweigh their benefits. Red blood cell-derived microparticles (RMPs) are a promising hemostatic agent. Previous studies demonstrated that they reduce bleeding in animal models, correct coagulation defects in patient blood, and have an excellent safety profile.

Fracture characteristics and functional outcomes for Schatzker V/VI bicondylar tibial plateau fractures with a separate tubercle fragment: a comparative study.

Introduction: A separate tibial tubercle fragment (TF) is found in up to half of all bicondylar tibial plateau (BTP) fractures. Adequate healing of the TF is required to reconstitute the extensor mechanism of the knee. The purpose of this study was to compare outcomes after surgical fixation of BTP fractures with and without a TF.

Comparison of cellular-based therapies following a long-segmental peripheral nerve defect in a rat model.

Peripheral nerve injury (PNI) is characterized by a loss of cellular and axonal integrity, often leading to limited functional recovery and pain. Many PNIs are not amenable to repair with traditional techniques; however, cell therapies, particularly Schwann cells (SCs), offer the promise of neural tissue replacement and functional improvement. Exosomes, which carry cellular signaling molecules, can be secreted by SCs and have shown promise in PNI.

Protocol for the isolation of brain microvessels and visualization of RNA fluorescence in mice and humans.

Here, we present a protocol for isolating microvessels from fresh or snap-frozen brain tissue from mice and humans, followed by visualization of RNA utilizing RNAscope hybridization for quantification of mRNA. We describe the steps for sample preparation and isolation, fixation, and hybridization. This protocol was specifically designed to integrate with RNAscope in situ hybridization.

Identification of Stable Reference miRNAs for miRNA Expression Analysis in Adult Neurogenesis Across Mouse and Human Tissues.

Accurate normalization in miRNA studies requires the use of appropriate endogenous controls, which can vary significantly depending on cell types, treatments, and physiological or pathological conditions. This study aimed to identify suitable endogenous miRNA controls for neural progenitor cells (NPCs) and hippocampal tissues, both of which play crucial roles in neurogenesis. Using small RNA sequencing, we identified the most stable miRNAs in primary mouse NPCs and hippocampal tissues and accessed their stability using NormFinder analysis.

Choroidal Response to Intravitreal Bevacizumab Injections in Treatment-Naïve Macular Neovascularization Secondary to Chronic Central Serous Chorioretinopathy.

Background/objectives: To evaluate the impact of intravitreal bevacizumab (IVB) therapy on anatomical and visual outcomes in patients with macular neovascularization (MNV) secondary to chronic central serous chorioretinopathy (cCSC).

Methods: This retrospective observational study reviewed the medical records of treatment-naïve patients diagnosed with cCSC complicated by MNV and treated with IVB injections over a 5-year period. The presence of MNV was confirmed using optical coherence tomography angiography (OCTA).