Preliminary Effects of American Elderberry Juice on Cognitive Functioning in Mild Cognitive Impairment Patients: A Secondary Analysis of Cognitive Composite Scores in a Randomized Clinical Trial.

Previous work examining dietary interventions high in polyphenols (i.e., antioxidant/anti-inflammatory properties) has shown cognitive benefits.

Evaluation of Angiotensin II in Patients With Catecholamine-Resistant Vasodilatory Shock Requiring Continuous Renal Replacement Therapy (ANGEL CRRT).

Objective: To compare clinical outcomes of patients with catecholamine-resistant vasodilatory shock (CRVS) receiving continuous renal replacement therapy who receive adjunctive angiotensin II (ANGII) to those who do not.

Design: Retrospective cohort analysis.

Setting: Multicenter, single health system consisting of one academic medical center and four community hospitals.

Impact of Helicobacter pylori Eradication on Clinical and Laboratory Parameters in Non-alcoholic Fatty Liver Disease Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Objective: Helicobacter pylori (HP) infection is associated with non-alcoholic fatty liver disease (NAFLD) and insulin resistance; however, the correlation between HP eradication and NAFLD remains controversial. This systematic review and meta-analysis examined the effect of HP treatment on clinical and laboratory parameters in NAFLD patients.

Methods: We conducted a literature search of the PubMed, Embase, Scopus, and Web of Science databases through September 2023 for randomized controlled trials (RCTs) examining the effect of HP treatment on NAFLD patients versus lifestyle changes alone.

The Patient Journey in Chronic Coronary Syndromes with/without Obstructive Coronary Arteries.

Background: In patients undergoing invasive coronary angiography for the investigation of angina, the management pathways for obstructive coronary artery disease (CAD) are well described, whereas the clinical and diagnostic journey of patients with ANOCA has largely been inferred, as there is limited quantitative data.

Objectives: To compare the journey of patients with ANOCA versus Obstructive CAD, particularly in relation to (i) clinical presentation and (ii) diagnostic assessment, (iii) 12 month patient-reported outcome measures (PROMs) and (iv) three year composite MACE.

Methods: A total of 2,285 ANOCA and 4,087 Obstructive CAD consecutive patients were included from the CADOSA (Coronary Angiogram Database of South Australia) registry between 2012-2018.

Results of Cardiovascular Testing among Pregnant and Postpartum Persons Undergoing Standardized Cardiovascular Risk Assessment.

Background: Cardiovascular disease (CVD) is the leading cause of maternal mortality in the United States, accounting for one in three pregnancy-related deaths. A standardized CVD Risk Assessment can guide clinicians in identifying patients at risk for CVD.

Objective(s): The objective of this study was to evaluate whether a standardized CVD risk assessment yields more abnormal findings on follow-up CVD testing among pregnant and postpartum patients compared to assessments based on clinician judgment alone.

Skin of color representation in cosmetic dermatology literature, 2018-2023.

Growing racial diversity raises concerns about equitable dermatology care. Only 4.5% of US medical textbooks include diverse skin types, and dermatologic literature lacks focus on Skin of Color (SOC).

Black community member perceptions and ethics recommendations on epigenomic research.

Background: Social epigenomics research investigates links between social experiences and epigenetic modifications, which may ultimately impact health. Such research holds promise for precision medicine and addressing health disparities based on social conditions, but also brings unique ethical challenges. The linking of social experiences to biological changes risks pathologizing experiences, potentially leading individuals and communities to be seen as 'damaged.

Timing of mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock: A systematic review and meta-analysis.

Background: Acute myocardial infarction (AMI) complicated by cardiogenic shock has a high mortality rate. Mechanical circulatory support (MCS) has been increasingly used; however, the optimal timing for MCS insertion remains uncertain. This study aimed to evaluate outcomes of pre-percutaneous coronary intervention (PCI) vs post-PCI MCS insertion in AMI patients with cardiogenic shock.

Low blood pressure and the effect of empagliflozin in acute heart failure: An EMPULSE analysis.

Aims: Empagliflozin improves outcomes in acute heart failure (AHF). Patients with AHF and low blood pressure (BP) have poor prognosis. Whether empagliflozin is effective and safe in patients with AHF and low BP is currently unknown.

Comparative efficacy and safety of SpyGlass percutaneous transhepatic cholangioscopy versus conventional cholangioscopy in challenging biliary access: a systematic review and meta-analysis.

Percutaneous transhepatic cholangioscopy (PTCS) is essential for managing patients with altered biliary anatomy when endoscopic retrograde cholangiopancreatography fails. This study aimed to compare the safety and efficacy of conventional PTCS (C-PTCS) with the SpyGlass PTCS (S-PTCS) system in cases of challenging biliary access. A systematic review and meta-analysis included 12 studies with 998 patients.

Adolescents' Use of Music for Pain Management.

To investigate the experiences of adolescents with chronic pain who participated in an intensive interdisciplinary pain treatment program, this secondary study analyzes the themes that emerged regarding the spontaneous utilization of music in coping strategies for chronic pain. During research interviews focused on coping skills and treatment engagement, participants spontaneously reported using music as an effective coping strategy for managing pain. A deductive thematic analysis revealed key themes related to their usage, including using music as a distractor, motivator and in other ways as coping strategies.

Successful Endovascular Management of Concomitant Ischemic Stroke, Myocardial Infarction, and Massive Pulmonary Embolism.

Background: Ischemic stroke, myocardial infarction (MI), and pulmonary embolism (PE) are emergent conditions which can be treated with catheter-directed therapies. Concomitant management of these conditions with catheter-directed therapy is not well-documented and lacks strong guidelines.

Case Summary: A 70-year-old woman presented with stroke symptoms and ST-segment elevation MI.

National Prescribing Practices for Pediatric Dystonia Among Providers in the United States.

While multiple oral medications are used to treat dystonia, limited information exists on current prescribing practices. This study analyzes real-world prescribing practices for pediatric dystonia in the United States, evaluating prescription frequency, dosing, and the impact of comorbidities. Oracle electronic health record real-world data were queried from 2014 to 2019 for encounters of patients under age 18 with a dystonia diagnosis and available medication records.

International Expert Opinion on Standard of Care for Patients With Schinzel-Giedion Syndrome: A Modified Delphi Study.

Schinzel-Giedion Syndrome (SGS) is an ultra-rare, multisystem, genetic developmental disorder caused by gain-of-function pathogenic variants in the SETBP1 gene. No standard of care (SoC) recommendations currently exist. To assess expert opinion on SoC for individuals with SGS using a modified Delphi method.

Effect of sotagliflozin on major adverse cardiovascular events: a prespecified secondary analysis of the SCORED randomised trial.

Background: Sodium-glucose co-transporter (SGLT)-2 inhibitors have shown consistent benefit in improving heart failure-related outcomes but not ischaemic cardiovascular events such as myocardial infarction or stroke. We assessed if the dual SGLT1/2 inhibitor sotagliflozin improves ischaemic outcomes.

Methods: We did a prespecified secondary analysis of the SCORED trial, which was a double-blind, placebo-controlled, randomised clinical trial enrolling patients (aged ≥18 years) with type 2 diabetes, chronic kidney disease (estimated glomerular filtration rate [eGFR] 25-60 mL/min per 1·73 m), and additional cardiovascular risk factors.

X-Linked Hypophosphatemia Management in Children: An International Working Group Clinical Practice Guideline.

Background: An International Working Group (IWG) developed new guidelines on the diagnosis, evaluation, management, and monitoring of X-linked hypophosphatemia (XLH) in children. Over the past 5 years, important advances have occurred in our understanding of the presentation, complications and treatment of XLH.

Methods: A group of 50 international experts in XLH from Canada, the United States, Europe, Asia and South America, along with methodology experts and patient partners, held 18 teleconference meetings in 2023-2024.

Associations Among Problematic Internet Usage in Adolescents, Parental Internet Factors, and Parent-Adolescent Communication.

Objective: Adolescents with problematic internet use (PIU) have excessive, impulsive, or risky internet use that negatively affects social, physical, and functional outcomes. The role of parents in the prevention of adolescent PIU remains unclear. The purpose of this study was to evaluate possible association between adolescent PIU, parent PIU, and internet-related parenting factors.

NICHD Magnetic Resonance Brain Imaging Score in Term Infants With Hypoxic-Ischemic Encephalopathy: A Secondary Analysis of a Randomized Clinical Trial.

Importance: The neonatal brain injury score on magnetic resonance imaging following moderate or severe hypoxic-ischemic encephalopathy developed by the National Institute of Child Health and Human Development Neonatal Research Network has been revised to separate watershed and basal ganglia or thalamic injury and their associated outcomes.

Objective: To evaluate the association of the injury score with outcomes of death or moderate or severe disability among all infants, and with neurodevelopment among survivors in a trial of deeper and longer cooling.

Design, Setting, And Participants: In this secondary analysis of a multicenter randomized clinical trial, brain imaging was obtained from infants between October 2010 and November 2013.

Enhancing Patient Education on Cardiovascular Rehabilitation with Large Language Models.

Introduction: There are barriers that exist for individuals to adhere to cardiovascular rehabilitation programs. A key driver to patient adherence is appropriately educating patients. A growing education tool is using large language models to answer patient questions.

Resource Management Challenges in Rural Dermatological Care: A Mapping Review.

Skin cancer prevalence in the United States is rapidly on the rise, particularly in rural communities where individuals are subjected to heavy sunlight exposure through occupations such as agricultural work and construction. These geographic regions are often lacking in dermatologic specialty care, thus increasing the disease burden of skin conditions in primary care settings. Access barriers to specialized dermatology care are exacerbated by prolonged wait times to schedule an appointment, travel demands, and a relative paucity of dermatology providers in rural areas as compared to urban areas.

Increasing Safety Net Antibiotic Prescriptions for Acute Otitis Media in Urgent Care Clinics.

Objective: To evaluate the effectiveness of multifaceted interventions in improving the use of safety net antibiotic prescriptions (SNAPs) for nonsevere acute otitis media (AOM).

Study Design: We used quality improvement methodology to develop iterative Plan-Do-Study-Act cycles to increase the use of SNAP for nonsevere AOM in 3 pediatric urgent care centers from October 2021 to June 2023. Interventions included education, electronic health record changes, audits and feedback, and a time-limited financial incentive.

Retrospective Investigation of Pediatric Histoplasmosis Diagnosed at a Tertiary Children's Hospital in an Endemic Area over 11 years.

Background: Most histoplasmosis data are from adults. We describe pediatric histoplasmosis diagnosed at a tertiary pediatric care center in an endemic area.

Methods: We performed a retrospective chart review of patients birth-18 years seen in our institution (January 1, 2010 - August 15, 2022) with histoplasmosis identified by International Classification of Disease (ICD) codes.