Dermal CIC-Rearranged Sarcoma With Neuroendocrine Differentiation Mimicking Merkel Cell Carcinoma.

Capicua transcriptional repressor (CIC)-rearranged sarcoma (CRS) is a rare and recently described tumor that most commonly affects patients between 15 and 30 years of age. It is an undifferentiated round cell malignancy, with a disease defining CIC fusion, with double homeobox 4 (DUX4) being the most common partner. Here, we report a 77-year-old woman who presented with a cutaneous thigh mass with a clinical morphology suggesting Merkel cell carcinoma.

Self-Management assistance for recommended treatment (SMART) IBD app randomized control trial in adolescents with IBD: Design and methodology.

Aims: Adherence to medical regimens, including medications and appointments, is a significant concern for adolescent populations that warrants behavioral interventions. Negative health behaviors during adolescence can persist into adulthood and lead to long-term negative health outcomes. Due to the limited availability and resources for behavioral self-management intervention, many youth do not receive evidence-based behavioral care and continue to struggle with managing their illness.

Effectiveness of cholangioscopy guided biopsy versus ERCP guided brushings in diagnosing malignant biliary strictures.

Background: Evaluation of lesions of the biliary tract are essential to diagnose given the dismal outcomes of cholangiocarcinoma. Historically, these diagnoses were made using brush biopsies obtained under Endoscopic Retrograde Cholangiopancreatography (ERCP). To increase the accuracy of biliary biopsies, SpyGlassTM Discover cholangioscopy guided biopsy has been developed, providing greater tissue yield and direct visualization of the biliary epithelium.

A Prospective, Randomized, Noninferiority Study to Evaluate the Safety and Effectiveness of Steerable Ureteroscopic Renal Evacuation Compared with Standard Ureteroscopy: 30-Day Results of the ASPIRE Study.

We report the first multicenter, prospective, randomized noninferiority controlled trial of steerable ureteroscopic renal evacuation (SURE) for nephrolithiasis treatment. Candidates for laser lithotripsy ≥18 years with ≥1 renal stone ≥7 mm and 7-20 mm stone burden were randomized 1:1 SURE ureteroscopy (URS). SURE was performed using the CVAC Aspiration System, a novel steerable irrigation-aspiration catheter.

Factors Influencing Patient Enrollment in a Community-based Physical Activity Program After Healthcare Provider Referral: A Mixed Methods Study.

Introduction And Objectives: Structured physical activity (PA) programs help to prevent and manage chronic diseases, yet systematic approaches to identify and enroll patients in these programs are lacking. Exercise is Medicine Greenville (EIMG) is a novel clinic-to-community model that identifies patients with chronic diseases in primary care settings and connects them to a structured, evidence-informed, community-based PA program. This study assessed influences on PA program enrollment using a mixed methods design.

I-RANT: Training session on a novel, scripted, bystander microaggression intervention tool for medical students.

Background: Microaggressions, subtle and often unintentional acts of hostility, have been recognized as a significant issue in healthcare, adversely affecting learners' emotional and physical well-being. Current strategies for addressing microaggressions are broad frameworks without empirical substantiation that leave learners without a clear direction for intervention. This study introduces a novel scripted, succinct, bystander intervention tool to combat microaggressions.

Leveraging artificial intelligence to reduce diagnostic errors in emergency medicine: Challenges, opportunities, and future directions.

Diagnostic errors in health care pose significant risks to patient safety and are disturbingly common. In the emergency department (ED), the chaotic and high-pressure environment increases the likelihood of these errors, as emergency clinicians must make rapid decisions with limited information, often under cognitive overload. Artificial intelligence (AI) offers promising solutions to improve diagnostic errors in three key areas: information gathering, clinical decision support (CDS), and feedback through quality improvement.

Preparing a dialysis patient.

Preparing a dialysis patient for access placement is a process that should ideally begin well before the need for access use. Unfortunately, this is often not the case and patients are often seen well after dialysis has been initiated with a catheter. The process should include a detail-oriented history and a thorough vascular oriented physical examination.

A novel load-sensing sliding hip screw to aid in the assessment of intertrochanteric fracture healing.

Bone healing after sliding hip screw internal fixation of intertrochanteric hip fractures is difficult to monitor with radiography. In this study, we describe and evaluate a device to non-invasively determine the loading on the screw implant as a possible qualitative indicator of bone healing. A novel load-sensing sliding hip screw (LS-SHS) was fabricated containing a radio-dense tungsten indicator rod that moves and can be measured within the screw cannulation when the screw bends under load via plain radiography.

Grey matter volume differences across Parkinson's disease motor subtypes in the supplementary motor cortex.

Parkinson's Disease (PD) is the second most prevalent neurodegenerative disease worldwide due to loss of dopaminergic neurons projecting from the basal ganglia (BG). It is associated with various motor symptoms that are grouped into subtypes, each with different clinical presentations and disease progressions. Neuroimaging biomarkers focusing on regions a part of motor circuits projecting from the BG can distinguish and improve overall subtyping.

Reducing Disparities in Access to Kidney Transplantation (RaDIANT) Regional Study: A Randomized Trial in the Southeastern U.S.

Background: The Southeastern United States (US) has among the lowest rates of kidney transplantation nationally and has documented racial and socioeconomic disparities in transplant access. We assessed the effectiveness and implementation of a multi-component intervention aimed at increasing access and reducing disparities in access to early transplant steps in Georgia (GA), North Carolina (NC), and South Carolina (SC).

Methods: The Reducing Disparities in Access to Kidney Transplantation (RaDIANT) Regional Study randomized 440 dialysis facilities in GA, NC, and SC to receive the RaDIANT Regional educational and quality intervention or standard of care in 2018.

Amlodipine versus nifedipine ER for the management of postpartum hypertension: a noninferiority randomized controlled trial.

Background: Postpartum hypertension is an increasingly prevalent problem and optimizing its treatment is imperative in reducing maternal morbidity and improving long-term health outcomes. Despite this, data on treatment of postpartum hypertension is limited. While most available studies focus on labetalol and nifedipine ER, these medications are not frequently used for hypertension treatment in the non-obstetric setting.

Developing a pharmacy residency research program educational series: A review of the literature and considerations for implementation.

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.

Time Isn't your FoCUS, do cardiac POCUS!

Background: Physicians often cite time as a limitation to performing a focused cardiac ultrasound (FoCUS) exam. The primary outcome of this study was to determine the amount of time to complete a quality FoCUS exam. Secondary outcomes evaluated time differences between different training levels.

Best Practices for Delivering Neoadjuvant Therapy in Pancreatic Ductal Adenocarcinoma.

Importance: Neoadjuvant therapy (NT) is an increasingly used treatment strategy for patients with localized pancreatic ductal adenocarcinoma (PDAC). Little research has been conducted on cancer care delivery during NT, and the standards for optimal delivery of NT have not been defined.

Objective: To develop consensus best practices for delivering NT to patients with localized PDAC.

In-Hospital Outcomes Associated With Initial Fibrinolysis Versus Primary Percutaneous Coronary Intervention Among Patients Residing in Rural Areas Presenting With ST-Segment Elevation Myocardial Infarction.

Fibrinolysis is more commonly used to manage ST-segment elevation myocardial infarction (STEMI) in rural versus urban areas. However, little is known about the outcomes associated with this treatment strategy in rural individuals. We sought to compare in-hospital outcomes associated with the use of fibrinolysis versus primary percutaneous coronary intervention (PCI) among patients residing in rural areas presenting with STEMI.

Does tranexamic acid reduce blood loss for children undergoing reconstruction for neuromuscular hip dysplasia? A matched comparative study.

Treatment for neuromuscular hip dysplasia (NMHD) typically involves osteotomies of the proximal femur and/or pelvis, and the potential for significant volume blood loss is high. Tranexamic acid (TXA) functions as an antifibinolytic and has been shown to reduce bleeding in many operative settings. Retrospective evidence for the use of TXA in children undergoing NMHD reconstruction is inconclusive, and to our knowledge, prospective evaluation has never been performed.

Sex and Gender Health Education Tenets: An Essential Paradigm for Inclusivity in Dentistry.

Sex and gender are essential components of person-centered care. This article presents and discusses four important tenets regarding sex and gender health that should be incorporated into dental education and oral health care to foster inclusivity and improve care for all patients, including a sex and gender-diverse patient population.