Demonstration of cavitary legionnaires' pneumonia in a renal transplant recipient.

Legionella pneumophila is a potentially life-threatening infection, especially for individuals with compromised cell-mediated immunity. Typical chest CT findings include multilobed or multisegmented consolidations and ground-glass opacities, but cavitary lesions are rare. This case report details a 29-year-old male renal transplant recipient who developed cavitary Legionnaires' pneumonia.

Using social network analysis to identify influential community organizations.

Background: We used a social network approach to identify influential community organizations within integrated public health networks in three regions in Texas, US: Houston/Harris County, Cameron County, and Northeast Texas. The study aimed to understand how network structures influence organizational performance in COVID-19 response.

Methods: In collaboration with community partners in each region, we administered a snowball sampling network data collection.

Relationship Between Intrapartum Continuous Glucose Monitoring Values and Neonatal Hypoglycemia in Individuals with Diabetes.

Objective: We aimed to evaluate the relationship between intrapartum continuous glucose monitoring (CGM) and neonatal hypoglycemia (NH) in individuals with diabetes.

Study Design: a multicenter prospective study (11/2021-12/2022) of laboring individuals with pregestational or gestational diabetes at ≥ 34 weeks. Cohorts had a blinded CGM placed from admission through delivery and were monitored with fingersticks (FS) according to usual care.

Non-bacterial thrombotic endocarditis: a clinical and pathophysiological reappraisal.

Non-bacterial thrombotic endocarditis (NBTE), formerly recognized as marantic endocarditis, represents a rare cardiovascular pathology intricately linked with hypercoagulable states, notably malignancy and autoimmune disorders. Characterized by the development of sterile vegetations comprised of fibrin and platelets on cardiac valves, NBTE poses a diagnostic challenge due to its resemblance to infective endocarditis. Therapeutic endeavours primarily revolve around addressing the underlying aetiology and instituting anticoagulant regimens to forestall embolic events, with surgical intervention seldom warranted.

Mindfulness buffers the association of pain with depression and anxiety among people with spinal cord injury: A cross-sectional study.

Purpose: Chronic pain is common among people with spinal cord injury (PwSCI) and impacts mental health (MH). Mindfulness may buffer the association of pain with MH, but few studies have examined this among PwSCI. This study examines the extent to which mindfulness moderates the association of pain intensity with MH among PwSCI.

Mineralocorticoid receptor expression and the effects of the mineralocorticoid receptor antagonist spironolactone in a murine model of graft-versus-host disease.

Purpose: The topical administration of spironolactone, a mineralocorticoid receptor antagonist (MRA) improves dry eye symptoms in patients with ocular graft-versus-host disease (GVHD); however, the detailed mechanism remains unclear. This study aimed to investigate the effects of spironolactone eyedrops on the ocular surface using a chronic GVHD (cGVHD) mouse model and to determine the expression of the mineralocorticoid receptor (MR).

Methods: A cGVHD mouse model was established by allogeneic bone marrow transplantation (BMT) from B10.

Reusable Generic Clinical Decision Support System Module for Immunization Recommendations in Resource-Constraint Settings.

Clinical decision support systems (CDSS) are routinely employed in clinical settings to improve quality of care, ensure patient safety, and deliver consistent medical care. However, rule-based CDSS, currently available, do not feature reusable rules. In this study, we present CDSS with reusable rules.

A Case Demonstration of the Open Health Natural Language Processing Toolkit From the National COVID-19 Cohort Collaborative and the Researching COVID to Enhance Recovery Programs for a Natural Language Processing System for COVID-19 or Postacute Sequelae of SARS CoV-2 Infection: Algorithm Development and Validation.

Background: A wealth of clinically relevant information is only obtainable within unstructured clinical narratives, leading to great interest in clinical natural language processing (NLP). While a multitude of approaches to NLP exist, current algorithm development approaches have limitations that can slow the development process. These limitations are exacerbated when the task is emergent, as is the case currently for NLP extraction of signs and symptoms of COVID-19 and postacute sequelae of SARS-CoV-2 infection (PASC).

"The unbearable lightness" of the primary end point in clinical trials.

In this Perspective, I discuss the limitations of a soft primary endpoint that is used in some of the recent randomized phase II/III clinical trials. Unfortunately, many clinicians and investigators do not interpret the data critically to recognize the limitations of such findings. I advise against over-interpreting the effects of an intervention on a soft primary endpoint.

Applying a Racial Lens to the "Cycle of Violence".

One overlooked result in a 1989 paper on the "cycle of violence" was a race-specific increase in risk for arrest for violence among Black maltreated children, but not White maltreated children. We examine whether race differences in the cycle of violence are explained by risk factors traditionally associated with violence. Using a prospective design, maltreated and non-maltreated children were matched on age, sex, race, and approximate family social class and interviewed at mean age 28.

A Directed Content Analysis for Greatest Problems Among People With and Without Traumatic Brain Injury.

Objective: To characterize the greatest problem or need among individuals with a history of traumatic brain injury (TBI), as compared with individuals with a history of other neurologic conditions, mental health conditions, and no history of neurologic or mental health conditions.

Design: A directed content analysis of open-text responses to a single online survey question using a framework guided by the Mayo-Portland Adaptability Inventory-4.

Setting: Community.

Characteristics and outcomes of children, adolescent, and young adult patients with myelodysplastic neoplasms: A single-center retrospective analysis.

Myelodysplastic syndrome, or myelodysplastic neoplasms, are a rare finding in pediatric, adolescent, and young adult (AYA) patients. More literature is needed to highlight trends of survival or treatment resistance in subpopulations to improve treatment. Here we report a single center retrospective analysis of pediatric and AYA patients from 2000 to 2022 including molecular and cytogenetic data.

Intrathecal baclofen therapy for spasticity in a person with spinal cord injury and end-stage renal disease dependent on hemodialysis: a case report.

Introduction: Spasticity is one of the most common secondary complications following a spinal cord injury (SCI), which can significantly debilitate a patient irrespective of the severity of the injury. Intrathecal baclofen therapy can effectively reduce global spasticity in bilateral lower extremities at lower doses and allows precise dose titration to manage spasticity optimally. In complex patients with spasticity and multiple medical comorbidities, multidisciplinary teamwork is required to assess ITB safety and deliver timely intervention to prevent secondary complications of spasticity and improve quality of life.

Plasma proteins associated with plant-based diets: Results from the Atherosclerosis Risk in Communities (ARIC) study and Framingham Heart Study (FHS).

Background & Aims: Plant-based diets are associated with a lower risk of chronic diseases. Large-scale proteomics can identify objective biomarkers of plant-based diets, and improve our understanding of the pathways that link plant-based diets to health outcomes. This study investigated the plasma proteome of four different plant-based diets [overall plant-based diet (PDI), provegetarian diet, healthful plant-based diet (hPDI), and unhealthful plant-based diet (uPDI)] in the Atherosclerosis Risk in Communities (ARIC) Study and replicated the findings in the Framingham Heart Study (FHS) Offspring cohort.

Spatiotemporal analysis of HPV vaccination and associated neighborhood-level disparities in Texas-an ecological study.

Background: HPV is responsible for most cervical, oropharyngeal, anal, vaginal, and vulvar cancers. The HPV vaccine has decreased cervical cancer incidence, but only 49% of Texas adolescents have initiated the vaccine. Texas shows great variation in HPV vaccination rates.

Ultrasound-Guided Percutaneous Cryoneurolysis of the Antebrachial Cutaneous Nerves for the Management of Prolonged Acute Post-Surgical Forearm Pain: A Report of Two Cases.

Prolonged acute postsurgical pain (PAPSP) contributes to the development of chronic postsurgical pain, impaired rehabilitation, longer hospital stays, and decreased quality of life. For upper extremity analgesia, the duration of postoperative pain management with continuous brachial plexus peripheral nerve blocks is limited due to the risk of infection. Ultrasound-guided percutaneous cryoneurolysis provides extended analgesia and avoids the risks and inconveniences of indwelling catheters.

Durable Objective Response to Lurbinectedin in Small Cell Bladder Cancer with TP53 Mutation: A Molecular-Directed Strategy.

Small cell bladder cancer (SCBC) is a rare and aggressive disease, often treated with platinum/etoposide-based chemotherapy. Key molecular drivers include the inactivation of onco-suppressor genes (, ) and amplifications in proto-oncogenes (). We report a patient with SCBC who achieved an objective and prolonged response to lurbinectedin, which has been approved for metastatic small cell lung cancer, after developing disease progression on cisplatin/etoposide and nivolumab/ipilimumab.

A Survey of Current Approaches to Inguinal Hernia Repair by Pediatric General Surgeons in the United States.

Introduction: Inguinal hernia repair (IHR) is a common pediatric operation performed via open or laparoscopic approaches. The objective of this survey study was to assess current approaches to IHR in a national sample of pediatric general surgeons.

Methods: A REDCap survey was distributed to all pediatric general surgeons at 21 US institutions in 2023.