Perifollicular concentric granulomas: A clue to IgG4-related lymphadenopathy.

A 69-year-old with well-controlled HIV was evaluated for persistent cough, in the context of years of fatigue and influenza A infection 6 months prior. Chest CT and PET scans were notable for adenopathy concerning for a lymphoproliferative disorder. Radiologic studies also showed diffuse FDG uptake in the prostate, consistent with prostatitis.

Myelinated Glial Cells: Their Proposed Role in Waste Clearance and Neurodegeneration in Arachnid and Human Brain.

One of the most important goals in biomedical sciences is understanding the causal mechanisms of neurodegeneration. A prevalent hypothesis relates to impaired waste clearance mechanisms from the brain due to reported waste aggregation in the brains of Alzheimer patients, including amyloid-β plaques and neurofibrillary tau tangles. Currently, our understanding of the mechanisms by which waste is removed from the brain is only fragmentary.

Talimogene laherparepvec (T-VEC) and Emerging Intralesional Immunotherapies for Metastatic Melanoma: A Review.

Purpose Of Review: As the incidence of cutaneous melanoma continues to rise worldwide, its heterogeneous presentation proves challenging for managing and preventing relapse.

Recent Findings: While surgery remains a mainstay in staging and treatment of locoregional metastatic melanoma, intralesional therapies have emerged as a new tool to treat unresectable in-transit and nodal metastases and reduce the risk of relapse through immunomodulatory mechanisms. In this review, we will provide an overview of intralesional therapies for melanoma with a particular focus on talimogene laherparepvec (T-VEC) and its future uses.

Nephrology providers' perspective and use of mortality prognostic tools in dialysis patients.

Background: Mortality prognostic tools exist to aid in shared decision making with kidney failure patients but are underutilized. This study aimed to elucidate nephrology providers' practice patterns and understand barriers to prognostic tool use.

Methods: Nephrology providers (8 physicians and 2 nurse practitioners) at an academic medical center underwent semi-structured interviews regarding their experience and perspective on the utility of mortality prognostic tools.

Effectiveness of Closed Incision Negative Pressure Wound Therapy for Suprainguinal Bypass in the Vascular Quality Initiative.

Background: We sought to explore the utility of closed incision negative pressure wound therapy (ciNPWT) in prevention of groin wound complications after suprainguinal bypass using a national quality improvement database reflective of real-world practice.

Methods: The Vascular Quality Initiative was queried for suprainguinal bypass procedures from December 2019 to August 2023. Propensity matching was performed comparing ciNPWT versus standard dressings at (1) the index hospitalization (full cohort) and (2) 30 days (subgroup).

Chronic Lymphocytic Leukemia with Orbital and Sinonasal Manifestations.

Chronic lymphocytic leukemia (CLL) is a slowly progressive disease most often affecting older patients. Although CLL is typically identified on routine blood work, unique manifestations of the disease have been described both at the time of diagnosis and in the setting of indolent disease. We present on 3 CLL patients with previously stable oncologic disease who presented with orbital pathologies including dacryocystitis, epiphora, proptosis, and diplopia.

Methylxanthines for the prevention or treatment of intermittent hypoxemia or respiratory insufficiency in late preterm infants.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of methylxanthines in preventing or treating intermittent hypoxemia or respiratory insufficiency in late preterm infants.

Cilostazol in patients with heart failure and preserved ejection fraction-The CLIP-HFpEF trial.

Background And Aims: Patients with heart failure with preserved ejection fraction (HFpEF) tend to have low resting and exercise heart rates. Phosphodiesterase-3 (PDE-3) inhibitors improve heart rates, haemodynamics and symptoms in patients with HFpEF. Cilostazol is an oral PDE-3 inhibitor used in peripheral artery disease.

Decision-Making Approach to the Treatment of Young and Low-Risk Patients With Aortic Stenosis.

Over a decade of randomized controlled trial data demonstrate excellent outcomes with transcatheter aortic valve replacement or surgical aortic valve replacement for patients with symptomatic severe aortic stenosis regardless of surgical risk. The 2020 American College of Cardiology/American Heart Association guidelines recommend both options for low-risk AS patients aged 65 to 80 years. However, the fastest growing population of patients receiving transcatheter aortic valve replacement in the United States is <65 years old, with little data to support the practice.

Classification of Breast Lymphedema in a Racially Diverse Cohort.

Breast lymphedema is a common sequela of breast conservation that delays healing and reduces quality of life. No rigorous classification system exists for this condition. We explored approaches for classifying breast lymph-edema based on breast ultrasound, physical exam, and patient-reported outcomes.

The Association between Body Mass Index and Mortality in Breast Cancer Patients Receiving Pembrolizumab.

Introduction: A higher body mass index (BMI) has been associated with a better response and overall survival in patients with lung cancer or melanoma receiving immune checkpoint inhibitors (ICIs). Pembrolizumab has been approved for the use of breast cancer, but its relationship with BMI on survival outcomes is unclear.

Methods: We conducted a retrospective, propensity score-matched cohort study using the TriNetX Analytics Network database, which contains de-identified data from over 120 participating healthcare institutions.

Diagnosis and Treatment Strategies of Meniscus Root Tears: A Scoping Review.

Background: Meniscus root tears comprise 10% to 21% of all meniscal tears. These tears alter knee biomechanics, elevating contact pressure, akin to a meniscectomy. Consequently, they are linked to advanced joint degeneration and cartilage damage in the affected compartment.

Appropriateness of Empiric Initiation of Meropenem in the Intensive Care Unit as Determined by Internal Medicine Residents.

Objective: To evaluate the appropriateness of empiric initiation of meropenem in the intensive care unit (ICU) and to determine the agreement between internal medicine (IM) residents and infectious diseases (ID) physicians/pharmacists on appropriateness.

Design: Retrospective observational study.

Setting: ICU in a tertiary care community teaching hospital.

Data set for the reporting of lung cancer: recommendations from the International Collaboration on Cancer Reporting (ICCR).

Lung cancer is the leading cause of cancer related deaths worldwide, although some patients with early-stage disease can be cured with surgical resection. Standardised reporting of all clinically relevant pathological parameters is essential for best patient care and is also important for ongoing data collection and refinement of important pathological features that impact patient prognosis, staging and clinical care. Using the established International Collaboration on Cancer Reporting (ICCR) procedure, a representative international expert panel of nine lung pathologists as well as an oncologist was convened.

Development of the Pulmonary Embolism Progression (PEP) score for predicting short-term clinical deterioration in intermediate-risk pulmonary embolism: a single-center retrospective study.

Accurate risk stratification in acute intermediate-risk pulmonary embolism (PE) is essential. Current prediction scores lack the ability to forecast impending clinical decline. The Pulmonary Embolism Progression (PEP) score aims to predict short-term clinical deterioration (respiratory failure or hemodynamic instability within 72 h) in patients with intermediate-risk PE.

Neonatal SARS-CoV-2 mRNA Vaccination Efficacy Is Influenced by Maternal Antibodies.

Problem: Vaccination in pregnancy guards against infection. Maternal antibodies, however, can inhibit antibody production in neonates. We sought to determine the effects of maternal vaccination on neonatal immune response to a SARS-CoV-2 mRNA vaccine.

Epidemiology and Outcomes Associated with New Persistent Opioid Use after Transabdominal Surgery.

Background: Overall, 3% to 12% of opioid-naive patients develop persistent opioid use after surgery. It is still unclear whether persistent opioid use after transabdominal surgery is associated with adverse surgical outcomes. We aimed to assess if new persistent opioid use after transabdominal surgery is associated with increased long-term mortality and readmission rates.