Development and Bioavailability Assessment of an Estriol-Containing Vaginal Hydrogel.

Genitourinary syndrome of menopause (GSM) affects a significant percentage of postmenopausal women and manifests as vaginal dryness, irritation, and urinary discomfort, typically treated with vaginal estrogens. Hydrogels are preferred over creams due to their superior comfort and mucoadhesive properties. This study introduces a novel vaginal gel formulation containing hydroxyethyl cellulose (HEC) and estriol-hydroxypropyl-β-cyclodextrin complex (E3-HPBCD) for the treatment of GSM.

The Role of Artificial Intelligence and Machine Learning in Accelerating the Discovery and Development of Nanomedicine.

The unique potential of nanomedicine to address challenging health issues is rapidly advancing the field, leading to the generation of more effective products. However, these complex systems often pose several challenges with respect to their design for specific functionality, scalable manufacturing, characterization, quality control, and clinical translation. In this regard, the application of artificial intelligence (AI) and machine learning (ML) approaches can enable faster and more accurate data assessment, identifying trends and predicting outcomes, leading to efficient nanomedicine product development.

Cross-education effects of balance training in individuals with chronic ankle instability.

Background: Individuals with chronic ankle instability (CAI) often experience deficits in balance, hip strength, and lumbopelvic stability. Unilateral balance training can lead to improved balance in the contralateral limb, but it is unknown if similar cross-education effects occur for hip strength and lumbopelvic stability. Our purpose was to determine if unilateral balance training improved balance, hip strength, and lumbopelvic stability of the contralateral limbs in individuals with CAI.

Formulation development of dual-compartment topical inserts combining tenofovir alafenamide and elvitegravir for flexible on-demand HIV prevention.

Pre-exposure prophylaxis (PrEP) has emerged as a prominent approach for the prevention of HIV infections. While the latest advances have resulted in effective oral and injectable product options, there are still gaps in on-demand, event-driven, topical products for HIV prevention that are safe and effective. Here we describe the formulation development of a dual-compartment topical insert containing tenofovir alafenamide fumarate (TAF) and elvitegravir (EVG) that may be administered when needed, vaginally or rectally, pre- or post-coitus, for flexible HIV prophylaxis.

Relationship of vitamin D to pathogenesis and outcomes of hidradenitis suppurativa: a systematic review.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by painful sinus tracts and significant scarring. Recent evidence suggests that vitamin D deficiency may play a role in the pathogenesis and outcomes of HS. This systematic review aims to evaluate the relationship between vitamin D levels and HS, exploring potential therapeutic benefits of vitamin D supplementation.

Synthesis and structure-activity relationship of boronic acid bioisosteres of combretastatin A-4 as anticancer agents.

The boronic acid group plays an important role in drug discovery. Following our discovery of a boronic acid analog of combretastatin A-4 (CA-4), a series of analogs featuring a boronic acid group on the C phenyl ring of CA-4 was synthesized and evaluated for cytotoxicity, as well as for their ability to inhibit tubulin polymerization, inhibit the binding of [H]colchicine to tubulin and cause depolymerization of cellular microtubules. Modifications on the C ring of CA-4, either eliminating the methoxy group or replacing the C phenyl ring with a pyridine ring, resulted in a reduced potency for inhibiting tubulin polymerization, colchicine binding and cytotoxic activities as compared to CA-4.

Screening, brief intervention, and referral to treatment for pain management for veterans separating from military service: study protocol of a hybrid type 2 study testing implementation facilitation versus training-as-usual.

Background: Veterans transitioning to civilian life often have chronic pain from service-related musculoskeletal disorders (MSD) with higher risk for substance misuse. Many seek VA (Department of Veterans Affairs) compensation for MSD. Use of Screening, Brief Intervention, and Referral to Treatment for Pain Management (SBIRT-PM) by VA Post-9/11 Military2VA (M2VA) case managers presents an opportunity to engage these veterans in VA pain care and address substance misuse.

A Retrospective Comparison of Emergency Department Throughput Before and After Instituting a Waiting Room Evaluation Process.

Background: The COVID-19 pandemic has strained the healthcare system with emergency department (ED) boarding and workforce shortages. This prompted the need for strategies to evaluate and treat patients while they waited for an ED room.

Objectives: The objective is to describe a waiting room evaluation process and ED throughput in the setting of ED staffing shortages and boarding.

A Multidisciplinary Assessment of Standard Low Dose Versus Ultra-low Dose Chest CT Scans for Pectus Excavatum Imaging.

Aim: Evaluation of ultra-low dose chest CT imaging for the assessment of pectus excavatum severity as determined by pediatric radiologists and pediatric surgeons using Haller (HI) and Correction indices (CI).

Methods: A single institution, prospective evaluation of patients being evaluated for pectus excavatum were scanned with a standard low-dose chest CT protocol (CARE) followed by a consecutive ultra-low dose CT scan (ULTRA). 3 surgeons and 4 radiologists were instructed to determine HI and CI in each series.

Vacuum Bell Therapy for Pectus Excavatum: Long-term Experience at a Single Center.

Aim: To evaluate factors associated with excellent correction in pectus excavatum patients undergoing vacuum bell therapy (VBT).

Methods: A single-institution retrospective chart review was performed November 2012-April 2023 to assess corrections of patients who underwent VBT. Patient demographics, presentation, and results were collected.

Exploring Angiotensin II and Oxidative Stress in Radiation-Induced Cataract Formation: Potential for Therapeutic Intervention.

Radiation-induced cataracts (RICs) represent a significant public health challenge, particularly impacting individuals exposed to ionizing radiation (IR) through medical treatments, occupational settings, and environmental factors. Effective therapeutic strategies require a deep understanding of the mechanisms underlying RIC formation (RICF). This study investigates the roles of angiotensin II (Ang II) and oxidative stress in RIC development, with a focus on their combined effects on lens transparency and cellular function.

Primary Intraocular Lymphoma: Rad-Path and Ophthalmologic Correlation.

Primary intraocular lymphoma (PIOL) is a rare form of primary central nervous system lymphoma that poses diagnostic challenges due to its nonspecific clinical features and complex imaging characteristics. This paper presents a focus case and two companion cases, highlighting the complexities in identifying and treating PIOL. In the focus case, A 66-year-old male experienced gradual painless vision loss with choroidal thickening on funduscopic exam and subsequent follow-up MRI.

HIV-TAT dysregulates microglial lipid metabolism through SREBP2/miR-124 axis: Implication of lipid droplet accumulation microglia in NeuroHIV.

Chronic HIV infection can dysregulate lipid/cholesterol metabolism in the peripheral system, contributing to the higher incidences of diabetes and atherosclerosis in HIV (+) individuals. Recently, accumulating evidence indicate that HIV proteins can also dysregulate lipid/cholesterol metabolism in the brain and such dysregulation could be linked with the pathogenesis of HIV-associated neurological disorders (HAND)/NeuroHIV. To further characterize the association between lipid/cholesterol metabolism and HAND, we employed HIV-inducible transactivator of transcription (iTAT) and control mice to compare their brain lipid profiles.

Radiation Induced Skin Fibrosis (RISF): Opportunity for Angiotensin II-Dependent Intervention.

Medical procedures, such as radiation therapy, are a vital element in treating many cancers, significantly contributing to improved survival rates. However, a common long-term complication of such exposure is radiation-induced skin fibrosis (RISF), a complex condition that poses substantial physical and psychological challenges. Notably, about 50% of patients undergoing radiation therapy may achieve long-term remission, resulting in a significant number of survivors managing the aftereffects of their treatment.

No small dilemma: small bowel volvulus mimicking acute coronary syndrome.

Acute abdominal pathologies can cause electrocardiogram (ECG) changes mimicking an acute coronary syndrome (ACS), resulting in diagnostic uncertainty and delay. We report a 65-year-old male with multiple risk factors for ACS who presented with four hours of progressive epigastric and chest pain that resolved in the emergency department. ECG findings were concerning for new deeply inverted T-waves with normal troponins, raising concerns for Wellens Syndrome.