Endogenous Opioid Activity as the Mechanism of Action for Mitragyna speciosa (Kratom): The Current State of the Evidence.

Kratom (Mitragyna speciosa) is a substance derived from botanical compounds native to Southeast Asia. This substance has been cultivated predominantly in Thailand, Malaysia, Vietnam, and Myanmar, where it has historically been used in traditional medicine as a near panacea for several health problems. Such ritualistic use of kratom has been present for centuries; however, recreational use appears to have increased globally, especially in the United States.

Physical Exercise as an Intervention for Depression: Evidence for Efficacy and Mu-Opioid Receptors as a Mechanism of Action.

Physical exercise is often cited as an important part of an intervention for depression, and there is empirical evidence to support this. However, the mechanism of action through which any potential antidepressant effects are produced is not widely understood. Recent evidence points toward the involvement of endogenous opioids, and especially the mu-opioid system, as a partial mediator of these effects.

The Roles of Endogenous Opioids in Placebo and Nocebo Effects: From Pain to Performance to Prozac.

Placebo and nocebo effects have been well documented for nearly two centuries. However, research has only relatively recently begun to explicate the neurobiological underpinnings of these phenomena. Similarly, research on the broader social implications of placebo/nocebo effects, especially within healthcare delivery settings, is in a nascent stage.

The Foundational Science of Endogenous Opioids and Their Receptors.

The function of endogenous opioids spans from initiating behaviors that are critical for survival, to responding to rapidly changing environmental conditions. A network of interconnected systems throughout the body characterizes the endogenous opioid system (EOS). EOS receptors for beta-endorphin, enkephalin, dynorphin, and endomorphin underpin the diverse functions of the EOS across biological systems.

Introduction to the Volume: The Journey Ahead.

The endogenous opioid system (EOS) is complex. The line of research contributing to our current body of knowledge about this system is diverse, as are the ways in which endogenous opioids affect human health and behavior. This chapter serves as an introduction to the edited volume.

The coronation of the clitoris: formally introducing the corona of the glans clitoris.

The glans clitoris has a corona; however, unlike the corona of the glans penis, the corona of the glans clitoris is practically "nonexistent" as evidenced by the noteworthy absence of its mention and depiction in anatomical and clinical sciences. Accordingly, the corona of the glans clitoris has been neglected in anatomical education and clinical practice. This report details the history regarding the anatomical terminology of the glans and identifies that descriptions of the glans penis, corona of the glans penis, and other penile structures have preceded descriptions of the homologous anatomy of the clitoris by at least a century.

Anesthetic Management and Considerations in a Rare Case of Parietal Bone Hemangioma.

Parietal bone hemangiomas represent a minority of diagnosed brain tumors. These lesions require careful management under anesthesia due to their vascularity and cranial location. We discuss a 31-year-old female with chronic headaches who underwent surgery for the removal of a large parietal bone hemangioma, necessitating considerations for stable hemodynamics, intracranial pressure (ICP), and bleeding risks.

Neonatal Mouse Bone Marrow Isolation and Preparation of Bone Marrow-Derived Macrophages.

Various techniques for isolating bone marrow from adult mice have been well established. However, isolating bone marrow from neonatal mice is challenging and time-consuming, yet for some models, it is translationally relevant and necessary. This protocol describes an efficient and straightforward method for preparing bone marrow cells from 7-9-day-old pups.

Over-the-Scope-Clip Iatrogenic Ligation of the Gastroduodenal Artery: A Case Report.

BACKGROUND The Over-the-Scope-Clip (OTSC) System is a class of endoscopic clips intended to provide improved strength and tissue capture compared to conventional through-the-scope clips. These clips are generally safe and effective in managing many gastrointestinal conditions, with a low overall adverse event rate. Although the OTSC has been used to treat gastrointestinal bleeding and bowel perforations for many years, it often is relegated to second-line therapy and has only recently become a first-line hemostatic therapy for gastrointestinal bleeding.

Pediatric Palliative Care of a Transgender Adolescent.

A 15-year-old patient with metastatic synovial sarcoma conveyed to his palliative care physician that his dying wish was to start gender-affirming hormone therapy. His medical team was able to identify resources to support both him and his family as they navigated the immense difficulty of a cancer diagnosis and began to understand their child's gender identity. Literature on the care of gender diverse pediatric patients with terminal illness is minimal, but applications from adult literature, and research on supporting gender diverse adolescents more broadly, provided guidance for palliative care, oncology, and gender-affirming care teams.

Education and training of telemental health providers: a systematic review.

Objective: To conduct a systematic literature review of education and training (E&T) programs for telemental health (TMH) providers in the past 10 years to qualitatively clarify field offerings and methodologies, as well as identify areas for future growth.

Methods: We searched five major electronic databases: PubMed, PsycINFO, Scopus, CINAHL, and Web of Science for original publications on TMH E&T from January 2013 to May 2023. We extracted information from each publication and summarized key features of training programs including setting, target group, study aims, training modality, methods of assessing quality, and outcomes.

Two Cases of Symptomatic Familial Hypocalciuric Hypercalcemia: Treatment Response to Calcimimetic Therapy.

Familial hypocalciuric hypercalcemia (FHH) is marked by mild to moderate hypercalcemia, normal-elevated serum PTH levels, and relative hypocalciuria. Cinacalcet, a calcimimetic therapy, has been reported to reduce symptom burden and serum calcium levels in FHH. We report 2 adult males with chronic hypercalcemia, with initial concerns for primary hyperparathyroidism.

Trans-synaptic Association of Vesicular Zinc Transporter 3 and Shank3 Supports Synapse-Specific Dendritic Spine Structure and Function in the Mouse Auditory Cortex.

Shank3 is a synaptic scaffolding protein that assists in tethering and organizing structural proteins and glutamatergic receptors in the postsynaptic density of excitatory synapses. The localization of Shank3 at excitatory synapses and the formation of stable Shank3 complexes is regulated by the binding of zinc to the C-terminal sterile-alpha-motif (SAM) domain of Shank3. Mutations in the SAM domain of Shank3 result in altered synaptic function and morphology, and disruption of zinc in synapses that express Shank3 leads to a reduction of postsynaptic proteins important for synaptic structure and function.

Occupancy of the HbYX hydrophobic pocket is sufficient to induce gate opening in the archaeal 20S proteasomes.

Enhancing proteasome function has been a long-standing but challenging target of interest for the potential treatment of neurodegenerative diseases, emphasizing the importance of understanding proteasome activation mechanisms. Most proteasome activator complexes use the C-terminal HbYX motif to bind and trigger gate-opening in the 20S proteasome. This study defines a critical molecular interaction in the HbYX mechanism that triggers gate opening.

Horizontal versus vertical strategies for infection prevention: current practices and controversies.

Purpose Of Review: Healthcare-associated infections (HAIs) represent a major burden on healthcare facilities. Effective infection prevention strategies are essential to prevent the spread of HAIs. These can be broadly classified as vertical and horizontal interventions.

Readmission Trends and Outcomes of Transcatheter Edge-to-Edge Repair of Mitral Regurgitation With and Without Anemia.

Background: Anemia is associated with worse clinical outcomes in cardiac patients. We aim to investigate the clinical outcomes and readmission rates in anemic patients undergoing transcatheter edge-to-edge repair (TEER) for severe mitral valve regurgitation (MR).

Methods: The National Readmissions Database (NRD) from 2015 to 2018 was queried using the ICD-10 codes to identify patients admitted for TEER.

Association of autoimmune and autoinflammatory disorders with chronic rhinosinusitis in children.

Background: Increasing evidence suggests that autoimmune disorders and their immunomodulating medications may increase the risk of rhinosinusitis. The goal of this study is to determine if autoimmune and autoinflammatory diseases are associated with increased risk of chronic rhinosinusitis (CRS) in children.

Methods: A retrospective case-control study of pediatric patients (age 2-18 years) seen in the West Virginia University Hospitals System in the past 10 years was performed.

Quadruple Disruption of Superior Shoulder Suspensory Complex With Proximal Humerus Open Fracture-Dislocation: A Case Report.

Case: A 34-year-old man was a restrained passenger involved in a high-speed rollover motor vehicle crash. The patient sustained a type 5 AC joint separation, severely comminuted intra-articular glenoid fracture with extension to the coracoid process base, displaced open scapular body fracture, a posterior shoulder dislocation of the glenohumeral joint, and a 2-part proximal humerus fracture.

Conclusion: To our knowledge, this is the first report describing this injury pattern involving the superior shoulder suspensory complex with an associated open proximal humerus fracture-dislocation.

Glucose instability and outcomes of neonates with hypoxic ischemic encephalopathy undergoing therapeutic hypothermia.

Background: To investigate the prevalence and associated outcomes of glucose abnormalities in infants with hypoxic ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH).

Methods: Glucose values were reviewed in all HIE infants. Pearson's correlation was used to assess the association of hypo- and hyperglycemic episodes with neonatal brain MRI and neurodevelopmental outcomes (NDO) at 12 & 24 months.

The Effect of Aromatherapy on Anxiety and Pain in Patients Undergoing Oculoplastic Surgery.

Purpose: To determine the effect of aromatherapy on postoperative anxiety and pain in patients undergoing oculoplastic surgery.

Methods: A randomized controlled study of 60 patients who underwent monitored anesthesia care sedation for oculoplastic procedures from August 2018 to November 2020. Patients were randomized to an aromatherapy (n = 32) or placebo (n = 28) condition.

Sleep Patterns, Pain, and Emotional Functioning in Youth with Inflammatory Bowel Disease.

Objective: Youth with inflammatory bowel disease (IBD) may be at increased risk for sleep difficulties due to the painful and inflammatory nature of their disease. Moreover, children and adolescents with IBD experience impairment across a variety of psychosocial domains. However, researchers have yet to investigate the complex interplay between sleep, disease-related symptoms, and psychosocial factors in this population.

Blueberry-on-Top Phenomenon in Apical Variant Hypertrophic Cardiomyopathy.

• “Inverse-amyloid” or “blueberry-on-top” strain pattern is a finding in AHCM. • The time to peak strain parametric map is the best depiction of this unique pattern. • This pattern provides a supportive diagnostic feature of apical variant HCM.

Dogs Licks Are Not Benign: Pasturella Multocida Bacteremia From Household Dog.

is a gram-negative coccobacilli commonly colonized in the oral, nasopharyngeal, and upper respiratory tracts of animals. Infections due to range in severity, and symptoms largely depend on underlying immune status and co-morbid conditions. Widely known, the transmission of is commonly thought to occur through biting and skin breakage alone.