Transcarotid Artery Revascularization for Symptomatic Retropharyngeal Internal Carotid Artery Stenosis.

Retropharyngeal internal carotid artery (ICA) is a rare, yet well-described anatomical variant that poses significant challenges to the management of carotid artery stenosis. In this case report, we discuss the treatment of symptomatic ICA stenosis with a retropharyngeal ICA using the transcarotid artery revascularization (TCAR) technique. A 70-year-old female with comorbidities presented with neurological symptoms and severe ICA stenosis.

Chronic Use of Abemaciclib Leading to Breathlessness and Demise: A Case Report.

Checkpoint inhibitor pneumonitis (CIP) is a potentially fatal disease that can occur at any duration of treatment. Patients may present with vague respiratory symptoms such as progressive cough, dyspnea, and decreased activity tolerance. Among checkpoint inhibitors, CIP is higher in programmed death 1 (PD-1) inhibitors.

An technique to measure resistance to compression and kinking of endotracheal tubes.

Background: During intraoperative care, ventilatory parameters including peak inflating pressure (PIP) and exhaled tidal volumes are continuously monitored to assess changes in respiratory resistance and compliance. Changes in these parameters, such as an increase in PIP or a decrease in the exhaled tidal volume, may indicate various pathologic processes that may require immediate attention to prevent inadequate ventilation resulting in hypoxemia or hypercarbia. A kinked endotracheal tube (ETT) may mimic other pathologic processes including bronchospasm, mainstem intubation, or ventilator malfunction.

Medical Error: Using Storytelling and Reflection to Impact Error Response Factors in Family Medicine Residents.

Unlabelled: I am a healer, yet sometimes I do more harm than good…David Hilfiker, 1984.

Objectives: Medical error is common and significantly impacts patients, physicians, learners, and public perception of the medical system; however, residents receive little formal training on this topic. Research on error response in practicing physicians is limited, and even more so on medical education interventions to improve this.

Updated Assessment of Practice Patterns of Perioperative Management of Antiplatelet and Anticoagulant Therapy in Interventional Pain Management.

Background: The role of antiplatelet/anticoagulant therapy is well known for its primary and secondary prevention of sequela from cardiovascular disease by decreasing the incidence of acute cerebral, cardiovascular, peripheral vascular, and other thrombo-embolicevents. The overwhelming data show that the risk of thrombotic events is significantly higher than that of bleeding during surgery after antiplatelet drug discontinuation. It has been assumed that discontinuing antiplatelet therapy prior to performing interventional pain management techniques is a common practice, even though doing so may potentially increase the risk of acute cerebral and cardiovascular events.

Top Three Healthcare Trends in Orthopaedics Affecting Musculoskeletal Care in the Elderly.

Several trends toward patient-centered multi-care models employing translational research strategies are currently emerging in orthopaedics. These align seamlessly with epigenetics discussions in pain, a clinical approach to pain management that prioritizes tailoring healthcare to individual needs, preferences, and circumstances. Recognizing the unique genetic and epigenetic factors influencing pain perception, healthcare providers can integrate personalized insights into their patient-centered approach, offering more targeted and effective pain management strategies tailored to each individual's experience.

Medical Educator Perceptions of Faculty Effort and Intent to Stay in Academic Medicine.

Purpose: Core roles of medical school faculty are increasingly diverse, substantial, and evolving. In alignment with this dynamic nature of medical education, faculty effort should be accurately appraised, constantly evaluated, and rewarded to ensure faculty satisfaction and promote a culture of belonging. The study goal was to examine the imbalance in official assignments and perceptions of medical school faculty effort in various educator domains.

Tech Gaming Designs, Neurodevelopmental Vulnerabilities, and Risks for Internet Gaming Disorder: What Clinicians Need to Know.

Digital gaming has surged in recent decades and is widely available to individuals of all ages. Although the construct of play and games is anthropologically linked to human development, the central question remains: Does the exponential technological advancement target vulnerabilities linked to the risk of addiction? A growing burden of individuals who blur the lines between use, misuse, and addiction adds to the list of many confounders linked to mental health crises. The growing body of literature led to the addition of internet gaming disorder (IGD) to the conditions that need further research section of the .

How Physicians are Trained to Interact With the Dying: A Thematic Analysis of Medical Student Exposures to End-Of-Life Cases.

Physicians-in-training feel uncomfortable coping with the grief they experience while delivering end-of-life care, and medical schools offer minimal formal curricular offerings on end of life care. Few studies have identified what experiences medical students have with death while training or what lessons they are being taught by more senior physicians at bedside. This qualitative study conducted semi-structured interviews prior to and six months into the medical school clinical year.

Compassionate Curiosity: Mitigating the Effects of Bias Through Motivational Interviewing.

There is strong evidence that the implicit biases of health care professionals affect the treatment of patients, and that minority and other marginalized patients are disproportionately harmed. Assumptions made about patient knowledge or lack thereof function as judgments that are prone to bias, which then affect the education and advice imposed upon patients. We review how the motivational interviewing (MI) approach to patient engagement includes components of evidence-based bias-mitigating strategies, such as understanding circumstances from the patient's point of view, and therefore we propose that the MI approach can reduce the impact of bias in patient care.

Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) After Infection During Pregnancy.

Objective: To estimate the prevalence of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) after infection with SARS-CoV-2 during pregnancy and to characterize associated risk factors.

Methods: In a multicenter cohort study (NIH RECOVER [Researching COVID to Enhance Recovery]-Pregnancy Cohort), individuals who were pregnant during their first SARS-CoV-2 infection were enrolled across the United States from December 2021 to September 2023, either within 30 days of their infection or at differential time points thereafter. The primary outcome was PASC , defined as score of 12 or higher based on symptoms and severity as previously published by the NIH RECOVER-Adult Cohort, at the first study visit at least 6 months after the participant's first SARS-CoV-2 infection.

Radiotherapy Enhancing and Radioprotective Properties of Berberine: A Systematic Review.

Background: Natural compounds such as Berberine (Ber) have been considered due to favorable anticancer properties, low side effects, and availability along with chemotherapy treatments.

Objectives: This study aimed to investigate the radiosensitizing and radioprotective properties of Ber.

Methods: In this systematic review that was performed according to PRISMA 2020 guidelines, we searched the publications before 25 Sep 2023 in Web of Science, PubMed, Scopus, Embase, and Cochrane Library databases.

Uric acid and cardiovascular diseases: a reappraisal.

Serum uric acid (SUA) has garnered an increased interest in recent years as an important determinant of cardiovascular disease. Uric acid, a degradation product of purine metabolism, is affected by several inheritable and acquired factors, such as genetic mutation, metabolic syndrome, chronic kidney disease, and medication interactions. Even though elevated SUA have been commonly associated with the development of gout, it has significant impact in the development of hypertension, metabolic syndrome, and cardiovascular disease.

Profound Rhabdomyolysis and Viral Myositis Due to SARS-CoV-2: A Case Report.

The novel SARS-CoV-2 introduced several new inflammatory conditions including SARS-CoV-2-associated rhabdomyolysis and viral myositis. We present a 22-year-old man who noted a week of cough followed by myalgias, dark-colored urine, and decreased oral intake. He was found to have acute nontraumatic rhabdomyolysis after an acutely positive SARS-CoV-2 test.

Through our eyes: A birth mom and adoptive parent share their perspectives on bias in obstetric care.

Understanding the impacts of bias, and how to mitigate these impacts, on clinical care is critically important for all healthcare team members. However, the concerns and needs in our current system are likely even more fundamental, as we are continuing to hear about the experiences of patients who are struggling to seek care that contains even the most basic tenants of respect and decency. Creating inclusive and diverse environments requires constant proactive evaluation, commitment, and energy.

Trophoblast-specific overexpression of the LAT1 increases transplacental transport of essential amino acids and fetal growth in mice.

Placental System L amino acid transporter activity is decreased in pregnancies complicated by intrauterine growth restriction (IUGR) and increased in fetal overgrowth. However, it is unknown if changes in the expression/activity of placental Large Neutral Amino Acid Transporter Small Subunit 1 (Slc7a5/LAT1) are mechanistically linked to placental function and fetal growth. We hypothesized that trophoblast-specific overexpression increases placental transport of essential amino acids, activates the placental mechanistic target of rapamycin (mTOR) signaling, and promotes fetal growth in mice.

The Power of Metaphor: Learning Space and Faculty Development.

Background: Education in the health sciences is transitioning to a student-centered approach that has impacted all components of educational institutions: classroom design, faculty training, selection of learners and faculty.

Activity: Using metaphor analyses, this study investigates the effects on instructor beliefs and values about teaching by having a series of professional development workshops in either a traditional lecture hall or in a collaborative/engaged learning-designed classroom. At the conclusion of the series, both sets of participants were invited to make a free-hand drawing of their "conception" of teaching and label the drawing that represents the conception.

Number needed to treat with intravenous tenecteplase to reduce the need for mechanical thrombectomy in large vessel occlusion acute ischemic stroke patients: A retrospective look at real-world experience data.

Objective: We sought to describe short term outcomes in patients with large vessel occlusion acute ischemic stroke (LVOAIS) who were treated with intravenous tenecteplase (TNK) as compared to alteplase (tPA), focusing on reduction in the need for mechanical thrombectomy (MT).

Background: In LVOAIS, TNK has shown improved reperfusion and outcomes with a similar safety profile to tPA. Ultra-early reperfusion has been described with TNK which would prevent the need for MT.

Association Between Gallstone Disease and Risk of Mortality of Cardiovascular Disease and Cancer: A Systematic Review and Meta-Analysis.

Background: Gallstone disease (GD) is increasing in the world and has various complications.

Objective: This study aims to examine the relationship between GD and the risk of mortality from cardiovascular disease (CVD) and cancer using a systematic review and meta-analysis approach.

Methods: A comprehensive and systematic search was done in various databases, such as Web of Science (WOS), Scopus, MEDLINE/PubMed, Cochrane, and Embase.