Activation of acid-sensing ion channels by carbon dioxide regulates amygdala synaptic protein degradation in memory reconsolidation.

Reconsolidation has been considered a process in which a consolidated memory is turned into a labile stage. Within the reconsolidation window, the labile memory can be either erased or strengthened. Manipulating acid-sensing ion channels (ASICs) in the amygdala via carbon dioxide (CO) inhalation enhances memory retrieval and its lability within the reconsolidation window.

Expression Analysis of Same-Patient Metachronous and Synchronous Upper Tract and Bladder Urothelial Carcinoma.

Purpose: We compared upper tract urothelial carcinoma (UTUC) and bladder urothelial carcinoma (BUC) in same-patient metachronous UTUC and synchronous UTUC and BUC using next-generation sequencing.

Materials And Methods: Consecutive untreated same-patient samples of UTUC and BUC were macrodissected from unstained formalin-fixed, paraffin-embedded slides after quality control. Samples were divided into 4 groups: 1) UTUC-metachronous BUC, 2) BUC-metachronous UTUC, 3) synchronous UTUC-BUC, 4) UTUC without BUC.

Novel Classification for Upper Tract Urothelial Carcinoma to Better Risk-stratify Patients Eligible for Kidney-sparing Strategies: An International Collaborative Study.

Background: The European Association of Urology risk stratification dichotomizes patients with upper tract urothelial carcinoma (UTUC) into two risk categories.

Objective: To evaluate the predictive value of a new classification to better risk stratify patients eligible for kidney-sparing surgery (KSS).

Design, Setting, And Participants: This was a retrospective study including 1214 patients from 21 centers who underwent ureterorenoscopy (URS) with biopsy followed by radical nephroureterectomy (RNU) for nonmetastatic UTUC between 2000 and 2017.

Supraventricular Tachycardia and Postural Orthostatic Tachycardia Syndrome Overlap: A Retrospective Study.

Postural orthostatic tachycardia syndrome (POTS) and supraventricular tachycardia (SVT) are disease states with distinctive features but overlapping clinical manifestations. Currently, studies on the presence of underlying SVT in patients with POTS are lacking. This retrospective study analyzed 64 patients [mean age: 43 years; 41 (61%) women] who had a POTS diagnosis and were found to have concomitant SVT during rhythm monitoring from September 1, 2013 to September 30, 2019 at our Syncope and Autonomic Disorders Clinic.

Acute biliary pancreatitis has better outcomes but increased resource utilization compared to acute alcohol-induced pancreatitis: insights from a nationwide study.

Background: The differences in outcomes between acute biliary pancreatitis (ABP) and acute alcohol-induced pancreatitis (AAP) have not been well studied. We sought to examine the differences between ABP and AAP as regards to in-hospital outcomes and resource utilization, using a large nationwide database.

Methods: We queried the National Inpatient Sample databases 2016 and 2017 using the International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM) coding system to identify the patients with a primary diagnosis of AAP and ABP.

Duration of symptomatic stroke and successful reperfusion with endovascular thrombectomy for anterior circulation large vessel occlusive stroke.

Background: It has been reported that longer time intervals from stroke onset to endovascular therapy are associated with lower rates of successful reperfusion in acute ischemic stroke patients with large vessel occlusion. However, procedural variables and potential mechanisms of this association have not been fully elucidated.

Methods: We performed a secondary analysis of individual patient data from the North American Solitaire Stent Retriever Acute Stroke (NASA) and Trevo Stent-Retriever Acute Stroke (TRACK) registries.

Sex differences in outcomes of acute pancreatitis: Findings from a nationwide analysis.

Background: Sex is thought to play a significant role in predicting outcomes in numerous diseases. The role sex plays in acute pancreatitis (AP) remains limited. We sought to determine if sex is associated with hospitalization outcomes in this population, using a large national database.

New-onset Postural Orthostatic Tachycardia Syndrome Following Coronavirus Disease 2019 Infection.

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2. We report a case of new-onset postural orthostatic tachycardia syndrome in an otherwise healthy female patient following COVID-19 infection. The patient presented with fatigue, orthostatic palpitations, dizziness, and presyncope.

Impact of exposure to patients with COVID-19 on residents and fellows: an international survey of 1420 trainees.

Objectives: To determine how self-reported level of exposure to patients with novel coronavirus 2019 (COVID-19) affected the perceived safety, training and well-being of residents and fellows.

Methods: We administered an anonymous, voluntary, web-based survey to a convenience sample of trainees worldwide. The survey was distributed by email and social media posts from April 20th to May 11th, 2020.

Comparative effectiveness of neoadjuvant chemotherapy in bladder and upper urinary tract urothelial carcinoma.

Objective: To assess the differential response to neoadjuvant chemotherapy (NAC) in patients with urothelial carcinoma of the bladder (UCB) compared to upper tract urothelial carcioma (UTUC) treated with radical surgery.

Patients And Methods: Data from 1299 patients with UCB and 276 with UTUC were obtained from multicentric collaborations. The association of disease location (UCB vs UTUC) with pathological complete response (pCR, defined as a post-treatment pathological stage ypT0N0) and pathological objective response (pOR, defined as ypT0-Ta-Tis-T1N0) after NAC was evaluated using logistic regression analyses.

Adenotonsillectomy as a treatment for sleep-disordered breathing in children with ADHD.

Sleep-disordered breathing (SDB) and attention deficit hyperactivity disorder (ADHD) are common disorders diagnosed in children. Although these diagnoses were previously considered unrelated, research now is showing that some symptoms of ADHD, specifically oppositional behavior, hyperactivity, and impulsivity, can be related to SDB in children and differs from bona fide ADHD. This article explores the connection between the two disorders and the importance of identifying and screening for SDB in children presenting with similar symptoms related to ADHD.

Stent placement for long-segment total occlusion of an aberrant right subclavian artery: A 7-year follow-up.

An aberrant origin of the right subclavian artery arising as the most distal vessel from the aortic arch is an uncommon but clinically important anomaly. Its abnormal course may result in esophageal compression with dysphagia, or tracheal compression resulting in asthma or stridor, and can greatly complicate radial artery access for coronary angiography. When an aberrant right subclavian artery is obstructed by atherosclerotic plaque, it may produce symptoms of arm ischemia such as pain and weakness.

Epidemiology, clinical presentation, and evaluation of upper-tract urothelial carcinoma.

An overview of epidemiological pattern of upper tract urothelial carcinoma (UTUC), including outcome of UTUC over past decades as well as factors responsible for observed epidemiological changes was performed. Gender and racial disparities influencing incidence of UTUC were reviewed. The incidence of multifocal urothelial carcinoma and relation of UTUC to urothelial carcinoma of bladder were examined.

Outcomes of treatment modalities for ruptured intracranial aneurysms based on age - A meta-analysis.

Background: Data comparing the effect of age on outcomes of patients who underwent either endovascular coiling (EVC) or neurosurgical clipping (NSC) for ruptured intracranial aneurysms remains limited.

Objective: To better elucidate the preferred intervention for ruptured aneurysm management by presenting the results of our systematic review of the literature that evaluated the potential advantages of the two interventions between different age groups.

Methods: Systematic review of PubMed and Embase was performed (2002 - June 10, 2019) following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2013 guidelines.

Evaluation of Basal Insulin Dose Reductions in Hospitalized Patients With Diabetes While Unable to Eat.

The American Diabetes Association guidelines recommend a basal plus correction or basal insulin regimen for patients with type 2 diabetes mellitus (T2DM) receiving nothing by mouth (NPO; nil per os) in the non-intensive care unit setting. In the perioperative setting, 60% to 80% of long-acting insulin or half-dose morning insulin NPH is recommended. The goal of this study was to determine the impact of basal insulin dose reduction for hospitalized patients with insulin-dependent T2DM while NPO.

Rates and Predictors of 30-Day Readmissions in Patients Undergoing Bariatric Surgery in the US: a Nationwide Study.

Background: Among various therapeutic options for morbid obesity, bariatric surgery (BS) is now considered one of the most effective methods of weight loss. We decided to perform an analysis to look at 30-day all-cause readmission and independent predictors of readmission in patients undergoing BS.

Methods: We queried the 2017 Nationwide Readmission Database (NRD) using ICD-10-CM diagnosis codes to identify all adult patients who underwent BS from January 1 to November 30, 2017.

A single, shared origin for all three coronary arteries from the right coronary cusp: a case report.

Background: Anomalous coronary arteries occur in less than 1% of the population and have been implicated in sudden cardiac and exercise-related death. The most common variant involves the left circumflex artery arising from a separate ostium than the left coronary artery. This case demonstrates a rare variation in which all three coronary arteries arise from a shared, single, ostium originating from the right coronary cusp.

Bupropion in the treatment of postural orthostatic tachycardia syndrome (POTS): a single-center experience.

Postural orthostatic tachycardia syndrome (POTS) is estimated to impact millions of people each year. However, there is no established gold standard for its treatment. Bupropion is a norepinephrine and a dopamine reuptake inhibitor and has been implicated as a potential treatment for POTS.

Surgical Treatment of a Chronic Morel-Lavallée Lesion: A Case Report.

Introduction: Morel-Lavallée lesions (MLLs) are a post-traumatic degloving injury which the superficial fascia and skin are separated from the deep fascia through shearing forces. This process leads to the development of a potential space in which blood products and necrotic material can collect, potentially resulting in abscesses, cellulitis, or osteomyelitis. Most of these cases occur at the greater trochanter, gluteal musculature, proximal femur, and around the knee.

Evaluation of the Safety and Efficacy of Metformin Use in Hospitalized, Non-Critically Ill Patients.

Contraindications and precautions to metformin have limited inpatient use, and limited evidence exists evaluating metformin in hospitalized patients. This study aimed to determine the safety and efficacy of inpatient metformin use. This study was an observational, retrospective, cohort study at an academic medical center between June 1, 2016, and May 31, 2018.

Reconstruction of Complex Cranial and Orbit Fractures with Associated Hemorrhages: Case Report and Review of the Literature.

We present our experience following a unique case of coincident intracranial hemorrhage and comminuted fractures of both the squamous temporal bone and zygomaticofrontal orbit. Surgical techniques and outcome for this presentation have yet to be sufficiently described. A 55-year-old male presented following trauma with Glasgow Coma Scale score of 7.

Chronic Septic Arthritis in a Patient Referred for Total Knee Arthroplasty.

Background: While and other species were historically considered contaminants, they are recently being identified as pathogens with increasing frequency. . We report the case of a 78-year-old gentleman with a three-year history of knee pain and established diagnosis of osteoarthritis referred for consideration for total knee arthroplasty.

Gag Reflex-Mediated Restoration of Sinus Rhythm during TEE Probe Insertion for Atrial Fibrillation: A Word of Caution.

It is recommended to attempt vagal maneuvers as initial therapy in various types of supraventricular tachycardia. While various forms of vagal techniques have been described, a gag reflex-mediated vagal technique, to the best of our knowledge, has not been. We present a case of gag reflex-mediated restoration of sinus rhythm in a patient with atrial fibrillation and rapid ventricular response upon transesophageal probe insertion.