Co-occurrence of ipsilateral partial Horner's syndrome in a patient with monomelic amyotrophy.

Monomelic amyotrophy (MMA) is a lower motor neuron predominant disorder affecting an upper limb, which can mimic amyotrophic lateral sclerosis (ALS). It often presents with unilateral, distal upper limb weakness and atrophy, whose trajectory is one of an initial period of progression followed by a prolonged plateau, as opposed to the typically relentless progression as is seen in ALS. This case report describes a novel observation of a patient with MMA with an unexplained ipsilateral partial Horner's syndrome (miosis and ptosis).

To fuse or not to fuse: surgical strategies for recurrent lumbar disc herniation from a 16-nation study.

Objective: Variations exist among surgeons in the treatment of recurrent lumbar disc herniation (LDH), generating major issues in decision-making models. The authors aimed to identify international nuances in surgical treatment patterns, highlight the differences in responses in each country group and different treatment trends across countries, and identify factors that influence surgical decisions.

Methods: An online survey with preformulated answers was submitted to 292 orthopedic surgeons and 223 neurosurgeons from 16 countries regarding 3 clinical vignettes (recurrence without low back pain, recurrence with severe low back pain, and recurrence with 2-level disc disease).

Mechanisms of Change in Exposure Therapy for Anxiety and Related Disorders: A Research Agenda.

Anxiety and related disorders are a significant public health burden with rising prevalence in the wake of the COVID-19 pandemic. As demand for effective anxiety treatment increases, so too does the need for strategies to bolster treatment outcomes. Research on the mechanisms of exposure therapy, the frontline behavioral treatment, will be critically important for optimizing clinical outcomes.

The Role of Liquid Biopsy in the Management of Patients with Genitourinary Malignancies.

Background And Objective: Liquid biopsy testing refers to the use of specific analytical methods to detect disease-related biomarkers in blood or its components. These tests can be either qualitative or quantitative. Liquid biopsy testing is increasingly used in patient care.

Genomic aberration detection by fluorescence in situ hybridization.

Fluorescence in situ hybridization (FISH) is a simple, rapid, and reliable method for detecting genomic alterations relevant to a wide range of diseases, particularly neoplastic disorders, using routine surgical and cytological specimens. By employing fluorescent-labeled nucleic acid or nucleotide analog probes to target specific DNA sequences on chromosomes, FISH facilitates accurate diagnosis, tumor classification, biomarker identification, selection of targeted therapies, and monitoring of treatment efficacy. As the technology continues to evolve, the demand for FISH is expected to grow, given its cost-effectiveness in supporting diagnostic and therapeutic decisions.

Stress reactivity and maternal health (STRIVE): protocol for a multisite observational cohort study.

Introduction: Black adults are generally exposed to more stressors over the life course and, due to the intersections of racism and economic and social resources, they tend to have more limited resources to cope with social stressors than white adults. This mismatch between stress exposures and resources may lead to dysregulated responses or reactivity to stressors and contribute to persistent racial disparities seen in adverse pregnancy outcomes (APOs). Prior studies examining stress exposures have been hampered by the challenge of capturing stress exposures comprehensively, given they are manifold, dynamic and accumulate over time.

The Dublin International Society of Urological Pathology (ISUP) Consensus Conference on Best Practice Recommendations on the Pathology of Glandular Lesions of the Urinary Bladder.

The Dublin ISUP Consensus Conference covered the proceedings on the best practice recommendations on nonurachal glandular lesions of the urinary bladder, bladder diverticular cancers, and molecular features of bladder and urachal glandular lesions. The conference proceedings on urachal neoplasms (except for their molecular features) are published elsewhere. The rationale for convening this conference was the lack of structured and consented pathologic recommendations in these rare lesions.

Urinary Tumor DNA-based Liquid Biopsy in Bladder Cancer Management: A Systematic Review.

Background And Objective: Urinary tumor DNA (utDNA) has emerged as a promising biomarker in the care, diagnosis, early detection, recurrence monitoring, and prognosis of bladder cancer (BCa). Its noninvasive nature, ease of access, and cost effectiveness make it an attractive option for both patients and health care providers. This review describes the current state of utDNA as a marker of BCa.

Reappraisal of Neuroendocrine Tumor Classification of the Prostate Gland: Translating Molecular Insights into Clinical Practice.

Neuroendocrine tumors (NETs) of the prostate gland represent a distinct entity within the spectrum of prostate cancer, characterized by neuroendocrine differentiation on morphology and unique clinical behavior. Despite their clinical significance, there remains a lack of consensus regarding their diagnosis, classification, immunohistochemical evaluation, and management. A comprehensive understanding of the molecular and clinical heterogeneity of prostate NETs is essential for developing tailored treatment strategies and improving patient outcomes.

RECi-PE (REducing CT in Pulmonary Embolism Diagnosis): an emergency department quality intervention.

Background: Pulmonary embolism (PE) is a potentially deadly disease and a diagnostic challenge in emergency departments (EDs). Established strategies exist for risk stratification and test stewardship for CT pulmonary angiography (CTPA). However, implementation of best practices has proven challenging, and rising CTPA utilisation increases costs, radiation exposure and ED crowding.

Artificial intelligence in prostate cancer.

Prostate cancer (PCa) ranks as the second most prevalent malignancy among men worldwide. Early diagnosis, personalized treatment, and prognosis prediction of PCa play a crucial role in improving patients' survival rates. The advancement of artificial intelligence (AI), particularly the utilization of deep learning (DL) algorithms, has brought about substantial progress in assisting the diagnosis, treatment, and prognosis prediction of PCa.

Myeloid sarcomas of the genitourinary tract: A multi-institutional study of sixteen tumors with review of literature.

Myeloid sarcoma (MS) is a rare extramedullary manifestation of acute myelogenous leukemia (AML). Leukemic involvement of the genitourinary (GU) tract is extremely rare with only 2-7 % of the reported MS cases involving the kidney or urinary system. Patients with urinary tract MS can present with signs and symptoms related to urinary tract obstruction, hematuria, or urinary retention.

Clinical Application of Large Language Models in Generating Pathologic Images.

Purpose: This study investigates the potential of DALL·E 3, an artificial intelligence (AI) model, to generate synthetic pathologic images of prostate cancer (PCa) at varying Gleason grades. The aim is to enhance medical education and research resources, particularly by providing diverse case studies and valuable teaching tools.

Methods: This study uses DALL·E 3 to generate 30 synthetic images of PCa across various Gleason grades, guided by standard Gleason pattern descriptions.

Association of Dipeptidyl Peptidase-4 Inhibitors with Glaucoma Risk in Patients with Type 2 Diabetes: A Nationwide Cohort Study.

Purpose: To investigate the association between dipeptidyl peptidase-4 inhibitors (DPP4is) and the risk of primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG) in patients with type 2 diabetes mellitus (T2DM).

Design: Retrospective cohort study.

Subjects: A total of 582 710 patients with T2DM treated with either DPP4i (exposure group) or non-DPP4i medications (control group) were analyzed between 2008 and 2021.

International Society of Urological Pathology Consensus Meeting 2024: Working Group 2 Preneoplastic and Precursor Lesions of the Urinary Bladder.

Preneoplastic and precursor lesions are important to recognize and report, as they can influence clinical management decisions. The International Society of Urological Pathology (ISUP) organized a consensus meeting in Florence, Italy, in September 2024 focused on preneoplastic and precursor lesions of the genitourinary organs. Working group 2 was assigned the topic of bladder and a group of pathologists and clinicians was convened.

Evaluation of antiretroviral regimen switching options in adults with HIV with sustained viral load non-suppression on dolutegravir, lamivudine, and tenofovir in eastern, central, southern, and western Africa: a modelling study.

Background: In Africa, for people with HIV on a dolutegravir-based regimen with a viral load of more than 1000 copies per mL despite enhanced adherence counselling, the appropriate course of action is uncertain. We aimed to evaluate the predicted effects of alternative antiretroviral regimen switching options in this population, including consideration of cost-effectiveness.

Methods: We used an existing individual-based model to simulate risk and experience of HIV in 100 000 adults alive between 1989 and 2076.

Addressing Pediatric Asthma Disparities through RI-AIR's Community Approach: A Randomized Trial.

Rationale: Clustering of social and environmental risks in low-income neighborhoods is a key factor in racial and ethnic asthma disparities. Integrating school and in-home programs, with treatment tailored to disease risk, is a promising approach for children with high disease burden.

Objectives: We evaluated the Rhode Island-Asthma Integrated Response (RI-AIR) Program in improving asthma outcomes at the individual and community levels.

A Thiopurine-like Mutagenic Process Defines TGCT Subtypes.

Testicular germ cell tumors (TGCTs) are the most common malignancy in young men, exhibit a unique developmental origin and exceptional chemosensitivity. However, the molecular distinctions between TGCT subtypes remain poorly understood. Here we present a comprehensive genomic analysis of 252 treatment-naive primary TGCTs, integrating deep whole-genome sequencing with matched transcriptomic and epigenomic data.

Acute Respiratory Tract Infection and Sudden Sensorineural Hearing Loss: A Multinational Cohort Study.

Sudden sensorineural hearing loss (SSNHL) is an acute condition with unclear etiology, commonly hypothesized to be associated with viral infections. Acute respiratory tract infections (RTIs), particularly those of viral origin, have been implicated in SSNHL through proposed mechanisms such as cochlear invasion and immune-mediated damage. However, robust large-scale epidemiological evidence examining this association remains limited.

Molecular Subtypes of Balanopreputial and Urethral Male Genital Lichen Sclerosus: Distinct Transcriptomic and Clinicopathological Profiles.

Male genital lichen sclerosus (MGLSc) is a heterogeneous and aggressive disease characterized by varying severities of balanopreputial and urethral disease (MGLSc-US) and outcomes, including stricture. This study aims to elucidate the transcriptomic heterogeneity of MGLSc and explore its associations with histological and clinical features. We collected 40 preputial samples and 14 urethral tissue samples from patients with MGLSc-US, non-MGLSc urethral strictures, and redundant prepuce.

Proteoglycan-4 (PRG4) serum concentration is lower in aged mice, and genetic deficiency impacts survival probability, blood parameters, and bone during aging.

Proteoglycan 4 (PRG4) is a mucin-like glycoprotein best known as a boundary lubricant of articular cartilage; however, it also has anti-inflammatory, anti-fibrotic, and immunomodulatory properties. Loss-of-function mutations in the PRG4 gene in humans result in Camptodactyly-Arthropathy-Coxa vara-Pericarditis (CACP), a rare disease in which patients often require joint replacements at young ages. However, it remains unknown how circulating PRG4 levels change with age or how PRG4 deficiency affects aging.