Involvement of the right lentiform nucleus is an independent predictor of poor outcomes in large vessel occlusion strokes with small infarct volumes.

Background: Final infarct volume (FIV) is a strong predictor of stroke outcomes. Although smaller FIV are associated with better outcomes, many patients fail to achieve functional independence. We aimed to identify poor outcome predictors in patients with anterior large vessel occlusion stroke (LVOS) who underwent mechanical thrombectomy (MT) and had small FIV.

If you build it, they will come - Implementation of a prehospital whole blood program.

Introduction: We sought to develop, implement and evaluate an urban prehospital whole blood (PH-WB) program.

Methods: Using retrospective heat map data, Quick Response Vehicles (QRVs) carrying PH-WB were strategically placed throughout the city and dispatched using dynamic deployment. Patient inclusion criteria were age ≥15 years, traumatic mechanism, and SBP ≤90 ​mmHg.

---Pars plana vitrectomy in congenital X-linked retinoschisis: a scoping review.

Purpose: Congenital X-linked retinoschisis (XLRS) has limited treatment options. Gene augmentation via pars plana vitrectomy (PPV) and subretinal RS1 gene delivery is promising, yet it is unclear how PPV may impact outcomes. We explored literature to better understand PPV outcomes in XLRS.

Outcomes Following Robotic Surgery for Complicated and Uncomplicated Diverticulitis.

BackgroundLaparoscopic colectomy is standard for uncomplicated diverticulitis (UD) but has higher conversion and morbidity rates in complicated diverticulitis (CD). Robotic colectomy (RC) is increasingly used for both UD and CD. This study compared outcomes of RC for CD and UD and evaluated factors contributing to adverse outcomes.

Coronary embolisation of a left ventricular fibroelastoma mimicking a thrombus and triggering Takotsubo cardiomyopathy.

We describe a case of a woman in her 70s who presented with acute chest pain and ST-segment elevation on ECG. Multimodality cardiac imaging confirmed Takotsubo cardiomyopathy alongside a pedunculated left ventricular mass, presumed to be a thrombus, with suspected embolisation to the left anterior descending artery, triggering an acute myocardial infarction. She received guideline-directed medical therapy for heart failure and anticoagulation for the thrombus.

Progesterone for Traumatic Brain Injury, Experimental Clinical Treatment III Trial Revisited: Objective Classification of Traumatic Brain Injury With Brain Imaging Segmentation and Biomarker Levels.

Objective: This post hoc study of the Progesterone for Traumatic Brain Injury, Experimental Clinical Treatment (ProTECT) III trial investigates whether improving traumatic brain injury (TBI) classification, using serum biomarkers (glial fibrillary acidic protein [GFAP] and ubiquitin carboxyl-terminal esterase L1 [UCH-L1]) and algorithmically assessed total lesion volume, could identify a subset of responders to progesterone treatment, beyond broad measures like the Glasgow Coma Scale (GCS) and Glasgow Outcome Scale-Extended (GOS-E), which may fail to capture subtle changes in TBI recovery.

Design: Brain lesion volumes on CT scans were quantified using Brain Lesion Analysis and Segmentation Tool for CT. Patients were classified into true-positive and true-negative groups based on an optimization scheme to determine a threshold that maximizes agreement between radiological assessment and objectively measured lesion volume.

Integrative medicine for chronic pain management: a narrative review.

Purpose Of Review: To present a broad overview of integrative medicine relevant to the field of pain management, summarize information for pain medicine practitioners, and highlight the possible role and incorporation of integrative medicine in daily practice.

Recent Findings: From 2002 to 2022, the percentage of American individuals using at least one of seven integrative medicine approaches has increased from 19.2 to 36.

Comfort With Sharing Food Insecurity Risk for Clinical Care Among Individuals With and Without a Cancer History: Findings From a National Survey.

Introduction: Food insecurity negatively affects timely access to care, treatment adherence, quality of life, and survival among cancer survivors. There is limited knowledge about cancer survivors' comfort with sharing food insecurity risk for clinical care on a national scale. This study aims to assess comfort with sharing food insecurity risk for clinical care among adults with and without a cancer history and to identify factors that may be associated with comfort for sharing food insecurity risk.

Intraocular hemorrhage in patients misdiagnosed with central retinal artery occlusion treated with thrombolysis.

Introduction: The diagnosis of acute central retinal artery occlusion (CRAO) is commonly delayed in emergency departments (ED) where ophthalmologists are rarely available for immediate consultation. Thrombolysis is sometimes given empirically for presumed CRAO without confirmation of the diagnosis with ocular funduscopic examination.

Methods: We describe one case of severe intraocular hemorrhage following intravenous thrombolysis for a retinal detachment misdiagnosed as a CRAO, and two cases of worsening intraocular hemorrhage following intravenous thrombolysis for misdiagnosed CRAO, and review the literature.

Associations Among Demographic and Clinical Characteristics and Discrimination Experiences of Autistic Youth.

Purpose: Autistic individuals experience discrimination as a neurominority. Nonetheless, there has been limited research on characteristics or factors contributing to discrimination against autistic people. Therefore, this study sought to examine demographic and clinical predictors of discriminatory experiences of autistic children and adolescents utilizing a large, population-based sample.

Clinical outcomes and independently adjudicated results of M2 aspiration thrombectomy: a subgroup analysis from the Imperative Trial.

Background: The ESCAPE-MeVO (Endovascular Treatment to Improve Outcomes for Medium Vessel Occlusions) and DISTAL (Endovascular Therapy plus Best Medical Treatment vs Best Medical Treatment Alone for Medium Vessel Occlusion Stroke) trials failed to demonstrate the superiority of endovascular thrombectomy over best medical management for medium and small vessel occlusions. Potential limitations of these trials include older patient populations, lower presenting National Institutes of Health Stroke Scale (NIHSS) scores, higher rates of premorbid disability, delayed revascularization times, inclusion of both medium and small vessel occlusions, and widespread use of stent retrievers. Here we present M2 occlusion data from the Imperative Trial, evaluating aspiration thrombectomy with the Zoom System.

Pediatric N-Methyl-d-Aspartate Receptor Encephalitis is Differentiated From Encephalitis Mimickers by Early Elevated Blood Pressure.

Background: Pediatric N-methyl-d-aspartate receptor (NMDAR) encephalitis (pNMDARE) is characterized by severe neuropsychiatric symptoms and prolonged hospitalization and recovery. Early pNMDARE diagnosis is complicated by neuropsychiatric mimickers requiring strong clinical suspicion to escalate to the required lumbar puncture (LP), delaying diagnosis and treatment. Since autonomic dysfunction is a cardinal feature of pNMDARE, we hypothesized that early vital signs serve as a potential noninvasive biomarker to screen for appropriate escalation of pNMDARE evaluation.

PD-1 expression identifies proliferating malignant CLL B cells and is a potential biomarker of response to BTK inhibitor therapy.

Chronic lymphocytic leukemia (CLL) remains incurable despite treatment advances, and a major challenge is that biomarkers that predict response and resistance to current therapies are lacking. We report that activated and proliferating malignant CLL B cells in circulation express PD-1, a protein normally expressed in T cells. PD-1 expression is absent in circulating B cells from healthy controls and nonmalignant B cells from patients with CLL.

Enhanced electrophysiological recordings in acute brain slices, spheroids, and organoids using 3D high-density multielectrode arrays.

Recent advances in three-dimensional (3D) biological brain models in vitro and ex vivo are creating new opportunities to understand the complexity of neural networks but pose the technological challenge of obtaining high-throughput recordings of electrical activity from multiple sites in 3D at high spatiotemporal resolution. This cannot be achieved using planar multi-electrode arrays (MEAs), which contact just one side of the neural structure. Moreover, the specimen adhesion to planar MEAs limits fluid perfusion along with tissue viability and drug application.

Aortoiliofemoral Lower Extremity CT Angiography.

CT angiography (CTA) of the aortoiliofemoral (AIF) arteries in the abdomen, pelvis, and lower extremities has become an invaluable tool in assessment of patients with peripheral arterial disease (PAD) and lower extremity trauma. AIF CTA provides rapid and comprehensive assessment of arterial inflow and outflow, guiding management of patients with chronic claudication and those with more acute manifestations, including atherothrombotic occlusion, embolic disease, or thrombosis of prior interventions such as bypass graft or stent placement. Careful attention to technique is critical in performing diagnostic AIF CTA, as pitfalls related to imaging too early or too late relative to the arrival of contrast material in the legs can lead to misdiagnosis or diagnostic uncertainty.

Localized high-risk prostate cancer harbors an androgen receptor activity-low subpopulation susceptible to HER2 inhibition.

Background: Localized high-risk prostate cancer (PCa) often recurs despite neoadjuvant androgen deprivation therapy (ADT). We sought to identify baseline molecular programs that predict pathologic response and reveal targetable vulnerabilities.

Methods: We profiled 147 biopsy foci from 48 MRI-visible lesions in 37 patients before 6 months of ADT plus enzalutamide and radical prostatectomy.

Show Me the Money: A Movement Towards Transparency in Pediatric Emergency Medicine Compensation.

Background: National studies report sustained gender-based differences in physician compensation, even after adjustment for workplace factors such as academic rank, specialty type, and work hours. This study examines differences in compensation among pediatric emergency medicine (PEM) fellows' first job after training.

Methods: Between May 2023 and June 2023, we distributed an electronic survey to all United States PEM fellowship program directors (FPDs), requesting they forward it to their graduating fellows.

A narrative review of toxicity after exposure to true morel ( genus) and false morel ( genus) mushroom ingestions.

Introduction: The clinical presentations associated with spp. (true morel) and spp. (false morel) mushroom ingestions are incompletely characterized.

Comprehensive Analysis of Conditional Survival in Radiation-treated Patients With Gynecologic Malignancies Using the SEER Database.

Objectives: In this study, we report conditional survival rate for gynecologic malignancies using Surveillance, Epidemiology, and End Results (SEER) database for patients who have received treatment with radiation therapy.

Methods: Utilizing the SEER 22 database and SEER*Stat 8.4.