Purpose: Nocturia significantly impacts patients’ quality of life but remains insufficiently evaluated and treated. The “Sleep C.A.L.M.” system categorizes the factors thought to collectively reflect most underlying causes of nocturia (Sleep disorders, Comorbidities, Actions [i.e., modifiable patient behaviors such as excess fluid intake], Lower urinary tract dysfunction, and Medications). The purpose of this study was to assess the association of nocturia with the Sleep C.A.L.M. categories using a nationally representative dataset. Methods: Retrospective analysis of the National Health and Nutrition Examination Survey from 2013/14–2017/18 cycles was conducted. Pertinent questionnaire, laboratory, dietary, and physical examination data were used to ascertain the presence of Sleep C.A.L.M. categories in adults ≥20 years of age. Nocturia was defined as ≥2 nighttime voids. Results: A total of 12,274 included subjects were included (51.6% female; median age, 49.0 years [interquartile range, 34.0–62.0 years]; 27.6% nocturia). Among subjects with nocturia, the prevalence of 0, ≥1, and ≥2 Sleep C.A.L.M. categories was 3.5% (95% confidence interval [CI], 2.8%–4.4%), 96.5% (95% CI, 95.6%–97.2%), and 81.2% (95% CI, 78.9%–83.3%), respectively. Compared to those with 0–1 Sleep C.A.L.M. categories, the adjusted odds of nocturia in subjects with 2, 3, and 4–5 Sleep C. A.L.M. categories were 1.77 (95% CI, 1.43–2.21), 2.33 (1.89–2.87), and 3.49 (2.81–4.35), respectively (P<0.001). Similar trends were observed for most age and sex subgroups. When assessed individually, each of the 5 Sleep C.A.L.M. categories were independently associated with greater odds of nocturia, which likewise persisted across multiple age and sex subgroups. Conclusions Sleep C.A.L.M. burden is associated with increased odds of nocturia in a dose-dependent fashion, and potentially a relevant means by which to organize the underlying etiologies for nocturia among community-dwelling adults.

Background: and Purpose The management of acute ischemic stroke (AIS) due to distal medium vessel occlusion (DMVO) remains uncertain, particularly in comparing the effectiveness of intravenous thrombolysis (IVT) plus mechanical thrombectomy (MT) versus IVT alone. This study aimed to evaluate the safety and efficacy in DMVO patients treated with either MT-IVT or IVT alone. Methods: This multinational study analyzed data from 37 centers across North America, Asia, and Europe. Patients with AIS due to DMVO were included, with data collected from September 2017 to July 2023. The primary outcome was functional independence, with secondary outcomes including mortality and safety measures such as types of intracerebral hemorrhage. Results: The study involved 1,057 patients before matching, and 640 patients post-matching. Functional outcomes at 90 days showed no significant difference between groups in achieving good functional recovery (modified Rankin Scale 0–1 and 0–2), with adjusted odds ratios (OR) of 1.21 (95% confidence interval [CI] 0.81 to 1.79; P=0.35) and 1.00 (95% CI 0.66 to 1.51; P>0.99), respectively. Mortality rates at 90 days were similar between the two groups (OR 0.75, 95% CI 0.44 to 1.29; P=0.30). The incidence of symptomatic intracerebral hemorrhage was comparable, but any type of intracranial hemorrhage was significantly higher in the MT-IVT group (OR 0.43, 95% CI 0.29 to 0.63; P<0.001). Conclusion The results of this study indicate that while MT-IVT and IVT alone show similar functional and mortality outcomes in DMVO patients, MT-IVT presents a higher risk of hemorrhagic complications, thus MT-IVT may not routinely offer additional benefits over IVT alone for all DMVO stroke patients. Further prospective randomized trials are needed to identify patient subgroups most likely to benefit from MT-IVT treatment in DMVO.

As a serine hydrolase, monoacylglycerol lipase (MAGL) is principally responsible for the metabolism of 2-arachidonoylglycerol (2-AG) in the central nervous system (CNS), leading to the formation of arachidonic acid (AA). Dysfunction of MAGL has been associated with multiple CNS disorders and symptoms, including neuroinflammation, cognitive impairment, epileptogenesis, nociception and neurodegenerative diseases. Inhibition of MAGL provides a promising therapeutic direction for the treatment of these conditions, and a MAGL positron emission tomography (PET) probe would greatly facilitate preclinical and clinical development of MAGL inhibitors. Herein, we design and synthesize a small library of fluoropyridyl-containing MAGL inhibitor candidates. Pharmacological evaluation of these candidates by activity-based protein profiling identified

A 65-year-old woman was addressed for clinical and biological suspicion of ovarian cancer relapse. 18F-FDG PET/CT revealed massive peritoneal carcinomatosis. Post-chemotherapy PET/CT showed complete metabolic response in initial localizations albeit three new 18F-FDG uptakes appeared in the mesentery and in the retro-hepatic space. Close follow-up (including PET/ CT scan) and surgical examination of the abdominal cavity confirmed the absence of malignancy and the benign nature of these lesions, which appeared to be peritoneal fibrosis mimicking persistent carcinomatosis.

No abstract available.
Arteries ; Cohort Studies

Patients are faced with many questions surrounding the after effects of the various surgical procedures and their ability to return to preoperative activities. While patients often question whether surgery would provide alleviation of pain, weakness, and instability, they often have additional questions about sexual activity during their convalescence that are not always addressed. Although the literature shows postsurgical improvement in sexual activity in association with improved low back pain, reports vaguely address the variability in sexual activity recommendations based on anatomic location and type of spinal surgery. We conducted a PubMed search of the English language from 1990 to 2018 with the following keywords: sexual activity, postoperative, spinal fusion, spinal decompression, functional outcomes, laminectomy, rehabilitation, biomechanics, lumbar disc surgery, metabolic energy expenditure, coital position, and Oswestry Disability Index. Additional studies are needed that survey both patients and spine surgeons to examine current recommendations and to help formulate future guidelines.
Bariatric Surgery ; Convalescence ; Decompression ; Energy Metabolism ; Humans ; Laminectomy ; Low Back Pain ; Rehabilitation ; Sexual Behavior ; Spinal Fusion ; Spine ; Surgeons

Acute limb ischemia (ALI) represents one of the most common emergent scenarios encountered by a vascular specialist. Despite expedient revascularization, high rates of limb loss are reported along with high mortality rates which are second only to ruptured abdominal aortic aneurysms. Surgical revascularization is standard of care. Endovascular techniques as an alternative have emerged to be appropriate first line therapy when addressing the threatened limb. We review the etiology and classification of ALI and current endovascular techniques and evidence to date in the management of patients acutely presenting with extremity ischemia.
Aortic Aneurysm, Abdominal ; Classification ; Embolism and Thrombosis ; Endovascular Procedures ; Extremities ; Humans ; Ischemia ; Mortality ; Peripheral Arterial Disease ; Specialization ; Standard of Care

Ingenol mebutate (IM) is approved for the treatment of actinic keratosis and induces cell death in precancerous lesions. The efficacy of IM in the treatment of genital warts was investigated in a therapy-refractory patient. The 74-year-old male was treated with IM gel for three consecutive days. Treatment course and efficacy were evaluated by clinical inspection and non-invasive diagnostics namely optical coherence tomography (OCT) and reflectance confocal microscopy (RCM). Within 24 to 48 hours IM induced a strong local inflammatory reaction. One week later a complete response was observed. OCT and RCM showed a strong reaction after treatment with erosions, swelling of cells, and a subepidermal dark band in representative lesions. IM has the advantage of a short treatment period in contrast to other topical treatments and shows a promising clinical outcome. Larger studies are needed to validate the data.
Aged ; Cell Death ; Condylomata Acuminata ; Humans ; Keratosis, Actinic ; Male ; Microscopy ; Microscopy, Confocal ; Tomography, Optical Coherence

BACKGROUND: Antibiotic spacers in shoulder periprosthetic joint infection deliver antibiotics locally and provide temporary stability. The purpose of this study was to evaluate differences between stemmed and stemless spacers. METHODS: All spacers placed from 2011 to 2013 were identified. Stemless spacers were made by creating a spherical ball of cement placed in the joint space. Stemmed spacers had some portion in the humeral canal. Operative time, complications, reimplantation, reinfection, and range of motion were analyzed. RESULTS: There were 37 spacers placed: 22 were stemless and 15 were stemmed. The stemless spacer population was older (70.9 ± 7.8 years vs. 62.8 ± 8.4 years, p = 0.006). The groups had a similar percentage of each gender (stemless group, 45% male vs. stemmed group, 40% male; p = 0.742), body mass index (stemless group, 29.1 ± 6.4 kg/m² vs. stemmed group, 31.5 ± 8.3 kg/m²; p = 0.354) and Charlson Comorbidity Index (stemless group, 4.2 ± 1.2 vs. stemmed group, 4.2 ± 1.7; p = 0.958). Operative time was similar (stemless group, 127.5 ± 37.1 minutes vs. stemmed group, 130.5 ± 39.4 minutes). Two stemless group patients had self-resolving radial nerve palsies. Within the stemless group, 15 of 22 (68.2%) underwent reimplantation with 14 of 15 having forward elevation of 109°± 23°. Within the stemmed group, 12 of 15 (80.0%, p = 0.427) underwent reimplantation with 8 of 12 having forward elevation of 94°± 43° (range, 30° to 150°; p = 0.300). Two stemmed group patients had axillary nerve palsies, one of which self-resolved but the other did not. One patient sustained dislocation of reverse shoulder arthroplasty after reimplantation. One stemless group patient required an open reduction and glenosphere exchange of dislocated reverse shoulder arthroplasty at 6 weeks after reimplantation. CONCLUSIONS: Stemmed and stemless spacers had similar clinical outcomes. When analyzing all antibiotic spacers, over 70% were converted to revision arthroplasties. The results of this study do not suggest superiority of either stemmed or stemless antibiotic spacers.
Anti-Bacterial Agents ; Arthroplasty* ; Body Mass Index ; Comorbidity ; Dislocations ; Humans ; Joints ; Male ; Operative Time ; Paralysis ; Prosthesis-Related Infections ; Radial Nerve ; Range of Motion, Articular ; Replantation ; Shoulder*

Objective:To analyze the feasibility of detecting Ph1 in leukemia patients in the Kinshasa University Clinics in the Democratic Republic of Congo,at KU Leuven,Belgium.Methods:Bone marrow and peripheral blood samples with chronic myeloid leukemia,acute myeloid leukemia or acute leukocytes leukemia were obtained from 32 patients in Kinshasa University clinics in the Democratic Republic of Congo and transferred to KU Leuven in Belgium for iFISH feasibility.Ph1 was detected by using a remote analysis of interphase fluorescence in situ hybridization (iFISH).Results:Out of the 32 patients involved in this study,65.6％ (n =21) of the cases were successfully tested,of which 52.4％ (n =11) were iFISH positives for the variant t(9;22)(presence of Ph1) in chronic myeloid leukemia samples and 47.6％ (n =10) negatives in all subtypes of hematological malignancies.However,there was a female predominance in chronic myeloid leukemia samples Phi-positives by iFISH,whereas no sexual influence was observed on acute subtypes of leukemia.Conclusions:iFISH analysis is feasible on samples obtained from remote sites in the Democratic Republic of Congo.However,the optimization of the sample storage is necessary to further improve iFISH's performance.