Lacroixberger2384

We report the case of a 31-year-old man with superior mesenteric artery syndrome after reoperation due to postoperative complications from rectal cancer. Although initial total parenteral nutrition (TPN) therapy failed, he underwent endoscopy-assisted feeding tube placement without complications instead of surgery. After 2 weeks of dual feeding (enteral feeding and TPN), he improved, gaining 6 kg; and an oral diet was advanced.Hypercoagulable and proinflammatory states induced by the novel coronavirus (SARS-CoV-2) lead to thrombotic and embolic events. In this case report, the authors describe how they successfully managed acute critical limb ischaemia in a patient of COVID-19 illness with severe pulmonary disease and high thrombus burden in the infrapopliteal arteries.Gaucher disease is an inborn error of metabolism resulting from the deficiency of the enzyme glucocerebrosidase and consequent accumulation of glucocerebroside within the lysosomes of macrophages. The clinical presentation is very diverse, depending on the age of onset and the severity of the disease, and results from the progressive infiltration of lipid-laden cells in various organs. Common manifestations of Gaucher disease include enlarged liver and/or spleen (hepatosplenomegaly), bone marrow disease (pancytopenia) and bone abnormalities, which are extremely variable and can affect multiple skeletal sites. While bone involvement of long bones and vertebrae is a well-recognised feature of Gaucher disease, jawbone involvement is less commonly noted. Here, we describe a case of a 63-year-old patient with type 1 Gaucher disease with a history of long-term use of bisphosphonates and who had presented with dental pain, with subsequent investigations confirming the radiological features of jaw involvement in Gaucher disease, including periodontal disease.

Cognitive behavioural therapy (CBT) is considered an effective first-line treatment for obsessive-compulsive disorder (OCD). However, the neural basis of CBT for OCD has not yet been elucidated. The role of the amygdala in OCD and its functional coupling with the cerebral cortex have received increasing attention, and may provide new understanding of the neural basis of CBT for OCD.

We acquired baseline resting-state functional MRI (fMRI) scans from 45 unmedicated patients with OCD and 40 healthy controls; we then acquired another wave of resting-state fMRI scans from the patients with OCD after 12 weeks of CBT. We performed seed-based resting-state functional connectivity analyses of the amygdala subregions to examine changes in patients with OCD as a result of CBT.

Compared to healthy controls, patients with OCD showed significantly increased resting-state functional connectivity at baseline between the left basolateral amygdala and the right middle frontal gyrus, and between the superficial amygdala for guiding effective treatment strategies with CBT for OCD.

To evaluate sex differences in mortality among people with kidney failure compared with the general population.

Population based cohort study using data linkage.

The Australian and New Zealand Dialysis and Transplant Registry (ANZDATA), which includes all patients receiving kidney replacement therapy in Australia (1980-2019) and New Zealand (1988-2019). Data were linked to national death registers to determine deaths and their causes, with additional details obtained from ANZDATA.

Of 82 844 people with kidney failure, 33 329 were female (40%) and 49 555 were male (60%); 49 376 deaths (20 099 in female patients; 29 277 in male patients) were recorded over a total of 536 602 person years of follow-up.

Relative measures of survival, including standardised mortality ratios, relative survival, and years of life lost, using general population data to account for background mortality (adjusting for country, age, sex, and year). Estimates were stratified by dialysis modality (haemodialysis or peritoneal diants.The HER3/ERBB3 receptor is an oncogenic receptor tyrosine kinase that forms heterodimers with EGFR family members and is overexpressed in numerous cancers. HER3 overexpression associates with reduced survival and acquired resistance to targeted therapies, making it a potential therapeutic target in multiple cancer types. Here, we report on immunogenic, promiscuous MHC class II-binding HER3 peptides, which can generate HER3-specific CD4+ Th1 antitumor immune responses. Using an overlapping peptide screening methodology, we identified nine MHC class II-binding HER3 epitopes that elicited specific Th1 immune response in both healthy donors and breast cancer patients. Most of these peptides were not identified by current binding algorithms. Cell Cycle inhibitor Homology assessment of amino acid sequence BLAST showed >90% sequence similarity between human and murine HER3/ERBB3 peptide sequences. HER3 peptide-pulsed dendritic cell vaccination resulted in anti-HER3 CD4+ Th1 responses that prevented tumor development, significantly delayed tumor growth in prevention models, and caused regression in multiple therapeutic models of HER3-expressing murine tumors, including mammary carcinoma and melanoma. Tumors were robustly infiltrated with CD4+ T cells, suggesting their key role in tumor rejection. Our data demonstrate that class II HER3 promiscuous peptides are effective at inducing HER3-specific CD4+ Th1 responses and suggest their applicability in immunotherapies for human HER3-overexpressing tumors.Patients with colorectal cancer frequently develop liver metastases after, and perhaps as a consequence of, lifesaving surgical resection of the primary tumor. This creates a potential opportunity for prophylactic metastatic treatment with novel immunostimulatory molecules. Here, we used state-of-the-art intravital imaging of an experimental liver metastasis model to visualize the early behavior and function of invariant natural killer T (iNKT) cells stimulated with α-galactosylceramide (α-GalCer). Intravenous α-GalCer prior to tumor cell seeding in the liver significantly inhibited tumor growth. However, some seeding tumor cells survived. A multiple dosing regimen reduced tumor burden and prolonged the life of mice, whereas tumors returned within 5 days after a single dose of α-GalCer. With multiple doses of α-GalCer, iNKT cells increased in number and granularity (as did NK cells). As a result, the total number of contacts and time in contact with tumors increased substantially. In the absence of iNKT cells, the beneficial effect of α-GalCer was lost. Robust cytokine production dissipated over time. Repeated therapy, even after cytokine dissipation, led to reduced tumor burden and prolonged survival. Serial transplantation of tumors exposed to α-GalCer-activated iNKT cells did not induce greater resistance, suggesting no obvious epigenetic or genetic immunoediting in tumors exposed to activated iNKT cells. Very few tumor cells expressed CD1d in this model, and as such, adding monomers of CD1d-α-GalCer further reduced tumor growth. The data suggest early and repeated stimulation of iNKT cells with α-GalCer could have direct therapeutic benefit for patients with colorectal cancer who develop metastatic liver disease.Problem-solving courts were created as a means of therapeutic jurisprudence. They arose in the context of the post-deinstitutionalization influx of defendants with behavioral and social problems entering the criminal court system. Seeing that typical judicial practices were poor solutions for individuals primarily facing problems such as homelessness, substance use disorders, and mental illness, courts developed specialized dockets as a solution to the problem of not being able to restrict the flow of these individuals into courtrooms. Although highly regarde, mental health courts (MHCs) and drug courts (DCs) can harm people with mental illness and addiction and contribute to the oppression of disenfranchised populations, including racial and ethnic minorities. By tying access to needed treatment to criminal justice system involvement, MHCs and DCs can increase criminalization of mental illness, subject individuals to long-term collateral consequences, and interfere with social policy reforms that would dismantle the prison-industrial complex (PIC). As forensic mental health professionals, we must reflect on our practices and consider the impact that our professional decisions have on the patients that we serve, and on society as a whole, and advocate for criminal justice and healthcare system reforms that truly free individuals in need of mental health or substance use treatment from the grasp of the PIC.The profession of pharmacy has come to encompass a myriad of identities including apothecary, dispenser, merchandiser, expert advisor, and health care provider. While these have changed over time, the responsibilities and scope of practice have not evolved to keep up with the goals of the profession and level of education of practicing pharmacists in the United States. By assuming both the product-centric and patient-centric responsibilities for the aforementioned names, our true professional identity is unclear, which can be linked to the development and preservation of impostor phenomenon among the profession. For pharmacy to truly move forward, we need a unified definition for the profession by either letting go of past identities or separating these identities from each other through altering our standards within professional degree programs and practice models. Without substantial changes to the way we approach this challenge as a profession, the problems described will only persist and deepen.Objective To evaluate a telehealth simulation rubric for a pharmacy skills lab course using inter-rater reliability (IRR) comparing different evaluator types.Methods A rubric was developed and used to score student pharmacists' competency in a telehealth simulation for a pharmacy skills lab course. Intra-class correlation coefficients (ICC) were calculated to determine the IRR.Results Fifty-five recorded telehealth simulation sessions were scored three times by a pool of evaluators using the rubric. The overall ICC for the rubric was 0.631 across different types of evaluators, indicating good IRR. Differences in ICC were observed when analyzed by type of evaluator and rubric sub-components.Conclusion The rubric demonstrated good IRR across multiple types of evaluators when used in a skills lab course. Additional evaluation of the rubric and continuous quality improvement is warranted to ensure that assessment becomes more consistent with continued use, regardless of the evaluator type.Objective. To evaluate the relationship between the Pre-Multistate Pharmacy Jurisprudence Examination (MPJE) and MPJE among pharmacy graduates and determine the influence of demographic, pre-pharmacy, and pharmacy school factors on MPJE outcomes.Methods. A retrospective review of pharmacy graduates' (n=156) MPJE scores, Pre-MPJE scores, demographics, pre-pharmacy academic performance factors, and pharmacy school academic performance factors was performed. Bivariate and correlational analyses were conducted along with multiple linear regression modules to determine the influence of variables on the MPJE total scaled score.Results. A total of 136 graduates were included with the majority being female (59%) and non-Hispanic White students (75%). The Pre-MPJE was not significantly correlated with the MPJE first attempt pass/fail outcome or total scaled score. Younger age at graduation, higher pharmacy law course grade, PCOA total and content area 1-4 scaled scores, and final pharmacy GPA were correlated to passing the MPJE.