ABSTRACT
We sought to determine whether the biomarkers of chronic inflammation predict cognitive decline in a prospective observational study. We measured baseline serum soluble urokinase plasminogen activator receptor (suPAR) and high sensitivity C-reactive protein (hs-CRP) levels in 282 participants of the University of Michigan Memory and Aging Project. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA) and the Clinical Dementia Rating (CDR) scale for up to five time points. SuPAR and hs-CRP levels were not significantly higher in participants with mild cognitive impairment (n = 97) or dementia (n = 59), compared to those with normal cognitive function (n = 126). Overall, 14% of participants experienced significant cognitive decline over the study period. The change in MoCA or CDR scores over time did not differ significantly according to baseline suPAR or hs-CRP levels. Chronic systemic inflammation, as measured by serum suPAR or hs-CRP levels, is unlikely to contribute significantly to cognitive decline.
ABSTRACT
INTRODUCTION: There are no established guidelines on periprocedural and postprocedural pain management after endoscopic sleeve gastroplasty (ESG). This study aimed to determine the need for perioperative and postoperative opioid therapy in patients undergoing ESG. METHODS: This retrospective study comprised consecutive patients undergoing ESG. The primary outcome was the percentage of patients requiring postoperative outpatient opioid therapy. Secondary outcomes included frequency and dosage of perioperative pain medications and postoperative pain scores. RESULTS: Of the 67 patients included, 39 (58.2%) required opioids in the perioperative setting. The mean ± SD opioid dose was 12.3 ± 8.4 morphine milligram equivalents. Postoperatively, 17.9% of patients required home opioid prescriptions. More than a third of patients reported no pain. DISCUSSION: In patients undergoing ESG, postoperative opioid therapy should be individualized to attenuate opioid overprescription and the risk of opioid overuse.
ABSTRACT
Ewing sarcoma is a highly aggressive malignancy of bone or soft tissue, which may present with metastasis for 20%-25% of patients. The most common sites of metastatic lesions are the bone, bone marrow, and lungs. When metastatic lesions present within rare visceral sites, such as the pancreas, it may lead to an incorrect diagnosis of small cell neuroendocrine carcinoma. We report a case of a 37-year-old man with metastatic Ewing sarcoma involving the pancreas, confirmed by imaging, sequencing, fluorescence in situ hybridization, and histology, which was initially mistaken for small cell neuroendocrine carcinoma.
ABSTRACT
OBJECTIVE: Otolaryngology residency applicants often struggle to gauge their competitiveness at programs due to the lack of information available, resulting in a rising number of applications. We aimed to evaluate otolaryngology websites for information pertaining to prospective applicants. STUDY DESIGN: Systematic content analysis. SETTING: Web. METHODS: We reviewed 50 otolaryngology websites from June to July 2021. We searched for information pertaining to the application process, including requirements, screening and/or selection processes, and average interviewee or matched resident statistics. RESULTS: All websites had a page for prospective applicants. Under half (n = 24, 48%) explicitly listed required application components. Only 23 (46%) mentioned the desired number of letters of recommendation, and only 2 (4%) noted the need for a letter from the department chair. The majority (n = 35, 70%) provided no information regarding the number of applications received or interviews granted. Most (n = 35, 70%) did not mention how candidates are evaluated. A minority (n = 14, 30%) provided very general metrics on which candidates are scored or ranked. Almost all (n = 49, 98%) did not mention screening processes in place to select applicants for interview. None provided information about the academic characteristics or demographics of their interviewed applicants, and only 1 (2%) included this information for matched applicants. CONCLUSION: Otolaryngology websites contain limited information pertaining to the residency application process for prospective applicants, making it difficult for candidates to discern their competitiveness at programs and potentially contributing to match inefficiency.