Medical Sciences Commons^™

Effects Of Stressor Exposure And Locus Coeruleus Opioid Signaling On Coping And Anxiety-Like Behavior In Rats, John Arthur Tkaczynski

Theses and Dissertations

Stress is a physiological state of altered neuroendocrine signaling and heightened indices of behavioral vigilance and arousal in response to threatening stimuli. This project aimed to investigate the adaptations to stress that occur in the noradrenergic locus coeruleus (LC) and how these changes affect stress coping behavior. We began by investigating how adolescent restraint and predator odor stress affects coping when presented with a secondary noxious stimulus in the defensive shock probe burying task one week following stressor exposure, finding that stressed male rats demonstrate a more active coping response and stressed female rats demonstrate a more passive coping response, …

"The Growing Burden: Overweight And Obesity Prevalence And Risk Factors Among Medical College Students In Mysuru: A Cross-Sectional Study", Akansha ., Nayanabai Shabadi, Anchu R Nath, Ravipati Manogna

Digital Journal of Clinical Medicine

ABSTRACT:

Background:

The transition from adolescence to adulthood is often accompanied by significant lifestyle changes, including changes in dietary habits, physical activity levels, and stress, which can contribute to unhealthy weight gain. In India, the prevalence of overweight and obesity among youth has shown an upward trend, raising concerns about early onset of non-communicable diseases. This study aims to assess the prevalence of overweight and obesity among degree college students in Mysuru and to identify the associated socio-demographic and lifestyle factors contributing to these conditions.

Methodology:

A cross-sectional study was conducted over three months, from January to March 2025, among …

Intouch Week Of June 30, 2025, New York Medical College

InTouch

• Annual Golf Tournament Brings Friends and Supporters to the Green
• The Academy of Medical Educators Wraps Up Successful First Year
• SOM Preceptors Recognized for Their Invaluable Role for Medical Students
• NYMC Alpha Omega Alpha Chapter Receives Grant to Combat Food Insecurity
• New Telehealth Partner for Student Mental Health Services
• Stay Safe and Connected with the NYMC 4U App
• Cellular Receptor GPR75 Linked to the Progression of Liver Disease
• BSB Gets a Bold New Look
• Alumni Spotlight: The Path to Connection

The Epilepsy Centers Of Excellence At The Veterans Health Administration, Zulfi Haneef, Caleb A Casanova, Vincent Zhang, Jennifer R Bonds King, Rizwana Rehman, Nina I Garga, Glenn D Graham, Alan R Towne

Faculty, Staff and Students Publications

Introduction: The Veterans Health Administration (VHA) Epilepsy Centers of Excellence (ECoE) was established in 2008 to provide specialized care for veterans with epilepsy. Although established more than a decade ago, there has been no systematic evaluation of the ECoE's performance in key mission areas. We evaluated their performance in several key mission areas-clinical care, research, education, and outreach-since inception to evaluate their success in meeting the initial mandate.

Materials and methods: We analyzed available data from relevant literature, ECoE annual reports, and the ECoE website between 2011 and 2023. Clinical care is the primary mission of the ECoE and was …

Lurasidone For Pediatric Bipolar Disorder: A Systematic Review, Alexia Koukopoulos, Claudia Calderoni, Georgios D Kotzalidis, Tommaso Callovini, Lorenzo Moccia, Silvia Montanari, Gianna Autullo, Alessio Simonetti, Mario Pinto, Giovanni Camardese, Gabriele Sani, Delfina Janiri

Faculty, Staff and Students Publications

Background/Objectives: Lurasidone ((3aR,4S,7R,7aS)-2-{(1R,2R)-2-[4-(1,2-benzisothiazol-3-yl)piperazin-1-ylmethyl]cyclohexylmethyl}hexahydro-4,7-methano-2H-isoindole-1,3-dione) is a second-generation antipsychotic approved for schizophrenia and mood disorders. Adolescents and children with bipolar disorder receive treatments that expose them to weight gain and metabolic syndrome. Lurasidone is relatively free from such side effects, so it may constitute a useful alternative for the treatment of these patients. We focused on the use of lurasidone in children and adolescents with bipolar disorder.

Methods: On 11 June 2025, we used the following strategy on PubMed: lurasidone AND ("bipolar disorder" OR "bipolar depression" OR mania OR manic). We filtered for humans and ages 0-18 years and included …

Hydration Status And Acute Kidney Injury Biomarkers In Ncaa Female Soccer Athletes During Preseason Conditioning, Daniel E Newmire, Erica M Filep, Jordan B Wainwright, Heather E Webb, Darryn S Willoughby

Faculty, Staff and Students Publications

Exercise training in extreme temperatures concurrent with hypohydration status may potentiate the development of acute kidney injury (AKI) in young, healthy persons.

Background/Objectives: It is unknown how repeated training bouts in ambient higher temperatures and humidity may influence measures of AKI. The purpose of this study was to investigate hydration status and renal biomarkers related to AKI in NCAA Division I female soccer athletes during preseason conditioning.

Methods: A convenience sample of n = 21 athletes were recruited (mean ± SEM; age: 19.3 ± 0.25 y; height: 169.6 ± 1.36 cm; mass: 68.43 ± 2.46 kg; lean body …

Spinoplastic Surgery: A Review Of Techniques, Indications, And Optimal Patient Selection, Daniel Vernik, Camryn Payne, Krishna Sinha, Casey Martinez, Walter Nicholas Jungbauer, Jonathan L Jeger, Michael Bohl, Alexander E Ropper, Sebastian Winocour, Edward Reece

Faculty, Staff and Students Publications

Background/Objectives: Spinoplastic surgery is an emerging multidisciplinary field developed to address and reduce the complication of pseudoarthrosis following complex spinal reconstructions. While the number of spinal fusion procedures continues to rise every year, fusion failure rates remain as high as 40%. Although pseudoarthrosis may not always manifest clinically, it remains a leading cause of persistent pain and need for subsequent revision surgeries. The multidisciplinary collaboration between spine and plastic surgeons in spinoplastic surgery has therefore emerged as a proactive strategy aimed at preventing complications, particularly in patients identified as high-risk for pseudoarthrosis. As the patient population expands and spinoplastic surgery …

"Holy Cow, Where Do I Sign Up?" Attitudes Of Military Veterans Toward Epigenomic Biomarker Toxic Exposure Testing, Stacey Pereira, Calvin Apodaca, Kyle Slominski, Rachele K Lipsky, Cristian Coarfa, Cheryl L Walker, Amy L Mcguire, Lea Steele, Drew A Helmer

Center for Medical Ethics and Health Policy Staff Publications

Introduction: After the Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics Promise to Address Comprehensive Toxics (PACT) Act in 2022, there has been a great interest in studying toxic exposures encountered during military service. Development of epigenomic biomarkers for exposures could facilitate understanding of exposure-related health effects, but such testing could also provide unwanted information.

Materials and methods: We explored attitudes toward epigenomic biomarker research and the potential to test for past exposures using semistructured interviews with Veterans (n = 22) who experienced potentially harmful exposures.

Results: Twenty Veterans said they would hypothetically want to receive …

Spinoplastic Surgery: A Review Of Techniques, Indications, And Optimal Patient Selection, Daniel Vernik, Camryn Payne, Krishna Sinha, Casey Martinez, Walter Nicholas Jungbauer, Jonathan L Jeger, Michael Bohl, Alexander E Ropper, Sebastian Winocour, Edward Reece

Faculty, Staff and Students Publications

Background/Objectives: Spinoplastic surgery is an emerging multidisciplinary field developed to address and reduce the complication of pseudoarthrosis following complex spinal reconstructions. While the number of spinal fusion procedures continues to rise every year, fusion failure rates remain as high as 40%. Although pseudoarthrosis may not always manifest clinically, it remains a leading cause of persistent pain and need for subsequent revision surgeries. The multidisciplinary collaboration between spine and plastic surgeons in spinoplastic surgery has therefore emerged as a proactive strategy aimed at preventing complications, particularly in patients identified as high-risk for pseudoarthrosis. As the patient population expands and spinoplastic surgery …

Bayesian-Weighted Mendelian Randomization Reveals Sleep Apnea Syndrome Mediates The Bmi-Chronic Pain Link, Wenbao Shi, Jing Luo, Liu Yang, Dalin Chen, Yongqin Zhang, Jun Peng, Kurt Ruetzler, Manyun Sun, Hua Jin

Faculty, Staff and Student Publications

Background: Body mass index (BMI) has a complex association with a variety of chronic pain conditions, which may be influenced by sleep apnea syndrome (SAS). However, the role of SAS within the causal pathway linking BMI to chronic pain remains unconfirmed. This study explored whether and to what extent SAS serves as a mediator between BMI and chronic pain using Bayesian-weighted Mendelian randomization (BWMR) techniques.

Methods: This study utilized genome-wide association study (GWAS) summary data for BMI (N=461,460) and SAS (N=476,853; based on ICD-10 code diagnostic registries) from the IEU OpenGWAS database, along with chronic pain GWAS data (ICD-10 code-based …

Phase Ii Basket Trial Of Dual Anti-Ctla-4 And Anti-Pd-1 Blockade In Rare Tumors (Dart) Swog S1609: Pancreatic Neuroendocrine Neoplasm (Pnen) Cohort, Sandip Pravin Patel, Jillian Fisher, Young Kwang Chae, Luisa Solis Soto, Anup Kasi, Bhavana Konda, Mark Walshauser, Edwin Parra, Jiexin Zhang, Caroline Duault, Edgar Gonzalez-Kozlova, Ganiraju Manyam, Jianhua Zhang, Hong Chen, Dzifa Yawa Duose, Caddie Laberiano Fernandez, Raja Luthra, Gheath Al-Atrash, Seunghee Kim-Schulze, Holden T Maecker, Ignacio I Wistuba, Sacha Gnjatic, J Jack Lee, Jianjun Zhang, Christine M Magner, Helen X Chen, Elad Sharon, Megan Othus, Christopher W Ryan, Charles Blanke, Cara L Haymaker, Razelle Kurzrock

Faculty, Staff and Student Publications

Purpose: SWOG S1609 Dual Anti-CTLA-4 and anti-PD-1 blockade in Rare Tumors (DART) studied the efficacy of ipilimumab combined with nivolumab across multiple rare tumor types. We report the results of the pancreatic neuroendocrine neoplasm (PNEN) cohort.

Experimental design: Treatment consisted of ipilimumab 1 mg/kg intravenously every 6 weeks with nivolumab 240 mg intravenously every 2 weeks. The primary endpoint was overall response rate (ORR) (Response Evaluation Criteria In Solid TumorsRECIST V.1.1). Secondary endpoints include progression-free survival (PFS), overall survival (OS), and toxicity. Clinical benefit rate (includes ORR plus stable disease (SD)>6 months was examined. Correlative …

Evaluating The Efficacy Of Thymoquinone Against Pseudomonas Aeruginosa In Hospital-Acquired Pneumonia: A Potential Therapeutic Approach, Hadeel S. Alsufyani, Faez M. Zagzoug, Karem Ibrahem

Journal of King Abdulaziz University: Medical Sciences

Background: The increasing prevalence of multidrug-resistant Pseudomonas aeruginosa presents a significant challenge in clinical microbiology. This study investigates the antimicrobial efficacy of thymoquinone (TQ) against both resistant and sensitive strains of P. aeruginosa, comparing their minimum inhibitory concentrations (MICs) to assess the potential of TQ as a therapeutic agent.

Methods: A total of 40 P. aeruginosa isolates, consisting of 20 resistant and 20 sensitive strains, were obtained from the Microbiology Culture in Clinical and Molecular Microbiology Laboratories at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. The MIC of TQ was determined using the broth microdilution method. Data were analyzed …

Mortality Rate And Prognostic Factors In Patients With Congenital Diaphragmatic Hernia: A Retrospective Study, Heidi Al-Wassia, Mazen Kurdi, Maha Bamehriz, Amani Al-Haddad, Maidah Algarni, Nasir M. Bustangi

Journal of King Abdulaziz University: Medical Sciences

Background: Congenital diaphragmatic hernia (CDH) is a rare anomaly associated with pulmonary hypoplasia and pulmonary hypertension of the newborn.

Objectives: This study aimed to elucidate factors associated with in-hospital mortality in neonates and young children with CDH.

Patients and Methods: All neonates and children up to five years with delayed diagnosis of CDH born at or transferred to our tertiary training and research hospital in Saudi Arabia from January 2015 to December 2022 were included. Patients above five years of age, those with post-surgical CDH recurrence, and those with diaphragmatic events were excluded.

Results: 36 patients were included with an …

Impact Of Lifestyle Factors On Breast Cancer Risk And Outcomes: A Scoping Review, Nada Alhazmi

Journal of King Abdulaziz University: Medical Sciences

Aim: This scoping review summarizes evidence on the impact of environmental factors on breast cancer risks and outcomes.

Methodology: A systematic search was performed on PubMed, CINAHL, and ScienceDirect to identify peer-reviewed, English-only sources published between 2020 and 2025 on the impact of lifestyle factors on breast cancer risk and outcomes.

Results: A total of 15 studies (three cohort studies, two cross-sectional studies, five systematic reviews, four narrative reviews, and one case-controlled study) met the inclusion criteria. Evidence from the sources identified physical inactivity, unhealthy diet, obesity, alcoholism, tobacco smoking, menopause, and delayed first-first as lifestyle factors that impact breast …

Dietary Polyunsaturated Fatty Acids And Cardiovascular Disease Risk Factors Among Adults In Saudi Arabia: A Cross-Sectional Study, Sarah N. Alsharif, Doaa A. Alyoubi, Wadyan R. Alzahrani, Sali M. Alamoudi, Abeer A. Aljahdali

Journal of King Abdulaziz University: Medical Sciences

Background: Polyunsaturated fatty acids (PUFAs) are a potential modifiable factor in cardiovascular disease (CVD) prevention. There is a dearth in the knowledge on PUFA knowledge and dietary intake among Saudis.

Objectives: The study aimed to assess PUFA knowledge and dietary intakes among Saudi Arabian adults with CVD risk factors. Furthermore, the sociodemographic and lifestyle factors related to PUFAs knowledge were investigated, shedding light on the factors associated with PUFAs.

Methods: A cross-sectional study was done on 211 adults. The level of PUFAs knowledge was assessed using six close-ended questions, and a correct answer was worth one point. PUFAs intake was …

Relationship Of Prolonged Exclusive Breastfeeding To Infant Anemia, Maryam A. Ahmed, Aveen S. Shareef, Farhad S. Armishty, Dunya P. Nizar, Ronahi Y. Ibrahim, Lina Y. Mohammed, Snor H. Husain, Berivan R. Rajab, Omar Khatab, Dalal A. Jameel, Amna A. Omar, Iman H. Yaseen, Hevy A. Ahmad

Journal of King Abdulaziz University: Medical Sciences

Background: Anemia can adversely affect cognitive development in infants and children, potentially leading to challenges in cognition, motor control, social interaction, and neurophysiological functioning. Full-term infants do not develop iron deficiency anemia within the first four months of life, as they are born with sufficient iron stores accumulated during their intrauterine life. These stores are usually adequate for four to six months of postnatal life. However, exclusive breastfeeding beyond six months without iron supplementation can increase the risk of iron deficiency anemia, as breast milk does not provide enough iron to meet the growing infant’s demand. The American Academy of …

Vocal Hygiene Practices Among Primary School Teachers In Jeddah City, Ghadah G. Alharbi

Journal of King Abdulaziz University: Medical Sciences

Background: Hygiene practices among primary school teachers in Jeddah City, focusing on their academic qualifications, teaching experience, and knowledge of vocal hygiene.

Methods: A digital questionnaire prepared using Google Forms was posted online with a description and distributed electronically to primary school teachers in Jeddah City. It consisted of 14 items, which were developed to achieve the study’s objectives.

Results: The results show high averages for "Reducing the noise in the classroom" (3.48), while "I use the microphone in large classes" is ranked last, with an average of 1.28. In addition, the results show that 38% know where to seek …

Knowledge Of Hiv Transmission And Prevention Among University Students In Pakistan: A Cross-Sectional Study, Muhammad Saleem, Sajid Masood, Shahid Hussain

Journal of Bioresource Management

HIV/AIDS remains a significant public health problem internationally, with young adults being especially at risk because of behavioral and knowledge deficits. In Pakistan, cultural inhibitions and suboptimal health education are the main reasons for limited awareness, particularly among university students. This study had the objectives of determining the knowledge level about HIV transmission and prevention among undergraduate students in Kohsar University Murree (KUM) and to investigate correlations with salient demographic variables. A cross-sectional survey was carried out among 510 students aged 18-27 years through a pre-validated, standardized questionnaire with 12 knowledge-based items. Descriptive statistics and Chi-square tests were utilized to …

Ifosfamide-Induced Encephalopathy In Children And Young Adults: The Md Anderson Cancer Center Experience, Shaikha Alqahtani, Sabrina D Bitar, Maria Estela Mireles, Fernando F Corrales-Medina, Cynthia E Herzog, John Slopis, Najat C Daw

Faculty, Staff and Student Publications

Background: Ifosfamide, an alkylating agent used for treating various cancers, can cause encephalopathy in 10-30% of adults and 8% of children. Methylene blue has been used to treat ifosfamide-induced encephalopathy (IIE). This study aimed to describe our institutional experience with IIE in children and young adults with cancer, including its clinical manifestations, treatment, and outcomes.

Methods: We reviewed the clinical records of patients with cancer aged up to 30 years who developed IIE over 10 years.

Results: Twenty-four patients (median age: 17.6 years, range: 4-30 years) were included; 54% were male, and 71% had bone/soft tissue sarcomas. …

Feasibility And Acceptability Of A Brief Intervention For Youth Suicidal Thoughts And Behaviors Among Pediatric Primary Care Providers, Caitlin M Pinciotti, Erica Buckland, Taryn L Mayes, John L Cooley, Sean M Mitchell, Lucas Zullo, Jennifer L Hughes, Puja G Patel, Colleen Neal, Melissa Defilippis, Taiwo T Babatope, Carmen Cruz, Madhukar H Trivedi, Eric A Storch, Wayne K Goodman, Laurel L Williams, Joan R Asarnow

Faculty, Staff and Students Publications

Background: Suicide is a leading cause of death among youth, and rates continue to increase across the United States. Pediatric primary care providers (PCPs) are uniquely positioned to identify acute periods of increased suicidal ideation and provide timely intervention.

Objective: The present study assessed the feasibility and acceptability of training and implementation of a primary care-adapted version of Safe Alternatives for Teens and Youth-Acute (SAFETY-A), a brief, strengths-based, cognitive-behaviorally oriented, family intervention for suicidal thoughts and behaviors in youth, among pediatric PCPs.

Method: This multisite pilot study involved collaboration between eight Texas-based academic institutions who assisted with the recruitment and …

Ifi16 Mediates Deacetylation Of Kshv Chromatin Via Interaction With Nurd And Sin3a Co-Repressor Complexes, Anandita Ghosh, Bala Chandran, Arunava Roy

School of Medicine Faculty Publications

IFI16 is a well-characterized nuclear innate immune DNA sensor that detects foreign dsDNA, including herpesviral genomes, to activate the inflammasome and interferon pathways. Beyond immune signaling, IFI16 also functions as an antiviral restriction factor, promoting the silencing of invading viral genes through transcriptional and epigenetic mechanisms. We recently demonstrated another role of IFI16, in which it interacts with and recruits the class I histone deacetylases, HDAC1 and 2, to the KSHV latency protein LANA, modulating its acetylation and function. In this study, we asked whether these IFI16-HDAC1/2 interactions contribute to broader epigenetic regulation of the KSHV chromatin. Our findings reveal …

A Rare Delayed Neuropsychiatric Encephalopathy After Hyperbaric Oxygen Treatment For Carbon Monoxide Poisoning: A Couple’S Case Report, Sabrina Kasha, William J. Naber Ii, Michael Reimer

Graduate Medical Education Research Journal

Background: Carbon monoxide (CO) poisoning is caused when carbon monoxide builds up in the blood, most specifically due to its high binding affinity for the heme structure in hemoglobin. This can lead to serious tissue damage and even be fatal. CO poisoning is primarily the result of incomplete combustion of fuels, with common sources domestically and internationally including furnaces, gas heaters, generators, and motor vehicles.2 Symptoms tend to present as neuropsychiatric symptoms, such as dementia, psychosis, parkinsonism, and incontinence. There are few well-researched CO poisoning specific treatments, which suggest supplemental oxygen and hyperbaric oxygen are most effective. We present a …

Transforming Primary Care: Innovative Post Graduate Pa Training For Real-World Solutions, Kenneth Botelho, James Ali

Lynchburg Journal of Medical Science

The ongoing crisis in primary care demands innovative and scalable strategies to prepare and retain advanced practice providers. This article introduces the Primary Care Practitioner (PCP) Program, a conceptual postgraduate training model designed for certified physician associates/assistants (PAs) who aim to serve in underserved and rural communities. The program integrates advanced clinical training, leadership development, telehealth competencies, VR-enhanced simulation, and evidence-based strategies to promote provider resilience. Rooted in systems-based thinking and real-world applicability, the PCP Program culminates in capstone projects that encourage innovation in care delivery and population health.

Aligned with national frameworks such as the HRSA Primary Care Training …

Unraveling The Mystery: A Case Study On Eosinophilic Esophagitis, Echo Kopplin

Lynchburg Journal of Medical Science

The incidence of Eosinophilic Esophagitis (EoE) has dramatically increased in the last two decades. This article reviews the presentation, diagnosis, and treatment of EoE, enhancing clinician awareness and recognition of the condition.

Targeting Obesity: The Role Of Glp-1 Receptor Agonists In Achieving Sustainable Weight Loss, Brad Vamplew

Lynchburg Journal of Medical Science

This review critically evaluates the effectiveness of glucagon-like peptide-1 receptor agonist pharmacotherapy in managing obesity. Obesity is a health epidemic that affects 100 million Americans, and it puts individuals at higher risk for numerous health comorbidities over a lifetime. A comprehensive literature review was completed by utilizing PubMed and its clinical queries function to locate relevant research. The research information was narrowed down with a focus on obesity management and glucagon-like peptide-1 receptor agonists for therapy. Numerous current clinical studies and trials were incorporated into this review. Many clinical trials substantiated the benefits of this pharmacotherapy for the management of …

Obesity And Its Effect On Work Performance, Erin Lajoie

Lynchburg Journal of Medical Science

This research aims to examine how obesity affects work productivity and performance and how companies can support their employees diagnosed with obesity. Obesity is a growing global health concern that has significant implications for decreased workplace productivity and performance. Obesity is considered a chronic complex disease often associated with hypertension (HTN), type-II diabetes mellitus (T2DM), and heart disease that can lead to overall increases in healthcare costs for employers through increased absenteeism, presenteeism, and decreased efficiency. A systemic literature search was completed using PubMed, Cochrane Library, and Google Scholar, identifying multiple journal articles about obesity and productivity in the workplace …

Self-Powered Rapid Antigen-Specific T-Cell Response Assay For Mycobacterium Tuberculosis Infections, Bo Ning, Sutapa Chandra, Yongchun Pan, Riti Sharan, Ngan Ha, Sanjay Singh, Alexandra Portillo Varela, Lin Li, Qingli Wu, Alexander Kay, Gugu P Maphalala, Clement Adu-Gyamfi, Santiago Carrero Longlax, Anna M Mandalakas, Smriti Mehra, Christopher J Lyon, Edward A Graviss, Andrew R Dinardo, Tony Hu

Faculty, Staff and Students Publications

Interferon-gamma release assays (IGRAs) that evaluate an individual’s T-cell activation response to Mycobacterium tuberculosis (M.tb)-specific peptides serve an important role in diagnosing tuberculosis (TB). However, there are substantial challenges to the use of IGRAs in resource-limited settings. Further, IGRA diagnostic performance can also be compromised in anergic individuals. Here we describe a microfluidic chip-based antigen-specific T-cell response assay (ASTRA) that automates the detection of M.tb-specific T-cell activation responses to facilitate screening for latent M.tb infection and TB. We observe that ASTRA demonstrates high specificity for M.tb infection in independent patient cohorts. Compared with IGRA, ASTRA shows greater …

Incidental Findings In Female Pelvis Mri Performed For Gynaecological Malignancies, Silvia Bottazzi, Roberta V Ninkova, Luca Russo, Andrea Ponsiglione, Benedetta Gui, Daniela Demundo, Massimo Imbriaco, Aradhana M Venkatesan, Evis Sala, Stephanie Nougaret, Lucia Manganaro, Stefania Rizzo

Faculty, Staff and Student Publications

Incidental findings on female pelvic MRI present diagnostic challenges and may have significant clinical implications. Defined as abnormalities unrelated to the primary imaging indication, these findings have become increasingly prevalent with the expanded use of MRI in gynaecological practice. Standard gynaecological MRI protocols, incorporating T1- and T2-weighted sequences, diffusion-weighted imaging, and contrast-enhanced sequences, facilitate the characterisation of numerous extra-gynaecological abnormalities, ranging from benign to critical lesions. This review proposes a compartment-based approach for identifying extra-gynaecological findings, discussing their imaging characteristics and differential diagnoses. This approach may help radiologists systematically assess incidental findings, potentially improving the recognition of clinically relevant abnormalities …

Letter Of Concern From The Association Of Academic Chairs Of Emergency Medicine Regarding Acgme Proposed Changes, Richard J Hamilton, Lance B Becker, Richard E Wolfe, D Adam Algren, Thomas Arnold, Michael Baumann, Ross P Berkeley, Terrell S Caffery, Chad M Cannon, Theodore J Corbin, Michael E Chansky, Harinder S Dhindsa, Charles L Emerman, David A Farcy, Chris Fox, Michael A Gibbs, Christopher S Goode, Steven Andy Godwin, Dietrich Jehle, David Johnson, Samuel M Keim, Babak Khazaeni, Barry J Knapp, Clint Hawthorne, John D Hoyle, Michael Christopher Kurz, Evan Leibner, Robert Mcnamara, Robert F Mccormack, Edward A Michelson, Chadwick Miller, Ashley Norse, Andrew Nugent, Brian J O'Neil, David T Overton, Edward A Panacek, William F Paolo, Denis R Pauzé, Amanda L Perez, Ralph J Riviello, Scott W Rodi, Peter S Pang, Juan A Gonzalez Sanchez, David Seaberg, Adam Schwartz, Stephen A Shiver, David P Sklar, Ben C Smith, Jeffrey R Stowell, Marc D Squillante, J Jeremy Thomas, Terry Vanden Hoek, Gregory A Volturo, E Lea Walters, Thomas E Wyatt, Donald M Yealy

Faculty, Staff and Student Publications

This letter, signed by over 50 academic chairs of emergency medicine, urges the ACGME to reconsider a proposed mandate requiring all emergency medicine residency programs to adopt a four-year training model. The authors argue that current three-year programs are supported by data demonstrating equivalent educational and clinical outcomes compared to four-year formats. They criticize the flawed survey methodology underpinning the proposal, note the loss of milestone-based training flexibility, and highlight the lack of added scholarly or clinical value in the fourth year. The letter also outlines negative consequences for fellowship participation, workforce development, trainee debt, and diversity. The signatories advocate …

Concurrent Use Of Skeletal Muscle Relaxants And Nsaids In Low Back Pain Management: A Critical Review Of Current Evidence And Future Directions, Rupesh A. Saindane, Nilima A. Thombre

The Thai Journal of Pharmaceutical Sciences

Low back pain (LBP) represents a leading cause of non-fatal disability globally. Its high prevalence and disabling nature highlight the urgent need for effective management strategies. The exact cause of LBP still remains unclear, and thus, its treatment remains symptomatic. LBP is commonly treated with non-steroidal anti-inflammatory drugs (NSAIDs) and skeletal muscle relaxants (SMRs). These agents are frequently used in combination to target both inflammation and muscle spasms. However, the clinical guidelines vary widely on the recommendation for the use of such combination therapy. The present review evaluates evidence from randomized clinical trials and systematic reviews on the concurrent use …