Howard University Hospital

Immune thrombocytopenia (ITP) is the most common cause of thrombocytopenia in pregnancy, with maternal autoantibodies crossing the placenta and predisposing neonates to severe thrombocytopenia. Neonatal immune thrombocytopenia (NIT) can result in significant morbidity, including intracranial hemorrhage. We report a term neonate born to a mother with chronic severe ITP. Despite antenatal therapy with corticosteroids, intravenous immunoglobulin (IVIG), and elective cesarean delivery at a safe maternal platelet threshold, the neonate presented with severe thrombocytopenia requiring multiple platelet transfusions, repeated courses of IVIG, and adjunctive steroids. The infant's course was prolonged, requiring 29 days of hospitalization, though ultimately discharged with recovery of platelet counts. This case underscores the persistent risk of NIT despite optimal maternal management, highlights maternal predictors such as prior affected offspring and history of splenectomy, and illustrates the therapeutic dilemmas in neonatal care. Early recognition and coordinated multidisciplinary management remain critical to reducing morbidity in mother-infant dyads affected by ITP.

Abstract. Introduction Assessment of pediatric chemotherapy prescriptions is essential for preventing Drug-Related Problems (DRPs). A preliminary review showed that 57% of pediatric injectable chemotherapy patients were at risk of potential DRPs, contributing to prolonged assessment times. These issues indicate the need for systematic improvements to enhance medication safety and workflow efficiency. This study aimed to evaluate differences in DRP incidence and prescription assessment duration before and after implementing an electronic cytotoxic reconstitution guidance system. Method An experimental design was used to compare assessments before and after implementation of the electronic guidance system. A total of 60 pediatric chemotherapy prescriptions were analyzed, consisting of 30 assessed without the system (control) and 30 assessed after implementation (treatment). DRP occurrences were documented, and assessment duration was measured in minutes and seconds. Statistical analyses were performed to identify differences between groups, with significance set at P < 0.05. Results In the control group, 26 DRPs were identified, compared with 6 in the treatment group. Statistical analysis confirmed that the guidance system significantly reduced DRP incidence (P < 0.05). The mean assessment duration also decreased substantially from 7 minutes 2 seconds before implementation to 3 minutes 18 seconds afterward, and this reduction was statistically significant (P < 0.05). Conclussion The electronic cytotoxic reconstitution guidance system effectively enhances the safety and efficiency of pediatric chemotherapy prescription assessments. It significantly reduces DRP incidence and shortens assessment duration, demonstrating its value in improving workflow and supporting safer chemotherapy services.

Abstract Background and Aims: Obesity, the gut–brain axis, and bariatric surgery may influence neurologic disease risk; however, population-level data are limited. This study compared the incidence of Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and epilepsy in adults with obesity who underwent bariatric surgery versus those who did not. Methods This was a retrospective cohort study using the TriNetX Global Collaborative Network. Adults with overweight/obesity (ICD-10 E66) were assigned to Surgical (RYGB or SG) or Non-Surgical cohorts. 1:1 propensity score matching was performed on demographic and clinical covariates. Risk ratios, risk difference, and hazard ratios were estimated for incident diagnoses (ICD-10: AD G30; PD G20; MS G35; epilepsy G40). Results In matched cohorts (n = 776,800; 388,400 per group), bariatric surgery was associated with a lower incidence of neurologic disease (0.6% vs 0.9%; RR 0.68, 95% CI 0.64–0.71; HR 0.71, 95% CI 0.68–0.75; p < 0.001). Risk reductions were also observed for Alzheimer’s disease (RR 0.64; HR 0.70), Parkinson’s disease (RR 0.80; HR 0.86), multiple sclerosis (RR 0.73; HR 0.76), and epilepsy (RR 0.64; HR 0.66). Relative risk reductions ranged from 20% to 36%, greatest for Alzheimer’s disease and epilepsy. Conclusion Among adults with obesity, bariatric surgery was associated with a lower recorded incidence of AD, PD, MS, and epilepsy. While these findings align with biologically plausible immunometabolic and gut–brain mechanisms, residual confoundings limit causal inference. Future research is needed to confirm causality.

Sickle cell disease (SCD) is an autosomal, recessive, genetic disorder that affects the structure and function of the hemoglobin. Pain is the hallmark of SCD, and opioids and nonsteroidal anti-inflammatory drugs are the mainstay of SCD pain control during vaso-occlusive crisis (VOC). Intravenous (IV) access is mostly used for opioid administration in emergency departments. Most people with SCD often need frequent venipuncture for IV access for medications, fluids, and transfusions. The frequent venipuncture sometimes damages their veins, making it difficult to establish or maintain IV access for therapies during VOC, prompting the need for alternative parenteral routes of opioid administration for pain management. This article aims to summarize existing evidence on alternative routes of opioid administration to provide support for their use in acute SCD-related pain. Literature search for human studies was conducted through Pubmed, Ovid, ProQuest, EBSCOHost, Scopus, National Institute of Medicine, Google Scholar, and governmental agency websites. Systematic reviews, randomized control trials, cohort studies, and clinical guidelines published in English between 1984 to 2025 were included. Future clinical research should be conducted on the safety and effectiveness of using alternative routes of opioid administration in individuals with SCD.

While scientific research has extensively explored how the brain integrates touch and pain signals, the cerebral processing of specific vibrotactile frequencies remains poorly understood. This gap is particularly significant given clinical evidence that vibrotactile stimulation can reduce pain in both chronic pain patients and experimental settings. Our study investigated the cortical electrophysiological correlates of peripheral vibrotactile stimulation across different frequencies in healthy volunteers, with a focus on frequency-dependent patterns of neuronal activation. While electroencephalogram (EEG) was recorded, healthy participants received vibrotactile stimulation (high-frequency burst stimulation with different inter-burst intervals) to the left index fingertip at frequencies corresponding to established neural rhythms: delta (2 Hz), theta (6 Hz), alpha (12 Hz), beta (20 Hz), and gamma (40 Hz). We compared the EEG bandwidth activity between vibrotactile stimulation conditions relative to resting baseline. Our findings demonstrated that vibrotactile stimulation produces distinct frequency-dependent patterns of cortical activation. A key finding was that 6 Hz stimulation selectively enhanced theta power in the left prefrontal cortex - an electrophysiological signature previously linked to successful pain relief. These findings advance the understanding of the “spectrotopic” nature of vibrotactile frequency processing in the cortex and provide a mechanistic foundation for developing novel vibration-based therapies in the future.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-14870-8.

Abstract Purpose: Professional female basketball players are at risk for spinal pathology although there is limited information on the impact of surgical intervention on postoperative performance. Our focus was to assess athletes in the WNBA who underwent surgical intervention for spinal pathologies and how these injuries influence return-to-play statistics and performance metrics. Methods: A retrospective case series of WNBA players undergoing spine surgery from 2007 and 2020 that were identified via publicly available injury reports and player profiles. Athletes' information collected included age , position , years of service in WNBA , height, body mass index. Statistics were collected for 1 season prior to surgical intervention and 2 seasons postoperatively and the player efficiency rating was calculated. Results: The mean age of the players was 31.5 years at the time of spinal surgical intervention with an average of the 8 years in the WNBA. It was observed a non-significant decline in the average player efficiency rating (PER) by 6.2 and 6.3 in the first and second seasons post-surgery. Of the six subjects, five underwent surgery for activity-related injuries, while one player underwent surgery for schwannoma removal. Notably, age above 33 correlated with a significant decrease in PER after spinal surgery (p<0.001), while taller players demonstrated a significant increase in PER following surgery ( p<0.001,). Discussion: These findings suggest that older athletes may face challenges in returning to pre-injury performance levels, while taller individuals may experience more favorable post-surgery performance outcomes. Limited sample size warrants caution, emphasizing the need for larger cohorts for validation and expansion of findings. These insights provide a helpful starting point in exploring the impact of surgical intervention in treating spinal injuries for female athletes.