Orthopaedic Center of Vero Beach

ABSTRACTBackgroundGlucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) have gained rapid popularity for both medical and consumer‐directed weight loss. This growth has been accompanied by increased public discussion regarding facial aesthetic changes, commonly referred to as “Ozempic face,” characterized by volume depletion and cutaneous laxity.ObjectiveTo quantify temporal patterns of public search interest in a widely known GLP‐1 RA and evaluate corresponding awareness of its cosmetic facial sequelae using infodemiologic methods.MethodsGoogle Trends data for “Ozempic” and related frequently co‐searched queries were analyzed from November 2021 to December 2024. Trends in relative search volume (RSV) were examined, with particular focus on terms associated with facial aesthetics, including “Ozempic face” and “plastic surgeons Ozempic face.”ResultsRSV for “Ozempic” showed a steady upward trajectory over the study period. Queries related to facial aesthetic consequences exhibited substantial proportional increases. Notably, “Ozempic face” demonstrated a 4600% rise in RSV, and searches for “plastic surgeons Ozempic face” similarly grew markedly.ConclusionsPublic interest in GLP‐1 RAs is strongly associated with rising awareness and concern about their facial aesthetic effects. These trends suggest that aesthetic practitioners should expect more patient inquiries regarding GLP‐1–related facial changes and should proactively integrate counseling and corrective treatment options into clinical practice.

Introduction: A real-world pilot study was conducted in healthy adults and confirmed CSID subjects to compare the diagnostic utility of concurrent measurements of hydrogen and methane levels in breath samples and self-reported severity of GI symptoms following a sucrose load. Methods: Study participants provided breath samples and reported the severity of 6 GI symptoms (abdominal bloating, borborygmi, diarrhea, flatulence, nausea, and abdominal pain, based on a 10-point Likert scoring system) immediately before and every 30 minutes for 4 hours after ingesting dissolved sucrose (50 grams) on an empty stomach. The area-under-the-curve (AUC) derived from the receiver operating characteristic curve (ROC) was used to compare the diagnostic accuracy of both tests for the 44 CSID (true positive) and 116 control (true negative) subjects with both HMBT and SCST data. HMBT AUC was determined using established cut-offs in breath hydrogen or methane levels and compared with a total of 30 AUCs based on change-from-baseline (CFB) severity scores for each of the 6 symptoms and 5 timepoints reported from 2 to 4 hr following sucrose ingestion. Results: The ROC-derived mean AUC for diagnosing carbohydrate malabsorption from the HMBT is 0.52 (95% CI: 0.46-0.59) in this study. In contrast, the mean AUCs derived from the 6 symptoms and 5 timepoints post-sucrose challenge were significantly higher (P-values < 0.001 for 26 symptom-timepoints and < 0.05 for all 30 symptom-timepoints). HMBT sensitivity and specificity were 18% and 86%, respectively. In contrast, the highest sensitivity and specificity from the SCST were 82% and 84%, respectively. Conclusion: The hydrogen methane breath test is a gold standard for diagnosis of carbohydrate malabsorption with assay sensitivity, specificity and accuracy that are generally >80% based on in-clinic testing. However, breath tests are frequently self-administered at home without data supporting its diagnostic utility in this setting. The results from this real-world study support the hypothesis that in the absence of medical supervision, GI symptoms are a more sensitive measure of sucrose intolerance associated with CSID than breath hydrogen or methane levels.

Dipteropeltis is a poorly described genus of fish louse endemic to South America. In a small blackwater region within Loreto, Peru, 13 adult and juvenile specimens of an unidentified species of Dipteropeltis Calman, 1912, as well as one adult specimen of D. hirundo Calman, 1912, were observed and collected. Scanning electron and light micrographs were acquired to examine and measure key features of these specimens. Morphological differences from the two known species of Dipteropeltis, D. hirundo and D. campanaformis Neethling et al., 2014, indicate that the collected specimens represent a new species. Dipteropeltis longicaudatus sp. nov. is diagnosed by elongate abdominal lobes, a chevron-shaped carapace, and uniquely shaped maxillae. One specimen represents the longest branchiuran documented to date at 31.5 mm. Additionally, we provide the first sequence data for this genus using DNA barcoding, which corroborates our designation of a new species. Videos were also captured that document behaviors including host attachment, pulsating abdominal lobes, suction disc "walking", and swimming. Findings have implications for its teleost hosts, Triportheus albus Cope, 1872 and Brycon amazonicus Spix & Agassiz, 1829, the latter being a critical species for aquaculture and commercial fisheries in Amazonia.

We report the first complete mitogenome (Mt) sequence of Aedes japonicus japonicus (Diptera: Culicidae). The sequence was extracted from one adult from the Big Island of Hawai’i Island. The length of the Ae. japonicus japonicus Mt was 16,528bp with 78.1% AT content. Its sequence is most similar to the Mt sequence of Aedes koreicus with 90.81% sequence identity. This is the first full Mt sequence available for this species and provides important genetic resource for studying population genetics and dynamics of this important invasive mosquito species.

"Brave new world: Mental health services 25 years since Dodo and 25 years in the future." Psychotherapy Research, ahead-of-print(ahead-of-print), pp. 1–2

Objective:To characterize diet quality across a global cohort of people with HIV (PWH).Design:Cross-sectional analysis.Methods:Leveraging REPRIEVE data from baseline across five Global Burden of Disease (GBD) regions, we analyzed participant responses to the Rapid Eating Assessment for Participants questionnaire. An overall diet quality score and scores for specific diet components were generated. Higher scores indicate better diet quality.Results:Among 7736 participants (median age 50 years, 30% women, median BMI 25.8 kg/m2) overall diet quality score (max score 30) was optimal in 13% of participants and good, suboptimal or poor in 45%, 38%, and 4% of participants, respectively; saturated fat score (max score 18) was good, suboptimal, or poor in 38%, 40%, or 7% of participants, respectively. Diet quality scores differed across GBD region with the highest scores reported in the South Asia region [median 23 (21–25)] and lowest in the sub-Saharan Africa region [median 15 (12–18)]; 61% of participants in the South Asia region reported optimal diet quality compared with only 6% in the sub-Saharan Africa region. Higher atherosclerotic cardiovascular risk scores were seen with worsening diet quality.Conclusion:Among PWH eligible for primary CVD prevention, diet quality was suboptimal or poor for almost half of participants, and there were substantial variations in diet quality reported by GBD region.TRIAL REGISTRATION:NCT02344290

To evaluate clinical and radiological efficacy in relapsing-remitting multiple sclerosis (RRMS) patients who received diroximel fumarate (DRF) or dimethyl fumarate (DMF) in EVOLVE-MS-2 and continued DRF in EVOLVE-MS-1.

Cucumus sativus (cucumber) is one of the most widely consumed fruit vegetables worldwide. Recent discovery of iminosugars in commonly consumed fruits and vegetables has promoted the interest in isolating these compounds and understanding the potential benefits to human health. The objective of the present study was to investigate the general toxicity and mutagenic effects of an aqueous extract of cucumber (Q-Actin), standardized to ≥1% (1–2%) ido-BR1 iminosugar. Single dose of Q-Actin was well tolerated without mortality at 2000 mg/kg body weight (bw) in Sprague Dawley rats. Oral (gavage) administration of Q-Actin up to 1000 mg/kg bw/day was well tolerated followed by repeated administration for a maximum period of 90 days in Sprague-Dawley rats. There were no treatment related changes in clinical observations, ophthalmic examinations, body weights and body weight gains or feed consumption, clinical chemistry and pathological changes compared to control. The mutagenicity as evaluated by Ames assay, in vitro chromosomal aberration test and in vivo micronucleus assay did not reveal any potential of Q-Actin to induce genotoxicity. The results showed that Q-Actin is well tolerated in general toxicity studies and did not induce mutagenicity. The no-observed-adverse-effect level (NOAEL) of the standardized aqueous cucumber extract (Q-Actin) is considered to be ≥1000 mg/kg bw/day, followed by repeated administration for90 days.

Herein, we describe several steps to improve surgeon autonomy during a Left Robotic-Assisted Laparoscopic Radical Nephrectomy (RALRN), using the Da Vinci Si system. Our kidney cancer program is based on 2 community hospitals. We use the Da Vinci Si system. Access is obtained with the following trocars: Two 8mm robotic, one 8mm robotic, bariatric length (arm 3), 15mm for the assistant and 12mm for the camera. We use curved monopolar scissors in robotic arm 1, Bipolar Maryland in arm 2, Prograsp Forceps in arm 3, and we alternate throughout the surgery with EndoWrist clip appliers and the vessel sealer. Here, we described three steps and the use of 3 robotic instruments to improve surgeon autonomy. Step 1: the lower pole of the kidney was dissected and this was retracted upwards and laterally. This maneuver was performed using the 3rd robotic arm with the Prograsp Forceps. Step 2: the monopolar scissors was replaced (robotic arm 1) with the robotic EndoWrist clip applier, 10mm Hem-o-Lok. The renal artery and vein were controlled and transected by the main surgeon. Step 3: the superior, posterolateral dissection and all bleeders were carefully coagulated by the surgeon with the EndoWrist one vessel sealer. We have now performed 15 RALRN following these steps. Our results were: blood loss 300cc, console time 140min, operating room time 200min, anesthesia time 180min, hospital stay 2.5days, 1 incisional hernia, pathology: (13) RCC clear cell, (1) chromophobe and (1) papillary type 1. Tumor Stage: (5) T1b, (8) T2a, (2) T2b. We provide a concise, step-by-step technique for radical nephrectomy (RN) using the Da Vinci Si robotic system that may provide more autonomy to the surgeon, while maintaining surgical outcome equivalent to standard laparoscopic RN.