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Artificial intelligence could have broad implications for medical education. Educators could lead the way when it comes to integrating this technology into clinical practice.

[...]inspection of the abstract reveals several methodological concerns in the reporting of a new diagnostic test. [...]the mean values obtained were not prospectively compared with the gold standard, pleural manometry, as part of a validation cohort to evaluate diagnostic test characteristics such as the sensitivity and specificity of an absent “sinusoid sign.” [...]a literature search revealed that although the measurements of anatomical characteristics via ultrasound has previously been used to predict the presence of a nonexpendable lung, the procedure is more complicated than the one suggested by Wong and colleagues (6).

The PET-CT also showed asymmetric FDG uptake of the vocal folds at the level of the thyroid cartilage (right greater than left), suggestive of left vocal fold paralysis ( figure 2 , yellow arrow). Figure 2; PET-CT showing asymmetric FDG uptake of vocal folds at the level of the thyroid cartilage (yellow arrow). Asymmetry in FDG uptake is more prominent when paralysis is acute or subacute rather than chronic. 1 The most likely aetiology of vocal fold paralysis in this patient was compression of the left recurrent laryngeal nerve by either the hilar lung mass or the associated mediastinal lymphadenopathy.

The elderly population is steadily increasing, concurrently with the incidence of pubic rami fractures (PRFs), impacting function, morbidity and mortality. We aimed to assess functional background, clinical course, hemoglobin decline, transfusion needs, complications, and long-term survival. A retrospective cohort study. Data was collected from patients hospitalized in a geriatric internal medicine ward, due to PRFs between 2012 and 2022. Demographic, clinical, and outcome data were recorded and analyzed. The study comprised 165 patients, mean age 85.9±6.4 years; 138 (83.6%) were women, 133 (80%) had experienced at least one PRF, an additional 32 cases had experienced another pelvic fracture. Functionally, 76 (46%) were independent, 49 (29.7%) partially dependent, and 40 (24.2%) fully dependent. Cognitively, 106 (64.2%) were preserved, 29 (17.6%) experienced a cognitive decline, and 30 (18.2%) suffered from dementia. The complication rate was 15.1%, half from infectious diseases. One-year mortality was 20%. The average maximum decrease in hemoglobin occurred 4.4 days post-fracture, with a difference in average admission hemoglobin between those who required blood transfusions and those who did not (9.81 g/dL and 12.06 g/dL) (p=0.0001). Almost 10% of the elderly needed blood transfusions. Logistic regression analysis identified two independent predictors for blood transfusions: an admission hemoglobin level <10 g/dL and the presence of cognitive decline or dementia. The model showed high accuracy, with a ROC AUC of 0.885, sensitivity of 0.875, and specificity of 0.792. Over half of the patients returned home; 35% were transferred to rehabilitation facilities. This study provides new and important information on PRFs in the elderly. We recommend closely monitoring these patients because of complications, functional decline, need for rehabilitation, and the high risk of significant blood loss peaking several days post-fracture, thereby, requiring transfusions, particularly, in elderly individuals suffering from cognitive decline or dementia and low initial hemoglobin.

Introduction: Hip fractures are a significant health risk in older adults and a major cause of morbidity, functional decline and mortality. Our aim was to compare clinical outcomes of older patients hospitalized in an ortho-geriatric (OG) unit to those hospitalized in an orthopedic department (OD) for surgical treatment of a hip fracture. Methods: A retrospective cohort study of hip fractured patients hospitalized between 2015-2016 in a single tertiary university-affiliated medical center. Included were patients aged 65 and older who had undergone hip fracture surgery and were admitted to either a geriatric or orthopedic ward. Results: 441 patients met the inclusion criteria (195 in the OG unit, 246 in the OD); 257 were transferred to an affiliated geriatric center hospital (107 from the OG unit and 127 from the OD) for rehabilitation. Patients in the OG unit were older, more cognitively and functionally impaired and with more comorbidities. The 1-year mortality rate was significantly lower in the OD group (OR 0.32, CI 95% 0.19-0.53, p < 0.001), however, after propensity matching, the 30-day and 1 year mortality rates were similar in both groups. No difference was found in the rehabilitation length of stay between the groups. The functional independence measure improvement was similar in both groups, with a non-significant trend toward better functional improvement among OG unit patients. Conclusions: Despite the higher complexity of patients, worse baseline functional capacity in the OG unit, improvement after rehabilitation was similar in both groups. These results demonstrate the advantages of the OG unit in treating and stabilizing frail older adults, thus maximizing their chances for a successful recovery after hip fractures. Level of Evidence: Level IV

The association between severity of psychiatric disorder and dental disease has not been adequately studied. The aim of the present study was to examine the level of dental caries morbidity and the association with Severe Mental Illness (SMI) and mild/moderate psychiatric disorders. The population sample included patients aged 30 to 50, treated at the Hadassah psychiatric outpatient clinic, after giving written informed consent. Exclusion criteria included eating disorders which are recognized as being associated with several dental pathologies. The term SMI, frequently used in the literature (1), refers to psychiatric patients suffering from a significant mental disorder and implies a greater burden of illness and dysfunction. The SMI group in this study included patients suffering from schizophrenia, bipolar disorder, resistant depression and chronic post-traumatic stress disorder (PTSD). The mild/ moderate illness group consisted of all other psychiatric disorders on Axis I or II according to DSM IV-TR (2).

Prolactin release in response to fenfluramine hydrochloride (60 mg orally) and placebo was evaluated in 18 medication-free patients with RDC major depressive disorder, endogenous subtype, before and after a series of bilateral treatments with ECT. Before ECT, fenfluramine induced a twofold increase in plasma prolactin levels. This response was significantly enhanced after the ECT series, while baseline prolactin levels and response to the placebo challenge were not altered. There was no significant difference in plasma fenfluramine and norfenfluramine levels during the pre- and post-ECT challenges. These findings suggest that ECT enhances central serotonergic responsivity and extend to depressed patients pre-clinical observations regarding the effect of electroconvulsive shock on serotonergic function.

The majority of men with progressive prostate cancer develop metastases with the skeleton being the most prevalent metastatic site. Unlike many other tumors that metastasize to bone and form osteolytic lesions, prostate carcinomas form osteoblastic lesions. However, histological evaluation of these lesions reveals the presence of underlying osteoclastic activity. These lesions are painful, resulting in diminished quality of life of the patient. There is emerging evidence that prostate carcinomas establish and thrive in the skeleton due to cross-talk between the bone microenvironment and tumor cells. Bone provides chemotactic factors, adhesion factors, and growth factors that allow the prostate carcinoma cells to target and proliferate in the skeleton. The prostate carcinoma cells reciprocate through production of osteoblastic and osteolytic factors that modulate bone remodeling. The prostate carcinoma-induced osteolysis promotes release of the many growth factors within the bone extracellular matrix thus f urther enhancing the progression of the metastases. This review focuses on the interaction between the bone and the prostate carcinoma cells that allow for development and progression of prostate carcinoma skeletal metastases.