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Bronchiectasis is a well-recognized chronic respiratory disease characterized by a productive cough and multi-microbial activation syndrome (MMAS) of various respiratory infections due to what can be the permanent dilatation of the bronchi. Bronchiectasis represents an ongoing challenge to conventional antibiotic treatment as the damaged bronchial environment remains conducive to ongoing opportunistic infections and microbial mutations, leading to multi-drug resistance. Standard treatment guidelines are designed to promptly identify and address the primary infection. Despite the strong focus on identification of the primary infection in each new episode, by combining clinical history, and high-resolution computed tomography (HRCT), a high proportion of patients remain classified as "idiopathic". Important underlying infections, such as Aspergillus and other mold infections, Pseudomonas aeruginosa, Mycobacterium, Mycoplasma, and various viruses, are frequently not identified for prolonged periods of time, and selected broad-spectrum antibiotics are often ineffective. The introduction of Induced Native Phage Therapy in 2021 and Induced Native Phage cocktails in 2024 provides a new treatment alternative that induces naturally occurring phages to eliminate specifically targeted acute and chronic mixed infections even in cases of multi-drug resistant infections as seen in chronic bronchiectasis. This article will present the successful long-term results in a case study demonstrating the speed, gentleness, and effectiveness of induced native phage cocktails in a 45-year-old male with life-long asthma resulting in multi-microbial activation syndrome in severe non-cystic fibrosis bronchiectasis for the last 20 years.

We report the case of a 37-year-old male patient diagnosed with moderate left-sided ulcerative colitis (UC). Initial therapy with 5-aminosalicylic acid (5-ASA) was terminated within days due to exacerbation of symptoms, leading to a diagnosis of 5-ASA intolerance. Although induction of remission was achieved with prednisolone, the patient developed steroid dependency. Treatment with vedolizumab and ustekinumab subsequently failed to achieve clinical or endoscopic improvement. Intensive granulocyte and monocyte apheresis (GMA) was introduced, successfully inducing remission. However, during maintenance therapy with GMA, the patient experienced a relapse. Initiation of golimumab yielded suboptimal results, necessitating a combination therapy involving prednisolone and reintensified intensive GMA. This multimodal approach successfully achieved remission induction and maintenance. This case highlights the potential utility of intensive GMA in combination with golimumab and prednisolone for the management of refractory UC, particularly in patients with 5-ASA intolerance and failure of multiple biologic agents. A brief review of the relevant literature is included.

Subconcussive impacts are very common in the sports world and can have many negative impacts on human function, including increased risk for cognitive decline and behavioral impairments such as chronic traumatic encephalopathy (CTE). The purpose of this article is to analyze the available literature on the effects of jugular vein compression applied by a cervical collar on cerebral structure and function in the setting of chronic impact exposure. This narrative review analyzed 17 articles on brain structure and function, published between 1992 and 2022. Our review of the 17 studies shows an overall neuroprotective effect of the external jugular vein compression applied by the cervical collar during insult to the head as compared to groups who did not wear a collar. These findings suggest a potential role of the cervical collar, in addition to helmets, in reducing the incidence of concussion-induced microtraumas and cascading secondary injury mechanisms. Though positive results are consistent throughout the studies, future studies with increased sample sizes are necessary to create precise estimates of the effects of the cervical collar. In addition, the analyzed studies mainly looked at the effects of the cervical collar on football players, soccer players, and Special Weapons and Tactics (SWAT) team members; thus, additional rigorous studies are needed to assess the impact of the cervical collar on other high-risk populations such as military and law-enforcement personnel, among others.

Introduction Awake brain surgery (ABS) is a groundbreaking technique that not only enhances tumor resection but also preserves vital neurocognitive functions, particularly through advanced brain mapping. Despite its success in adults, ABS in pediatric patients remains significantly underexplored, especially concerning the role of speech-language pathology (SLP) in these procedures. This study addresses this gap by providing a thorough examination of SLP interventions in pediatric ABS across various university hospitals, including those in Morocco and internationally. Methods We utilized a web-based survey, translated into French, English, and Spanish, to capture the clinical practices of 10 pediatric ABS teams globally, including one team at Rabat University Hospital in Morocco. The survey included questionnaires tailored for neurosurgeons, speech therapists, and other professionals involved in ABS. Additionally, a detailed review of medical records for three pediatric patients who underwent ABS in Morocco between 2017 and 2022 was conducted. Data were analyzed using SPSS (IBM Corp., Armonk, NY, USA) for quantitative results and qualitative content analysis for case study evaluations. Results The study found a global consensus on the essential role of SLP in pediatric ABS, with 62.5% of neurosurgeons stressing the need for specialized SLP training. A significant correlation was observed between postoperative speech therapy and reduced neurolinguistic disorders (Pearson correlation=0.340, p=0.007). Challenges in assessing written language components were identified due to a lack of suitable tools, highlighting the need for improved resources. Additionally, most speech assessments during brain mapping were conducted in the patient's mother tongue (60.7%), and assessments were most commonly performed during all three stages of surgery (25%). Conclusion This study emphasizes the importance of speech therapy in pediatric ABS, highlighting the need for specialized tools and training. Findings suggest a positive impact of postoperative speech therapy on neurolinguistic outcomes, but further research with larger cohorts and long-term follow-up is needed to confirm these benefits.

Introduction Implant technology for total hip arthroplasty (THA) was developed to improve hip function and patient satisfaction. Actis (DePuy Synthes, Warsaw, IN, USA) is a short fit-and-fill titanium stem, with a medial-collared and triple-taper (MCTT) geometry, that is fully coated with hydroxyapatite (HA). We evaluated the radiographic and clinical outcomes of the Actis Total Hip System during a mean follow-up of five years. Patients and methods We retrospectively analyzed data from 80 patients (14 male and 66 female, mean age: 65 ± 8.4 years) who underwent primary THA using Actis stems (anterolateral approach, 60 hips; posterior approach, 20 hips). Radiographs were obtained postoperatively and at the time of the final examination. Radiographic assessments included the alignment of the femoral stem, spot welds, stress shielding, cortical hypertrophy, subsidence (>2 mm), radiolucent line, pedestal formation, Dorr type, canal fill ratio (CFR), and stem fixation. Clinical evaluation included the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) and Harris Hip Score (HHS). Results The mean follow-up period was 64.0 ± 6.0 months. No significant differences were observed in the alignment of the femoral components between approaches. Of the 80 hips, 53 (66.3%) showed radiographic signs of stem osseointegration, predominantly in the mid-distal region of the stem at the final follow-up. Multiple logistic regression analysis revealed that younger age and a higher CFR (20 mm proximal to the lesser trochanter) were associated with the presence of spot welds. Mild stress shielding occurred in 25 hips (31.3%), and no patient experienced severe stress shielding. All stems were fixed by bone on growth. The JHEQ and HHS significantly improved at the final assessment. Conclusion At the five-year follow-up, patients who received the Actis Total Hip System during THA had good radiographic and clinical outcomes.

Introduction Obstructive sleep apnea (OSA) is characterized by repetitive upper airway collapse resulting in episodes of apnea and hypopnea. Studies have shown worsened coronavirus disease 2019 (COVID-19) severity due to coexisting respiratory conditions and suggest increased severity of COVID-19 in patients with or at high risk of OSA. However, the extent of this correlation is unclear. This retrospective study aimed to evaluate the association between OSA severity and COVID-19 severity and assess the impact of continuous positive airway pressure (CPAP) compliance. Methods This single-center retrospective study was conducted at King Abdulaziz University Hospital (KAUH), a tertiary care center in Jeddah, Saudi Arabia. Data were collected from 62 adult patients with OSA who were diagnosed via polysomnography (PSG) and had a positive documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test result. COVID-19 severity was categorized into mild, moderate, and severe. Results There was no significant correlation between OSA severity as measured by the apnea-hypopnea index (AHI), low oxyhemoglobin desaturation (LSAT), arousal index (AI), respiratory disturbance index (RDI), or the type of treatment used, including adherence to CPAP, and the outcomes of COVID-19. However, higher arousal with respiratory index (ARI) and a lower percentage of time with SpO2 < 90% (T90) values were linked to moderate COVID-19 severity with significant p-values of 0.046 and 0.007, respectively. Conclusion There was no significant correlation between the severity or types of OSA treatment and the severity of COVID-19. Further research including multicenter studies with bigger populations and extensive sleep study data is warranted. Understanding the OSA-COVID-19 link may improve risk stratification and patient management.

Introduction Osteoporosis mainly affects postmenopausal women and is characterized by decreasing bone mass and an increased risk of fracture. As populations age, it becomes more common and is frequently missed until fractures happen. Simultaneously, there is conflicting evidence about the relationship between bone health and diabetes, a chronic metabolic illness, with varying effects on the skeletal system. In light of the rising incidence of both disorders, this study examines the relationship between diabetes and osteoporosis/osteopenia in patients at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. Methods At KAUH, Jeddah, a retrospective study on 423 type 2 diabetes patients (2011-2021) was conducted, analyzing clinical outcomes, including BMI and blood glucose levels, using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, NY, USA). Ethical approval was granted by the Institutional Review Board, ensuring compliance with Good Clinical Practice (GCP) Guidelines. Results In this study, 423 diabetic patients with an average body mass index (BMI) of 29.12 kg/m² and ages ranging from 24 to 104 years (mean, 63.67) were primarily male, with 216 patients accounting for 51.1%. A total of 227 patients (53.7%) were aged 60-79 years. Most participants, 400 patients (94.6%), had average bone mineral density (BMD), while 161 patients (38.1%) were classified as obese. Among those with abnormal BMD, 23 patients (5.4%); 12 (2.8%) were identified as having osteopenia, and 11 (2.6%) were diagnosed with osteoporosis. Glycemic management and bone health indicators were examined in the lab, along with comprehensive BMD and T/Z scores. Conclusion This study enhances our understanding of the relationship between type 2 diabetes and bone health, emphasizing the importance of individualized evaluations for high-risk populations. Further research is needed to explore the complex interplay between diabetes, bone health, and demographic factors, to inform more effective preventive and therapeutic strategies.

A literature review was conducted of epipharyngeal abrasive therapy (EAT) in the treatment of chronic epipharyngitis, focusing on the mechanism of action by autonomic nerve stimulation. The mechanism of action of EAT in stimulating the immune system has recently become clear. However, the mechanism of action of EAT on the autonomic nervous system remains to be elucidated. The purpose of this paper is to provide insight into the still not fully understood mechanism of EAT stimulation of the autonomic nervous system in chronic epipharyngitis by collecting and integrating previous studies and papers focusing on the autonomic nerve stimulating effects of EAT. The EAT stimulates a network of brainstem neurons involved in swallowing, vomiting, breathing, and circulatory centers, and further affects endocrine reflexes via the hypothalamus and pituitary, and stress responses via the limbic system. The EAT reflex is hierarchically integrated and is thought to reflexively control not only the pharyngeal reflex but also autonomic functions such as airway, breathing, cardiovascular, cerebral circulation, digestive, and endocrine glands. The immune system, endocrine system, and autonomic nervous system are thought to interact with each other to produce the therapeutic effect of EAT. It is important to determine which mechanism is predominantly involved in each case of chronic epipharyngitis and to utilize it in treatment. Elucidating the mechanism of action of EAT autonomic nerve stimulation will be an important guideline in determining the treatment strategy for chronic epipharyngitis.

The rapid evolution of generative artificial intelligence (AI) has introduced transformative technologies across various domains, with text-to-video (T2V) generation models emerging as transformative innovations in the field. This narrative review explores the potential of T2V AI generation models used in healthcare, focusing on their applications, challenges, and future directions. Advanced T2V platforms, such as Sora Turbo (OpenAI, Inc., San Francisco, California, United States) and Veo 2 (Google LLC, Mountain View, California, United States), both announced in December 2024, offer the capability to generate high-fidelity video contents. Such models could revolutionize healthcare by providing tailored videos for patient education, enhancing medical training, and possibly optimizing telemedicine. We conducted a comprehensive narrative literature search of databases including PubMed and Google Scholar, and identified 41 relevant studies published between 2020 and 2024. Our findings reveal significant possible benefits in improving patient education, standardizing customized medical training, and enhancing remote medical consultations. However, critical challenges persist, including risks of misinformation (or deepfake), privacy breaches, ethical concerns, and limitations in video authenticity. Detection mechanisms for deepfakes and regulatory frameworks remain underdeveloped, necessitating further interdisciplinary research and vigilant policy development. Future advancements in T2V AI generation models could enable real-time healthcare visualizations and augmented reality training. However, achieving these benefits will require addressing accessibility challenges to ensure equitable implementation and prevent potential disparities. By addressing these challenges and fostering collaboration among stakeholders, healthcare systems and AI technologists, T2V AI generation models could transform global healthcare into a more effective, universal, and innovative system while safeguarding against its potential misuse.