Geisinger Commonwealth School of Medicine (GCSOM) is a private medical school associated with the Geisinger Health System and located in northeastern and north central Pennsylvania. GCSOM offers a community-based model of medical education with four regional campuses - North (Scranton), South (Wilkes-Barre), Central (Danville), and Guthrie (Sayre). It offers a Doctor of Medicine (MD) Program and a Master of Biomedical Sciences (MBS) Program.
Background The Monopoint reperfusion system (Monopoint; Route 92 Medical, San Mateo, California, USA) is a large bore (0.088 or 0.070 inch inner diameter) aspiration thrombectomy platform designed to minimize ledge effect and improve neurovascular navigation and embolectomy. We aimed to describe a multicenter, real world experience of the safety and performance of the Monopoint system in first line aspiration thrombectomy for large vessel occlusions (LVOs), outside of the recently completed SUMMIT MAX (A Randomized, Controlled Trial to Evaluate the Safety and Effectiveness of the Route 92 Medical Reperfusion System) clinical trial.Methods Adults with acute anterior circulation LVO stroke between January 2019 and December 2024 consecutively treated with first line aspiration thrombectomy using the Monopoint at 10 centers were retrospectively reviewed. The primary outcome was first pass effect (FPE, modified Thrombolysis in Cerebral Infarction (mTICI) 2C/3 on first pass) and modified FPE (mFPE, mTICI 2B/2C/3 on first pass). The primary safety outcome was the rate of intraprocedural complications attributed to the Monopoint system.Results In 193 included patients, median age was 67 years (IQR 67-78), and 46.6% (90/193) were women. Successful delivery of the aspiration catheter to the clot site occurred in 96.2% (185/193) of patients. FPE was achieved in 57.5% (111/193) and mFPE was achieved in 68.4% (132/193) of patients. Of 10 (5.2%) total complications, most were vasospasm treated with intra-arterial verapamil (8/193, 4.1%); major complications included one dissection (1/193, 0.5%) and one perforation (1/193, 0.5%).Conclusion This multicenter study of the Monopoint reperfusion system for LVO thrombectomy outside of the SUMMIT MAX trial demonstrated a high FPE rate and a low rate of major complications.
The therapeutic landscape for breast cancer (BC) continues to evolve dramatically beyond conventional therapies, ushering in a new era of precision medicine. In this review we synthesize the current evidence and developments of the most promising targeted therapies reshaping BC treatment. We explore the mechanism and clinical application of antibody-drug conjugates (ADCs), which deliver cytotoxic payloads directly to tumor cells, and bi-specific antibodies that engage immune effectors. We detail the paradigm of synthetic lethality brought by PARP inhibitors for BRCA-mutant cancers and the pivotal role of CDK4/6 inhibitors in hormone receptor-positive disease. Furthermore, we examine emerging strategies that target key oncogenic pathways, including Akt, FGFR, and MEK, alongside anti-angiogenic drugs, immune checkpoint inhibitors (ICIs) and therapeutic cancer vaccines. Collectively, these modalities represent a multifaceted armamentarium aimed at overcoming resistance and improving outcomes. This review highlights the current landscape of targeted and immunological strategies in BC, synthesizes efficacy and safety data across therapeutic classes, and identifies critical knowledge gaps including biomarker development, resistance mechanisms, and the need for rationally designed combination regimens
Social media use is nearly universal among adolescents and has become a prominent focus of concern regarding its potential impact on mental health. The aim of this narrative review is to synthesize and critically evaluate the evidence on the relationship between social media use and adolescent mental health, with particular attention to risk pathways, protective factors, underlying mechanisms, moderating variables, and intervention strategies. Existing research suggests that social media may function as both a risk factor and a source of support, depending on patterns of use, individual vulnerability, and contextual influences. A narrative review of the literature was conducted using PubMed, Google Scholar, and PsycINFO to identify peer-reviewed articles published between 2007 and 2025. Search terms included social media, adolescents, mental health, depression, anxiety, sleep, cyberbullying, body image, problematic use, and digital interventions. Systematic reviews, meta-analyses, longitudinal studies, experimental trials, and high-quality observational studies were prioritized, and findings were synthesized thematically. Social media influences adolescent mental health through multiple risk and protective pathways, with modest individual-level effects but meaningful population-level relevance due to widespread use during a sensitive developmental period. Outcomes are shaped by psychological mechanisms, moderating factors, and patterns of engagement, while emerging multilevel interventions show promise in reducing harm and enhancing benefits. Overall, social media is not inherently harmful to adolescent mental health; rather, its impact depends on how, why, and in what context it is used, underscoring the need for nuanced, developmentally informed, and multilevel approaches.
ABSTRACT:We report 3 cases of localized occipital alopecia after greater occipital nerve block injections containing triamcinolone acetonide 40 mg (1 mL). In 1 case, alopecia areata was initially suspected based on clinical and histologic features. However, deeper review revealed subcutaneous fat atrophy consistent with steroid-induced lipoatrophy. In all cases, alopecic patches corresponded precisely to prior injection sites. These findings highlight an underrecognized iatrogenic cause of patchy scalp alopecia that may mimic alopecia areata. Recognition of this entity is important to avoid misdiagnosis and unnecessary treatment.
