This multicenter retrospective cohort compared romosozumab outcomes between oral glucocorticoid users and non-users. Bone turnover marker responses and lumbar spine bone mineral density gains were similar, whereas total hip bone mineral density gains were smaller among glucocorticoid users. To investigate the impact of oral glucocorticoids (GC) on the effectiveness of romosozumab by comparing outcomes between GC users and non-users after adjusting for patient background. This multicenter, retrospective cohort study analyzed patients who completed 12 months of therapy (n = 428). Inverse probability of treatment weighting was employed to construct a pseudo-population with balanced baseline characteristics, yielding 40 GC users and 39.8 non-users (95.3
Abstract Background Although electrocutions commonly occur at domestic voltages of 100–240 V worldwide, fatal electrical injuries at voltages below 100 V are uncommon. We report an unusual fatal case of electrocution associated with a single 9 V dry cell battery. Case presentation A man in his 30s was found dead with metal wires inserted into the skin of his chest. The wires were connected to a 9 V dry cell battery. Postmortem computed tomography performed before autopsy provided detailed images of the internal structures, including the metal wires. One wire reached the myocardium, whereas the other remained in the thoracic soft tissue anterior to the heart. Autopsy and histopathological examination of the heart demonstrated pericardial fibrosis and granulation tissue consistent with a nonacute lesion, suggesting one or more prior episodes of foreign body stimulation. By contrast, the findings indicated that the myocardial wall was reached only shortly before death, with subsequent electrical stimulation precipitating a fatal arrhythmia. Conclusions This report describes a fatal electrocution involving an extremely low-voltage source. This rare case is of forensic interest and demonstrates the value of integrating postmortem computed tomography, autopsy, and histopathology in the investigation of electrocution. To the best of our knowledge, this may represent one of the lowest-voltage fatal electrocution cases reported to date.
Transcranial motor-evoked potentials (TcMEPs) are widely used to detect intraoperative spinal motor pathway impairment. We developed a novel transesophageal motor-evoked potentials (TeMEPs) technique that directly stimulates the spinal cord from the esophagus at the lower cervical to upper thoracic level. This study compared the ability of TeMEPs and TcMEPs to detect reversible motor pathway suppression. Ten pigs (25.0 ± 0.6 kg) were anesthetized with propofol and remifentanil. Motor pathway suppression was induced using T9–T10 level thoracic epidural anesthesia. After baseline measurements, 3 mL of 0.2
To ensure adequate uterine contractions, oxytocin is routinely administered after fetal delivery during cesarean delivery and additional dosing is typically guided by palpation-based assessment. However, manual palpation is subjective and has limited reproducibility and interobserver consistency. The PEK-MP® is a handheld device that quantifies tissue hardness and may provide an objective intraoperative assessment of uterine contraction. This study aimed to examine the relationship between PEK-MP measurements and palpation-defined uterine tone (sufficient vs. insufficient). In this secondary analysis of a randomized controlled trial, 63 paired data points from 21 patients who underwent elective cesarean delivery were analyzed. Uterine fundal hardness was measured at 3, 5, and 9 min after oxytocin administration by obstetrician-performed palpation. In the primary linear mixed-effects model adjusted for measurement timepoint, the estimated difference in PEK-MP values between the palpation-defined groups (sufficient minus insufficient) was 6.3 (95
Few studies have investigated the efficacy of immuno-oncology (IO) combinations at different metastatic sites in renal cell carcinoma (RCC). We evaluated the differential efficacy of IO–IO and IO–tyrosine kinase inhibitor (TKI) combinations by metastatic site in metastatic RCC (mRCC). This retrospective multicenter study by the JK-FOOT Study Group included 579 patients with intermediate- or poor-risk mRCC (per International Metastatic RCC Database Consortium criteria) treated with first-line IO combinations between September 2018 and December 2024. Metastatic sites were lymph nodes, lungs, bones, liver, brain, and others. The primary endpoints were progression-free survival (PFS) and overall survival (OS); the secondary endpoint was objective response rate. Efficacy was compared between IO–IO and IO–TKI for each site. For lymph node (n = 36), lung (n = 132), or brain (n = 16) metastases, OS or PFS was not significantly different between IO–IO and IO–TKI. In bone metastases (n = 80), OS tended to favor IO–TKI (P = 0.053). In liver metastases (n = 22), OS was significantly longer with IO–TKI (P = 0.011). IO–TKI may be a more appropriate first-line option than IO–IO for mRCC with bone or liver metastases, while efficacy is similar for other sites.
