MedStar Harbor Hospital is a private nonprofit, 150-bed, acute care teaching hospital in Baltimore City, Maryland, U.S. It is located on South Hanover Street along the Middle Branch of the Patapsco River in the Cherry Hill neighborhood of South Baltimore. The hospital has around 10,000 inpatients admissions and close to 60,000 emergency department visits per year. Its areas of specialty include orthopaedics, oncology, women's services, cardiology, internal medicine and neurosurgery. Harbor Hospital also offers a medical residency program in internal medicine and a transitional program that prepares residents to specialize in other areas.
Statins are widely used to lower LDL cholesterol and prevent cardiovascular disease. Although generally safe, there is increasing evidence that they may increase the risk of new-onset diabetes mellitus (NODM). Recent studies show a modest but consistent rise in diabetes risk associated with statin use, especially among individuals with prediabetes, obesity, or other metabolic risk factors. High-intensity statins like atorvastatin and rosuvastatin carry a greater risk compared to agents such as pravastatin or pitavastatin. Proposed mechanisms include increased insulin resistance, impaired insulin secretion, and changes in hepatic glucose production. Despite the diabetes risk associated with statins, their well-established cardiovascular benefits generally outweigh this concern. This review discusses the current evidence on the association between statin use and NODM, explores potential biological mechanisms, compares the diabetogenic effects of different statins, assess the impact of statin dose and intensity, and outlines implications for clinical practice.
To investigate the safety profile and tolerability of SOB100, a targeted exosome drug delivery platform derived from HEK293T cells engineered with an anti-Human Leukocyte Antigen G(HLA-G) nanobody. An open-label, dose-escalation Phase I with a total of fifteen subjects will be enrolled in five cohorts, three subjects in each cohort, comprising one single-ascending dose (SAD) cohort or multiple-ascending dose (MAD) cohorts (low, medium, and high dose levels). This will be the first in-human study to evaluate the safety and tolerability of HLA-G targeted exosome (SOB100) in healthy volunteers.Trial registration number: NCT07219940 (ClinicalTrials.gov).
Background/Objectives: Routine depression screening is recommended in primary care, yet depression may remain underdetected among Filipino American patients. Provider-level factors, including culturally responsive preparation, communication challenges, workflow constraints, and attitudes toward mental health screening, may influence opportunities for early identification and referral. This exploratory cross-sectional study examined provider perspectives on barriers to depression screening and mental health discussions with Filipino American patients using the Capability, Opportunity, Motivation, and Behavior (COM-B) framework as an implementation-informed organizing lens. Methods: A cross-sectional survey was conducted among healthcare providers (N = 81) with experience caring for Filipino American patients in the United States. Survey items assessed provider confidence, perceived adequacy of mental health training, cultural and communication barriers, perceived stigma-related concerns, comfort discussing mental health, and interest in additional culturally responsive resources. Items from the adapted Attitudes Toward Assisting Filipino American Patients with Mental Health Symptoms (ATFA) scale and one item from the Mental Illness Clinicians' Attitudes scale were conceptually mapped to the COM-B domains. Descriptive statistics, internal consistency estimates, and nonparametric tests were used to summarize findings and explore differences by provider characteristics. Results: Most providers recognized that Filipino cultural beliefs and customs may influence mental health help-seeking and symptom expression. Although many providers reported confidence identifying mental health symptoms, fewer reported adequate training to assess mental health concerns among Filipino American patients. Communication barriers, stigma-related concerns, and interest in additional culturally tailored resources were commonly reported. COM-B domain scores were not significantly associated with provider role or years of clinical experience. Providers who identified as Filipino reported greater perceived capability and opportunity related to initiating mental health discussions compared with non-Filipino providers. Conclusions: Findings suggest that provider motivation to address mental health concerns may be present, while capability- and opportunity-related barriers, including culturally responsive training, communication support, workflow integration, and referral resources, may remain important targets for future implementation efforts. Because this exploratory study used a modest convenience sample and an adapted measure that requires further psychometric validation, the findings should be interpreted with caution. Larger studies using validated instruments are needed to examine further provider-level determinants of culturally responsive depression screening among Filipino American patients.
Patients with serious illnesses and short prognoses often experience depression and suicidal ideation. Traditional antidepressants are limited by delayed onset, creating a need for rapidly acting therapies. In this Palliative Care Rounds, we examine the evidence for ketamine/esketamine's efficacy as antidepressants, including evidence specific to people with serious illnesses. In psychiatric studies, intravenous ketamine produces rapid (1-24 hours), moderate-to-large antidepressant effects lasting one to two weeks, with a number needed to treat of three in the first week. Esketamine nasal spray demonstrates similar early efficacy and is U.S. Food and Drug Administration-approved for treatment-resistant depression and major depression with suicidal ideation. Evidence in serious illness is limited to several perioperative cancer trials and small open-label studies, which show short-term reductions in depressive symptoms and suicidal ideation but do not address long-term management or maintenance dosing. Safety across serious illness studies is generally favorable, with transient dissociation, hypertension, and somnolence the most common adverse effects; serious adverse events remain rare. Ketamine and esketamine offer the strongest evidence among rapid-acting antidepressants and may be preferred when urgent symptom relief is needed. However, rigorous psychiatric trials in serious illness are lacking. Clinicians should consider prognosis, access to Risk Evaluation and Mitigation Strategies-certified esketamine programs or equivalent regulatory frameworks outside the U.S., and the need for an appropriate maintenance regimen when integrating ketamine into palliative care depression management.
