Radiologists in training draw from their early experiences in residency when choosing a fellowship. Once they have decided on an abdominal imaging fellowship, applicants must learn to navigate the interview process. During this challenging time, applicants explore the difference in clinical curricula and rotations, meet potential mentors and clinical faculty, consider potential academic interests and projects, and choose what location they would like to train for one year after residency. When in training, fellows undergo the challenge of finding employment while learning new skills and refining their abilities to become a well-rounded radiologist and clinician. This article summarizes key points potential applicants should consider when deciding on an abdominal imaging fellowship, how to prepare for the interview season, and how to plan their fellowship year before fellows take the next step to becoming attendings.

Due to antimicrobial resistance, current treatments for tuberculosis (TB) are very limited and have very low efficacy. Existing therapeutics are inadequate for the ongoing epidemic of drug resistance TB. The evolutionary push of mutations created is destabilizing global TB control, thereby needing new novel therapies for treatment and screening purposes. In this paper, we propose two potential pathways that target TB through IFN-I signaling and the AhR pathway which allows for more accurate and efficient early screening of TB. Targeting these pathways impacts TB outcome by increasing treatment efficacy and strengthening host defense. IFN-I signaling and the AHR pathway can be seen as potential targets for host directed therapies.

General anesthesia (GA) is a widely used medical intervention, given to patients to eliminate pain during invasive procedures and surgeries, effectively revolutionizing the field of medicine. GA induces a reversible unconscious state by potentiating inhibitory receptors like GABA (γ-aminobutyric acid) receptors. Despite the practical uses of GA, recent studies have raised concerns about the potential risks associated with anesthesia exposure on the brain and cognitive function. In recent studies, these adverse effects, like neuronal death, can cause neurotoxicity despite the reversible and transitory nature of most GAs. In this paper, we discuss the neurological and behavioral outcomes after GA in developing and post-developed brains. These findings highlight serious concern on how GA impacts neurocognition and brain activity in both immature and mature brains and the potential harmful long term effects of GA. By understanding anesthetic-induced neurotoxicity, more avenues can be explored to particularly learn how to effectively protect vulnerable populations from harmful effects to the brain and warrant further research on clinical applications of anesthesia.

This paper details a theoretical research proposal to explore the efficacy of theevent-related potential (ERP) component P300 as a potential biomarker in the early detection of Alzheimer’s disease. To determine P300’s efficacy as a biomarker, an electroencephalogram test, which monitors and generates data on the electrical activity of the brain via scalp electrodes, and an auditory oddball test, which aims to assess the cognitive functioning of participants, were performed. The auditory oddball test involved playing a series of tones of two different frequencies (one is the standard tone, and the other is the target tone) for participants and having participants press a button whenever they heard a target tone. Accuracy and reaction time were recorded. The aforementioned two tests depicted a strong association between P300 and the cognitive decline of patients with Alzheimer’s Disease (AD), suggesting that this ERP component may be used for the early detection of AD, which may improve the efficacy of future treatment and the overall quality of life for diagnosed patients in the long run.

Background

The goal of this study was to describe the incidence, characteristics, and outcomes of secondary malignant neoplasms (SMN) in survivors of Wilms tumor.

Procedures

Patients who were 0-20 years of age at time of primary diagnosis with Wilms tumor and reported to the Surveillance, Epidemiology, and End Results [SEER] program between 1973 and 2011 were eligible for inclusion in the cohort. We used competing risks methods to estimate the cumulative incidence of SMNs and assess contributing factors for developing SMN. We estimated standardized incidence ratios (SIR), absolute excess risk and overall survival after SMN using standard methods.

Results

Within the SEER database, 2,851 patients were diagnosed with Wilms tumor as their first malignancy. Of these, 34 patients were reported to have a SMN. Cumulative incidence of for a secondary malignancy was 0.6% (95% confidence interval [95% CI] 0.3-1.0%) at 10 years, 1.6% (95% CI 1.0-2.3%) at 20 years, and 3.8% (95% CI 2.4-5.9%) at 30 years. Median time from primary diagnosis to SMN diagnosis was 12.5 years. SIR for SMN for survivors of Wilms tumor was 3.4 (95% CI 2.2-4.9) with an absolute excess risk of 7.6 per 10,000 persons per year. Exposure to radiation did not significantly increase risk for development of second malignancy. Overall survival for patients with SMN was 64.5% at 5 years.

Conclusion

Survivors of Wilms tumor are at an increased risk of SMN compared to the general population, but the added risk is relatively small compared to other pediatric cancers.

New prophylactic approaches are needed to control infection with the Gram-positive bacterium Staphylococcus aureus, which is a major cause of nosocomial and community-acquired infections. To develop these, greater understanding of protective immunity against S. aureus infection is needed. Human immunity to extracellular Gram-positive bacterial pathogens is primarily mediated by opsonic killing (OPK) via antibodies specific for surface polysaccharides. S. aureus expresses two such antigens, capsular polysaccharide (CP) and poly-N-acetyl glucosamine (PNAG). Here, we have shown that immunization-induced polyclonal animal antisera and monoclonal antibodies specific for either CP or PNAG antigens have excellent in vitro OPK activity in human blood but that when mixed together they show potent interference in OPK activity. In addition, reductions in antibody binding to the bacterial surface, complement deposition, and passive protection were seen in two mouse models of S. aureus infection. Electron microscopy, isothermal calorimetry, and surface plasmon resonance indicated that antibodies to CP and PNAG bound together via an apparent idiotype-anti-idiotype interaction. This interaction was also found in sera from humans with S. aureus bacteremia. These findings suggest that the lack of effective immunity to S. aureus infections in humans could be due, in part, to interference in OPK when antibodies to CP and PNAG antigens are both present. This information could be used to better design S. aureus vaccine components.