John M Stern

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Researchers studied the blood supply in the front part of the foot, focusing on the deep plantar arterial arch, which is crucial for surgeries like foot amputations. They examined 89 feet from 45 human cadavers and found that this arch was present in all cases, with about 43% of feet showing dominance from the lateral plantar artery and a similar percentage from the deep plantar artery. Understanding these patterns is important because knowing where the blood vessels are can help surgeons avoid complications during foot surgeries, improving patient outcomes.

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This study examined the use of AI-generated text in personal statements from applicants for adult reconstruction fellowship programs, comparing submissions before and after the release of ChatGPT. Out of 421 analyzed personal statements, only 0.4% were AI-generated before ChatGPT, but this jumped to 15.1% after its release. This trend is concerning because personal statements are important for candidate selection, suggesting that the medical field needs clearer rules about using AI in these applications.

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This study looked at how total knee replacement surgeries in the U.S. have moved from hospitals to outpatient centers between 2019 and 2022. It found that the share of surgeries done in hospitals dropped from 64% to 14%, while outpatient centers handled 86% of the procedures. Patients at outpatient centers were generally younger, healthier, and less likely to have severe health issues compared to those in hospitals, which highlights the importance of choosing the right patients for these types of surgeries to ensure safety and fair access to care.

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This study looked at how a machine learning tool called the Functional/Dissociative Seizures Likelihood Score (FSLS) can help doctors better diagnose functional seizures, which can be confused with epilepsy. The researchers found that 90% of the participating clinicians performed better than chance when using this score, with some improving their accuracy by 12% to 15%. This matters because accurate diagnosis can lead to better treatment for patients, and using tools like the FSLS can help clinicians make more informed decisions in tricky cases.

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This study looked at how nicotine, without the effects of tobacco smoke, impacts bone healing after joint replacement surgeries. It found that nicotine generally delays bone healing and decreases new bone formation, especially in higher doses, while also reducing the stability of titanium implants used in surgeries. This matters because understanding nicotine's direct effects could help improve recovery after joint surgeries for patients who use nicotine.

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This study looked at kidney donations in the U.S., specifically comparing surgeries where donors give their right versus left kidneys. It found that the use of right kidneys for transplants has dropped from 27% in 1995 to only 10-12% lately, with different hospitals showing a wide range in their use of right kidneys, from none to 37%. The research also showed that right kidneys have a higher chance of immediate problems after transplant, with 2.4% facing delayed function and 8.7% failing within 90 days, compared to left kidneys. This is significant because it highlights ongoing challenges and risks with right kidney donations, even with improved surgical techniques.

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This study looked at the outcomes of heart and kidney transplants performed either on the same day or 1-2 days apart. It found that patients receiving both organs during one operation had shorter hospital stays and slightly lower death rates after four years compared to those who had the transplants staged. However, when adjusting for other factors, there were no significant differences in long-term survival or kidney and heart failure between the two groups, suggesting that needing both organs at once may be linked to better overall health, rather than the timing of the surgeries itself.

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A gene-edited pig kidney was transplanted into a brain-dead human and kept functioning for a planned 61-day study using only standard approved anti-rejection drugs. The kidney maintained stable electrolyte balance and eliminated the need for dialysis, but antibody-mediated rejection emerged on day 33 and was reversed with plasma exchange and complement inhibition. The study shows a minimally modified pig kidney can sustain human-equivalent kidney function and identifies pre-existing immune cells reactive to pig tissue as a key obstacle to long-term success.

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This study looked at how using cannabis and tobacco affects recovery after surgery for wrist fractures. Researchers found that patients who used both cannabis and tobacco had a higher chance of complications, like not healing properly, compared to those who used only tobacco or cannabis. Specifically, 5% of those who used both had nonunion after surgery, and overall, using cannabis alone increased the risk of infections and improper healing. This matters because it highlights the potential risks of cannabis use after surgery, especially for those who also smoke tobacco.

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This study looked at two methods for detecting functional seizures: a specialized tool called the Functional Seizures Likelihood Score (FSLS) and advanced AI models, ChatGPT and GPT-4. The FSLS correctly identified functional seizures 74% of the time, while GPT-4 was more accurate at 85%. The findings matter because they show that while AI can improve seizure diagnosis, it also has inconsistencies and might not always agree with other methods, which could impact patient care.

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This study looked at how brain networks change during the early stages of epilepsy using a rat model. Researchers found that the brain connections in rats that later developed epilepsy were less stable, especially in the frontal cortex and hippocampus, compared to control rats. This matters because understanding these changes could help in developing better treatments for epilepsy by targeting these early alterations in brain function.

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Researchers developed a machine learning system that can automatically detect tonic-clonic seizures in epilepsy patients by analyzing video footage. In a study involving 49 seizures from 25 patients, the system was nearly perfect, identifying seizures 95% of the time with almost no delay and producing very few false alarms. This technology could help monitor seizures more efficiently in hospitals and possibly lead to reliable methods for tracking seizures at home, improving care for those with epilepsy.

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The study focused on how people with epilepsy in the U.S. face significant obstacles in accessing healthcare, resulting in poorer health outcomes. The researchers found various reasons for these disparities, including gaps in knowledge, economic challenges, and limitations within the healthcare system. They created a set of recommendations to improve epilepsy care by enhancing research, advocacy, and education, highlighting that while these recommendations are aimed at the U.S., similar issues exist for epilepsy patients worldwide.

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This study looked at the health risks for family members of men who have fertility issues, specifically low sperm counts. It found that relatives of men with very low sperm counts (azoospermic) or below-normal sperm counts (oligozoospermic) had a higher chance of dying from various causes, especially cardiovascular problems, compared to relatives of men with normal sperm counts. This matters because it highlights that both fertility problems and overall health might be influenced by shared genetics or environmental factors within families.

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Researchers improved a method for analyzing lung tissue samples from patients with non-tuberculous mycobacterial infections, which are becoming more common globally. By refining an imaging technique, they successfully reduced background noise from the samples, allowing clearer and more detailed pictures of immune cells in the lungs. This method is important because it helps better understand the immune response in different lung diseases, which could lead to better treatment strategies.

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Researchers surveyed 15 epilepsy experts to understand how they handle clusters of seizures in specialized monitoring units. They found that definitions of seizure clusters varied, but 12 experts often use immediate rescue medications, usually benzodiazepines, to manage them. Importantly, 9 experts reported that seizure clusters sometimes disrupted evaluations for surgery, which highlights the need for clear treatment guidelines in these situations to ensure better patient care.

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This study looked at the honesty of applicants for orthopaedic research fellowships to see how accurately they reported their research contributions. Out of 87 applications reviewed, 15 (about 17%) contained inaccuracies, with 9 applications overstating the applicant's role in publications and 8 applications claiming non-existent or withdrawn papers. These misrepresentations can undermine trust in the application process and suggest a need for better systems to ensure that applicants report their research fairly and accurately.

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Researchers studied a rare type of tumor in an infant that appeared as a painless bump on his back. After removing the tumor and confirming its type through testing, a second surgery was needed to ensure all the cancerous cells were gone. This case is important because it shows how unusual tumors can look like common cysts, highlighting the need for doctors to consider these rare growths when diagnosing similar cases in children.

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This study looked at two types of late-onset epilepsy in older adults: one with no known cause and another linked to brain injuries. Researchers found that the epilepsy without a known cause was easier to treat, requiring fewer medications and resulting in fewer hospital stays for monitoring. However, both types of epilepsy carried a similar risk of dementia, highlighting the need for ongoing checks on memory and cognitive health in these patients.

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Pig organ transplantation into humans has advanced rapidly from animal studies to a handful of compassionate-use cases, with early results revealing key obstacles including antibody-mediated rejection, dangerous drops in platelet counts, and unknown long-term immune responses. As formal clinical trials approach, major decisions remain unresolved: which pig genetic modifications to use, how to suppress the immune system without leaving patients vulnerable to infection, and which patients are appropriate candidates. Addressing these challenges through coordinated, multidisciplinary work will determine whether xenotransplantation can realistically close the gap between organ supply and demand.

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Clinical research draws large volumes of blood from study subjects, but most blood collected for routine clinical tests goes unused and is discarded after analysis. In a 61-day xenotransplant experiment, researchers collected leftover clinical samples from the hospital lab twice weekly, recovering enough plasma to supply 62% of all research plasma needs without taking additional blood from the subject. This recycling approach can meaningfully reduce unnecessary blood loss in patients enrolled in intensive research studies.

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Researchers transplanted a pig kidney-thymus combination into a deceased human and tracked the immune response over 61 days. T cells from the recipient infiltrated the organ and specific clones expanded in blood, tissue, and lymph nodes around rejection events. This reveals that T cell-driven rejection of pig organs in humans closely mirrors what happens with human-to-human transplants, informing how future immunosuppression strategies must be designed.

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Researchers studied sleep patterns by creating a new algorithm that uses data from heart rates and movement instead of expensive sleep tests. Their algorithm accurately classified sleep into four stages—wake, light sleep, deep sleep, and REM—with 83.3% accuracy. This is important because it offers a simpler way to track sleep quality using wearable devices, making sleep studies more accessible and efficient.

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This study looked at how quickly a nasal spray called diazepam could stop seizure clusters in people with epilepsy. Researchers found that when diazepam was given within 5 minutes of a seizure starting, the seizures ended in about 4 minutes on average, compared to nearly 23 minutes when it was given later. This is important because faster treatment can lead to better outcomes for patients experiencing these intense episodes.

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This study examined how a new trial design, which focuses on how quickly patients with hard-to-treat epilepsy experience seizures, can help evaluate the effectiveness of antiseizure medications. Researchers looked at 11 previous trials and found that using this new method would have reached the same conclusions about the medications’ effectiveness as the longer trials while reducing the exposure of participants to ineffective treatments. This matters because it could lead to faster and safer testing of new epilepsy medications, potentially helping patients get the right treatment more quickly.

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The study looked at how effective diazepam nasal spray is for treating prolonged seizures that last between 5 to 15 minutes after they start. It found that when administered 6 minutes after the seizure begins, the median time to stop the seizure was about 7 minutes, resulting in an overall seizure duration of around 15 minutes. This is important because it shows that even with a slight delay in treatment, diazepam nasal spray can still effectively control prolonged seizures, making it a valuable option for emergency care.

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This study looked at how telehealth can be used to care for people with epilepsy, especially during the COVID-19 pandemic when it became more common. The researchers found that telehealth is effective for things like medication management and follow-up visits for straightforward cases, benefiting patients who can't travel or live in facilities. However, in-person visits might be better for those with more complicated medical needs or communication challenges, highlighting that telehealth should be a flexible option for epilepsy care.

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A 66-year-old woman developed groin pain and a noticeable mass three years after undergoing hip replacement surgery. After multiple tests failed to identify the problem, she had a second surgery that involved repairing the hip and cutting a tendon, which significantly relieved her pain and improved her ability to move. This case shows that diagnosing and treating certain complications after hip surgery can be difficult, but addressing them can lead to major improvements in a patient's quality of life.

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Researchers studied how to measure quality of life for adults with drug-resistant epilepsy. They involved 109 participants, including patients and caregivers, who agreed on 36 important areas to focus on, with 88.8% of these areas being unrelated to the number or severity of seizures. This matters because it highlights that managing epilepsy is about more than just seizures; it also involves other important aspects of life that affect overall well-being.

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This study looked at how written seizure action plans (SAPs) could help adults with epilepsy manage emergencies related to their condition. It found that while these plans are common for children, many adults do not use them, despite their promised benefits—like reducing emergency room visits and improving overall quality of life. Implementing these plans for adults can lead to better health outcomes and make it easier for patients and caregivers to respond effectively during seizure emergencies.

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Researchers examined epilepsy with eyelid myoclonia (EEM), a condition mostly affecting girls that starts in childhood. They found that about one-third of patients have a family history of epilepsy, and specific genetic mutations are recognized in some cases. This is important because over half of those with EEM struggle to control their seizures with medication, leading to ongoing challenges into adulthood.

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Researchers studied a technique called hybrid stereo-electroencephalography (SEEG) in patients with epilepsy that doesn't respond to medication. They found that this method successfully located the source of seizures in 87.6% of patients and helped 63.7% of those who had surgery achieve freedom from seizures. This technique is important because it not only guides effective surgery but also offers new insights into how the brain works and how to treat other brain disorders.

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Researchers gathered a group of 30 experts to determine the best ways to treat a specific type of epilepsy called eyelid myoclonia. They found that valproic acid is the best first choice for treatment, especially for women of childbearing age, while alternative medications like levetiracetam and lamotrigine are also effective. This information is important because it helps improve how doctors manage this condition, which typically continues into adulthood, and provides insights into areas that need more study.

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Researchers gathered an international group of experts to agree on how to diagnose and understand epilepsy with eyelid myoclonia (EEM), a type of epilepsy that mostly affects girls and usually starts between ages 3 and 12. They found that eyelid twitching is a key symptom for diagnosis, but many patients may go years without being diagnosed. The experts emphasized that certain tests, like EEGs, are crucial for diagnosis, while genetic testing is recommended if there is a family history of epilepsy or other related issues. These findings aim to improve the speed and accuracy of diagnosing this condition.

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This study looked at brain differences in 37 women with functional seizures, which are seizure-like episodes not caused by epilepsy, compared to 37 women without seizures. Researchers found that the right lateral amygdala in these patients was smaller, while other areas of the amygdala and hippocampus were larger or thinner, indicating abnormalities in brain structure. These findings are important because they suggest links between functional seizures, stress, and depression, and could lead to better diagnosis and treatment options for those affected.

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This study looked at how the difficulties in finding and keeping participants for epilepsy drug trials have changed since 1990. Researchers found that fewer participants are being recruited per trial site, with recent trials averaging under five participants per site, a decline over time. Additionally, more people are experiencing improvements from placebos, which makes it harder to see if the actual treatments are effective. This is important because it highlights the need to rethink how clinical trials are designed to better engage participants and get clearer results.

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Researchers studied the link between late-onset epilepsy (seizures starting after age 60) and brain problems associated with Alzheimer's disease, specifically related to proteins called amyloid and tau. They found that many patients with this type of epilepsy showed signs of brain damage linked to these proteins, indicating a higher risk of developing Alzheimer's and cognitive decline. This matters because it could help in identifying elderly patients at risk for dementia earlier, leading to better management and treatment options.

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This study looked at how kidney transplant recipients respond to COVID-19 vaccines. Out of 34 patients who had never been infected with COVID-19 before getting vaccinated, only 1 (about 3%) developed antibodies against the virus. In contrast, those who had been previously infected were 18 times more likely to respond positively to the vaccine. These findings matter because they show that the COVID-19 vaccine doesn't trigger harmful immune reactions in kidney transplant patients and that prior infection significantly boosts vaccine effectiveness for them.

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This study looked at transplanting genetically modified pig hearts into two recently deceased human patients to see how well they would function. Both pig hearts worked well right after the transplant, but one heart eventually had problems due to being too large for the recipient. Importantly, there were no signs that the human bodies rejected the hearts or that any diseases were passed from pigs to humans, which is a significant step forward in addressing the shortage of human organs for transplant.

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This research looked at how different symptoms reported by patients could help distinguish between functional seizures (FS) and epileptic seizures (ES). They analyzed data from 877 adult patients and found that the symptoms alone were not very effective for telling the two conditions apart—showing only a 74% accuracy at best. This matters because it highlights that relying solely on symptom reports may not be a reliable way to diagnose these seizure types, suggesting a need for better methods to differentiate them.

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Researchers studied the brain structure of patients with functional seizures (FS) compared to people without seizures but experiencing mental health issues like depression and anxiety. They found that patients with FS had specific differences in their brain areas: their superior temporal cortex was thinner, the lateral occipital cortex was thicker, and they had more white matter in the cerebellum. Understanding these brain differences is important because it helps clarify how functional seizures are distinct from other psychiatric conditions, potentially leading to better diagnosis and treatment.

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This research studied how CT scan-based robotic technology can improve total hip replacement surgery compared to traditional manual methods. The findings showed that using robotic assistance led to better accuracy in placing hip implants, fewer problems with leg length, and lower dislocation rates. Out of 24 studies examined, 23 showed that patients had better satisfaction and outcomes, along with reduced costs and shorter hospital stays, making this approach a recommended option for surgeons to consider.

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The study focused on how to safely adjust doses of existing antiseizure medications when adding a new drug called cenobamate for adults with uncontrolled focal seizures. Experts agreed that lowering the doses of certain medications, like clobazam and phenytoin, can help avoid side effects when starting cenobamate, while other medications might only need adjustments if problems arise. This is important because making these changes can help patients manage their seizures more effectively with fewer adverse effects.

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This study looked at brain tissue differences in patients with tonic-clonic seizures compared to healthy people. The researchers found that patients had less "randomness" in their brain tissue, indicating greater homogeneity, in key areas related to autonomic functions and motor control, which could suggest significant tissue damage. Understanding these changes is important because they may be linked to severe problems, like sudden unexpected death in epilepsy patients, and provide valuable insights into brain health beyond just measuring volume.

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This study looked at research on knee replacement surgeries published in 2021, focusing on randomized controlled trials (RCTs), which are the most reliable type of medical research. Out of 197 studies, only 26 focused on the design and use of prosthetic devices, and 15% were from the U.S. The findings highlight a lack of rigorous research in prosthetic design, which is important because better studies could lead to improved surgical outcomes and patient care in knee replacements.

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Researchers studied the histories of brain injuries in patients with either epileptic seizures or functional seizures. They found that 70% of patients with functional seizures reported a history of brain injury compared to 59% with epileptic seizures, and those with functional seizures were more likely to have experienced less serious injuries, like brief loss of consciousness, as well as falls or car accidents. This matters because it challenges the common assumption that a history of brain injury always indicates a higher risk for significant issues, like posttraumatic epilepsy, and highlights the need for careful assessment in patients with seizures.

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Researchers successfully transplanted kidneys from genetically modified pigs into two brain-dead human patients and found that the pig kidneys started making urine almost immediately and functioned well for 54 hours. In this time, kidney function improved significantly, with one patient's kidney filtering rate increasing from 23 to 62 ml per minute and the other's from 55 to 109 ml per minute. This research is important because it shows that pig kidneys can potentially be used for transplant without being rejected, helping to address the shortage of human organs available for patients in need.