Publications

The synthetic progestin, 17α-hydroxyprogesterone caproate (17-OHPC), is administered to pregnant individuals at risk for preterm birth and is likely transferred from mother to fetus. Yet, there is little information regarding the potential effects of 17-OHPC administration on behavioral and neural development in offspring. In rats, neonatal 17-OHPC exposure altered dopaminergic fiber distribution and density in the prelimbic medial prefrontal cortex (mPFC) in neonates and adolescents, respectively. Additionally, neonatal 17-OHPC exposure in male rats increased response omissions in a delay discounting task of impulsive decision-making. Because developmental 17-OHPC exposure has differential effects in males and females, investigating the effects of 17-OHPC on impulsive decision-making in female rats is necessary. The present study tested the effects of developmental 17-OHPC exposure (P1–P14) in a delay discounting task in which female rats chose between a small immediate reward and a larger delayed (0, 15 30, or 45 s) reward. 17-OHPC-exposed females made more omissions than controls. There was no effect of 17-OHPC on large reward preference nor on response time, and omissions were similar during both free- and forced-choice trials. The present study also aimed to investigate the neural mechanisms underlying omissions in 17-OHPC-exposed female rats. The dopamine transporter inhibitor, methylphenidate (MPH), was administered prior to delay discounting testing. MPH treatment did not reduce omissions in 17-OHPC-exposed females. If anything, MPH increased omissions in control females nearly fourfold during the longest delays. These results suggest that developmental 17-OHPC exposure increased omissions without affecting impulsivity or slowing decision-making. Furthermore, omissions may be regulated, at least in part, by dopaminergic mechanisms.

Glioblastoma (GBM) is one of the most aggressive forms of brain cancer that presents with a median survival rate of 14-30 months and along with a discouraging five-year survival rate of 4-5%. Standard treatment of newly diagnosed GBM, also known as the Stupp protocol, includes a maximally safe surgical resection followed by radiation and chemotherapy. Despite these treatment regimens, recurrence is almost inevitable, emphasizing the need for new therapies to combat the aggressive nature of GBMs. Tumor Treating Fields (TTFs) are a relatively new application to the treatment of GBMs, and results have been promising with both progression-free survival and overall survival when TTFs have been used in combination with temozolomide. This article critically reviews the biophysical and biological mechanisms of TTFs, their clinical efficacy, and discusses the results in clinical trials, including EF-11 and EF-14. Both trials have demonstrated that TTFs can enhance progression free survival and overall survival without compromising quality of life or causing severe adverse effects. Despite the high cost associated with TTFs and the need for further analysis to determine the most effective ways to integrate TTFs into GBM treatments, TTFs represent a significant advancement in GBM therapy and offer hope for improved patient prognosis.

Orthopedic diseases often present with dermatological symptoms that require prompt identification for appropriate treatment. Understanding these dermatologic presentations is crucial for accurate diagnosis and effective management. This article critically reviewed the dermatological manifestations observed in general and regional pathologies, followed by treatment-related manifestations. An extensive literature search was performed and limited to manifestations in orthopedic disease, excluding those pertaining to infection or syndromes. Case reports and case series documenting unusual and rare dermatologic presentations of orthopedic conditions were examined, providing novel perspectives on both prevalent and uncommon illnesses. The identified pathologies are discussed in detail, including their clinical features and diagnosis, while treatment approach varies depending on the severity of the condition, ranging from self-care to surgical intervention. The findings emphasize the need for interdisciplinary collaboration and highlight the importance of careful diagnosis and appropriate management to eliminate unnecessary approaches and ensure optimal outcomes for patients with orthopedic diseases and dermatologic symptoms.

Atopic dermatitis (AD) is a prevalent inflammatory skin condition impacting both children and adults globally, with a prevalence of 15-30%. It ranks as the most prevalent skin disorder based on disability-adjusted life-years by the World Health Organization. It presents with symptoms like skin irritation, redness, dryness, itchiness, and vesicular blisters and commonly coexists with other atopic symptoms like allergic rhinitis, asthma, and food allergies. The pathophysiology involves a complex interplay of genetic predispositions, immunological dysfunctions, and environmental factors leading to tissue inflammation and disrupted skin barrier integrity. Alopecia areata is characterized by nonscarring hair loss and shares correlations with AD including a higher prevalence of atopic diseases, shared intracellular mechanisms involving the JAK-STAT pathway, and potential treatment overlap such as dupilumab. These correlations could direct new areas of research and increased insight for both diseases. Treatment of AD requires a personalized approach due to its complex, multifactorial nature integrating nonpharmacological interventions like skin hydration and trigger avoidance as well as topical and systemic approaches, if necessary, with topical corticosteroids being the first line for flares; long term corticosteroid use poses risk for adverse effects like skin atrophy. Severe cases may require systemic treatments or phototherapy. Future treatment prospects include targeting the dysbiotic microbiome and identifying biomarkers for tailored therapeutic strategies, emphasizing the importance of personalized medicine in optimizing AD management.

Isotretinoin (13-cis-retinoic acid) is a well-established systemic treatment for moderate to severe acne vulgaris, renowned for its ability to target multiple contributors to acne pathogenesis. However, its therapeutic potential extends beyond conventional acne management. This case report highlights its efficacy in treating recalcitrant pustular dermatosis, a condition that proved resistant to standard therapies and posed significant diagnostic challenges. A 25-year-old female patient presented with a diffuse, inflamed pustular rash that was unresponsive to a wide range of conventional treatments, including antibiotics, antifungals, and topical agents. Initially diagnosed as bacterial folliculitis based on clinical appearance, the condition persisted despite these interventions. Multiple punch biopsies and laboratory tests aimed at ruling out other conditions, such as pityriasis folliculorum, eosinophilic folliculitis, and cutaneous mastocytosis, provided inconclusive results. Without a definitive diagnosis and after exhausting standard treatments, the decision to initiate systemic isotretinoin was driven by its unique mechanism of action as a "sebocyte modulator," which targets sebum production, inflammation, and abnormal keratinization-key factors suspected to underlie the patient’s condition. Over several months, gradual but consistent improvement was observed, culminating in the complete resolution of pustular lesions. The patient’s successful response to isotretinoin highlights the importance of considering this treatment in refractory pustular dermatosis when conventional therapies fail, advocating for its broader clinical application in managing complex pustular skin disorders.