No abstract

Objective We sought to determine whether cortical excitability, measured via transcranial magnetic stimulation (TMS), is associated with cognition in healthy individuals and whether gender and education have an impact on this relationship. Methods Fifty-four healthy individuals (31 males, mean age = 41.94, SD = 21.98; 23 females, mean age 48.57; SD = 22.84) underwent TMS to assess their resting motor threshold (RMT) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to assess cognition. Multiple regression analyses were conducted to assess the association between RMT, education, gender and cognition. Results The multiple regression model revealed a significant association between RBANS Total Index Score and RMT in the female group (B = 0.624, β = 0.602, P = 0.001) and not the male group (B = 0.048, β = 0.034, P = 0.858). Conclusion This study demonstrated that lower cortical excitability is associated with better global cognition in healthy female and not male individuals. RMT could be further studied as a tool to better personalize brain stimulation protocols that aim at enhancing cognition.

Infectious mononucleosis is typically a self-limited viral infection of adolescence and early adulthood that resolves in a period of weeks, causing no major sequelae. We describe a case of a healthy 18-year-old female diagnosed with infectious mononucleosis who also presented with right upper quadrant abdominal pain, moderate transaminitis, and cholestatic biochemistry. An ultrasound revealed acute acalculous cholecystitis, generally a condition seen in the context of critical illness. Further investigating emergency department patients with infectious mononucleosis is often not indicated, but may be important for those who present atypically.

Acute myeloid leukemia (AML) is an aggressive, acute-onset hematological malignancy. Greater use of intensive chemotherapy (IC), supportive care, and stem cell transplantation have led to an increasing number of long-term survivors. Few studies have examined employment issues among AML survivors and to our knowledge, no study has examined the long-term effects of treatment on return to work. This study is the first to utilize a validated measure of work-related limitation and productivity (WLQ-16) to assess the long-term effects of AML treatment on employment rates, work-related limitations, and overall productivity. We examined RTW issues in 111 adult AML 1-year survivors after conventional IC. We found that, over time, the number of employed survivors increased (to 54% by 36 months) while the number of unemployed, retired, and sick leave patients decreased. Among those employed, the majority were employed full time. Employed individuals reported few work-related limitations and productivity loss scores were low, ranging from 3.47% at 18 months to 2.34% at 36 months. These data suggest that, over time, over half of AML survivors who underwent IC regain social, emotional, cognitive, and physical function sufficient to RTW with few limitations.