Nicotine is the psychoactive component given tobacco has several main components and acts as an agonist for nicotinic acetylcholine receptors (nAChRs) in the nervous system. Although the ligand-gated cation channels known as nAChRs are found throughout the nervous system and body, this review focuses on neuronal nAChRs. Individuals with psychiatric diseases such as schizophrenia, comorbid substance use disorders, attention-deficit hyperactivity disorder, major depression, and bipolar disorder have increased rates of smoking. These psychiatric disorders are associated with various cognitive deficits, including working memory, deficits in attention, and response inhibition functions. The cognitive-enhancing effects of nicotine may be particularly relevant predictors of smoking initiation and continuation in this comorbid population. Individuals with schizophrenia make up a significant proportion of smokers. Literature suggests that patients smoke to alleviate cognitive deficiencies due to the stimulating effects of nicotine. This narrative review examines the role of nicotine on cognition in schizophrenia.

Introduction/Objective Extramedullary hematopoiesis (EMH) is characterized by ectopic proliferation and differentiation of hematopoietic precursor cells outside the bone marrow. In postnatal life, EMH occurs due to hematopoietic disorders, infection or advanced tumors and is usually seen in the spleen, liver, and lymph nodes. Intracranial EMH is an extremely rare entity that has been reported to be associated with hematological disorders, meningioma, subdural hematoma and pilocytic astrocytoma. Methods/Case Report To highlight the significance of identifying EMH as one of the differential diagnoses of brain lesions, we present a 67-year-old female with a history of headaches and generalized malaise. Her past medical history was significant for hypertension and mild anemia. As part of the headache workup, magnetic resonance imaging (MRI) of the brain showed a 3.7cm cystic mass in the right inferomedial parietal lobe with medial mural enhancement, associated with edema and mass effect. A similar 3mm left parietal lobe enhancing focus was also noted. These findings were suggestive of a hemangioblastoma. Resection of the larger mass showed a benign vascular lesion with endothelial hyperplasia without the appearance of cavernous hemangioma or vascular malformation. Foci of erythroid and myeloid precursors, and megakaryocytes were seen. Immunohistochemical stains were negative for GFAP, CK AE1/AE3 and inhibin ruling out glial neoplasms, metastatic carcinoma and hemangioblastoma. Hematopoietic cells were positive for CD45, while immature red cells were positive for E-cadherin and endothelial cells were positive for CD31, consistent with EMH. Further workup was negative for any underlying hematological disorders, resulting in the diagnosis of idiopathic intracranial EMH. The patient received intensity- modulated radiation therapy (IMRT) for her remaining left parietal lesion. After 3 months of regular follow-up, her headache and malaise significantly improved. Results (if a Case Study enter NA) NA. Conclusion To our knowledge, this is the first reported case of idiopathic intracranial EMH.

Bacterial infective endocarditis is a rare but a life-threatening infection during pregnancy. Infective endocarditis during pregnancy is often associated with a congenital heart condition or an earlier history of rheumatic heart disease. In pregnant women with infective endocarditis, the maternal and fetal mortality rate can reach as high as 33% and 29%, respectively. In most cases, infective endocarditis runs a subacute course and involves the mitral valve, nonetheless, rarely it can involve the aortic valve as well. We are documenting a rare case of subacute infective endocarditis in a 26-year-old pregnant female with severe aortic stenosis with associated multiple systemic emboli. The patient was managed by urgent cesarean section at 35 weeks of gestation followed by aortic valve replacement; there was no maternal or fetal mortality. This case report highlights the importance of early diagnosis, and timely management of infective endocarditis in pregnant women to prevent maternal and fetal death.

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Chordomas are low-grade, locally invasive, frequently recurring, malignant bone tumor with poor prognosis. Cervical chordoma in adults is rare and often missed when patients present with cervical radiculopathy. They can mimic other malignant tumors and, hence require histologic distinction for prognostic risk stratification and optimal treatment. We present a 61-year-old male with chronic neck pain and sensory neuropathy in bilateral upper limbs. The patient underwent cervical discectomy and fusion which revealed a cystic mass arising from the right neural foramina at C5-C6 level. Histopathological examination of the mass was consistent with chordoma. Elderly patients with cervical radiculopathy should be evaluated for neoplasia including chordoma and differentiated from other etiologies. Early diagnosis and treatment can reduce morbidity and mortality from chordoma.