Inflammatory breast cancer (IBC) is one of the most lethal subtypes of breast cancer (BC), accounting for approximately 1–5% of all cases of BC. Challenges in IBC include accurate and early diagnosis and the development of effective targeted therapies. Our previous studies identified the overexpression of metadherin (MTDH) in the plasma membrane of IBC cells, further confirmed in patient tissues. MTDH has been found to play a role in signaling pathways related to cancer. However, its mechanism of action in the progression of IBC remains unknown. To evaluate the function of MTDH, SUM-149 and SUM-190 IBC cells were edited with CRISPR/Cas9 vectors for in vitro characterization studies and used in mouse IBC xenografts. Our results demonstrate that the absence of MTDH significantly reduces IBC cell migration, proliferation, tumor spheroid formation, and the expression of NF-κB and STAT3 signaling molecules, which are crucial oncogenic pathways in IBC. Furthermore, IBC xenografts showed significant differences in tumor growth patterns, and lung tissue revealed epithelial-like cells in 43% of wild-type (WT) compared to 29% of CRISPR xenografts. Our study emphasizes the role of MTDH as a potential therapeutic target for the progression of IBC.

Clinical reasoning is essential to the practice of medicine. Such reasoning involves analytical (deductive) and non-analytical (recall) processes. Non-analytical reasoning is taught extensively in medical schools, and it dominates medical students' time as they review question banks and lecture notes, watch videos online, and memorize flashcards, algorithms, and illness scripts. However, few opportunities are provided in the curriculum to develop students' clinical reasoning skills, and when they are, the diverse levels of innate reasoning ability among students often lead to significant learning disparity. To address this deficiency, a pilot module on cranial nerve anatomy was developed to foster analytical clinical reasoning in an individualized manner. It was hypothesized that this module would not only introduce the foundations of an essential medical skill but also improve overall student understanding of the subject and reduce learning disparities among students. A comparative study was conducted using this module in one group and a didactic module in the other, employing pre- and post-testing measures. Results indicated a 26% improvement in average scores following the analytical module, whereas the control module showed no significant improvement. In addition, the disparity between students improving or not improving following the intervention was reduced, with 74% of students improving after the reasoning module and only 33% of students improving after the didactic module. A novel cranial nerve educational module introduced analytical reasoning in medical students' first few weeks of education, facilitating the learning of complex anatomy and reducing learning disparity between students.

Background: The flexor digitorum brevis tendon to the fifth digit is frequently absent, and this absence is typically an incidental discovery during dissection or surgical studies. This study aimed to assess the frequency of a missing flexor digitorum brevis tendon in a Hispanic population for the first time, the association between the absence of the flexor digitorum brevis tendon, variables such as sex and ethnicity, and the functional implications of an absent tendon. Methods: Our sample consists of 30 cadavers whose feet were dissected and examined for the presence or absence of the digiti minimi tendon. Results: We found no significant relationship between the presence or absence of the tendon to sex or ethnicity. However, due to a lack of significant effects on human ambulation from the absence of this tendon, and the ability of adjacent muscles to adapt to its absence, the absence of this tendon might become increasingly prevalent over time. Conclusions: Knowledge of the frequency of flexor digitorum brevis variations concerning the demographic characteristics of patients would be of clinical importance for tendon repair, tendon transfer to correct deformities such as claw toe or hammer toe, or soft tissue reconstruction in foot surgery.

Anatomical variations of the gluteus maximus have significant clinical implications. The gluteus muscle is commonly innervated by the Inferior Gluteal Nerve (IGN). However, this innervation could be affected by its embryological development. An anomalous innervation of the gluteus maximus by the Sciatic Nerve (SN) was identified during a bilateral dissection of the gluteal region. Dissection was performed on an elderly female cadaver, preserved with 10% forrnalin, and performed following the guidelines given in Grant's Dissector 16th edition. The left and right gluteus maximus were innervated by their corresponding IGN. However, both demonstrated an additional innervation by the SN. This branch by the SN was located proximal to the IGN and emerged near the inferior border of the piriformis muscle. Patients with dual gluteus maximus innervation can present with clinical signs and symptoms which might be easily misdiagnosed. Therefore, physicians need to be aware of this abnormal innervation to accurately diagnose and avoid potential iatrogenic nerve injuries during interventions.

There are multiple treatment options for breast cancer (BC), including lumpectomy, chemo- and radiotherapy, complete mastectomy, and, when indicated, an axillary lymph node dissection. Such node dissections commonly lead the surgeon to encounter the intercostobrachial nerve (ICBN), which, if injured, leads to significant postoperative numbness of the upper arm. To assist in identifying the ICBN, we report a unilateral variation of a dual ICBN. The first ICBN (ICBN I) originates from the second intercostal space, as classically described in human anatomy. On the contrary, the second ICBN (ICBN II) originates from the second and third intercostal spaces. The anatomical knowledge of ICBN origin and its variations are crucial for axillary lymph node dissection in BC and other surgical interventions that involve the axillary region (e.g., regional nerve blocks). An iatrogenic injury of the ICBN has been associated with postoperative pain, paresthesia, and loss of upper extremity sensation in the dermatome supplied by this nerve. Therefore, maintaining the integrity of the ICBN is a worthy goal during axillary dissections in BC patients. Increasing the awareness of ICBN variants among surgeons reduces potential injuries, which would contribute to the BC patient's quality of life.

Background: This study examines the long-term effectiveness and safety of the vertical expandable prosthetic titanium rib (VEPTR) device, developed in 1989 to treat early-onset scoliosis (EOS) and thoracic insufficiency syndrome (TIS). Specifically, it assesses VEPTR outcomes over 20 years in a single center, focusing on spine deformity correction, pulmonary function, weight percentile changes, and complication rates. Methods: A retrospective analysis was conducted on 36 patients from the EOS clinic who underwent VEPTR implantation without prior spine surgery, with at least 2 years of follow-up. Data collected included age, sex, weight, height, BMI, weight percentiles, comorbidities, radiographic parameters, pulmonary function tests, and complications. Weight percentile (WP) was calculated as preoperative WP and last follow-up WP. Coronal and sagittal deformities were measured preoperatively, immediately postimplantation, and at the last follow-up. Pulmonary function tests included forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) and were correlated with weight percentile changes. Complications were classified using established criteria. Results: The mean age at VEPTR implantation was 86±34 months, with most cases attributed to neuromuscular scoliosis (56%). The initial coronal Cobb angle improved from 59±18 to 32±14 degrees postimplantation but increased to 60±25 at the final follow-up. Sagittal angles showed similar trends. Pulmonary function tests indicated a decline in FVC and FEV1 over time. There was no correlation between weight percentile changes and pulmonary function changes. Complication rates were high, affecting 63% of patients, which included hardware prominence, device migration, and infections as the most common. Conclusions: Although VEPTR devices initially corrected spinal deformities, their long-term benefits are limited as the correction becomes less pronounced over time. Expected improvement in pulmonary function is not observed. A different approach to treating EOS and TIS is necessary, as the significant complication rates challenge the implants’ effectiveness. Level of Evidence: Level III.