A Climate of Stigma, Uncertainty, and Distrust: Stakeholder Perception of Barriers to SNF Placement for Patients with Opioid Use Disorder Treated with Methadone.

Background: Patients with opioid use disorder (OUD), especially those treated with methadone, face significant challenges to placement in a skilled nursing facility (SNF). Efforts to address this via legal actions have not resulted in improved access.

Objective: To understand regulatory and non-regulatory factors that impact SNF placement of patients with OUD treated with methadone.

Peripheral to brain and hippocampus crosstalk induced by exercise mediates cognitive and structural hippocampal adaptations.

Endurance exercise leads to robust increases in memory and learning. Several exercise adaptations occur to mediate these improvements, including in both the hippocampus and in peripheral organs. Organ crosstalk has been becoming increasingly more present in exercise biology, and studies have shown that peripheral organs can communicate to the hippocampus and mediate hippocampal changes.

A case report of thrombocytopenic COVID-19 and Miller-Fisher syndrome on a concurrent chronic immune neuropathy.

Rationale: Miller-Fisher syndrome (MFS) is a rare subtype of Guillain-Barre syndrome with classic features of ataxia, areflexia, and ophthalmoplegia that can be caused by a preceding infection including COVID-19. We present a current, asymptomatic thrombocytopenic COVID-19 infection as a cause of MFS in a 60-year-old male with a concurrent chronic immune neuropathy.

Patient Concerns: A 60-year-old male presenting with acute symptoms of MFS including ataxia, areflexia, and ophthalmoplegia on a chronic immune neuropathy for at least 1 year and concurrent asymptomatic COVID-19 positive infection.

Bone-marrow mononuclear cells and acellular human amniotic membrane improve global cardiac function without inhibition of the NLRP3 Inflammasome in a rat model of heart failure.

Recent studies have suggested that therapies with stem cells and amniotic membrane can modulate the inflammation following an ischemic injury in the heart. This study evaluated the effects of bone-marrow mononuclear cells (BMMC) and acellular human amniotic membrane (AHAM) on cardiac function and NLRP3 complex in a rat model of heart failure.On the 30th day,the echocardiographic showed improvements on ejection fraction and decreased pathological ventricular remodeling on BMMC and AHAM groups.

Metastatic exocrine pancreatic adenocarcinoma in a giant otter (Pteronura brasiliensis).

Neoplasms of the exocrine pancreas are uncommon in domestic animals and rarely occur in wildlife. This article describes the clinical and pathological findings of one case of metastatic exocrine pancreatic adenocarcinoma in an 18-year-old giant otter (Pteronura brasiliensis) in captivity with a history of inappetence and apathy. Abdominal ultrasonography was inconclusive, and tomography revealed a neoplasm affecting the urinary bladder and hydroureter.

Investigating self-reported efficacy of lifestyle medicine approaches to tackle erectile dysfunction: a cross-sectional eSurvey based study.

Background: Erectile dysfunction (ED) is the most common sexual dysfunction in men. Some types of ED are amenable to treatment using lifestyle medicine approaches with or without pharmacotherapy.

Aim: Investigate self-reported efficacy of lifestyle medicine approaches to tackle ED.

Infections by entomopathogenic fungi in common green iguanas (Iguana iguana) in captivity in Brazil.

Entomopathogenic fungi, widely available biological agents used to control agricultural pests, are sporadically reported to cause focal or disseminated infection in reptiles and mammals, including humans. This study summarizes the clinical presentation, histopathological and molecular findings by panfungal polymerase chain reaction and sequencing of four cases of hypocrealean fungal infections in captive common green iguanas (Iguana, iguana). One case of granulomatous pneumonia, hepatitis and serositis was related to Metarhizium flavoviride complex infection.

Male genital organs of the black-crowned dwarf marmoset (Callibella humilis).

This study provides the first morphological description of the male genital organs of black-crowned dwarf marmoset (Callibella humilis). Internal and external genital organs were similar to other species of non-human primates. However, some shape and size differences were noted.

COVID-19 and MOG-IgG-associated acquired demyelinating polyneuropathy compatible with chronic inflammatory demyelinating polyneuropathy in a previously healthy girl.

Neurological manifestations of COVID-19 in the pediatric population are not as well described as those in the adult population. We describe a case of myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG)-associated disorder in a 9-year-old girl, who experienced complete recovery. This rare disorder is a demyelinating disease that often relapses and has the potential to cause severe morbidity.

Canine and feline uveal melanocytic tumours: Histologic and immunohistochemical characteristics of 32 cases.

Objective: Gross, histopathological, and immunohistochemical characteristics of uveal melanocytic neoplasms in dogs and cats were investigated.

Samples: Thirty-two enucleated globes with uveal melanocytic neoplasms, 27 from dogs and 5 from cats, were examined.

Procedures: Morphological characteristics of uveal melanocytic neoplasms in dogs and cats were evaluated with anti-PNL2, anti-Melan-A, anti-Ki-67, anti-caspase-3, and anti-BAP1 immunomarkers.

Handheld Echocardiography in a Clinical Practice Scenario: Concordances Compared to Standard Echocardiographic Reports.

Background: The purpose of this study was to assess the utility of a handheld device (HH) used during common daily practice and its agreement with the results of a standard echocardiography study (STD) performed by experienced sonographers and echocardiographer.

Methods: A prospective follow-up was conducted in an adult outpatient echocardiography clinic. Experienced sonographers performed the STD and an experienced echocardiographer performed the HH.

Postinfectious SARS-CoV-2 Opsoclonus-Myoclonus-Ataxia Syndrome.

Background: The opsoclonus-myoclonus-ataxia syndrome (OMAS) represents a pathophysiology and diagnostic challenge. Although the diverse etiologies likely share a common mechanism to generate ocular, trunk, and limb movements, the underlying cause may be a paraneoplastic syndrome, as the first sign of cancer, or may be a postinfectious complication, and thus, the outcome depends on identifying the trigger mechanism. A recent hypothesis suggests increased GABAA receptor sensitivity in the olivary-oculomotor vermis-fastigial nucleus-premotor saccade burst neuron circuit in the brainstem.

Pulmonary thromboembolism in conjunction with intracavitary thrombus caused by severe acute respiratory syndrome coronavirus-2 infection in a patient living with human immunodeficiency virus.

Approximately one-third of patients with coronavirus disease 2019 (COVID-19) present with coagulation disorders and hematological changes. However, the clinical manifestations of COVID-19 and prognoses of people living with human immunodeficiency virus (HIV) remain controversial. This study reports the case of a 27-year-old HIV-infected man who regularly used antiretroviral medications, had no other comorbidities and was admitted for acute respiratory distress syndrome caused by COVID-19.

Tissue-engineered amniotic membrane in the treatment of myocardial infarction: a systematic review of experimental studies.

Objective: myocardial infarction (MI) remains the leading cause of death worldwide. Cell-based therapies have become potential therapeutic approaches, attempting to recover the contractility of necrotic cardiomyocytes. In the present study, we aimed to systematically evaluate experimental studies on the use of tissue-engineered amniotic membrane (hAMC) in MI treatment.

Non-tuberculous Mycobacterial Granulomatous Dermatitis in an African Pygmy Hedgehog (Atelerix albiventris).

A 2-year-old female African pygmy hedgehog (Atelerix albiventris) with a cutaneous nodular lesion on the dorsal surface of the right forelimb was presented for clinical examination. Histopathological findings included granulomatous dermatitis with extensive necrosis. Long and slender acid-fast bacilli were seen within the cytoplasm of macrophages and in extracellular spaces.

Thinking About Pathomechanisms and Current Treatment of Erectile Dysfunction-"The Stanley Beamish Problem." Review, Recommendations, and Proposals.

Introduction: Up to 50% of all men over 50 years of age suffer from erectile dysfunction. Since the late 1990s erectile dysfunction has been treated mostly with phosphodiesterase 5 inhibitors (PDE5I). Over the past 20 years, numerous scientific findings on the development of erectile dysfunction have been collected, which have so far received little attention in the treatment of erectile dysfunction.

Overcoming the hydrophilicity of bacterial nanocellulose: Incorporation of the lipophilic coenzyme Q10 using lipid nanocarriers for dermal applications.

Although used in a wide range of medical and pharmaceutical applications, the potential of the natural biopolymer bacterial nanocellulose (BNC) as drug delivery system is by far not fully exploited. Particularly, the incorporation of lipophilic drugs is still considered as an unsolved task. In the present study, the homogeneous incorporation of the lipophilic coenzyme Q10 (CoQ10) into BNC was accomplished by several post-synthesis techniques utilizing different nanoemulsions and liposomes.

Fatal disseminated toxoplasmosis in a brown-throated sloth (Bradypus variegatus) from Northern Brazil - Case report.

The clinical and pathological findings of a case of fatal disseminated toxoplasmosis in a captive brown-throated sloth (Bradypus variegatus) from the northern region of Brazil are reported. Clinical signs were nonspecific and included apathy, prostration, dyspnoea, and loss of appetite. Treatment with penicillin was attempted, but the animal died within five days of the onset of clinical signs.

Intestinal T-cell lymphoma in a coati (Nasua nasua) - Short communication.

A 10-year-old female coati (Nasua nasua) was necropsied after an 8-day history of apathy, weight loss and dehydration. Gross changes consisted of multifocal to coalescing nodules ranging from 0.5 to 2.

Development and characterization of bacterial nanocellulose loaded with Boswellia serrata extract containing nanoemulsions as natural dressing for skin diseases.

The combination of the anti-inflammatory lipophilic Boswellia serrata extract with the natural hydropolymer bacterial nanocellulose (BNC) for the treatment of skin diseases is counteracted by their different hydro/lipophilicity. To overcome the hydrophilicity of the BNC, the water in its network was exchanged by single and double nanoemulsions. Incorporation of the Boswellia serrata extract in the nanoemulsions formed particles of about 115 to 150 nm with negative zeta potential and storage stability over 30 days at temperatures between 4 and 32 °C.

Oral Lesions in Dogs with Visceral Leishmaniosis.

Canine visceral leishmaniosis (CVL) is an important zoonotic disease, which is endemic in Brazil and several other parts of the world. The disease may affect multiple organs, but lesions in the oral cavity are considered uncommon. Twenty-three cases of oral lesions compatible with CVL were diagnosed from 2015 to 2018 in the Federal District, Brazil.