Summary of New Guidance on Selected Immunizations.

In 2022, the Centers for Disease Control and Prevention (CDC) updated its Adult Immunization Schedule Recommendations for Ages 19 Years or Older to provide the most current evidence-based recommendations following comprehensive reviews of data related to vaccines. In its report, the CDC highlighted the importance of health care professionals staying up to date on the latest evidence. During the novel coronavirus pandemic, the ability to provide routine vaccinations to the adult population was limited and even halted at times.

High-fat diet exacerbates cognitive decline in mouse models of Alzheimer's disease and mixed dementia in a sex-dependent manner.

Background: Approximately 70% of Alzheimer's disease (AD) patients have co-morbid vascular contributions to cognitive impairment and dementia (VCID); this highly prevalent overlap of dementia subtypes is known as mixed dementia (MxD). AD is more prevalent in women, while VCID is slightly more prevalent in men. Sex differences in risk factors may contribute to sex differences in dementia subtypes.

Multidrug-resistant tuberculosis in transplant recipients: Case report and review of the literature.

Transplant recipients are at increased risk of tuberculosis (TB). We describe a case of pulmonary and vertebral multidrug-resistant TB (MDR-TB) in a kidney transplant patient who required neurosurgical intervention and unfortunately developed fatal nosocomial complications. Thirteen transplant recipients with MDR-TB were previously reported in the literature (one hematopoietic cell transplant, one heart transplant, one lung transplant, one heart-lung transplant, and nine kidney transplant recipients).

Notes from the Field: Verona Integron-Encoded Metallo-Beta-Lactamase-Producing Carbapenem-Resistant Enterobacteriaceae in a Neonatal and Adult Intensive Care Unit--Kentucky, 2015.

During August 4-September 1, 2015, eight cases of Verona integron-encoded metallo-beta-lactamase (VIM)-producing Carbapenem-resistant Enterobacteriaceae (CRE) colonization were identified in six patients, using weekly active surveillance perirectal cultures in a Kentucky tertiary care hospital. No cases of clinical infection or complications attributable to colonization were reported. Four of the eight isolates were identified as Enterobacter cloacae; other organisms included Raoultella species (one), Escherichia coli (one), and Klebsiella pneumoniae (two).

Identification of two distinct proteins that are immunologically related to the alpha 1 subunit of the skeletal muscle dihydropyridine-sensitive calcium channel.

The alpha 1 subunit of the dihydropyridine-sensitive calcium channel is a protein which is critical for excitation-contraction coupling and L-type calcium current in skeletal muscle. Using antibodies generated against peptides from three regions of the deduced amino acid sequence of the alpha 1 subunit, we have identified two distinct proteins in rabbit skeletal muscle. Both proteins appeared to be recognized by antibodies against the amino (N) terminus of the alpha 1 subunit sequence.

Dihydropyridine-sensitive calcium channels from skeletal muscle. I. Roles of subunits in channel activity.

Dihydropyridine-sensitive Ca2+ channels from skeletal muscle are hetero-oligomeric proteins. Little is known about the functional roles of the various subunits, except that the alpha 1 subunit is the essential channel unit. We have reconstituted both partially purified holomeric channels and the separated subunits into liposomes and measured their properties using an assay based on the Ca2+ indicator dye fluo-3.

Mechanism of inhibition of peptide chain initiation by amino acid deprivation in perfused rat liver. Regulation involving inhibition of eukaryotic initiation factor 2 alpha phosphatase activity.

In previous studies, initiation of protein synthesis was shown to be inhibited in perfused rat livers deprived of single essential amino acids. In the present study, histidinol, a competitive inhibitor of histidinyl-tRNA synthetase, was used to amplify the effects of histidine deprivation on protein synthesis in perfused liver to facilitate investigation of mechanisms involved in the inhibition of peptide chain initiation. Protein synthesis was reduced to 77% of the control rate in livers deprived of histidine and to 13% of the control rate in livers deprived of histidine and exposed to 2.

Multiple nosocomial infections. An incidence study.

Prospective surveillance for nosocomial infections was performed for a five-year admission cohort (1980-1984) at North Carolina Memorial Hospital. One or more nosocomial infections developed in 2,662 patients (2.6%) from 102,206 patients at risk; greater than or equal to 2 nosocomial infections developed in 775 of these 2,662 patients (29.

Aortic disease associated with pregnancy.

Our experience with the management of two patients with life-threatening aortic disease during pregnancy is presented with a review of the literature. One of our patients had intimal disruption caused by trauma; the other had probable Ehlers-Danlos type IV syndrome, causing an acute dissection of the descending thoracic aorta and eventually requiring replacement of the aorta from the left subclavian artery to common iliac arteries. The challenge of treating both the pregnant woman and the fetus was managed successfully by an emergent cesarean section followed by Dacron graft replacement of the descending thoracic aorta.

Septal geometry in the unloaded living human heart.

Right ventricular loading leads to diastolic septal flattening in man without necessarily requiring right ventricular pressure to exceed left ventricular pressure. This observation suggested that the unstressed septal configuration is flat and that its normal concave shape is due to the left-to-right transseptal pressure gradient. To examine this hypothesis, we studied septal configuration by two-dimensional echocardiography in nine patients with normal global and regional left ventricular function during surgery for coronary artery disease.

Partial anomalous pulmonary venous return with intact atrial septum: report of four cases.

Four patients are reported who underwent repair of partial anomalous pulmonary venous drainage with intact atrial septum. One patient also had azygos continuation of the inferior vena cava and two patients had associated mitral stenosis. Diagnostic considerations and guidelines for operative repair are presented.

Left ventricular aneurysmectomy. Factors influencing postoperative results.

One hundred consecutive patients who underwent resection of aneurysms of the left ventricle were reviewed. Eighty-four of these patients had resection or plication of an aneurysm of the anterior left ventricular wall either alone or in combination with coronary artery bypass grafting. In 27 patients who had little or no congestive heart failure, the primary indication for operation was disabling angina pectoris.

Fatal pulmonary hemorrhage complicating Swan-Ganz catheterization.

A case of fatal pulmonary hemorrhage secondary to catheterization with a balloon-tipped catheter is described, and the literature describing possible mechanisms for this complication is reviewed. A common denominator in patients suffering pulmonary hemorrhage is pulmonary hypertension. Recommendations for management of this complication are discussed.

Clinical and hemodynamic evaluation of the 19 mm Björk-Shiley aortic valve prosthesis.

Between November, 1973, and March, 1980, 43 patients underwent isolated aortic valve replacement with 19 mm Björk-Shiley prostheses at the Johns Hopkins Hospital. There were 4 male and 39 female patients ranging from 12 to 75 years old (mean, 54.5 years).

Survival following myocarditis and myocardial calcification associated with infection by Coxsackie virus B-4.

A Coxsackie virus B-4 was isolated from a neonate with clinical sepsis and clinical evidence of myocardial dysfunction. Radiographs demonstrated the presence and subsequent resolution of myocardial calcification. Electrocardiograms showed a left bundle branch block, presumably caused by calcification in the corresponding segment of the bundle of His.