EDP-938 Has a High Barrier to Resistance in Healthy Adults Experimentally Infected with Respiratory Syncytial Virus.

Background: EDP-938 is an oral once-daily RSV nucleoprotein (N) inhibitor with potent antiviral activity. In a human RSV challenge trial, EDP-938 significantly reduced viral load and symptom severity. During antiviral development, it is critical to understand the propensity for resistance to develop.

The small molecule inhibitor of SARS-CoV-2 3CLpro EDP-235 prevents viral replication and transmission in vivo.

The COVID-19 pandemic has led to the deaths of millions of people and severe global economic impacts. Small molecule therapeutics have played an important role in the fight against SARS-CoV-2, the virus responsible for COVID-19, but their efficacy has been limited in scope and availability, with many people unable to access their benefits, and better options are needed. EDP-235 is specifically designed to inhibit the SARS-CoV-2 3CLpro, with potent nanomolar activity against all SARS-CoV-2 variants to date, as well as clinically relevant human and zoonotic coronaviruses.

Health Care Workers' Knowledge, Attitudes, and Beliefs Related to COVID-19 in Palliative Medicine and Hospice Care.

Although coronavirus disease 2019 (COVID-19) has impacted on a global scale, the knowledge, attitudes, and beliefs of the health care workers who provide the care at the end of life have not been evaluated. To assess and understand palliative medicine and hospice care health care workers' knowledge, attitudes, and beliefs related to COVID-19. A web-based survey was created.

The ongoing impact of COVID-19 on asthma and pediatric emergency health-seeking behavior in the Bronx, an epicenter.

Background: The Bronx has the highest prevalence of asthma in the United States (US), and was also an early COVID-19 epicenter, making it a unique study location. Worldwide reports describe significant declines in pediatric emergency department (PED) visits during COVID-19. The ongoing impact of COVID-19 on all PED presentations, including asthma, at an early epicenter has not been studied beyond the pandemic peak and into the early phases of state re-opening.

The influenza A virus host shutoff factor PA-X is rapidly turned over in a strain-specific manner.

The influenza A endoribonuclease PA-X regulates virulence and transmission of the virus by reducing host gene expression and thus regulating immune responses to influenza A virus. Despite this key function in viral biology, the levels of PA-X protein remain markedly low during infection, and previous results suggest that these low levels are not solely the result of regulation of the level of translation and RNA stability. How PA-X is regulated post-translationally remains unknown.

An Interdisciplinary Framework for Palliative and Hospice Education and Practice.

Leading highly functional health care teams in all practice settings is sustained through the identification of a conceptual framework to guide education and practice. This article presents an interdisciplinary framework for palliative and hospice education and practice. The framework builds on theoretical caring to convey elements of relational, holistic and compassion; articulates interprofessional tenets for guiding values; and aligns with constructs for palliative and hospice best practices.

The Influenza A Virus Endoribonuclease PA-X Usurps Host mRNA Processing Machinery to Limit Host Gene Expression.

Many viruses shut off host gene expression to inhibit antiviral responses. Viral proteins and host proteins required for viral replication are typically spared in this process, but the mechanisms of target selectivity during host shutoff remain poorly understood. Using transcriptome-wide and targeted reporter experiments, we demonstrate that the influenza A virus endoribonuclease PA-X usurps RNA splicing to selectively target host RNAs for destruction.

A 21st Century Problem: Cannabis Toxicity in a 13-Month-Old Child.

Background: Cannabis is one of the most abused drugs worldwide, with more than 20 million users in the United States (US). As access to cannabis products increases with expanding US legislation and decriminalization of marijuana, emergency physicians must be adept in recognizing unintentional cannabis toxicity in young children, which can range from altered mental status to encephalopathy and coma.

Case Report: We report the case of a 13-month-old female presenting with self-limiting altered mental status and lethargy, with a subsequent diagnosis of tetrahydrocannabinol exposure on confirmatory urine gas chromatography-mass spectrometry.

Host Shutoff in Influenza A Virus: Many Means to an End.

Influenza A virus carries few of its own proteins, but uses them effectively to take control of the infected cells and avoid immune responses. Over the years, host shutoff, the widespread down-regulation of host gene expression, has emerged as a key process that contributes to cellular takeover in infected cells. Interestingly, multiple mechanisms of host shutoff have been described in influenza A virus, involving changes in translation, RNA synthesis and stability.

It Is Not Always Sepsis: Fatal Tachypnea in a Newborn.

Coarctation of the aorta (CoA) is a congenital cardiac malformation that is well understood. Despite being well characterized, CoA is a commonly missed congenital heart disease (CHD) during the newborn period. We report a full-term nine-day-old male who presented to the pediatric emergency department (ED) with isolated tachypnea.

Safe Use of Subcutaneous Diphenhydramine in the Inpatient Hospice Unit.

Background: Diphenhydramine (DPH) is most commonly used via oral, topical, intramuscular (IM) and intravenous (IV) routes for the palliation of pruritus, treatment of extrapyramidal symptoms, management of parkinsonism and for allergic reactions. However, many hospice patients are unable to take oral medications and/or do not have IV access. Moreover, topical administration has a relatively slow rate of absorption.

The educational value of emergency department teaching: it is about time.

There is a paucity of research on the quality and quantity of clinical teaching in the emergency department (ED) setting. While many factors impact residents' perceptions of attending physicians' educational skill, the authors hypothesized that the amount of time residents spend with attending in direct teaching is a determinant of residents' perception of their shift's educational value. Researchers shadowed emergency medicine (EM) attendings during ED shifts, and recorded teaching time with each resident.

Hypoglycemia management in nondiabetic adults at the end of life #291.

Hypoglycemia can be both an uncomfortable symptom and a life-limiting condition. In patients with altered mental status who have a fair to good functional capacity, this could significantly detract from their ability to enjoy life. There are a variety of treatment options, including corrective action and management of the side effects of the adrenergic discharge that should be considered, as long as they are consistent with the patient’s goals of care and comfort.

The Risk of Misdiagnosing the Primary Site Responsible for Bone Metastases in Patients With Chronic Lymphocytic Leukemia and a Second Primary Carcinoma.

Chronic lymphocytic leukemia (CLL) is a common malignancy which may coexist with other primary cancers. CLL is rarely the cause of solitary bone lesions; such lesions in the context of CLL are believed to result from either Richter's transformation or metastasis from another primary malignancy. Renal cell carcinoma (RCC), on the other hand, is a malignancy which frequently metastasizes to bone and may cause an osteolytic solitary bone lesion.

[Treatment of myofascial lumbar dorsal pain. Effective clinical diagnostics and therapy].

Backround: Lumbar dorsal pain is a problem that must be taken seriously and is part of many people's everyday lives. Not only does it cause high costs for the health system, it also frequently leads to inability to work. The significance of the myofascial system is still not taken seriously enough in therapy and clinical diagnostics, when treating dorsal pain.

Palliative chemotherapy for malignant ascites secondary to ovarian cancer.

Although research has shown that palliative chemotherapy is beneficial compared to lack of treatment (Schorge JO, Schaffer JI, Halvorson LM, et al. ed. Williams Gynecology.

Multisystem atrophy made worse by lithium treatment in a hospice patient: a case report.

Multisystem atrophy is a neurologic condition defined as an adult-onset, progressive, neurodegenerative disease of unknown etiology. It carries a multisystem clinical course, including autonomic, urogenital, cerebellar, and parkinsonian features. Lithium toxicity, classically manifesting as increased thirst, polyuria, gastric distress, weight gain, tremor, fatigue, and mild cognitive impairment, can present in a similar manner.

Comparison of bolus remifentanil versus bolus fentanyl for induction of anesthesia and tracheal intubation in patients with cardiac disease.

Objective: Large bolus-dose remifentanil may be advantageous for use during induction of anesthesia because of its short duration of effect. Currently, there are little data on the use of large bolus-dose remifentanil because of reports of severe bradycardia and hypotension. The purpose of this study is to compare the hemodynamic effects of bolus remifentanil versus fentanyl with glycopyrrolate for induction of anesthesia in patients with heart disease.

Argon laser trabeculoplasty in pigmentary glaucoma.

Purpose: To evaluate the long-term effect of argon laser trabeculoplasty (ALT) in pigmentary glaucoma.

Methods: The authors retrospectively analyzed results of ALT in 32 eyes of 32 patients with medically uncontrolled pigmentary glaucoma. Data were longitudinally adjusted to normalize the disparity in time of follow-up and evaluated by life-table analysis.

Central visual field, visual acuity, and sudden visual loss after glaucoma surgery.

The relationship between Snellen visual acuity and central visual field loss as determined by the Humphrey 10-degree test was examined in 96 glaucomatous eyes of 79 patients. The severity of the field defect was determined by the number of affected quadrants, defined as a sensitivity loss of at least 10 decibels from normal at the most central point of 1.4-degree eccentricity.

Early and late phases of ocular anaphylaxis in actively immunized guinea pigs.

A model of ocular anaphylaxis with distinct early- and late-phase components was studied in actively immunized guinea pigs. Twenty guinea pigs were injected with dinitrophenylated (DNP) bovine gamma globulin emulsified in Freund's complete adjuvant and challenged topically with di-DNP-lysine. Clinical signs were monitored over a 48 h period.

Effect of topical dexamethasone on the ocular allergic reaction in passively sensitized guinea pigs.

We examined the effect of extended topical pretreatment with dexamethasone (Dex) on the ocular allergic response in passively sensitized guinea pigs. The passive IgG1 antibody dependent guinea pig model used in these studies demonstrates both early- and late-phase ocular anaphylactic reactions. Fourteen hours prior to challenge with the hapten di-DNP-lysine, three groups of guinea pigs were sensitized subconjunctivally with antiserum rich in IgG1 anti-DNP antibodies in both eyes (group 1, n = 11) or in one eye (group 2, n = 9; group 3, n = 10).