SARS-CoV-2 Breakthrough Infections among US Embassy Staff Members, Uganda, May-June 2021.

The SARS-CoV-2 Delta variant emerged shortly after COVID-19 vaccines became available in 2021. We describe SARS-CoV-2 breakthrough infections in a highly vaccinated, well-monitored US Embassy community in Kampala, Uganda. Defining breakthrough infection rates in highly vaccinated populations can help determine public health messaging, guidance, and policy globally.

Chronic Intermittent Sucrose Consumption Facilitates the Ability to Discriminate Opioid Receptor Blockade with Naltrexone in Rats.

The opioid antagonist naltrexone (NTX) decreases intake of preferred diets in rats at very low doses relative to doses needed to decrease intake of "bland" laboratory chow. In the absence of an opioid agonist, NTX is not discriminable using operant techniques. In the current study, we found that rats given intermittent access to a 25% sucrose solution learned to discriminate between various naltrexone doses and saline.

Role of calpains in the injury-induced dysfunction and degeneration of the mammalian axon.

Axonal injury and degeneration, whether primary or secondary, contribute to the morbidity and mortality seen in many acquired and inherited central nervous system (CNS) and peripheral nervous system (PNS) disorders, such as traumatic brain injury, spinal cord injury, cerebral ischemia, neurodegenerative diseases, and peripheral neuropathies. The calpain family of proteases has been mechanistically linked to the dysfunction and degeneration of axons. While the direct mechanisms by which transection, mechanical strain, ischemia, or complement activation trigger intra-axonal calpain activity are likely different, the downstream effects of unregulated calpain activity may be similar in seemingly disparate diseases.

Calpains mediate axonal cytoskeleton disintegration during Wallerian degeneration.

In both the central nervous system (CNS) and peripheral nervous system (PNS), transected axons undergo Wallerian degeneration. Even though Augustus Waller first described this process after transection of axons in 1850, the molecular mechanisms may be shared, at least in part, by many human diseases. Early pathology includes failure of synaptic transmission, target denervation, and granular disintegration of the axonal cytoskeleton (GDC).

Calpastatin overexpression protects axonal transport in an in vivo model of traumatic axonal injury.

Traumatic brain injury (TBI) causes substantial morbidity and mortality worldwide. A key component of both mild and severe TBI is diffuse axonal injury. Except in cases of extreme mechanical strain, when axons are torn at the moment of trauma, axonal stretch injury is characterized by early cytoskeletal proteolysis, transport disruption, and secondary axotomy.

Short-duration treatment with the calpain inhibitor MDL-28170 does not protect axonal transport in an in vivo model of traumatic axonal injury.

Traumatic axonal injury is characterized by early cytoskeletal proteolysis and disruption of axonal transport. Calpain inhibition has been shown to protect axons in rodent models of traumatic brain injury. However, in these models, both white and gray matter are injured, making it difficult to determine if calpain inhibitors are directly protecting injured axons.

Calpain mediates proteolysis of the voltage-gated sodium channel alpha-subunit.

Alterations in the expression, molecular composition, and localization of voltage-gated sodium channels play major roles in a broad range of neurological disorders. Recent evidence identifies sodium channel proteolysis as a key early event after ischemia and traumatic brain injury, further expanding the role of the sodium channel in neurological diseases. In this study, we investigate the protease responsible for proteolytic cleavage of voltage-gated sodium channels (NaChs).

Immediate short-duration hypothermia provides long-term protection in an in vivo model of traumatic axonal injury.

A prospective, multicenter, randomized trial did not demonstrate improved outcomes in severe traumatic brain injured patients treated with mild hypothermia [Clifton, G.L., Miller, E.

Neuroprotection with delayed calpain inhibition after transient forebrain ischemia.

Objective: Delayed neurodegeneration after transient global brain ischemia offers a therapeutic window for inhibiting molecular injury mechanisms. One such mechanism is calpain-mediated proteolysis, which peaks 24 to 48 hrs after transient forebrain ischemia in rats. This study tests the hypothesis that delayed calpain inhibitor therapy can reduce brain calpain activity and neurodegeneration after transient forebrain ischemia.

Serum cleaved tau does not predict postconcussion syndrome after mild traumatic brain injury.

Objectives: Our objective was to determine if the biomarker for axonal injury, serum cleaved tau (C-tau), predicts postconcussion syndrome (PCS) in adults after mild traumatic brain injury (mTBI).

Methods: C-tau was measured from blood obtained in the emergency department. Outcome was assessed at 3 months post injury using the Rivermead Postconcussion Symptoms Questionnaire and Acute Medical Outcomes SF-36v2 Health Survey (SF-36).

Fatal myocarditis due to Clostridium novyi type B in a previously healthy woman: case report and literature review.

Clostridium novyi is a Gram-positive anaerobe, which is commonly a pathogen of domestic and wild animals. Disease in humans typically presents as myonecrosis. C.

Ruptured femoral pseudoaneurysm presenting as a lateral abdominal wall hematoma.

Lateral abdominal wall hematomas are rare. We describe a patient with a delayed rupture of a femoral artery pseudoaneurysm, who presented with such a hematoma. In contrast to other types of abdominal wall hematomas, which are often managed conservatively, a ruptured femoral artery pseudoaneurysm frequently requires emergent surgical intervention.

Effect of education and guidelines for treatment of uncomplicated dental pain on patient and provider behavior.

Study Objective: Patients with uncomplicated odontalgia use a significant proportion of emergency department (ED) resources. Some odontalgia patients are unaware that routine dental care is unavailable in most EDs. Using extensive input from regional dentists and oral surgeons, and after reviewing the dental literature, guidelines for the ED management of uncomplicated odontalgia were written for physician and patient use.

A case of Lemierre's syndrome.

Lemierre's syndrome is a rare but potentially life-threatening entity that follows an oropharyngeal infection. The syndrome is characterized by an antecedent acute oropharyngeal infection, with secondary suppurative thrombophlebitis of the internal jugular vein and septic emboli. In the pre-antibiotic era, it had a 90% mortality rate.