Effect of Androgen Suppression on Clinical Outcomes in Hospitalized Men With COVID-19: The HITCH Randomized Clinical Trial.

Importance: SARS-CoV-2 entry requires the TMPRSS2 cell surface protease. Antiandrogen therapies reduce expression of TMPRSS2.

Objective: To determine if temporary androgen suppression induced by degarelix improves clinical outcomes of inpatients hospitalized with COVID-19.

Vitamin C and Thiamine for Sepsis and Septic Shock.

Background: Sepsis and septic shock are medical emergencies resulting in significant morbidity and mortality. Intravenous (IV) vitamin C, thiamine, and hydrocortisone have shown promise in reducing hospital mortality. The Memphis Veterans Affairs Medical Center (VAMC) similarly implemented this regimen, called the vitamin C protocol, for patients presenting in sepsis or septic shock in the intensive care unit (ICU).

A 74-Year-Old Man Presenting With Cough, Malaise, and Mediastinal Lymphadenopathy.

A 74-year-old white male farmer was admitted from his primary care physician's office after he presented with symptoms of cough productive of clear sputum, malaise, weakness, fatigue, and shortness of breath on exertion for 3 weeks. He was an ex-smoker with a history of hypertension, hyperlipidemia, and coronary artery bypass graft surgery. He did not report any chills, night sweats, or fevers during this presentation.

The Utility of the Candida Score in Patients With Sepsis.

Background: Candida is a leading cause of infection in the intensive care unit. Colonization versus infection remains a challenge. A Candida Score (CS) of 3 or greater has been used to target antifungal therapy in surgical patients at risk of candidemia but has not been well evaluated in medical patients with sepsis.

Patient Demographics and Socioeconomic Characteristics of an Ambulatory Care Clinic Served by a University PCCM Training Program.

Objectives: Continuity clinics are an important aspect of pulmonary medicine fellowship training. We provide a description of a pulmonary outpatient clinic in an inner city, county-owned, university-affiliated hospital.

Methods: This is a descriptive study of administrative data on consecutive patient visits to the University of Tennessee Regional One Health at Memphis ambulatory clinic (Medplex) between January 2000 and August 2006.

Exaggerated plasma interleukin 6, interleukin 10, and subsequent development of health care-associated infections in patients with sepsis.

Background: Health care-associated infections (HAIs) are the target of many well-known preventive measures in the intensive care unit (ICU); however, little is known about post-sepsis-induced immunosuppression.

Objectives: This study explores the relationship between baseline plasma levels of inflammatory cytokines interleukin 6 (IL-6), IL-10, and IL-6:IL-10 and subsequent development of HAIs in patients with admitted with sepsis.

Methods: Prospective observational study was conducted among veterans admitted to the ICU with sepsis and monitored daily through ICU discharge (up to 28 days) to investigate HAI development.

Unusual presentations of disseminated histoplasmosis.

Histoplasmosis is considered to be the most prevalent endemic mycosis in United States that can present as a disseminated infection. The initial presentation of Disseminated Histoplasmosis (DH) can be atypical. We report three cases with such atypical presentation.

Potential role of leukotriene modifiers in the treatment of chronic obstructive pulmonary disease.

Abstract Chronic obstructive pulmonary disease (COPD) is characterized by progressive, irreversible airflow limitation coupled with an abnormal inflammatory process. It is associated with high morbidity and mortality. Leukotriene modifiers, approved by the United States Food and Drug Administration as treatment for asthma and allergic rhinitis, may also alleviate the abnormal inflammatory response seen in patients with COPD.

Nuclear factor-kappaB- and glucocorticoid receptor alpha- mediated mechanisms in the regulation of systemic and pulmonary inflammation during sepsis and acute respiratory distress syndrome. Evidence for inflammation-induced target tissue resistance to glucocorticoids.

To test the hypothesis that the interaction between nuclear factor-kappaB (NF-kappaB) and glucocorticoid receptor alpha (GRalpha) is a key pathogenetic mechanism regulating the progression of systemic and pulmonary inflammation in sepsis and acute respiratory distress syndrome (ARDS), we used an ex vivo model of systemic inflammation. Naïve peripheral blood leukocytes (PBL) were exposed to longitudinal (days 1-10) plasma samples from ARDS patients divided into three groups based on physiological improvement and clinical outcome by days 7-10: improvers, nonimprovers-survivors, and nonimprovers-nonsurvivors. In a separate group of nonimprovers-survivors, we correlated the severity of lung histopathology with the intensity of NF-kappaB and GRalpha nuclear staining in immunohistochemistry analysis of lung tissue obtained by open lung biopsy.