Psychiatry and Family Medicine Residents' Likelihood of Prescribing HIV Pre-exposure Prophylaxis to Patients With Mental Illness and HIV Vulnerability.

Background: People living with mental illness (PLMI) experience disproportionately high incidence of and vulnerability to HIV. Pre-exposure prophylaxis (PrEP) is an effective and safe HIV prevention method, but data regarding prescription to PLMI are lacking. Psychiatrists may serve as important points of access for PrEP prescription for PLMI.

Availability of Testing for Sexually Transmitted Infections and HIV in U.S. Outpatient Mental Healthcare Settings.

People with mental illnesses experience higher incidence of sexually transmitted illnesses (STIs) and HIV, and estimates show fewer than 50% have received testing. The purpose of this study was to examine the prevalence of STI/HIV testing among United States outpatient mental healthcare service providers. Data from the National Mental Health Services Survey (NMHSS) was used to determine the rates of STI and HIV testing amongst 9,267 outpatient mental healthcare service providers in the U.

Emerging Causes of Drug-Induced Anaphylaxis: A Review of Anaphylaxis-Associated Reports in the FDA Adverse Event Reporting System (FAERS).

Background: Drug-induced anaphylaxis is a well-known adverse drug reaction for some drug classes, but emerging drug causes of anaphylaxis and novel mechanisms may contribute in unrecognized ways.

Objective: We sought to determine the top drugs reported in association with anaphylaxis and anaphylaxis followed by death in the Food and Drug Administration Adverse Event Reporting System (FAERS).

Methods: We reviewed the publicly available FAERS database from 1999 to 2019.

Safety, Efficacy, and Effectiveness of Delabeling in Patients with Multiple Drug Allergy Labels.

Background: Patients with multiple drug allergy labels (MDALs) present a challenging barrier to patient care.

Objective: To assess the efficacy, safety, and effectiveness of removing MDALs in a single clinic visit.

Methods: Retrospective chart review was performed from October 1, 2014, to October 31, 2018, on patients with MDALs who had electronic health record (EHR) allergy label to 2 or more drugs and who were delabeled to 1 or more drug.

Effect of Pause Procedures on Participant Reflection and Commitment-to-Change in Continuing Medical Education.

Conferences are the most common form of continuing medical education (CME), but their effect on clinician practice is inconsistent. Reflection is a critical step in the process of practice change among clinicians and may lead to improved outcomes following conference-based CME. However, reflection requires time to process newly-learned material.

Development and Validation of a Penicillin Allergy Clinical Decision Rule.

Importance: Penicillin allergy is a significant public health issue for patients, antimicrobial stewardship programs, and health services. Validated clinical decision rules are urgently needed to identify low-risk penicillin allergies that potentially do not require penicillin skin testing by a specialist.

Objective: To develop and validate a penicillin allergy clinical decision rule that enables point-of-care risk assessment of patient-reported penicillin allergies.

Yeast and human P4-ATPases transport glycosphingolipids using conserved structural motifs.

Lipid transport is an essential process with manifest importance to human health and disease. Phospholipid flippases (P4-ATPases) transport lipids across the membrane bilayer and are involved in signal transduction, cell division, and vesicular transport. Mutations in flippase genes cause or contribute to a host of diseases, such as cholestasis, neurological deficits, immunological dysfunction, and metabolic disorders.

Euglycaemic diabetic ketoacidosis in bariatric surgery patients with type 2 diabetes taking canagliflozin.

A 52-year-old type 2 diabetic man previously on canagliflozin developed severe anion gap metabolic acidosis and markedly elevated beta-hydroxybutyrate on postoperative day (POD) 2 status post laparoscopic Roux-en-Y gastric bypass. An insulin drip and aggressive intravenous fluid repletion were initiated, and electrolytes were monitored and repleted. His anion gap closed, and he was discharged on POD 4.

Relationships Between Reflection and Behavior Change in CME.

Introduction: Reflection exposes performance gaps and is a step in the process of behavior change among adult learners. However, little is known about the relationships between reflection and behavior change in CME. Our objectives were to measure associations between validated reflection scores and behavior change among CME participants and to identify associations between reflection and characteristics of CME presentations.

Measurement of Aortic Pulse Wave Velocity With a Connected Bathroom Scale.

Background: Measurement of arterial stiffness should be more available. Our aim was to show that aortic pulse wave velocity can be reliably measured with a bathroom scale combining the principles of ballistocardiography (BCG) and impedance plethysmography on a single foot.

Method: The calibration of the bathroom scale was conducted on a group of 106 individuals.

All CLEAR? Preparing for IT Downtime.

Health care information technology (IT) outages pose a threat to patient safety and patient care continuity. Organizations' downtime plans must be updated regularly and staff at the work area level should have experience with implementing IT outage operations through downtime drills. This article describes the study institution's IT Outage Toolkit, based on the acronym CLEAR, which guides the development of a downtime plan as well as design, execution, and assessment of work area downtime drills.

Associations between teaching effectiveness scores and characteristics of presentations in hospital medicine continuing education.

Background: There is little research regarding characteristics of effective continuing medical education (CME) presentations in hospital medicine (HM). Therefore, we sought to identify associations between validated CME teaching effectiveness scores and characteristics of CME presentations in the field of HM.

Design/setting: This was a cross-sectional study of participants and didactic presentations from a national HM CME course in 2014.

The characteristics and impact of a hospitalist-staffed post-discharge clinic.

Background: Limited primary care access and care discontinuities hamper care for patients following hospital discharge. As the proportion of inpatient care delivered by hospitalists continues to increase, hybrid models that incorporate hospitalists in post-discharge care may ameliorate this problem.

Methods: We established a post-discharge clinic staffed by hospitalists in a large academic urban primary care practice in October 2009.

An undergraduate laboratory exercise to study sensory inhibition.

Sensory inhibition was first described by von Békésy as a process in which excitation of a field of sensory neurons leads to the reduction of activity of surrounding neurons and thus promotes contrast enhancement of the excited field. In the context of somatosensory cortex, the cortical neurons excited by touch or vibration will suppress excitation of neurons from surrounding receptive fields. USING TACTILE STIMULATORS BOTH DESIGNED AND FABRICATED AT THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL, WE CONDUCTED TWO SIMPLE EXPERIMENTS IN WHICH SENSORY INHIBITION PLAYS A ROLE IN INFORMATION PROCESSING: a unilateral study in which stimuli are delivered to the digits of one hand, and a bilateral study in which stimuli are delivered to the digits of both hands.

Proatherogenic high-density lipoprotein, vascular inflammation, and mimetic peptides.

Atherosclerosis is an example of an inflammatory disorder. During the acute phase and under inflammatory conditions, high-density lipoprotein (HDL), which is normally anti-inflammatory, can become proinflammatory. Reactive oxygen species generated by several enzyme systems can modify phospholipids and sterols, producing oxidized phospholipids and oxidized sterols that reduce the capacity of HDL to protect against undesirable oxidative modifications of molecules.

High-density lipoprotein: antioxidant and anti-inflammatory properties.

The ability of high-density lipoprotein (HDL) to promote cholesterol efflux is an important component of its ability to protect against cardiovascular disease. In addition, the anti-inflammatory properties of HDL are important as well. As part of the innate immune system, HDL appears to have evolved to increase inflammation in the presence of an acute phase response but to inhibit inflammation in the absence of an acute phase response.

Oxidation hypothesis of atherogenesis: HDL inflammatory index and apolipoprotein A-I mimetic peptides.

Coronary heart disease is the leading cause of death in the USA and worldwide. Optimizing the ratio and levels of low- and high-density lipoproteins (HDLs) has been a major focus of treatments in preventing atherosclerosis. While these therapies have made significant contributions in reducing heart disease, many patients with normal lipid levels still continue to have significant coronary heart disease and crippling cardiac events.

Elevated troponins and the Churg-Strauss syndrome: a case report.

In a patient with persistently elevated troponin levels but normal ischemic work-up, a diagnostic dilemma can ensue. This is the case of a 65-year-old woman whose only cardiac risk factor was age. She presented repeatedly with chest pain, elevated troponins, and consistently elevated eosinophil levels until the fourth admission when she presented with multi-organ abnormalities including asthma and vasculitis that led to the diagnosis of Churg-Strauss syndrome (CSS).