Assessment of the vaginal microbiota before and after use of hyperosmolal lubricant during transvaginal ultrasound.

Background: Vaginal lubricants are commonly used during sexual activity and clinical procedures such as transvaginal ultrasound (TVUS). Epidemiologic and laboratory studies indicate hyperosmolal water-based lubricants may disrupt the vaginal microbiota, particularly the beneficial Lactobacillus spp. These bacteria play a critical role in protecting against sexually transmitted infection acquisition and other adverse gynecologic and obstetric outcomes.

Creating a plasma coordination center to support COVID-19 outpatient trials across a national network of hospital blood banks.

Introduction: In response to the COVID-19 pandemic, we rapidly implemented a plasma coordination center, within two months, to support transfusion for two outpatient randomized controlled trials. The center design was based on an investigational drug services model and a Food and Drug Administration-compliant database to manage blood product inventory and trial safety.

Methods: A core investigational team adapted a cloud-based platform to randomize patient assignments and track inventory distribution of control plasma and high-titer COVID-19 convalescent plasma of different blood groups from 29 donor collection centers directly to blood banks serving 26 transfusion sites.

Agile monitoring dashboard for clinical research studies.

Background: Clinical trial success hinges on efficient participant recruitment and retention. However, slow accrual and attrition frequently hinder progress. To address these challenges, a novel dashboard tool with control charts has been developed to provide investigators on the multi-site study of Delirium and Neuropsychological Recovery among Emergency General Surgery Survivors (DANE study) with timely information to improve trial recruitment.

Impact of State Abortion Policies on Family Medicine Practice and Training After .

Purpose: The (Dobbs) Supreme Court decision revoked the constitutional right to abortion. Now, restrictive state abortion laws may contribute to the shortage and strain already felt in primary care practice, especially related to the provision of reproductive health care. The purpose of this study is to evaluate perceived impacts of state abortion legislation on family medicine clinicians' practice and medical education regarding reproductive health care.

Heavy duty.

A 54-year-old woman with myopia, hypothyroidism, and asthma presented with intermittent double vision. Serum was positive for anti-low density lipoprotein receptor-related protein 4 (LRP4) antibodies suggesting the diagnosis of myasthenia gravis. There was no improvement with pyridostigmine, prednisone, or azathioprine.