An Adolescent Presenting With Mania and Catatonia Associated With Coronavirus Disease-2019 Encephalitis.

There is growing evidence that coronavirus disease-2019 (COVID-19) infection may have various neuropsychiatric manifestations and long-term outcomes. In this article, the authors report a rare case of a 16-year-old male with no previous history of psychiatric illness who presented with an acute manic episode, including laughing for no evident reason, talking to himself, isolation, irritability, sleeplessness, decreased appetite, prolonged staring episodes, having delusions about being harmed or controlled, and aggression. Despite initiating outpatient treatment with a mood stabilizer and antipsychotic for presumed bipolar disorder with psychotic features, his symptoms worsened, and he became catatonic with a decreased level of consciousness, leading to his hospitalization on day 10.

Cushing's Disease Presenting with Functional Neurological (Conversion) Disorder.

While psychiatric manifestations are common in patients with Cushing's syndrome (CS), to our knowledge, there are no reported cases of CS presenting with functional neurological disorder (FND), a neuropsychiatric condition in which patients experience neurological symptoms, such as motor dysfunctions, sensory symptoms, speech disorders, or nonepileptic seizures, in the absence of neurological disease. Here, we report a case of a complex patient with Cushing's disease who presented with multiple FND symptoms including nonepileptic seizures, bilateral lower extremity paralysis, decreased finger flexion resulting in limited hand function, and stuttering. This case illustrates a rare psychiatric manifestation of CS presenting as multiple neurological complaints.

Effects of COVID-19 on Intravitreal Injection Clinic After Lockdown.

Purpose: To examine the return of patients to intravitreal injection clinic after the COVID-19 lockdown.

Patients And Methods: The electronic medical records of all patients who received intravitreal injections at a tertiary care Veterans Health Administration (VHA) clinic 14 weeks post-lockdown (5/9/20-8/13/20) in Los Angeles County were reviewed. Reference groups included injection patients during the 7-week COVID-19 lockdown (3/19/20-5/8/20) and a 7-week pre-pandemic period in 2019 (3/19/19-5/8/19).

Comparison of Ocular and Brain Abnormalities Among Neonates With In Utero Exposure to Opium or Other Drugs.

Background There are growing concerns regarding ocular and brain abnormalities in infants who had in utero exposure to various kinds of substances/drugs. We compared the ocular and brain abnormalities among neonates based on the type of drug used by mothers. Methodology This prospective cohort study of 305 neonates included all neonates at Mahdieh Hospital, Tehran, Iran, who had their records for ophthalmic screening and brain sonography and were born to mothers with a history of substance use disorder (2014-2017).

The Impact of Non-Ophthalmic Factors on Intravitreal Injections During the COVID-19 Lockdown.

Purpose: Early on in the COVID-19 pandemic, it was difficult to know what factors would affect patient and physician decision-making regarding ophthalmic care utilization. The purpose of this study is to investigate the effect of non-ophthalmic factors on patient decision-making to receive intravitreal injections during the COVID-19 lockdown.

Patients And Methods: Data on patients who had intravitreal injection appointments at a tertiary care Veterans Health Administration clinic during a seven-week period (March 19, 2020-May 8, 2020) of the COVID-19 outbreak in Los Angeles County were collected and compared to patients who had intravitreal injection appointments during the same time period in 2019.

Implementation of Teleretinal Screening Using Optical Coherence Tomography in the Veterans Health Administration.

The Veterans Health Administration (VHA) has an existing teleretinal screening program that uses nonmydriatic fundus photography to screen for diabetic retinopathy in primary care clinics. Concurrently, optical coherence tomography (OCT) has become a routine screening modality in eye clinics for the diagnosis and management of retinal diseases. This study aimed to evaluate the first year of a pilot tele-OCT program that used existing resources within the VHA.

Possible Vertical Transmission From an Unsuspected SARS-CoV-2-Infected Mother to Her Newborn.

Although the Coronavirus Disease 2019 (COVID-19) has been found to have multiple routes of transmission, limited data exist on whether the vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can occur from asymptomatic infected mothers to their newborns during pregnancy. We report a full-term newborn girl who was found to be positive for COVID-19 at 24 hours of life and subsequently symptomatic with fever, tachycardia, tachypnea, elevated lactate dehydrogenase, and elevated total bilirubin. The newborn was delivered by a mother who was not suspected of having COVID-19 before giving birth, but who developed fever and dyspnea five hours after delivery and was found to be positive for COVID-19.

Effect of dairy consumption and its fat content on glycemic control and cardiovascular disease risk factors in patients with type 2 diabetes: a randomized controlled study.

Background: Dietary Guidelines for Americans recommend the consumption of 3 servings/d of low-fat/nonfat dairy. The effects of higher dairy consumption and its fat content are unknown in patients with type 2 diabetes.

Objective: Evaluate the impact of higher consumption of high- compared with low-fat dairy on glycated hemoglobin (HbA1c), body weight, and cardiovascular disease risk factors in patients with type 2 diabetes.

Effect of diabetes-specific nutrition formulas on satiety and hunger hormones in patients with type 2 diabetes.

Objectives: Diabetes-specific nutritional formulas (DSNFs) are frequently used by patients with type 2 diabetes (T2D) as part of nutrition therapy to improve glycemic control and reduce body weight. However, their effects on hunger and satiety hormones when compared to an isocaloric standardized breakfast are not fully understood. This study aims to evaluate the postprandial effects of two DSNFs-Glucerna (GL) and Ultra Glucose Control (UGC)-versus oatmeal on selected satiety and hunger hormones.

Frequency of self-monitoring of blood glucose in relation to weight loss and A1C during intensive multidisciplinary weight management in patients with type 2 diabetes and obesity.

Objective: We evaluated the relationship between frequency of self-monitoring of blood glucose (SMBG) and body weight, A1C, and cardiovascular risk factors in patients with type 2 diabetes (T2D) and obesity enrolled in a 12-week intensive multidisciplinary weight management (IMWM) program.

Research Design And Methods: We conducted a retrospective analysis of 42 patients who electronically uploaded their SMBG data over 12 weeks of an IMWM program and divided them into tertiles based on their average frequency of SMBG per day. Mean (range) SMBG frequencies were 2.

Fat Versus Carbohydrate-Based Energy-Restricted Diets for Weight Loss in Patients With Type 2 Diabetes.

Purpose Of Review: The prevalence of combined obesity and diabetes has increased dramatically in the last few decades. Although medical and surgical weight management are variably effective in addressing this epidemic, it is essential to parallel these strategies with a hypocaloric diet comprising the appropriate macronutrient composition to induce weight loss, enhance glycemic control, and improve cardiovascular risk factors. This review reports the current evidence of the role of carbohydrates and fat-based diets for weight management in patients with combined type 2 diabetes (T2D) and obesity.

Patient-Driven Diabetes Care of the Future in the Technology Era.

The growing burden of diabetes is fueled by obesity-inducing lifestyle behaviors including high-calorie diets and lack of physical activity. Challenges in access to diabetes specialists and educators, low adherence to medications, and inadequate motivational support for proper disease self-management contribute to poor glycemic control in patients with diabetes. Simultaneously, high patient volumes and low reimbursement rates limit physicians' time spent on lifestyle behavior counseling.

Intensive multidisciplinary weight management in patients with type 1 diabetes and obesity: A one-year retrospective matched cohort study.

Aims: Recent studies report that approximately 50% of patients with type 1 diabetes (T1D) are overweight or obese. This work studies the effects of intensive multidisciplinary weight management (IMWM) in patients with T1D and obesity.

Methods: We retrospectively evaluated 68 patients with T1D and obesity who enrolled in a 12-week IMWM program (IMWM cohort: mean age, 42 ± 11 years; HbA1c, 8.

Weight Management in Patients with Type 2 Diabetes: a Multidisciplinary Real-world Approach.

Purpose Of Review: Obesity and type 2 diabetes (T2D) are closely linked metabolic diseases. Most individuals with T2D are overweight or obese, which raises their cardiovascular risk. The etiology of both diseases is multifaceted, thus requiring a multidisciplinary approach to control them.

Weight Management in Patients with Type 1 Diabetes and Obesity.

Purpose Of Review: Patients with type 1 diabetes (T1D) are typically viewed as lean individuals. However, recent reports showed that their obesity rate surpassed that of the general population. Patients with T1D who show clinical signs of type 2 diabetes such as obesity and insulin resistance are considered to have "double diabetes.

Prevalence of vitamin D deficiency in pregnant mothers in Tehran and investigating its association with serum glucose and insulin.

Purpose: (1) To determine the prevalence of vitamin D deficiency in pregnant women. (2) To identify any correlations between maternal vitamin D levels and maternal and newborns' glucose and insulin levels.

Methods: This observational cohort study followed 149 healthy pregnant women visiting a hospital in Tehran, Iran in 2014 until the delivery of their term babies.

Maternal zinc deficiency and congenital anomalies in newborns.

Background: Zinc deficiency in pregnant women is common, especially in the third trimester of pregnancy. The available data, however, on the association between zinc deficiency and congenital malformations in the Iranian population are insufficient. The aim of this study was therefore to determine whether maternal serum zinc deficiency is associated with major congenital malformations in newborns.