Risk of Coccidioidomycosis Infection Among Individuals Using Biologic Response Modifiers, Corticosteroids, and Oral Small Molecules.

Objective: The study objective was to examine associations between the use of biologic response modifiers (BRMs), corticosteroids, and oral small molecules (OSMs) and subsequent coccidioidomycosis infection risk among US Medicare beneficiaries with rheumatic or autoimmune diseases.

Methods: This retrospective cohort study used US 2011 to 2016 Medicare claims data. We identified geographic areas with endemic coccidioidomycosis (≥25 cases per 10,000 beneficiaries).

Trends and social aspects in the management and conversion of agricultural residues into valuable resources: A comprehensive approach to counter environmental degradation, food security, and climate change.

The circular economy is essential as it encourages the reuse and recycling of resources while reducing waste, which ultimately helps to reduce environmental pollution and boosts economic efficiency. The current review highlights the management of agricultural and livestock residues and their conversion into valuable resources to combat environmental degradation and improve social well-being. The current trends in converting agricultural residues into useful resources emphasize the social benefits of waste management and conversion.

Effectiveness of Standard vs Enhanced Self-measurement of Blood Pressure Paired With a Connected Smartphone Application: A Randomized Clinical Trial.

Importance: Self-measured blood pressure (SMBP) with commercially available connected smartphone applications may help patients effectively use SMBP measurements.

Objective: To determine if enhanced SMBP paired with a connected smartphone application was superior to standard SMBP for blood pressure (BP) reduction or patient satisfaction.

Design, Setting, And Participants: This randomized clinical trial was conducted among 23 health systems participating in PCORnet, the National Patient-Centered Clinical Research Network, and included patients who reported having uncontrolled BP at their last clinic visit, a desire to lower their BP, and a smartphone.

Improving burnout and well-being among medicine residents: Impact of a grassroots intervention compared to a formal program curriculum.

Background: With growing resident burnout, Accreditation Council for Graduate Medical Education issued new requirements for program interventions to optimize resident well-being. Little evidence exists on how to best teach resiliency to residents. This study assesses the impact of both a grassroots intervention and formal resiliency curriculum on resident burnout and well-being.

Health Risk Assessment of Different Heavy Metals Dissolved in Drinking Water.

Water pollution is a major threat to public health worldwide. The health risks of ingesting trace elements in drinking water were assessed in the provinces of Punjab and Khyber Pakhtunkhwa, Pakistan. Eight trace elements were measured in drinking water, using Inductively Coupled Plasma Mass Spectrometry (ICP-MS), and compared with permissible limits established by the World Health Organization (WHO) and the Pakistan Environmental Protection Agency (Pak EPA).

Domperidone for delayed gastric emptying in lung transplant recipients with and without gastroesophageal reflux.

Evidence demonstrates a link between gastroesophageal reflux disease and chronic allograft dysfunction in lung transplant recipients. Delayed gastric emptying plays an important role in the occurrence of gastroesophageal reflux disease, with limited therapeutic options available for treatment. This retrospective observational study reports the use of domperidone in the management of delayed gastric emptying in lung transplant recipients.

Outcomes of cholecystectomy in US heart transplant recipients.

Objective: The aim of this study was to evaluate outcomes and predictors of in-hospital mortality after cholecystectomy in heart transplant (HTx) recipients.

Background: There is a paucity of data on outcomes after cholecystectomy in HTx recipients.

Methods: The Nationwide Inpatient Sample (NIS) database was used to identify HTx recipients who underwent cholecystectomy between 1998 and 2008.

Differential association of race with treatment and outcomes in Medicare patients undergoing diverticulitis surgery.

Background: Observed racial disparities in diverticulitis surgery have been attributed to differences in health insurance status and medical comorbidity.

Objective: To examine disparities in procedure type (elective vs urgent/emergency) and mortality in patients with surgically treated diverticulitis insured by Medicare, accounting for comorbidities.

Design: Retrospective analysis of Medicare Provider Analysis and Review inpatient data.

Differential effects of deep TMS of the prefrontal cortex on apathy and depression.

Background: Apathy is one hallmark of major depression (MDD). It is distinguished by lack of emotion, whereas other aspects of depression involve considerable emotional distress. Investigating both apathy and depression may increase the degree of treatment efficacy for both ailments together and apart.

Congestive heart failure and chronic obstructive pulmonary disease predict poor surgical outcomes in older adults undergoing elective diverticulitis surgery.

Background: Diverticulitis is a common medical condition that disproportionately affects older adults. The ideal management of recurrent diverticulitis, including the role of prophylactic colectomy, remains uncertain.

Objective: This study aimed to investigate the outcomes among older patients undergoing elective surgery for diverticulitis and examine subgroups of patients with comorbid congestive heart failure and chronic obstructive pulmonary disease to determine whether outcomes in these patients are worse than in other groups.

Deep transcranial magnetic stimulation over the prefrontal cortex: evaluation of antidepressant and cognitive effects in depressive patients.

Background: Electroconvulsive therapy (ECT) is an effective alternative for pharmacotherapy in treatment-resistant depressive patients, but the side effects limit its use. Transcranial magnetic stimulation (TMS) has been proposed as a refined alternative, but most studies do not indicate that TMS is as effective as ECT for severe depression.

Objective: We propose that the limited effectiveness of standard TMS resides in its superficial effect on the cortex, although much of the pathophysiology of depression is associated with deeper and larger brain regions implicated in the reward system.

Interest in marijuana treatment programs among teenage smokers and nonsmokers.

Little is known about adolescents' interest in marijuana treatment programs. This question was evaluated by telephone interview in a convenience sample of 575 adolescents responding to advertisements for tobacco research studies. Eighty-one percent of respondents endorsed the need for marijuana treatment programs for adolescents.

A randomized controlled feasibility and safety study of deep transcranial magnetic stimulation.

Objective: The H-coils are a new development in transcranial magnetic stimulation (TMS) research, allowing direct stimulation of deeper neuronal pathways than does standard TMS. This study assessed possible health risks, and some cognitive and emotional effects, of two H-coil versions designed to stimulate deep portions of the prefrontal cortex, using several stimulation frequencies.

Methods: Healthy volunteers (n=32) were randomly assigned to one of four groups: each of two H-coil designs (H1/H2), standard figure-8 coil, and sham-coil control.

Essential thrombocythemia: a rare case of central retinal artery occlusion.

Essential thrombocythemia is a myeloproliferative disorder with an increased amount of abnormal platelets, causing both hemorrhagic and thrombotic pathology. Some of its systemic complications include deep vein thrombosis, pulmonary emboli, myocardial infarcts, and renal vessel thrombosis among others. We present the rare case of a woman suffering from essential thrombocythemia with the sudden loss of vision in her right eye, caused by central retinal artery occlusion.