Rise in Serum 25-Hydroxyvitamin D Levels during the COVID-19 Pandemic.

With the emergence of the COVID-19 pandemic, the absence of established evidence-based treatment protocols led healthcare professionals and the public to explore experimental treatments, including high doses of vitamin D supplements. This study aimed to assess changes in serum 25-hydroxyvitamin D levels during the pandemic, employing a retrospective cohort analysis of data from Charleston Area Medical Center (CAMC). The study analyzed serum 25-hydroxyvitamin D levels in a cohort of 35,556 patients treated at CAMC in 2019, a representative pre-pandemic period, to 2021, a representative pandemic period.

Surveying the Knowledge and Practices of Primary Care Residents in Managing Adult Patients with Obesity.

Background: The prevalence of obesity is increasing worldwide at an alarming rate, yet obesity remains under-addressed during clinic encounters. A lack of training in how to treat obesity is one crucial factor contributing to this deficiency.

Objective: This study explored resident physicians' perceptions of their education on obesity and its relationship with confidence and practice behaviors when caring for patients with obesity.

A Nationwide Analysis of Fluid Resuscitation Outcomes in Patients With Acute Pancreatitis.

Background: Traditionally, fluid resuscitation has been the foundation of effective acute pancreatitis (AP) treatment. Experts advocate for aggressive intravenous fluid (IVF) resuscitation, especially within the first 24 hours. Research suggests limited efficacy of this approach; in fact, some studies show there may be a risk of increased complications.

Predictors and timeline of spontaneous conversion to normal sinus rhythm: A single center retrospective cohort study of patients with symptomatic atrial fibrillation.

Introduction: Annual healthcare expenditures associated with atrial fibrillation (AF) in the United States (US) continue to grow as more symptomatic patients present to emergency departments (ED). Predictors of spontaneous conversion to normal sinus rhythm (ScNSR) remain poorly understood, as well as the timeline of ScNSR remains unclear. We sought to 1) to assess the association of key demographics, anthropometric, and clinical factors to ScNSR and 2) to evaluate the timeline of ScNSR, and 3) determine clinical predictors of ScNSR.

Outcomes of Hospitalized Patients With Fecal Occult Positive Stool Prior to Cardiac Catheterization in Acute Coronary Syndrome (ACS).

Introduction Cardiac catheterization is an essential component of patient care in Acute Coronary Syndrome (ACS). Fecal occult blood testing (FOBT) has been used in the inpatient setting to evaluate the risk of bleeding with dual anti-platelet therapy prior to cardiac catheterization although no guidelines exist for this indication and FOBT testing in the inpatient setting is not recommended for evaluation of GI blood loss. We sought to assess the outcomes of patients with fecal occult positive stool prior to cardiac catheterization compared to those that did not undergo FOBT during admission for non-ST-elevation myocardial infarction (NSTEMI).

Risk of COVID-19 Infection After Full Immunization in Patients With Inflammatory Bowel Disease on Treatment: A Research Network Analysis.

Background: Acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is an issue in treating patients with Inflammatory Bowel Disease (IBD) due to concerns for infection risk and poor post-vaccination antibody response. We examined the potential impact of IBD treatments on SARS-CoV-2 infection rates after full immunization against COVID-19.

Methods: Patients who received vaccines between January 2020 and July 2021 were identified.

Pneumomediastinum and Pneumorrhachis Associated With Cannabinoid Hyperemesis Syndrome.

More complications continue to be reported with the increasing use of marijuana (MJ) in the United States, including the increasing prevalence of Cannabinoid Hyperemesis Syndrome (CHS). To our knowledge, based on a thorough review of the literature, we present the third case of CHS with associated pneumomediastinum (PM) and the first case of pneumorrhachis (PR) in a young healthy patient. The main objective of this paper is to heighten awareness of CHS and its potential complications.

Case Reports of Heroin Injection Site Necrosis: A Novel Antecedent of Nicolau Syndrome.

Heroin injection-site necrosis (HISN) is a novel and poorly understood complication of intravenous drug abuse (IVDA). We present three cases of HISN that were evaluated and treated in Charleston, West Virginia, in 2019 and 2020. The documented cases show similarities involving patient care, follow-up, clinical progression, patient demographic, and dermatologic sequelae.

Acute Pancreatitis Due to COVID-19 Active Infection.

Background This study investigates the relationship between coronavirus disease 2019 (COVID-19) infection and acute pancreatitis. We present large registry data assessing the association between acute pancreatitis and mortality in patients with COVID-19 post-infection. Methods The researchers identified adult patients aged 18-90 years with COVID-19 infections in the TriNetX (COVID-19 research network) database between January 20, 2020, and June 1, 2021.

Usual opioid dosing does not adversely affect the course of healthcare-associated infection.

We sought to determine if opioid exposure may have a detrimental effect on the course of infection (CDI). We compared opioid exposure in patients with well-defined severe CDI and non-severe CDI. Following exclusions, 403 records were reviewed.

A More Directive Living Will for Older Adult Patients with End-Stage Medical Conditions?

Objectives: Many older adult patients want to be treated aggressively for reversible conditions, even when their current quality of life is limited; however, most standard living wills focus on the very end of life and provide little guidance to acute care providers (ACPs) should their older adult patient be admitted with a potentially treatable acute condition and temporarily lose capacity. We developed what we believe is a more informational and directive living will for this population. We sought to determine whether ACPs would find our pilot living will more helpful when caring for their older adult patients.

What information about sudden unexpected death in epilepsy (SUDEP) is available on YouTube?

Objective: We sought to assess and analyze the information available about sudden unexpected death in epilepsy (SUDEP) and the general perception of this condition by the public on YouTube.

Methods: We evaluated all consecutive videos containing references to 'sudden unexpected death in epilepsy' and 'SUDEP' on YouTube. Data were extracted after applying the inclusion and exclusion criteria.

Proton pump inhibitors not associated with hypomagnesemia, regardless of dose or concomitant diuretic use.

Background And Aim: Proton pump inhibitors (PPIs) are among the most commonly prescribed medications worldwide, with dramatic efficacy for upper gastrointestinal acid-related disorders. In recent years, however, the safety of long-term PPI use has been questioned. One issue based on scant and conflicting literature is the possibility of PPI-related hypomagnesemia.

La Crosse Encephalitis: An Adult Case Series.

Background: La Crosse viral encephalitis is well described in children, but to date, there are only 2 adult cases described in the literature. Despite the fact that pediatric infection can be life threatening and typically presents as a febrile meningoencephalitis often complicated by seizures and mental status changes, little is known about the presentation and course of adult infection. We report the largest case series of adult La Crosse encephalitis.

Detecting initial orthostatic hypotension: a novel approach.

Our purpose, by modification of standard bedside tilt-testing, was to search for lesser known but important initial orthostatic hypotension (IOH), occurring transiently within the first 30 seconds of standing, heretofore only detectable with sophisticated continuous photoplethysmographic monitoring systems, not readily available in most medical facilities. In screened outpatients over 60 years of age, supine blood pressure (BP) parameters were recorded. To achieve readiness for immediate BP after standing, the cuff was re-inflated prior to standing, rather than after.

The impact of implementation of the Bethesda System for Reporting Thyroid Cytopathology on the surgical treatment of thyroid nodules.

Published data suggest that the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) is valuable in directing therapy of thyroid nodules. Literature examining the effect of the BSRTC on management when compared with pre BSRTC is lacking, however. This study evaluates the impact of applying the BSRTC retrospectively to a series of patients who underwent surgery after a fine-needle aspiration biopsy (FNAB) classified using the pre BSRTC system, and investigates how the BSRTC application to the same population would have ultimately affected the management strategy.

The importance of location for tobacco cessation: rural-urban disparities in quit success in underserved West Virginia Counties.

Context: Adults who live in rural areas of the United States have among the highest smoking rates in the country. Rural populations, including Appalachian adults, have been historically underserved by tobacco control programs and policies and little is known about their effectiveness.

Purpose: To examine the end-of-class quit success of participants in A Tobacco Cessation Project for Disadvantaged West Virginia Communities by place of residence (rural West Virginia and the urban area of Greater Charleston).