Detection of levamisole and its metabolites in horses after oral levamisole administration over seven days.

Objective: Levamisole is a regulated substance sometimes administered to racehorses to treat equine protozoal myelitis. Metabolites include compound II, aminorex, and pemoline. Aminorex and pemoline are Horseracing Integrity and Safety Authority-banned substances.

Going (Anti)Viral: Improving HIV and HCV Screening and HPV Vaccination in Primary Care.

Background: Human immunodeficiency virus (HIV) and hepatitis C (HCV) screening and human papillomavirus (HPV) vaccine uptake remain suboptimal. To improve HIV and HCV screening and HPV vaccination, the authors implemented a quality improvement project in three southwestern Pennsylvania family medicine residency practices.

Methods: From June 1 to November 30, 2021, participating practices used universal screening and vaccination guidelines and chose from multiple strategies at the office (for example, standing orders), provider (for example, multiple forms of provider reminders), and patient (for example, incentives) levels derived from published literature and tailored to local context.

Obesity.

Obesity is a common condition and a major cause of morbidity and mortality. Fortunately, weight loss treatment can reduce obesity-related complications. This review summarizes the evidence-based strategies physicians can employ to identify, prevent, and treat obesity, including best practices to diagnose and counsel patients, to assess and address the burden of weight-related disease including weight stigma, to address secondary causes of weight gain, and to help patients set individualized and realistic weight loss goals and an effective treatment plan.

Filling a gap in care: addressing obesity in transgender and gender diverse patients.

Transgender and gender diverse (TGD) adults are more likely to have obesity compared to cisgender peers. Based on surveys, the TGD population experiences disparities in healthy lifestyle behaviors (e.g.

Meeting the Body Mass Index Requirement for Gender-affirming Surgery Using Antiobesity Medication.

One-fourth of transgender and gender diverse (TGD) patients presenting for initial gender-affirming surgery (GAS) consult is denied surgery due to obesity. Many surgery centers enforce body mass index (BMI) requirements for GAS because of concerns about perioperative risks, cosmetic outcomes, and reoperation. TGD people experience gender minority stress and disparities in lifestyle factors that likely contribute to excess weight gain.

Practice-Level Variation in Telemedicine Use in a Pediatric Primary Care Network During the COVID-19 Pandemic: Retrospective Analysis and Survey Study.

Background: Telehealth, the delivery of health care through telecommunication technology, has potential to address multiple health system concerns. Despite this potential, only 15% of pediatric primary care clinicians reported using telemedicine as of 2016, with the majority identifying inadequate payment for these services as the largest barrier to their adoption. The COVID-19 pandemic led to rapid changes in payment and regulations surrounding telehealth, enabling its integration into primary care pediatrics.

Effects of Alternating Standing and Sitting Compared to Prolonged Sitting on Cerebrovascular Hemodynamics.

Purpose: Previous research suggests that prolonged sitting may acutely reduce cerebral blood flow velocity (CBFv). The purpose of this study was to evaluate the effects of alternating standing and sitting vs prolonged sitting on CBFv.

Methods: This randomized crossover study enrolled working adults (N=25) with pre-to-stage 1 hypertension not using antihypertensive medications, and a body mass index from 25 to < 40 kg/m.

Unscheduled Referrals and Unattended Appointments After Pediatric Subspecialty Referral.

Objectives: Incomplete subspecialty referrals, whether unscheduled or unattended, represent unmet patient needs and an opportunity to improve patient safety and experiences. Our objectives were to describe the rates of appointment scheduling and visit attendance after pediatric subspecialty referral and to examine patient and systems factors associated with scheduled referrals and attended appointments.

Methods: We conducted a retrospective review of referrals within a network of 52 primary and urgent care sites from November 2016 to October 2017.

Effect of Using a Sit-Stand Desk on Ratings of Discomfort, Fatigue, and Sleepiness Across a Simulated Workday in Overweight and Obese Adults.

Background: Limited research examines the influence of sit-stand desks on ratings of discomfort, sleepiness, and fatigue. This study evaluated the time course of these outcomes over 1 day.

Methods: Adults (N = 25) completed a randomized cross-over study in a laboratory with two 8-hour workday conditions: (1) prolonged sitting (SIT) and (2) alternating sitting and standing every 30 minutes (SIT-STAND).

Effect of alternating standing and sitting on blood pressure and pulse wave velocity during a simulated workday in adults with overweight/obesity.

Objective: Reducing prolonged sitting at work has been recommended by an expert panel, but whether intermittent standing improves vascular health is unclear. We aimed to test whether using a sit-stand desk could reduce blood pressure (BP) and pulse wave velocity (PWV) during a simulated workday.

Methods: Overweight/obese adults with pre-to-Stage 1 hypertension completed a randomized crossover study with two simulated workday conditions: STAND-SIT (alternating standing and sitting condition every 30 min) and SIT (continuous sitting condition).

Assessment of Magnetic Resonance Imaging Artifact Following Cervical Total Disc Arthroplasty.

Background: Cervical disc arthroplasty has become a technique for the treatment of cervical degenerative disc disease. Clinically, the need to accurately assess the neural elements at the operative and adjacent levels is critical postoperatively. The purpose of this study was to quantitatively and qualitatively measure the amount of MRI artifact produced by various cervical total disc replacements.

Positional effects of transforaminal interbody spacer placement at the L5-S1 intervertebral disc space: a biomechanical study.

Background Context: Transforaminal lumbar interbody fusion (TLIF) is an increasingly used alternative fusion method over anterior and posterior lumbar interbody fusions. There are conflicting results on the optimal positioning of interbody devices. No study has addressed the lumbosacral segment, L5-S1, where the lordotic configuration presents unique challenges.

Structural properties of 6 forearm ligaments.

Purpose: To first determine the structural properties of 6 forearm ligaments and then to create linear and nonlinear analytical models of each ligament from these properties.

Methods: We nondestructively tested the annular ligament, dorsal and palmar radioulnar ligaments, and the distal, central, and proximal bands of the interosseous ligament from 7 fresh cadaver forearms in a servohydraulic testing apparatus. We performed testing with the bone-ligament-bone constructs positioned corresponding to neutral forearm rotation as well as in 45° of supination and 45° of pronation.

Protection Afforded by Fluoroquinolones in Animal Models of Respiratory Infections with Bacillus anthracis, Yersinia pestis, and Francisella tularensis.

Successful treatment of inhalation anthrax, pneumonic plague and tularemia can be achieved with fluoroquinolone antibiotics, such as ciprofloxacin and levofloxacin, and initiation of treatment is most effective when administered as soon as possible following exposure. Bacillus anthracis Ames, Yersinia pestis CO92, and Francisella tularensis SCHU S4 have equivalent susceptibility in vitro to ciprofloxacin and levofloxacin (minimal inhibitory concentration is 0.03 μg/ml); however, limited information is available regarding in vivo susceptibility of these infectious agents to the fluoroquinolone antibiotics in small animal models.

Levofloxacin rescues mice from lethal intra-nasal infections with virulent Francisella tularensis and induces immunity and production of protective antibody.

The ability to protect mice against respiratory infections with virulent Francisella tularensis has been problematic and the role of antibody-versus-cell-mediated immunity controversial. In this study, we tested the hypothesis that protective immunity can develop in mice that were given antibiotic therapy following infection via the respiratory tract with F. tularensis SCHU S4.

Escherichia coli isolated from a Crohn's disease patient adheres, invades, and induces inflammatory responses in polarized intestinal epithelial cells.

Inflammatory diseases of the intestinal tract are a major health concern both in the United States and around the world. Evidence now suggests that a new category of Escherichia coli, designated Adherent Invasive E. coli (AIEC) is highly prevalent in Crohn's Disease (CD) patients.

Role of primary human alveolar epithelial cells in host defense against Francisella tularensis infection.

Francisella tularensis, an intracellular pathogen, is highly virulent when inhaled. Alveolar epithelial type I (ATI) and type II (ATII) cells line the majority of the alveolar surface and respond to inhaled pathogenic bacteria via cytokine secretion. We hypothesized that these cells contribute to the lung innate immune response to F.

Human monoclonal antibody AVP-21D9 to protective antigen reduces dissemination of the Bacillus anthracis Ames strain from the lungs in a rabbit model.

Dutch-belted and New Zealand White rabbits were passively immunized with AVP-21D9, a human monoclonal antibody to protective antigen (PA), at the time of Bacillus anthracis spore challenge using either nasal instillation or aerosol challenge techniques. AVP-21D9 (10 mg/kg) completely protected both rabbit strains against lethal infection with Bacillus anthracis Ames spores, regardless of the inoculation method. Further, all but one of the passively immunized animals (23/24) were completely resistant to rechallenge with spores by either respiratory challenge method at 5 weeks after primary challenge.