A fatal case of disseminated infection in a renal transplant recipient.

Dematiaceous molds often cause noninvasive disease but have the potential to cause disseminated infection, particularly in immunosuppressed hosts. is the most neurotropic of dematiaceous molds and is associated with brain abscesses, but disseminated infection is quite rare. Here we present a case of disseminated in a 67-year-old renal transplant recipient with multifocal soft tissue, bone and presumed central nervous system involvement.

Veteran and healthcare team perspectives on the TeleWound Practice Program within the Veterans Health Administration.

Objective: The Veterans Health Administration (VHA) recently piloted the implementation of the TeleWound Practice Program (TWP), which provides interprofessional wound care to Veterans remotely. We assessed the perceptions of Veterans and healthcare team members (HCTMs), and their experiences with the TWP.

Method: We surveyed Veterans from four VHA medical centres who had received at least one TWP visit between 1 May 2020 and 31 May 2021, and HCTMs associated with any TWP encounter between 1 September 2019 and 31 March 2021.

Preventing Community-Acquired Pressure Injury in Spinal Cord Injury: Simulation for Registered Nurses.

Purpose: The study purpose was to develop and assess a simulation for registered nurses to apply knowledge, skills, and attitudes in conducting a focused assessment in the clinic setting to prevent community-acquired pressure injuries (CAPrIs) in individuals living with spinal cord injury (SCI).

Methods: Development, psychometric assessment, and pilot of a simulation for a nurse-patient clinic appointment to prevent CAPrIs at home. Evaluations were conducted via focus group.

Statin therapy in primary and secondary cardiovascular disease prevention.

Purpose Of Review: Atherosclerotic cardiovascular disease (ASCVD) is one of the most common causes of death globally and the leading one in the US. Elevated low-density lipoprotein (LDL) cholesterol is one of the main modifiable disease risk factors and statin therapies have been extensively studied in that regard. The present work presents the clinical trials derived evidence supporting the use of statins in primary and secondary cardiovascular disease prevention.

Clinical and Economic Correlates of Pharmacotherapy in Patients with Essential Tremor.

Background: Essential tremor (ET) is among the most common movement disorders, yet there are few treatment options. Medications have limited efficacy and adverse effects; thus, patients often discontinue pharmacotherapy or take several medications in combination. We evaluated the economic correlates (healthcare resource utilization [HCRU] and costs) and comorbidities among adults with and without ET and among subgroups of patients with ET prescribed 0 to ≥3 ET medications.

Humans exploit the trade-off between lateral stability and manoeuvrability during walking.

People use the mechanical interplay between stability and manoeuvrability to successfully walk. During single-limb support, body states (position and velocity) that increase in lateral stability will inherently resist lateral manoeuvres, decrease medial stability and facilitate medial manoeuvres. Although not well understood, people can make behavioural decisions exploiting this relationship in anticipation of perturbations or direction changes.

Developing an Evidence-Based Interprofessional Algorithm to Apply Noninvasive Ventilation in Acute Exacerbation of COPD.

Background: When administered as first-line intervention to patients admitted with acute hypercapnic respiratory failure secondary to COPD exacerbation in conjunction with guideline-recommended therapies, noninvasive ventilation (NIV) has been shown to reduce mortality and endotracheal intubation. Opportunities to increase uptake of NIV continue to exist despite inclusion of this therapy in clinical guidelines. Prior studies suggest that efforts to increase NIV use in acute exacerbation of COPD (AECOPD) need to account for the complex and interprofessional nature of NIV delivery and the need for interprofessional team coordination.

Cabozantinib inhibits tumor growth in mice with ovarian cancer.

Ovarian cancer is usually detected in the advanced stages. Existing treatments for high grade serous ovarian cancer (HGSOC) are not adequate and approximately fifty percent of patients succumb to this disease and die within five years after diagnosis. We conducted pre-clinical studies in a mouse model of ovarian cancer to evaluate disease outcome in response to treatment with the multi-kinase inhibitor cabozantinib.

Fragmented Care, Commission on Cancer Accreditation, and Overall Survival in Patients Receiving Surgery and Chemotherapy for Lung Cancer.

Background: Patients may receive their adjuvant therapy at a facility different from where they had their lung cancer operation. Whether this fragmentation of care affects outcomes is unclear.

Methods: We used the National Cancer Database to identify lung cancer patients undergoing resection and adjuvant chemotherapy from 2006-2020.

Clinical parameters of death and heart failure hospitalization in biventricular systolic dysfunction assessed via cardiac magnetic resonance.

Aims: While factors associated with adverse events are well elucidated in setting of isolated left ventricular dysfunction, clinical and imaging-based prognosticators of adverse outcomes are lacking in context of biventricular dysfunction. The purpose of this study was to establish role of clinical variables in prognosis of biventricular heart failure (HF), as assessed by cardiac magnetic resonance imaging.

Methods: Study cohort consisted of 840 patients enrolled in DERIVATE registry with coexisting CMR-derived right ventricular (RV) and left ventricular (LV) dysfunction, as defined by RV and LV ejection fractions ≤45 % and ≤ 50 %, respectively.

Postnatal Neuronal Nogo-A Knockdown Decreased the Message of Glutamatergic Synaptic Proteins.

It is well known that oligodendrocyte-associated Nogo-A protein is an important regulator of axonal outgrowth and an important inhibitor of functional recovery and anatomical plasticity after central nervous system (CNS) injury. Abundant studies of oligodendrocyte-associated Nogo-A function in the uninjured rodent have suggested a role in neuronal development and synaptic function. On the other hand, the roles of neuron-associated (i.

Optimal Management of Osteoporosis in the Spinal Cord (Injury) Population.

Spinal cord injury (SCI) leads to significant bone loss resulting in osteoporosis and an increased risk of fractures below the level of injury. It is imperative to screen for osteoporosis in all individuals with SCI starting immediately after the acute injury. Although data are limited, clinicians are encouraged to discuss preventative treatment in the acute SCI period and to treat osteoporosis when diagnosed.

Seizure Risk Associated With the Use of Transcranial Magnetic Stimulation for Coma Recovery in Individuals With Disordered Consciousness After Severe Traumatic Brain Injury.

Objective: Repetitive Transcranial Magnetic Stimulation (rTMS) is emerging as a promising treatment for persons with disorder of consciousness (DoC) following traumatic brain injury (TBI). Clinically, however, there are concerns about rTMS exacerbating baseline seizure risk. To advance understanding of risks, this article reports evidence of DoC-TBI rTMS-related seizure risk.

Ceftazidime/avibactam alone or in combination with an aminoglycoside for treatment of carbapenem-resistant Enterobacterales infections: A retrospective cohort study.

Background: Ceftazidime/avibactam is one of the preferred treatment options for carbapenem-resistant Enterobacterales (CRE). However, the benefit of combining ceftazidime/avibactam with another antibiotic remains unclear.

Objectives: To identify variables associated with treatment failure during the use of ceftazidime/avibactam for CRE infections and assess the effect of combining an aminoglycoside with ceftazidime/avibactam.

Challenges and Opportunities in Developing an Oncology Clinical Trial Network in the United States Veterans Affairs Health Care System: The VA STARPORT Experience.

The United States Veterans Affairs (VA) Health Care System has a strong history of conducting impactful oncology randomized clinical trials (RCTs). We developed a phase II/III RCT to test the use of metastasis-directed therapy in Veterans with oligometastatic prostate cancer (OMPC)-the first VA RCT in OMPC that leverages novel imaging and advanced radiotherapy techniques. To accomplish this, we developed a clinical trial network to conduct the study.