The relationship between required physician letters of recommendation and decreasing diversity in osteopathic medical school admissions.

Context: Some racial and ethnic groups are underrepresented in the medical field because they face unique barriers to admission to medical school. One admission requirement that can present a barrier for applicants is the physician letter of recommendation (PLOR). Undergraduate students report confusion with the application process and lack of mentorship to be two of their biggest challenges to becoming a doctor.

Treatment of Recurrent Pressure Injury Using an Allograft Adipose Matrix.

A 77-year-old man with a more than 10-year history of a spinal cord injury developed bilateral trochanteric stage 3 pressure injuries (PIs) several years ago. They initially healed. The right trochanteric PI opened again and continued to reopen every 2 to 3 months, likely because of deficient adipose layer in the area of the healed PI.

Utility of Abbreviated Small Bowel Follow Through Study in the Management of Small Bowel Obstruction.

Introduction: Small bowel obstruction is a common surgical complaint. Most small bowel obstructions are managed successfully nonoperatively. Unanimous guidelines for nonoperative management of small bowel obstruction do not exist.

Significant Hypophosphatemia Is Predictive of Brain Death in Severe Traumatic Brain Injury.

Traumatic brain injury (TBI) is one of the most common causes of morbidity and mortality worldwide. Severe TBI carries the greatest risk of brain death progression. There are currently no laboratory markers that predict patient's outcome.

Clinical Impact and Accuracy of Shave Biopsy for Initial Diagnosis of Cutaneous Melanoma.

Introduction: Effective treatment of malignant melanomas is dependent upon accurate histopathological staging of preoperative biopsy specimens. While narrow excision is the gold standard for melanoma diagnosis, superficial shave biopsies have become the preferred method by dermatologists but may transect the lesion and result in inaccurate Breslow thickness assessment. This is a retrospective cohort study evaluating an initial method of biopsy for diagnosis of cutaneous melanoma and indication for reoperation based on inaccurate initial T-staging.

Incorporating physical manipulatives into an integrated pharmacotherapy course to reinforce antimicrobial spectrum of activity.

Background And Purpose: Teaching and learning the spectrum of activity (SOA) of antimicrobial agents can be a challenge in pharmacy education. This study describes the implementation and assessment of a novel tool to aid in the instruction of SOA. Physical manipulatives were used as an active-learning technique to model bacterial pathogens for antimicrobial SOA in an infectious diseases (ID) integrated medication therapy management course.

The Impact of an Educational Program on Medical Students' Knowledge and Awareness of Elder Abuse.

Objective: Approximately 1 in 6 adults 60 and older have experienced a form of abuse in the past year. Many cases remain under-reported due to lack of knowledge and awareness. This study created an educational program on elder abuse for medical students to determine if participation would increase knowledge and awareness of elder abuse.

Angioedema: differential diagnosis and acute management.

A clinical vignette illustrates a typical presentation of a patient seeking help for acute angioedema. Despite the risks of SARS-CoV-2 (COVID-19) exposure, it is critical to evaluate patients with acute angioedema in person, because there is always the potential for angioedema to progress to the head, neck, or lungs, which can rapidly compromise the airways and require immediate intervention to avoid potential asphyxiation. There are three mediators of angioedema, histamine, leukotriene, or bradykinin, each requiring different management.

Y-site physical compatibility of hydrocortisone continuous infusions with admixtures used in critically ill patients.

Purpose: Critically ill patients with septic shock often receive multiple intravenous medications, necessitating either the placement of separate lines for medication administration or administration of medications concurrently through a Y-site connector only where compatibility has been demonstrated. The purpose of this study was to examine the physical compatibility of hydrocortisone infusions and select intravenous medications through a simulated Y site.

Methods: The medications tested for simulated Y-site physical compatibility with hydrocortisone included acetaminophen, albumin, cefepime, ciprofloxacin, cisatracurium, doripenem, epinephrine, esomeprazole, ibuprofen, levofloxacin, levothyroxine, meropenem, and norepinephrine.

Physical Compatibility of Medications Used in Critically Ill Patients with Balanced Fluid Solutions.

Using balanced fluids for resuscitation in patients with septic shock may lead to improved patient outcomes. However, compatibility data on co-administering balanced fluids via y-site connector with other intravenous medications is lacking. The purpose of this study was to examine the physical compatibility of frequently used intravenous medications for patients with septic shock with balanced fluids, Plasma-Lyte A, and Lactated Ringers, using a simulated y-site.

Simulated microgravity-mediated reversion of murine lymphoma immune evasion.

No human has returned to the moon since the end of the Apollo program 47 years ago, however, new missions are planned for an orbital outpost. Space radiation and the potential for cancer remain as important issues to the future of human space exploration. While improved shield technologies and protective biologicals are under development, little is known concerning the interaction between cancer cells and host immunity in microgravity.

Prolonged exposure to simulated microgravity diminishes dendritic cell immunogenicity.

Immune dysfunction due to microgravity remains a hurdle in the next step of human space exploration. Dendritic cells (DC) represent a critical component of immunity, given their role in the detection of invaders and the subsequent task of activating T cells to respond and eliminate the threat. Upon encounter with microbes, DC undergo a process of maturation, whereby the cells upregulate the expression of surface proteins and secrete cytokines, both required for the optimal activation of CD4 and CD8 T cells.

Retrospective review of the patient cases at a major trauma center in Nairobi, Kenya and implications for emergency care development.

Introduction: Low- and middle-income countries (LMICs) are continuing to experience a "triple burden" of disease - traumatic injury, non-communicable diseases (NCDs), and communicable disease with maternal and neonatal conditions (CD&Ms). The epidemiology of this triad is not well characterised and poses significant challenges to resource allocations, administration, and education of emergency care providers. The data collected in this study provide a comprehensive description of the emergency centre at Kenya's largest public tertiary care hospital.

Sulfonamide Allergies.

As one of the earliest developed antimicrobial classes, sulfonamides remain important therapeutic options for the empiric and definitive treatment of various infectious diseases. In the general population, approximately 3-8% of patients are reported to experience a sulfonamide allergy. Sulfonamide allergies can result in various physical manifestations; however, rash is reported as the most frequently observed.

Longitudinal improvement in nasal obstruction symptoms of chronic rhinosinusitis directly associates with improvement in mood.

Purpose: The effects of nasal obstruction in patients with chronic rhinosinusitis (CRS) are associated with depressed mood. We sought to validate this finding by determining whether improvement in nasal obstruction would translate to improvement in depressed mood.

Methods: This was a prospective observational study of 150 patients undergoing medical management for CRS.

T cell resistance to activation by dendritic cells requires long-term culture in simulated microgravity.

Immune impairment mediated by microgravity threatens the success of space exploration requiring long-duration spaceflight. The cells of most concern, T lymphocytes, coordinate the host response against microbial and cancerous challenges leading to elimination and long-term protection. T cells are activated upon recognition of specific microbial peptides bound on the surface of antigen presenting cells, such as dendritic cells (DC).

Ebola virus secreted glycoprotein decreases the anti-viral immunity of macrophages in early inflammatory responses.

During Ebola virus (EBOV) infection, secreted glycoprotein (sGP) is found in large quantities in the serum of both patients and infected animal models. It is thought to serve as a decoy for anti-EBOV antibodies. Using an in vitro model incorporating treatment of non-infected human THP-1 macrophages with recombinant EBOV sGP, this study sought to examine the impact of sGP upon key macrophage functions.