Impacts of COVID-19 on Health and Healthcare for Rural Veterans in Home-Based Primary Care.

This qualitative study explored the impact of COVID-19 on older rural-dwelling veterans and their caregivers enrolled in home-based primary care (HBPC) through the Birmingham VA Health Care System (BVAHCS). Phone interviews were conducted with 16 veterans and/or their caregivers and rapid qualitative analysis of interview notes was performed. Average age of veterans was 77 (range = 69-97) and 93.

Experience With Adaptive Servo-Ventilation Among Veterans in the Post-SERVE-HF Era.

Background: The sleep medicine community has struggled to identify the ideal role for adaptive servo-ventilation (ASV) therapy following a study that found increased mortality in patients with central sleep apnea (CSA) and heart failure with reduced ejection fraction who used ASV therapy. We aimed to identify characteristics of patients who benefit from ASV therapy.

Methods: We performed a record review of all patients treated with ASV therapy at the Hampton Veterans Affairs Medical Center in Virginia from January 1, 2015, to April 30, 2020.

The Prevalence of Anxiety and Depression Symptoms in Obstructive Sleep Apnea.

Objectives Mood disorders are common in obstructive sleep apnea (OSA), though the interactions are not well-understood. The objective of this study was to evaluate the relationship between anxiety and depression with OSA.  Methods Patients who presented to the sleep center underwent polysomnography (PSG).

A Study to Assess the Relationship between Attention Deficit Hyperactivity Disorder and Obstructive Sleep Apnea in Adults.

The association between obstructive sleep apnea (OSA) and attention deficit hyperactivity disorder (ADHD) is well-established in children. However, there is a paucity of literature regarding this association in adults. The aim of this study was to determine if ADHD is more common in adult patients with OSA.

Resolution of Sleepwalking Behavior after Initiation of Sodium Oxybate in a Patient with Narcolepsy Type 2.

A 44-year-old male veteran with long-standing excessive daytime sleepiness was diagnosed with Narcolepsy Type 2. The patient was unable to tolerate effective doses of methylphenidate, due to mood disturbances, or modafinil, due to adverse gastrointestinal effects. Although the patient also reported an ongoing history of sleepwalking with potentially injurious behaviors, a cautious trial of sodium oxybate was initiated.

Assessment of the potential impact of dose rounding parenteral chemotherapy agents on cost savings and drug waste minimization.

Background Fiscally responsible utilization of anticancer treatments is necessary to combat their continually increasing cost. Dose rounding is one strategy that has been explored to minimize cost and waste without losing clinical effectiveness. Objectives To determine if dose rounding chemotherapy agents is a feasible cost-containment strategy at an institution with a small oncology clinic.

Clinical effects of phosphodiesterase 3A mutations in inherited hypertension with brachydactyly.

Autosomal-dominant hypertension with brachydactyly is a salt-independent Mendelian syndrome caused by activating mutations in the gene encoding phosphodiesterase 3A. These mutations increase the protein kinase A-mediated phosphorylation of phosphodiesterase 3A resulting in enhanced cAMP-hydrolytic affinity and accelerated cell proliferation. The phosphorylated vasodilator-stimulated phosphoprotein is diminished, and parathyroid hormone-related peptide is dysregulated, potentially accounting for all phenotypic features.

Participation in a novel treatment component during residential substance use treatment is associated with improved outcome: a pilot study.

Background: A person-centered substance use treatment component, the Natural Recovery Program, was developed. The Natural Recovery Program is comprised of small group therapy combined with pursuit of hobbies.

Methods: This was a pilot study of the program and was not randomized.

The effect of calcium on iron absorption.

The experimental and epidemiological evidence demonstrating that Ca inhibits Fe absorption was reviewed, with the objectives of estimating the potential impact of variations in Ca intake on dietary Fe bioavailability and of providing some guidelines for predicting the effects on Fe status of recent recommendations for higher dietary Ca intake. In animal models Ca salts reduced both haem- and non-haem-Fe absorption, the effect being dependent on the amount of Ca administered rather than the Ca:Fe molar ratio; dairy products had a variable effect; factors other than Ca may have been important. In single-meal human absorption studies, both haem- and non-haem-Fe absorption was inhibited by Ca supplements and by dairy products, the effect depending on the simultaneous presence of Ca and Fe in the lumen of the upper small intestine and also occurring when Ca and Fe were given in the fasting state.

The potential impact of iron supplementation during adolescence on iron status in pregnancy.

Iron deficiency anemia (IDA) during pregnancy is associated with significant morbidity for mothers and infants. Over 50% of pregnant women in developing countries suffer from IDA. It is also prevalent among adolescent girls because the growth spurt and onset of menstruation increase iron requirements.

Interaction of iron with other nutrients.

Iron is essential for oxygen transport, oxidative metabolism, and cellular growth. Interactions between iron and other dietary factors play a significant role in determining the adequacy of iron nutrition and have important implications for food fortification in developing countries. Vitamin A and vitamin C deficiency states may affect iron transport, metabolism, and storage within the body.