Lifestyle Medicine and Vasomotor Symptoms: An Analytic Review.

This paper is an literature evaluation of the treatments based on the 6 pillars of Lifestyle Medicine (nutrition, physical activity, restorative sleep, stress management, positive social connection, and avoidance of risky substances) to improve vasomotor symptoms. Main findings were: (1) the Mediterranean diet and other plant-forward approaches may effectively reduce vasomotor symptoms; (2) stress can directly impact menopausal symptoms by increasing the frequency and intensity of hot flashes and other symptoms; (3) the incidence of sleep disturbances are high during the menopause transition; (4) evidence on the impact of physical activity and exercise on vasomotor symptoms is mixed, although moderate activity and strength training may be better for vasomotor symptom optimization than vigorous exercise and part of a healthy aging process; (5) evidence on the impact of social support on VMS is mixed with some studies suggesting benefit; and (6) evidence on the impact of risky substances is mixed but appears stronger for the effects of tobacco cessation than for alcohol cessation. In summary, while there is a variety of quality of evidence depending on the pillar, lifestyle medicine may be generally considered to improve vasomotor symptoms for patients that cannot use or decline hormone therapy.

Late-onset prosthetic aortic valve stenosis caused by pannus formation.

Unlabelled: Transcatheter aortic valve replacement (TAVR) is a less invasive alternative to an open surgical aortic valve replacement (SAVR) for treating severe symptomatic aortic stenosis. Despite gaining widespread acceptance and approval for use in patients with high, moderate, and low surgical risk, the increasing use of TAVR has raised concerns about potential short- and long-term complications. We present the case of a 69-year-old female who underwent TAVR and subsequently presented to our outpatient cardiology clinic with progressively worsening dyspnea, orthopnea, and paroxysmal nocturnal dyspnea two years after the procedure.

Use of autologous whole blood clot in the treatment of complex surgical wounds: a case series.

Objective: Dehiscence and infection of hard-to-heal surgical wounds results in an increased risk of complications and mortality. A hard-to-heal surgical wound will present decreased levels of growth factors along with increased levels of debris and matrix metalloproteinases, resulting in the destruction of the extracellular matrix (ECM). ActiGraft (RedDress Ltd.

Utilization of a topical autologous blood clot for treatment of pressure ulcers.

Management and treatment of pressure ulcers (PUs) are met with great difficulty due to various factors that cause vulnerability of the soft tissue such as location, limited mobility, increased friction and shearing forces, as well as other comorbidities that may delay or halt wound healing. The topical autologous blood clot therapy (TABCT) is a point-of-care treatment used as a blood clot to assist in recreating and repairing the extracellular matrix (ECM). The mechanism of action consists of reconstruction of the ECM by incorporating into the ulcer, providing protection from further external destruction, while assisting in advancement through the wound healing phases via interaction of necessary growth factors, mediators, and chemokines.

Innovative treatment utilizing an autologous blood clot for diabetic foot ulcers.

Introduction: Diabetic foot ulcer is a complex wound that requires considerable effort to restart a stalled healing process. In this study, a TABCT product was used in a point-of-care setting to treat DFUs by reconstructing the ECM and adjusting intricate phenotypes and mechanisms of mediators to progress towards complete healing. The mechanism of action consists of reconstruction of the ECM, which protects the wound area from further destruction while it incorporates into the ulcer to promote granulation over exposed vital structures (ie, tendons, bone, and neurovascular structures).

Developing and Validating Multi-Modal Models for Mortality Prediction in COVID-19 Patients: a Multi-center Retrospective Study.

The unprecedented global crisis brought about by the COVID-19 pandemic has sparked numerous efforts to create predictive models for the detection and prognostication of SARS-CoV-2 infections with the goal of helping health systems allocate resources. Machine learning models, in particular, hold promise for their ability to leverage patient clinical information and medical images for prediction. However, most of the published COVID-19 prediction models thus far have little clinical utility due to methodological flaws and lack of appropriate validation.

Inhibiting the Musculoskeletal Pathological Processes in Post-knee Replacement Surgery With Osteopathic Manipulative Treatment: A Systematic Review.

Total knee arthroplasty (TKA) is a very common surgical treatment approach for severe osteoarthritis. Complications of TKA include loss of range of motion and prolonged analgesic requirement for pain control. Osteopathic manipulative techniques (OMT) have been utilized to address localized muscular stiffness to improve range of motion; however, limited studies directly correlate OMT and TKA recovery.

A reevaluation of the role of the trihelix transcription factors as repressors of the seed maturation program.

Developmental transitions are typically tightly controlled at the transcriptional level. Two of these transitions involve the induction of the embryo maturation program midway through seed development and its repression during the vegetative phase of plant growth. Very little is known about the factors responsible for this regulation during early embryogenesis, and only a couple of transcription factors have been characterized as repressors during the postgerminative phase.

Portomesenteric venous thrombosis in a postmenopausal female with testosterone implant: a case report.

Background: Acute portal vein thrombosis is a rare medical event usually seen in liver disease, but it can also occur due to any inherited or acquired procoagulable state that triggers venous occlusion. Hormonal therapies have been associated with an increased risk of prothrombotic states. This case report documents a portomesenteric venous thrombosis in a postmenopausal woman with testosterone implant for the treatment of hypoactive sexual desire and discusses the importance of identifying hypercoagulable risk factors before initiating hormone replacement therapy.

Association of mortality and recent Mycoplasma pneumoniae infection in COVID-19 patients.

To compare characteristics and outcomes of patients who had COVID-19 with Mycoplasma pneumoniae immunoglobulin M (IgM) antibodies to those without M. pneumoniae antibodies. We retrospectively reviewed cases admitted over a 4-week period between 17 March 2020 and 14 April 2020 to the Hoboken University Medical Center, NJ, USA.

N95 Usage During the COVID-19 Pandemic.

Personal Protective Equipment (PPE), formerly ubiquitous and disposable in the hospital and healthcare environment, has become scarce during the COVID-19 pandemic. This shortage has precipitated creative solutions to re-use and/or extend the lifetime of PPE, most notably the N95 mask. This article attempts to summarize options regarding re-use of N95 respirators and is for informational purposes only.

Intraductal Papillary Mucinous Neoplasm of the Pancreas: Understanding the Basics and Beyond.

Intraductal papillary mucinous neoplasm (IPMN) is a benign cystic lesion that grows in the pancreatic ductal system. While the risk for undergoing malignant transformation is dependent on a number of factors, the risk is certainly present, differentiating it from other cystic lesions of the pancreas. Additionally, IMPN is to be starkly contrasted with adenocarcinoma of the pancreas, which is by nature malignant.

Esophageal Intramural Diverticula: Multiple and Single.

More than 50 years ago, two investigators described a rare case of multiple esophageal diverticula, which they named esophageal intramural pseudodiverticulosis (EIPD). To this day, the pathogenesis of this condition remains obscure. Several coexisting conditions, such as strictures, esophageal dysmotility, or infection, require medical treatment.

Psychopharmacology of autism spectrum disorders.

At present, no evidence-based effective pharmacologic options are available for treating the core deficits of autism spectrum disorders (ASDs), which are best addressed by behavioral and educational interventions. However, such evidence exists for several of the frequently associated/comorbid symptoms such as aggression and severe irritability, hyperactivity, and repetitive behaviors, which can become a major source of additional distress and interference in functioning. This article offers information on the psychopharmacology of ASD that is current, relevant, and organized in a user-friendly manner, to form a concise but informative reference guide for primary pediatric clinicians.

Pharmacotherapy for substance abuse disorders in adolescence.

The public health effects of adolescent substance abuse disorders (SUD) reaches further than the immediate intoxicating effects. Medications play a limited role in the treatment of youth beyond addressing short-term symptoms but may improve longer-term outcomes for some patients. Given the potential devastating consequences of SUD, clinicians should become familiar with all available treatment options.

Pharmacotherapy for child and adolescent attention-deficit hyperactivity disorder.

Research in the past 2 decades showed that attention-deficit/hyperactivity disorder (ADHD) is a frequently occurring psychiatric disorder that causes considerable suffering to patients and their families. This article outlines current pharmacologic ADHD treatment options and focuses on their safety profile and efficacy. In addition, it addresses treatment selection, guidelines for monitoring treatment, and recent controversies in the field.