A call for collaboration and consensus on training for endotracheal intubation in the medical intensive care unit.

Endotracheal intubation (EI) is a potentially lifesaving but high-risk procedure in critically ill patients. While the ACGME mandates that trainees in pulmonary and critical care medicine (PCCM) achieve competence in this procedure, there is wide variation in EI training across the USA. One study suggests that 40% of the US PCCM trainees feel they would not be proficient in EI upon graduation.

Lessons Learned From a Mental Health Hospital: Managing COVID-19.

Congregate settings such as psychiatric units have an increased risk of disease transmission because of the milieu setting and the inability to isolate patients. Interventions to prevent infection and cross-contamination are discussed including monitoring of patient temperatures, personal protective equipment, remote care, monitoring of human resources, and reinforcement of infection prevention strategies. We discuss the effectiveness of those interventions and the lessons learned, including implications for psychiatric clinical care, during future pandemics or a next wave of COVID-19.

The inFlow intraurethral valve-pump for women with detrusor underactivity: A summary of peer-reviewed literature.

Detrusor underactivity (DUA) in women can result in urinary retention and the need for chronic bladder drainage management. Without a cure for urinary retention due to DUA, treatment options are focused on effective bladder drainage most often by intermittent or continuous catheter drainage. The inFlow intraurethral valve pump was FDA approved for use in women with this condition in 2014.

Leveraging Stereoelectronic Effects in Biofilm Eradication: Synthetic β-Amino Human Milk Oligosaccharides Impede Microbial Adhesion As Observed by Scanning Electron Microscopy.

Alongside Edward, Lemieux was among the earliest researchers studying negative hyperconjugation (i.e., the anomeric effect) or the preference for gauche conformations about the C1-O5 bond in carbohydrates.

Chronic Rhinotillexomania Leading to Multiple Infectious Sequelae in a 66-Year-Old Female.

Rhinotillexomania, more commonly known as nose-picking, is a body-focused repetitive behavior that involves compulsive picking of the nares. While nose-picking in general is a common and largely unharmful practice worldwide, severe complications from chronic nose-picking do exist. This case highlights a 66-year-old female with a longstanding history of nose-picking and nose blowing who presented to the emergency department with acute delirium and various bodily complaints.

Further SAR on the (Phenylsulfonyl)piperazine Scaffold as Inhibitors of the Aedes aegypti Kir1 (AeKir) Channel and Larvicides.

Zika virus (ZIKV), dengue fever (DENV) and chikungunya (CHIKV) are arboviruses that are spread to humans from the bite of an infected adult female Aedes aegypti mosquito. As there are no effective vaccines or therapeutics for these diseases, the primary strategy for controlling the spread of these viruses is to prevent the mosquito from biting humans through the use of insecticides. Unfortunately, the commonly used classes of insecticides have seen a significant increase in resistance, thus complicating control efforts.

Antiepileptic Drugs in the Management of Cerebral Metastases.

Seizures represent a common and debilitating complication of central nervous system metastases. The use of prophylactic antiepileptic drugs (AEDs) in the preoperative period remains controversial, but the preponderance of evidence suggests that it is not helpful in preventing seizure and instead poses a significant risk of adverse events. Studies of postoperative seizure prophylaxis have not shown substantial benefit, but this practice remains widespread.

Baseline neuropsychological characteristics in patients with epilepsy with left temporal lobe encephaloceles compared with left mesial temporal sclerosis.

Background: Temporal lobe encephaloceles (TE) are increasingly recognized as a cause of drug-resistant temporal lobe epilepsy. Improved recognition of these lesions offers an opportunity to treat them with a limited resection sparing the hippocampus. However, as they can be difficult to identify on imaging, additional clues pointing to the diagnosis can be helpful.

Gaps in the care cascade for screening and treatment of refugees with tuberculosis infection in Middle Tennessee: a retrospective cohort study.

Background: Treatment of tuberculosis infection (TBI) in individuals at high risk for tuberculosis (TB) disease is a priority for TB elimination in the US. Newly arrived refugees in Middle Tennessee are screened for TBI, but factors associated with gaps in the TBI care cascade are not well characterized.

Methods: We assessed the TBI care cascade from US entry to completion of treatment for refugees who resettled in Middle Tennessee from 2012 through 2016.

Diagnoses and Difficulties in Mesenteric Pathology.

Mesenteric diseases are broadly separated into 2 groups: non-neoplastic and neoplastic. Common non-neoplastic mesenteric diseases include those involving the mesenteric vasculature and those of inflammatory processes. Mesenteric inflammatory processes can mimic a neoplastic process.

Combined blockade of EGFR and glutamine metabolism in preclinical models of colorectal cancer.

Improving response to epidermal growth factor receptor (EGFR)-targeted therapies in patients with advanced wild-type (WT) RAS colorectal cancer (CRC) remains an unmet need. In this preclinical work, we evaluated a new therapeutic combination aimed at enhancing efficacy by targeting cancer cell metabolism in concert with EGFR. We hypothesized that combined blockade of glutamine metabolism and EGFR represents a promising treatment approach by targeting both the "fuel" and "signaling" components that these tumors need to survive.

Sensory hypersensitivity in Tourette syndrome: A review.

Tourette syndrome (TS) is a neurodevelopmental disorder defined by tics, but most patients also experience bothersome sensory phenomena, in the form of premonitory urges and/or sensory hypersensitivity. Whereas premonitory urges are temporally paired with tics, sensory hypersensitivity is a constant, heightened awareness of external and/or internal stimuli. The intensity of sensory hypersensitivity does not strongly correlate with the severity of tics or premonitory urges, suggesting it is a dissociable clinical phenomenon.

Functional engagement of white matter in resting-state brain networks.

The topological characteristics of functional networks, derived from measurements of resting-state connectivity in gray matter (GM), are associated with individual cognitive abilities or specific dysfunctions. However, blood oxygen level-dependent (BOLD) signals in white matter (WM) are usually ignored or even regressed out as nuisance factors in the data analyses that underlie network models. Recent studies have demonstrated reliable detection of WM BOLD signals and imply these reflect associated neural activities.

Initial psychometric testing of the Head and Neck Cancer Patient Self-Management Inventory (HNC-PSMI).

Purpose: Head and neck cancer (HNC) and its treatment are associated with significant symptom burden and functional impairment. HNC patients must engage in intensive and complex self-management protocols to minimize acute and late treatment effects. Self-management among HNC patients is understudied due to the limited availability of disease-specific self-management measures.

Effectiveness of fat suppression using a water-selective binomial-pulse excitation in chemical exchange saturation transfer (CEST) magnetic resonance imaging.

Purpose: The purpose of this study was to characterize the individual contribution of multiple fat peaks to the measured chemical exchange saturation transfer (CEST) signal when using water-selective binomial-pulse excitation and to determine the effects of multiple fat peaks in the presence of B inhomogeneity.

Methods: The excitation profiles of multiple binomial pulses were simulated. A CEST sequence with binomial-pulse excitation and modified point-resolved spectroscopy localization was then applied to the in vivo lumbar spinal vertebrae to determine the signal contributions of three distinct groups of lipid resonances.

Non-invasive venous waveform analysis (NIVA) for volume assessment in patients undergoing hemodialysis: an observational study.

Background: Accurate assessment of volume status to direct dialysis remains a clinical challenge. Despite current attempts at volume-directed dialysis, inadequate dialysis and intradialytic hypotension (IDH) are common occurrences. Peripheral venous waveform analysis has recently been developed as a method to accurately determine intravascular volume status through algorithmic quantification of changes in the waveform that occur at different volume states.

Opioid-free spine surgery: a prospective study of 244 consecutive cases by a single surgeon.

Background Context: There have been no reported efforts to eliminate opioid use for elective spine surgery, despite its well-known drawbacks.

Purpose: We sought to test the hypothesis that opioid-free elective spine surgery, including lumbar fusions, can be performed with satisfactory pain control.

Study Design/ Setting: This study analyzes prospectively collected data from a single surgeon's patients who were enrolled into an institutional spine registry.

Leptospirosis as an unusual culprit of acute pancreatitis and portal vein thrombosis in a New Yorker.

Leptospirosis often takes clinicians by surprise when presenting in urban locations with unusual manifestations. This delays diagnosis and treatment which increases mortality rate. Our case illustrates the importance of taking into account the socioeconomic backgrounds, environmental exposures, and clinical presentations of patients to create a good differential diagnosis.

Pilot study investigating the feasibility of mitral valve repair without aortic cross-clamping and cardioplegia.

There is evidence that perfusing the heart with a heart and lung machine is less injurious than cross-clamping the aorta and administering cardioplegia during cardiac surgery. Although mitral valve replacement has been carried out without aortic cross-clamping and cardioplegia, it has been stated that cross-clamping is necessary in order to maintain visualization and a motionless surgical field for mitral valve repair. The purpose of this study was to determine the surgical feasibility of mitral valve repair without cross-clamping the aorta and using cardioplegia.

8q24 genetic variation and comprehensive haplotypes altering familial risk of prostate cancer.

The 8q24 genomic locus is tied to the origin of numerous cancers. We investigate its contribution to hereditary prostate cancer (HPC) in independent study populations of the Nashville Familial Prostate Cancer Study and International Consortium for Prostate Cancer Genetics (combined: 2,836 HPC cases, 2,206 controls of European ancestry). Here we report 433 variants concordantly associated with HPC in both study populations, accounting for 9% of heritability and modifying age of diagnosis as well as aggressiveness; 183 reach genome-wide significance.