Impact of Pharmacist Expertise on Acceptance Rates in a Comprehensive E-Consult Program within a Large Academic Health System.

Although electronic consults (e-consults) are utilized in healthcare systems by medical professionals, use of e-consults by pharmacy remains novel outside of niche disease states. Additional research is required to fill literature gaps to assist in optimizing the pharmacist's role in e-consult programs. This study aimed to assess the impact of pharmacist expertise on e-consult outcomes.

Long-term Renal Function Outcomes After Stereotactic Ablative Body Radiotherapy for Primary Renal Cell Carcinoma Including Patients with a Solitary Kidney: A Report from the International Radiosurgery Oncology Consortium of the Kidney.

Background And Objective: Renal function preservation is particularly important following nonoperative treatment of localized renal cell carcinoma (RCC) since patients are often older with medical comorbidities. Our objective was to report long-term renal function outcomes after stereotactic ablative radiotherapy (SABR) including patients with a solitary kidney.

Methods: Patients with primary RCC treated with SABR with ≥2 yr of follow-up at 12 International Radiosurgery Consortium for Kidney institutions were included.

Age-related Changes of GAD1 mRNA Expression in the Central Inferior Colliculus.

Encoding sounds with a high degree of temporal precision is an essential task for the inferior colliculus (IC) to perform and maintain the accurate processing of sounds and speech. However, the age-related reduction of GABAergic neurotransmission in the IC interrupts temporal precision and likely contributes to presbycusis. As presbycusis often manifests at high or low frequencies specifically, we sought to determine if the expression of mRNA for glutamic decarboxylase 1 (GAD1) is downregulated non-uniformly across the tonotopic axis or cell size range in the aging IC.

Diagnosis of metaplastic synovial cysts in clinical dermatology.

Metaplastic synovial cysts are a rare clinical finding, with less than 70 cases diagnosed to date. These cysts are painful and can greatly impact patients' quality of life. The goal of this case report is to describe the manifestations of these cysts to aid in clinical diagnosis and management.

Risk of venous thromboembolism in pediatric hospitalized patients undergoing noncardiac surgery: A report from the Children's Hospital-Acquired Thrombosis consortium.

Background: Surgery is a known risk factor for hospital-acquired venous thromboembolism (HA-VTE) in children.

Objectives: To assess whether the odds of HA-VTE differs across six anatomic sites of noncardiac surgery and to identify risk factors for HA-VTE in these children.

Methods: This was a multicenter, case-control study.

Patent Ductus Arteriosus Stent Versus Surgical Aortopulmonary Shunt for Initial Palliation of Cyanotic Congenital Heart Disease with Ductal-Dependent Pulmonary Blood Flow: A Systematic Review and Meta-Analysis.

Background In patients with ductal-dependent pulmonary blood flow, initial palliation includes catheter-based patent ductus arteriosus (PDA) stent or surgical aortopulmonary shunt (APS). This meta-analysis aimed to compare outcomes between PDA stent and APS. Methods and Results A comprehensive literature search yielded six retrospective observational studies.

Improving risk prediction for pulmonary embolism in COVID-19 patients using echocardiography.

SARS-CoV-2 infection is associated with increased risk for pulmonary embolism (PE), a fatal complication that can cause right ventricular (RV) dysfunction. Serum D-dimer levels are a sensitive test to suggest PE, however lacks specificity in COVID-19 patients. The goal of this study was to identify a model that better predicts PE diagnosis in hospitalized COVID-19 patients using clinical, laboratory, and echocardiographic imaging predictors.

Acute phlegmonous gastritis: A case report.

Acute phlegmonous gastritis (APG) is an extremely uncommon and potentially rapid fatal systemic infection with very few reported cases in the literature. This case report demonstrates a case of idiopathic APG in an afebrile, otherwise healthy individual that resolved with broad-spectrum antibiotic therapy and did not require operative management.

Procedural frequency: Results from 18 academic, community and freestanding emergency departments.

Background: Emergency physicians must maintain procedural skills, but clinical opportunities may be insufficient. We sought to determine how often practicing emergency physicians in academic, community and freestanding emergency departments (EDs) perform 4 procedures: central venous catheterization (CVC), tube thoracostomy, tracheal intubation, and lumbar puncture (LP).

Methods: This was a retrospective study evaluating emergency physician procedural performance over a 12-month period.

Estimates of throughput and utilization at freestanding compared to low-volume hospital-based emergency departments.

Objective: Our investigation compared throughput metrics and utilization measures for freestanding emergency departments (FSEDs) versus hospital-based emergency departments (HBEDs) of similar volumes in the United States.

Methods: This study is a cross sectional survey of 183 FSEDs and 317 HBEDs located across the United States using the Emergency Department Benchmarking Alliance (EDBA) Database. We measured common emergency department (ED) throughput metrics.

Utility of specific amino acid ratios in screening for pyruvate dehydrogenase complex deficiencies and other mitochondrial disorders associated with congenital lactic acidosis and newborn screening prospects.

Pyruvate dehydrogenase complex deficiencies (PDCDs) and other mitochondrial disorders (MtDs) can (a) result in congenital lactic acidosis with elevations of blood alanine (Ala) and proline (Pro), (b) lead to decreased ATP production, and (c) result in high morbidity and mortality. With ~140,000 live births annually in Ohio and ~1 in 9,000 overall prevalence of MtDs, we estimate 2 to 3 newborns will have PDCD and 13 to 14 others likely will have another MtD annually. We compared the sensitivities of plasma amino acids (AA) Alanine (Ala), Alanine:Leucine (Ala:Leu), Alanine:Lysine and the combination of Ala:Leu and Proline:Leucine (Pro:Leu), in subjects with known primary-specific PDCD due to and mutations vs controls.

The role of the community pharmacist in veterinary patient care: a cross-sectional study of pharmacist and veterinarian viewpoints.

Background: The role of the community pharmacist is rapidly expanding to encompass the care of veterinary patients in the United States of America This change makes it imperative for pharmacists and veterinarians who practice in community settings to establish mutual agreement on the roles of pharmacists in the care of these patients.

Objective: To examine community-based pharmacist and veterinarian viewpoints on interprofessional collaboration and the role of the community pharmacist in veterinary patient care.

Methods: Cross-sectional surveys were sent to pharmacists and veterinarians who practice in a community setting in Ohio.

What smells? Developing in-field methods to characterize the chemical composition of wild mammalian scent cues.

Olfactory cues play an important role in mammalian biology, but have been challenging to assess in the field. Current methods pose problematic issues with sample storage and transportation, limiting our ability to connect chemical variation in scents with relevant ecological and behavioral contexts. Real-time, in-field analysis portable gas chromatography-mass spectrometry (GC-MS) has the potential to overcome these issues, but with trade-offs of reduced sensitivity and compound mass range.

Anemia from A to zinc: Hypocupremia in the setting of gastric bypass and zinc excess.

Hypocupremia can result in a bi-lineage deficiency of leukocytes and erythrocytes. Although commonly seen from gastrointestinal malabsorption, hypocupremia can be further exacerbated with excessive zinc intake causing increased fecal copper excretion. Dietary supplementation is prevalent in the outpatient setting and must be considered as a possible source of hematologic pathologies.

Hepatocyte-Specific Expression of Human Carboxylesterase 1 Attenuates Diet-Induced Steatohepatitis and Hyperlipidemia in Mice.

Rodents have at least five carboxylesterase 1 () genes, whereas there is only one gene in humans, raising the question as to whether human and mouse genes share the same functions. In this study, we investigate the role of human CES1 in the development of steatohepatitis or dyslipidemia in C57BL/6 mice. Hepatocyte-specific expression of human CES1 prevented Western diet or alcohol-induced steatohepatitis and hyperlipidemia.

Bile Acid Biology, Pathophysiology, and Therapeutics.

http://aasldpubs.onlinelibrary.wiley.

Ureteral Polyp Managed by Endoscopic Techniques.

Fibroepithelial polyps (FEPs) are rare benign tumors of mesodermal origin. They are found in the ureters 85% of the time, with the remainder located in the renal pelvis and occasionally the bladder. FEPs can present as flank pain, lower abdominal pain, and/or gross hematuria.

Symptomatic Rosai-Dorfman Disease Presenting as Isolated Bilateral Perinephric Infiltration.

This case explores a rare initial presentation of Rosai-Dorfman disease isolated to the peri-renal space. Also described as sinus histiocytosis with massive lymphadenopathy, Rosai-Dorfman disease is non-neoplastic and most often presents with massive cervical lymphadenopathy, but the disease can affect any organ system. Not often considered by those in the urology community or found in urology journals, this report reviews a clinical presentation of Rosai-Dorfman disease affecting bilateral kidneys and the fundamental histopathology needed for its diagnosis.

Lipocalin-2 Protects Against Diet-Induced Nonalcoholic Fatty Liver Disease by Targeting Hepatocytes.

Hepatocytes are the major source of hepatic lipocalin-2 (LCN2), which is up-regulated in response to inflammation, injury, or metabolic stress. So far, the role of hepatocyte-derived LCN2 in the development of nonalcoholic fatty liver disease (NAFLD) remains unknown. Herein we show that overexpression of human LCN2 in hepatocytes protects against high fat/high cholesterol/high fructose (HFCF) diet-induced liver steatosis and nonalcoholic steatohepatitis by promoting lipolysis and fatty acid oxidation (FAO) and inhibiting lipogenesis (DNL), lipid peroxidation, and apoptosis.

Adipose-Specific Lipin-1 Overexpression Renders Hepatic Ferroptosis and Exacerbates Alcoholic Steatohepatitis in Mice.

Lipin-1 is a Mg-dependent phosphatidic acid phosphohydrolase involved in the generation of diacylglycerol during synthesis of phospholipids and triglycerides. Ethanol-mediated inhibitory effects on adipose-specific lipin-1 expression were associated with experimental steatohepatitis in rodents. In the present study, using an adipose-specific lipin-1 overexpression transgenic (-Tg) mouse model, we tested a hypothesis that adipose-specific lipin-1 overexpression in mice might dampen ethanol-induced liver damage.

A systematic review: the appraisal of the effects of metformin on lipoprotein modification and function.

Aims: Metformin is a commonly prescribed anti-hyperglycaemic pharmacological agent, and it remains a staple in the management of type II diabetes. In addition to metformin's glucose lowering effects, research has indicated that metformin inhibits glycation-mediated and oxidative modification of lipoprotein residues. The purpose was to discuss the effects of metformin as it relates to high-density lipoprotein (HDL) and low-density lipoprotein (LDL) modification.

White Paper-Geriatric Emergency Medicine Education: Current State, Challenges, and Recommendations to Enhance the Emergency Care of Older Adults.

Older adults account for 25% of all emergency department (ED) patient encounters. One in five Americans will be 65 or older by 2030. In response to this need, geriatric emergency medicine (GEM) has developed into a robust area of academic and clinical interest, with extensive evidence-based research and guidelines, including clear undergraduate and postgraduate GEM competencies.