COVID-19 Infection and Simultaneous Worsening of Pre-Existing Neurologic Conditions: A Case Report Series.

Viral infection commonly causes exacerbation of chronic conditions. However, this is not yet well reported in patients with a SARS-CoV2-infection and a history of a chronic neurologic disorder. At our institute, we had a patient presenting with more definitive upper respiratory symptoms and no history of vaccination, while the other patient was a breakthrough case with minimal pulmonary symptoms.

Point-of-Care Ultrasound Use by EMS Providers in Out-of-Hospital Cardiac Arrest.

Aim: Paramedics received training in point-of-care ultrasound (POCUS) to assess for cardiac contractility during management of medical out-of-hospital cardiac arrest (OHCA). The primary outcome was the percentage of adequate POCUS video acquisition and accurate video interpretation during OHCA resuscitations. Secondary outcomes included POCUS impact on patient management and resuscitation protocol adherence.

The Effects of Pre-medical Anatomy and Clinical Experiences on Medical School Anatomy-Related Academic Performance.

Purpose: The objective of this study was to examine the effects that pre-medical patient care clinical experiences and anatomical education had on undergraduate medical course grades and anatomy practical exam scores. This study provides a unique perspective to this line of inquiry in that it included data from 9 class year cohorts between academic years 2010-2011 and 2018-2019, all from a single institution.

Methods: A survey to assess pre-medical clinical and anatomical experiences was completed by each new matriculate.

Potential Therapeutic Targets for Combination Antibody Therapy against Infections.

Despite advances in antimicrobial therapy and even the advent of some effective vaccines, remains a significant cause of infectious disease, primarily due to antibiotic resistance. Although is commonly treatable with readily available therapeutics, these therapies are not always efficacious, particularly for certain classes of patients (e.g.

Real World Utilization of Bamlanivimab at a Rural Community Hospital.

Introduction Although there were several proposed treatments for patients that were hospitalized with COVID-19, outpatient treatments for those with mild to moderate illness were limited prior to the emergency use authorization (EUA) of virus-neutralizing monoclonal antibodies. To assess the efficacy of outpatient monoclonal therapy, the investigators assessed the seven, 14, and 28-day emergency department and hospitalization rates of adult patients given bamlanivimab for the treatment of COVID-19 at a community hospital. Methods A retrospective chart review was performed of all adult patients given bamlanivimab within the emergency department or an outpatient infusion center from December 2, 2020 through January 8, 2021 for the treatment of mild to moderate COVID-19.

Pancreatic fat relates to fasting insulin and postprandial lipids but not polycystic ovary syndrome in adolescents with obesity.

Objective: Adolescents with polycystic ovary syndrome (PCOS) and obesity can have insulin resistance, dysglycemia, and hepatic steatosis. Excess pancreatic fat may disturb insulin secretion and relate to hepatic fat. Associations between pancreatic fat fraction (PFF) and metabolic measures in PCOS were unknown.

An Analysis of US Academic Medical Center Websites: Usability Study.

Background: Health care organizations are tasked with providing web-based health resources and information. Usability refers to the ease of user experience on a website. In this study, we conducted a usability analysis of academic medical centers in the United States, which, to the best of our knowledge, has not been previously carried out.

Brush swab as a noninvasive surrogate for tissue biopsies in epigenomic profiling of oral cancer.

Background: Oral squamous cell carcinoma (OSCC) has poor survival rates. There is a pressing need to develop more precise risk assessment methods to tailor clinical treatment. Epigenome-wide association studies in OSCC have not produced a viable biomarker.

Hypotension during propofol sedation for colonoscopy: a retrospective exploratory analysis and meta-analysis.

Background: Intraoperative and postoperative hypotension occur commonly and are associated with organ injury and poor outcomes. Changes in arterial blood pressure (BP) during procedural sedation are not well described.

Methods: Individual patient data from five trials of propofol sedation for colonoscopy and a clinical database were pooled and explored with logistic and linear regression.

Epigenetic Modifications at the Center of the Barker Hypothesis and Their Transgenerational Implications.

Embryo/fetal nutrition and the environment in the reproductive tract influence the subsequent risk of developing adult diseases and disorders, as formulated in the Barker hypothesis. Metabolic syndrome, obesity, heart disease, and hypertension in adulthood have all been linked to unwanted epigenetic programing in embryos and fetuses. Multiple studies support the conclusion that environmental challenges, such as a maternal low-protein diet, can change one-carbon amino acid metabolism and, thus, alter histone and DNA epigenetic modifications.

Superb Microvascular Imaging-Based Vascular Index to Assess Adult Hepatic Steatosis: A Feasibility Study.

The aim of the study was to assess the feasibility of using a superb microvascular imaging-based vascular index (SMI-VI) for evaluating adult hepatic steatosis. We prospectively compared liver parenchyma SMI-VI (color pixels/total pixels in the region of interest), portal vein velocity, hepatic artery Doppler parameters (peak systolic velocity, end diastolic velocity, resistive index) and serum lipid and alanine aminotransferase (ALT) levels between 16 normal livers and 34 steatotic livers using magnetic resonance imaging-proton density fat fraction (MRI-PDFF) as the reference. On the basis of a two-tailed t-test, differences in SMI-VI, portal vein velocity, MRI-PDFF and ALT between normal (MRI-PDFF <5%) and steatotic (MRI-PDFF ≥5%) livers were statistically significant (p < 0.

Efficacy of hyoscine in pain management during hysteroscopy: a systematic review and meta-analysis.

We conducted a systematic review and meta-analysis of relevant clinical trials from full-text, scientific journal archives to assess the efficacy of hyoscine for the management of pain during in-office hysteroscopy (OH) procedures. Cochrane CENTRAL, ClinicalTrials.Gov, MEDLINE, PubMed, SCOPUS and the Web of Science were searched for all clinical trials that matched our search criteria.

Social Media and Clinical Research in Dermatology.

Purpose Of Review: The immense growth of social media has afforded new opportunities in dermatology clinical research. This review serves to outline how social media has impacted clinical research and to explore future avenues for which social media can make a significant impact in dermatology clinical research.

Recent Findings: Recent clinical trials augmented by social media have demonstrated increased participant enrollment, shortened recruitment timelines, and decreased recruitment cost.

The Evolution and Future of Targeted Cancer Therapy: From Nanoparticles, Oncolytic Viruses, and Oncolytic Bacteria to the Treatment of Solid Tumors.

While many classes of chemotherapeutic agents exist to treat solid tumors, few can generate a lasting response without substantial off-target toxicity despite significant scientific advancements and investments. In this review, the paths of development for nanoparticles, oncolytic viruses, and oncolytic bacteria over the last 20 years of research towards clinical translation and acceptance as novel cancer therapeutics are compared. Novel nanoparticle, oncolytic virus, and oncolytic bacteria therapies all start with a common goal of accomplishing therapeutic drug activity or delivery to a specific site while avoiding off-target effects, with overlapping methodology between all three modalities.

Amino Acid Transport and Metabolism Regulate Early Embryo Development: Species Differences, Clinical Significance, and Evolutionary Implications.

In this review we discuss the beneficial effects of amino acid transport and metabolism on pre- and peri-implantation embryo development, and we consider how disturbances in these processes lead to undesirable health outcomes in adults. Proline, glutamine, glycine, and methionine transport each foster cleavage-stage development, whereas leucine uptake by blastocysts via transport system B promotes the development of trophoblast motility and the penetration of the uterine epithelium in mammalian species exhibiting invasive implantation. (Amino acid transport systems and transporters, such as B, are often oddly named.

Provider Perceptions of Barriers to HIV Care Among Women with HIV in Miami-Dade County, Florida, and Possible Solutions: A Qualitative Study.

In Miami-Dade County, women with HIV (WWH) enrolled in Ryan White Program (RWP) services belong to groups that have historically faced structural barriers to care. To examine provider perceptions of WWH's barriers to care and elicit possible solutions, we conducted semi-structured interviews (n = 20) with medical case managers and human immunodeficiency virus (HIV) healthcare providers from medical case management sites serving WWH enrolled in the Miami-Dade RWP. Verbatim transcripts were analyzed thematically by two coders through an iterative process; disagreements were resolved through consensus.

A Scoping Review of Emergency Department Discharge Risk Stratification.

Introduction: Although emergency department (ED) discharge presents patient-safety challenges and opportunities, the ways in which EDs address discharge risk in the general ED population remains disparate and largely uncharacterized. In this study our goal was to conduct a review of how EDs identify and target patients at increased risk at time of discharge.

Methods: We conducted a literature search to explore how EDs assess patient risk upon discharge, including a review of PubMed and gray literature.

Delayed care in myocardial infarction and ischemic stroke patients during the COVID-19 pandemic.

Unlabelled: COVID-19 has profound direct health consequences, however secondary effects were much broader as rates of hospital visits steeply declined for non-COVID-19 concerns, including myocardial infarction (MI) and stroke, with patients choosing to wait longer before symptoms convince them to seek medical attention. Thus, patients where ischemia leads to tissue loss should be a major concern.

Methods: The months of March to June 2019 and 2020 were compared to each other at 4 Denver area hospitals.

Myofunctional therapy for OSA: a meta-analysis.

Introduction: Myofunctional therapy (MT) improves obstructive sleep apnea (OSA) in patients.

Areas Covered: We systematically reviewed publications to evaluate MT as a treatment for OSA. We identified relevant articles and performed a meta-analysis on apnea-hypopnea index (AHI) scores, lowest oxygen saturation (LSAT), and Epworth Sleepiness Scale (ESS).