Inactivation of Zika Virus with Hydroxypropyl-Beta-Cyclodextrin.

: Zika virus (ZIKV) infection is associated with life-threatening diseases in humans. To date, there are no available FDA-approved therapies or vaccines for the specific treatment or prevention of ZIKV infection. Variation in the ZIKV envelope protein (Env), along with its complex quaternary structure, presents challenges to synthetic approaches for developing an effective vaccine and broadly neutralizing antibodies (bnAbs).

Primary breast osteosarcoma: A case report highlighting the importance of radiologic-pathologic correlation.

Osteosarcoma of primary breast origin is a rare form of malignancy. Imaging findings are nonspecific and often overlap with other differential considerations reinforcing the importance of radiologic-pathologic correlation for an accurate diagnosis. This case report details the clinical presentation, imaging findings, histopathological features, and therapeutic approach that transpired to diagnose and treat this rare malignancy.

Unlocking Rural Live-Kidney Donation Through Insights From a Decade-Long Analysis at a Single Center in the Northern Great Plains.

Background: Data on barriers to live-kidney donation in the rural United States is limited despite its widespread adoption across the country.

Methods: A retrospective review of 1776 self-referrals for live-kidney donation between June 1, 2012, and May 31, 2022, was conducted. Multivariate analyses evaluated independent factors which may have potentially influenced donation at different stages in its process.

Advanced Cardiac Imaging Modalities: A Brief Review for the Primary Care Physician.

Advanced cardiac imaging modalities have revolutionized the field of cardiovascular medicine, offering invaluable tools for both diagnosis and the management of a wide spectrum of cardiovascular diseases. These imaging methods, including echocardiography, cardiac computed tomography (CT), computed tomography angiography (CTA), cardiac magnetic resonance imaging (MRI), nuclear imaging, and fluoroscopy, offer various approaches to evaluate both the structure and function of the heart. This article provides an overview of imaging modalities for primary care physicians, highlighting their types, advantages, limitations and clinical uses.

Do We Need a Fluid Bolus? The Necessary Refinement of Pediatric Propofol Sedation - a Quality Improvement Project.

Background: Propofol is commonly used for pediatric MRIs to minimize patient movement. At our institution, intensivists typically administer a prophylactic 20 ml/kg saline bolus to maintain blood pressure (BP) during propofol sedation. This quality improvement project assessed whether a 10 ml/kg and a completely eliminated saline bolus are as effective as the standard 20 ml/kg bolus in completing pediatric propofol sedation and maintaining Mean Arterial Pressure (MAP).

Tularemia in a Psoriasis Patient on Biologic Therapy After Relocation to Western South Dakota.

Background: Francisella tularensis is an aerobic, gram negative coccobacillus bacterium that causes tularemia. F. tularensis spreads primarily through ticks, biting flies, droplet inhalation, contaminated mud or water, or infected animal bites, and it can survive in animal carcasses with the most common mode of transmission occurring via inoculation into the skin and inhalation/ingestion.

Improving Access to Palliative Care through Education and Training.

The population is aging, especially in rural areas where people experience higher rates of mortality and chronic illness as well as greater distances to care, including specialty care. Since there is a lack of access to specialty palliative care, all clinicians must be trained to provide the fundamentals of palliative care to improve quality of life and limit suffering. Numerous options are available for clinicians to be trained in palliative care.

A Survey of Employed Orthopedic Surgeons Ability to Estimate Operating Room Device Costs.

Background: Orthopaedic devices represent a large amount of the overall cost incurred in the operating room. It is unknown if employed sports medicine surgeons are aware of the true prices of these devices. The purpose of this study was to assess sports medicine orthopaedic surgeons' knowledge of implant and device costs, as well of commonly used items in their operating rooms.

Cough-hypersensitivity Syndrome-A New Paradigm in the Evaluation of Chronic Refractory Cough and Its Novel Therapeutic Horizons-A Review.

Chronic cough is defined as a persistent cough, lasting beyond 8 weeks, poses a global health challenge, impacting a substantial portion of the world's population. In the United States, it stands as a prominent cause for numerous visits to primary care and pulmonology clinics, imposing a significant healthcare burden and utilizing valuable resources. While chronic cough can be indicative of serious underlying lung conditions, once serious pulmonary diseases are excluded, the leading culprits are often identified as gastroesophageal reflux, upper airway cough syndrome, and eosinophilic airway inflammation.

The structure and function of the ghrelin receptor coding for drug actions.

Drugs targeting the ghrelin receptor hold therapeutic potential in anorexia, obesity and diabetes. However, developing effective drugs is challenging. To tackle this common issue across a broad drug target, this study aims to understand how anamorelin, the only approved drug targeting the ghrelin receptor, operates compared to other synthetic drugs.

Participatory Modeling for High Complexity, Multi-System Issues: Challenges and Recommendations for Balancing Qualitative Understanding and Quantitative Questions.

Community stakeholder participation can be incredibly valuable for the qualitative model development process. However, modelers often encounter challenges for participatory modeling projects focusing on high-complexity, synergistic interactions between multiple issues, systems, and granularity. The diverse stakeholder perspectives and volumes of information necessary for developing such models can yield qualitative models that are difficult to translate into quantitative simulation or clear insight for informed decision-making.

Cholesterol deficiency directs autophagy-dependent secretion of extracellular vesicles.

Extracellular vesicle (EV) secretion is an important, though not fully understood, intercellular communication process. Lipid metabolism has been shown to regulate EV activity, though the impact of specific lipid classes is unclear. Through analysis of small EVs (sEVs), we observe aberrant increases in sEV release within genetic models of cholesterol biosynthesis disorders, where cellular cholesterol is diminished.

Assessing the effectiveness of a rural distribution program in reducing time to prothrombin complex concentrate administration in patients taking warfarin.

Study Objectives: Reversal of warfarin-induced anticoagulation using prothrombin complex concentrate (PCC4) is more rapidly achieved than with traditional methods such as fresh frozen plasma (FFP). In many rural facilities the availability of both FFP and PCC4 has been limited. A tertiary hospital instituted a program to provide PCC4 to rural sites using an air transport team and pharmacy exchange.

Advancement in the Treatment of Recurrent Pericarditis: Exploring Innovative Therapeutic Options.

Acute pericarditis, the predominant pericardial disease, often lacks a clear etiology, with 15-30% of patients experiencing recurrence, rising to 20-50% in those with prior relapses. Autoimmune mechanisms significantly contribute to recurrence, with interleukin-1 identified as a pivotal inflammatory mediator. While NSAIDs, colchicine, and steroids remain staples for acute cases, the spotlight in recurrent pericarditis management has shifted toward immunosuppressive medications.

A Review of Current Treatment Options for Stage III and Stage IV Metastatic Melanoma.

The incidence of melanoma has increased for decades, and while surgical treatment of early stage disease is often curative, metastatic disease continues to have significant morbidity and mortality and carries a high associated health burden and economic cost. An expanding number of dermatologists are playing a key role in coordinating the care of patients with advanced melanoma, including in the setting of multidisciplinary melanoma clinics, many of which are anchored in dermatology departments. Advances in the understanding of the genetic and immunoregulatory aspects of melanoma development and progression have yielded a wave of novel therapeutics that has made significant impact on the approach to patients with metastatic disease.

Induced Resistance of Ocular Surface Flora in Patients Undergoing Cataract Surgery.

Purpose: This study investigated the effects of pre-operative topical moxifloxacin prior to cataract surgery on the growth of ocular surface bacteria and induced antibiotic resistance after a 3-day course of moxifloxacin.

Methods: The study was a prospective, dual arm, randomized study. The study group of 17 patients used moxifloxacin four times daily, for three days prior to surgery.

A Rare Case of Hypopharyngeal Hamartoma Causing Acute Airway Obstruction.

A hamartoma is a benign tumor of tissue resembling the site of origin, despite exhibiting disorganized architecture. While benign, symptoms typically arise from mass effects. They are often found in the lower gastrointestinal tract and are a rare finding in the pharynx and larynx.

A Case of Skin Limited IgA Vasculitis in an 84-Year-Old Female.

IgA vasculitis is a small vessel vasculitis and while it represents the most common form of vasculitis in pediatric populations, it is rare in adults. This manuscript describes a case of skin limited IgA vasculitis in an 84-yearold Caucasian female. The patient presented for bilateral lower extremity rash that occurred roughly one month following a viral upper respiratory illness.

Orf Infection (Ecthyma Contagiosum) Transmitted from Sheep to Child: A Case Report.

Orf is a parapoxvirus endemically found in sheep and goats. Orf can be transmitted to humans in close contact with infected animals, causing a self-limited viral skin infection known as ecythyma contagiosum. The diagnosis can be made clinically and treatment is usually conservative; however, unfamiliarity with orf may lead to an extended work-up.

The Development of Immobilization Induced Hypercalcemia in the Outpatient Setting - A Case Report.

Immobilization induced hypercalcemia is an uncommon and serious disorder that requires a thorough evaluation to exclude more common causes of an elevated calcium. Although the pathogenesis is not clearly illuminated, immobilization results in an uncoupling between osteogenic and osteoclastic factors that maintain bone homeostasis. When calcemic bone resorption overwhelms urinary calcium excretion, blood hypercalcemia ensues.

Water Quality and Kidney Health in Farming Communities.

Since the turn of the century, there has been an increase in the frequency of chronic interstitial nephritis in agricultural communities. This is particularly evident in young farm workers from equatorial regions, where the prevalence of chronic kidney disease cannot be explained by classical risk determinants or exposure to heat stress alone. Potentially causal agents have included organic and inorganic drinking water contaminants.

SGLT-2 Inhibitors: A Narrative Review.

SGLT2 inhibitors have emerged as a remarkable class of drugs, revolutionizing the management of various medical conditions beyond their initial purpose of controlling diabetes. With their proven benefits in cardiovascular health, kidney disease, hypertension, and even potential applications in cancer treatment, SGLT2 inhibitors have broadened their scope. While concerns about adverse effects and contraindications exist, these medications hold great promise for a diverse range of patients.

Eczema Herpeticum: A Fatal Rash That Mimics Many.

Eczema herpeticum (EH) is a potentially life-threatening condition, especially in the pediatric population, that occurs among patients with atopic dermatitis (AD). AD is a chronic inflammatory skin disorder with a complex pathophysiology that predisposes patients to EH. Herpes simplex virus (HSV) 1 is implicated in 90 % of EH cases and often initially presents with gingivostomatitis.

2024 Scholars' Research Symposium Abstract: Education on the Understanding of Noise-Induced Hearing Loss in Vulnerable Undergraduate Population.

Introduction: With the introduction of increasingly powerful audio equipment and increase of personal mobile audio devices in the 21st century, the prevalence of noise-induced hearing loss (NIHL) in young adults is expected to increase. This increase, estimated to impact 30 million adults in the next four decades, is due in part to recreational exposure. While many young adults have a general understanding of NIHL, a detailed education on various topics of NIHL could further promote adherence to the use of preventive measures.