Frailty in elderly patients with acute colonic diverticulitis is associated with worse in-hospital outcomes: a nationwide analysis.

Background: Frailty has been identified as an independent predictor of mortality in the elderly. We investigated the effects of frailty status on in-hospital outcomes of acute colonic diverticulitis (ACD) in the elderly, using the Hospital Frailty Risk Score.

Methods: We used the National Inpatient Sample (NIS) databases from 2016-2020 to identify patients aged ≥75 years hospitalized with ACD.

Association between smoking status and inpatient outcomes of acute cholangitis in the United States: a propensity matched analysis.

Background: Acute cholangitis (AC) is an infection of the biliary tract superimposed on stasis. This study aimed to investigate the effects of smoking on inpatient outcomes of AC.

Methods: We identified primary AC hospitalizations using the National Inpatient Sample database (2017-2020).

Comparative Pharmacokinetics of Commercially Available Cannabidiol Isolate, Broad-Spectrum, and Full-Spectrum Products.

Background And Objectives: A wide variety of products containing cannabidiol (CBD) are available on the commercial market. One of the most common products, CBD oil, is administered to self-treat a variety of conditions. These oils are available as CBD isolate, broad-spectrum [all terpenes and minor cannabinoids except Δ-9-tetrahydrocannabinol (THC)], or full-spectrum (all terpenes and minor cannabinoids with THC < 0.

Increasing inpatient mortality of nonvariceal upper gastrointestinal bleeding during the COVID-19 pandemic: a nationwide retrospective cohort study.

Upper gastrointestinal bleeding results in significant morbidity, mortality, and healthcare burden. This study aimed to evaluate inpatient outcomes of nonvariceal upper gastrointestinal bleeding (NVUGIB) during the year 2020 of the COVID-19 pandemic. The National Inpatient Sample databases were used to identify NVUGIB-related hospitalizations.

Pharmacokinetic and Pharmacodynamic Consequences of Cytochrome P450 3A Inhibition on Mitragynine Metabolism in Rats.

Mitragynine, an opioidergic alkaloid present in (kratom), is metabolized by cytochrome P450 3A (CYP3A) to 7-hydroxymitragynine, a more potent opioid receptor agonist. The extent to which conversion to 7-hydroxymitragynine mediates the in vivo effects of mitragynine is unclear. The current study examined how CYP3A inhibition (ketoconazole) modifies the pharmacokinetics of mitragynine in rat liver microsomes in vitro.

Preterm Neonate With Dexamethasone-Induced Acute Hypertrophic Cardiomyopathy and Cardiogenic Shock.

This case report describes an extremely low birth weight infant, born at 26-week gestational age, who developed hypertrophic cardiomyopathy (HCM) and cardiogenic shock a few hours after administration of a small dose of dexamethasone. Although cases of steroid-induced cardiomyopathy in preterm neonates are known in literature, their adverse effects are insidious and are transient in occurrence. This is the first report of HCM and cardiogenic shock occurring acutely after administration of small-dose dexamethasone.

Sporadic Dyschromatosis Universalis Hereditaria: A Second Case Report From Iran.

Dyschromatosis universalis hereditaria (DUH) is a rare pigmentary genodermatosis mostly reported from Japan. It is usually characterized by widespread hyper/hypopigmented macules all over the body. Here, we report the case of a patient from Iran who presented with disseminated hyper and hypopigmented lesions over the trunk, neck, and extremities since the age of eight.

Lean Methodology in Health Care.

To improve the delivery of patient care, governments and health-care institutions adopted quality improvement methods that had been developed decades earlier in manufacturing industries. Many health-care practitioners are either unaware or are inexperienced about what these practices entail and whether they are successful in health care. This article reviews Lean, an improvement philosophy made famous by the Toyota Motor Company.

Transfer of natalizumab into breast milk in a mother with multiple sclerosis.

Natalizumab (Tysabri) is a recombinant humanized antibody to α4-integrin that is approved by the Food and Drug Administration for the treatment of multiple sclerosis (MS) and Crohn disease. This is a case report of a 28-year-old woman with MS who was taking natalizumab (300 mg intravenously infused over 1 hour every 4 weeks) while breastfeeding her 11.5-month-old daughter 3 times a day.

Self-reported adherence to medications in a pediatric renal clinic: psychological aspects.

Background: Chronically ill children and adolescents comprise a vulnerable population that requires specific considerations in order to positively impact their treatment outcome. Pediatric renal patients can be non-compliant and also forgetful in taking their medications.

Objective: The objectives of the study were to (a) assess medication adherence and (b) to identify emotionality and variables that influence non-adherence by use of "The Child & Adolescent Adherence to Medication Questionnaire" (CAAMQ), which was constructed at Texas Tech University Health Sciences Center.

Transfer of carboplatin and paclitaxel into breast milk.

Carboplatin is an alkylating agent that is FDA approved for the treatment of advanced ovarian cancer. Paclitaxel is a plant taxane mitotic inhibitor approved for primary or salvage treatment of ovarian and breast cancer. This is a case report of a 40-year-old woman who was exclusively breastfeeding prior to being treated for papillary thyroid cancer with intravenous carboplatin (233 mg) and intravenous paclitaxel (30 mg/m(2)) for 6 consecutive weeks.

Infant feeding and contraceptive practices among adolescents with a high teen pregnancy rate: a 3-year retrospective study.

Background: Adolescents consistently demonstrate the lowest rates of breastfeeding among women of reproductive age despite well-documented benefits of breastfeeding. In Amarillo, Texas, a medium-sized community with a perennially high teen pregnancy rate, we sought (1) to determine breastfeedings practices among adolescent females immediately after delivery and again at 6 weeks and (2) to identify contraceptive choices among the same teen population.

Methods: This was a retrospective chart review focused on adolescents between the ages of 13 and 18 coming to a university-based obstetrical service between January 1, 2006, and December 31, 2008.

Intramural pregnancy presenting in a patient with tuberous sclerosis.

Intramural pregnancies are a rare form of ectopic pregnancy located within the myometrium separate from the endometrial cavity. In an effort to prevent potential complications, diagnosis should be made early when more conservative approaches can be performed to preserve reproductive potential. The diagnosis of ectopic pregnancies can be successfully accomplished through sonography; however, intramural pregnancies may be difficult to diagnose as they can appear similar to other etiologies.

Migration of an intrauterine contraceptive device during the course of pregnancy: a case report.

Uterine perforation by a contraceptive intrauterine device (IUD) is a relatively rare event. These events may result secondary to mechanical force applied during placement (primary perforation) or migration by uterine contractions or surgical manipulation after placement (secondary perforation). A 33-year-old woman with an IUD placed 9 years before admission visited the emergency department with an early pregnancy and a 3-day history of vaginal bleeding.

Differentiating seizure and convulsive syncope: the importance of history taking.

Distinguishing syncope with convulsions from a seizure disorder remains difficult. Convulsions occurring secondary to syncope typically result in an incorrect diagnosis of a seizure disorder. Available diagnostic testing often does not provide a conclusive answer; to ensure diagnostic accuracy, the careful and experienced clinician should obtain a patient history and physical examination.

Adult-onset idiopathic hypogonadotropic hypogonadism and pregnancy in a 35-year-old woman: a case report.

Background: Idiopathic hypogonadotropic hypogonadism (IHH) is a rare condition characterized by low gonadotropin production, absent or incomplete puberty and absence of a central nervous system tumor. An adult-onset form of IHH has been found previously only in men.

Case: A 35-year-old woman completed puberty and experienced monthly menstrual cycles for 5 years before developing hypogonadotropic secondary amenorrhea that lasted for 17 years.

Prenatal diagnosis of a neonate with fetus in fetu.

Fetus in fetu is a rare condition not usually considered in the differential of a neonatal abdominal mass. This article illustrates the importance of prenatal ultrasound in the treatment of this condition as it facilitated the assembly of a multispecialty healthcare team that intervened within days of birth.

Maternal serum free beta-hCG levels in uncomplicated pregnancies at the 10th-15th week of gestation and the development of obstetric complications.

Objective: To determine if free beta-human chorionic gonadotropin (hCG) serum levels at the 10th-14th week of gestation were different in groups of women who had experienced pregnancy complications.

Study Design: The obstetric records of women who had uncomplicated pregnancies when they consented to donate blood for biochemical research purposes early in pregnancy were reviewed. Two hundred thirteen of these women had donated blood at the 10th-14th week of gestation.

The administrative colloquium: developing management and leadership skills for faculty.

Objective: Development of leadership competencies has become a priority for many academic health science centers. However, traditional faculty development has focused almost exclusively on improving teaching skills. The process and outcomes of developing leadership skills for academic health science center faculty has not been extensively studied.

The association between cotton and prevalence of rural childhood asthma.

In the United States, asthma now ranks as the most prevalent chronic disease among children. Within rural cotton-producing regions, a popular belief is that cotton production increases the prevalence of asthma. This case-control study was conducted to determine if the prevalence of asthma is higher in children living in rural cotton-producing countries than in children where cotton production is negligible.

Primary hyperparathyroidism, hypercalcemic crisis and subsequent seizures occurring during pregnancy: a case report.

A first-trimester primigravid patient presented with hyperemesis and malaise. Work-up was consistent with primary hyperparathryoidism. During acute treatment, she developed generalized motor seizures considered to be secondary to hypercalcemia.

Influenza in the nursing home.

Although influenza affects persons of all ages, the Centers for Disease Control and Prevention has identified several groups who are at increased risk for complications. One such group is residents of nursing homes or other long-term care facilities. During influenza epidemics, mortality rates among nursing home residents often exceed 5 percent.