Efficacy and safety of balloon dilation of eustachian tube in children: Systematic review and meta-analysis.

Objectives: Eustachian tube dysfunction is a common condition that may lead to otitis media with effusion, hearing loss and developmental delays in children. We sought to determine the efficacy and safety of balloon dilation of the eustachian tube (BDET) in the pediatric population.

Data Sources: Original studies of BDET in a pediatric population were identified in PubMed, Embase, Web of Science, Cochrane, Clinicaltrials.

IL-17RA-signaling in Lgr5 intestinal stem cells induces expression of transcription factor ATOH1 to promote secretory cell lineage commitment.

The Th17 cell-lineage-defining cytokine IL-17A contributes to host defense and inflammatory disease by coordinating multicellular immune responses. The IL-17 receptor (IL-17RA) is expressed by diverse intestinal cell types, and therapies targeting IL-17A induce adverse intestinal events, suggesting additional tissue-specific functions. Here, we used multiple conditional deletion models to identify a role for IL-17A in secretory epithelial cell differentiation in the gut.

Testicular Necrosis Post Kidney Transplantation: Lessons Learned.

There is a paucity of literature on testicular complications after kidney transplant. Testicular necrosis after kidney transplantation has only been reported twice before. We present a 60- year-old man with end-stage renal disease who underwent uneventful deceased-donor kidney transplant.

Clinical Utility of Subcutaneous Factor VIII Replacement Therapies in Hemophilia A: A Review of the Evidence.

Hemophilia therapies have tremendously improved over the last decades with the development of prolonged half-life factor VIII (FVIII) and FIX concentrates, non-factor therapies, such as emicizumab, anti-TFPI antibodies or siRNA antithrombin and gene therapy. All of these new molecules significantly reduced the burden of the disease and improved the quality of life of patients with severe hemophilia. Emicizumab, a non-factor therapy, is currently the only subcutaneous molecule available for prophylactic treatment of severe hemophilia A.

Effective Prophylaxis of COVID-19 in Rhesus Macaques Using a Combination of Two Parenterally-Administered SARS-CoV-2 Neutralizing Antibodies.

SARS-CoV-2 is a respiratory borne pathogenic beta coronavirus that is the source of a worldwide pandemic and the cause of multiple pathologies in man. The rhesus macaque model of COVID-19 was utilized to test the added benefit of combinatory parenteral administration of two high-affinity anti-SARS-CoV-2 monoclonal antibodies (mAbs; C144-LS and C135-LS) expressly developed to neutralize the virus and modified to extend their pharmacokinetics. After completion of kinetics study of mAbs in the primate, combination treatment was administered prophylactically to mucosal viral challenge.

The effect of hydroxyapatite on titanium pedicle screw resistance: an electrical model.

Background Context: Intraoperative detection of a pedicle wall breach implicitly reduces surgical risk, but the reliability of intraoperative neuromonitoring has been contested. Hydroxyapatite (HA) has been promulgated to increase pedicle screw resistance and negatively influence the accuracy of electromyography.

Purpose: The primary purpose of this experiment is to evaluate the effect of HA on pedicle screw electrical resistance using a controlled laboratory model.

Age-Dependent Changes in Bone Architecture, Patterning, and Biomechanics During Skeletal Regeneration.

Mouse digit amputation provides a useful model of bone growth after injury, in that the injury promotes intramembranous bone formation in an adult animal. The digit tip is composed of skin, nerves, blood vessels, bones, and tendons, all of which regenerate after digit tip amputation, making it a powerful model for multi-tissue regeneration. Bone integrity relies upon a balanced remodeling between bone resorption and formation, which, when disrupted, results in changes to bone architecture and biomechanics, particularly during aging.

The Impact of Early-Life Exposures on Women's Reproductive Health in Adulthood.

Purpose Of Review: To review the effects of early-life, preconception, and prior-generation exposures on reproductive health in women.

Recent Findings: Women's early-life factors can affect reproductive health by contributing to health status or exposure level on entering pregnancy. Alternately, they can have permanent effects, regardless of later-life experience.

Haemostatic effect of adding tranexamic acid to emicizumab prophylaxis in severe haemophilia A: A preclinical study.

Background: Patients with severe haemophilia have impaired haemostatic response, delayed clot formation and fibrin clots that are vulnerable to fibrinolysis. Emicizumab is a bispecific antibody that mimics activity of activated factor VIII (FVIII) and increases haemostatic capacity to the level of moderate-to-mild haemophilia, thereby used for prophylaxis. Regardless of the impressive clinical performance of emicizumab, breakthrough bleeds may still occur.

Particle Dynamics and Bioaerosol Viability of Aerosolized Bacillus Calmette-Guérin Vaccine Using Jet and Vibrating Mesh Clinical Nebulizers.

Bacillus Calmette-Guérin (BCG) is a vaccine used to protect against tuberculosis primarily in infants to stop early infection in areas of the world where the disease is endemic. Normally administered as a percutaneous injection, BCG is a live significantly attenuated bacteria that is now being investigated for its potential within an inhalable vaccine formulation. This study investigates the feasibility and performance of two jet and two vibrating mesh nebulizers aerosolizing BCG and the resulting particle characteristics and residual viability of the bacteria postaerosolization.

Comparison of Self-reported Versus Actual Height and Weight in the Orthopaedic Population.

The purpose of our study was to determine the accuracy of orthopaedic patient's reported height, weight, and body mass index (BMI). We hypothesized that patient's age, sex and/or BMI may affect their accuracy. We performed a prospective, observational study in the setting of our orthopaedic clinic.

Eastern Association for the Surgery of Trauma Multicenter Trial: Comparison of pre-injury antithrombotic use and reversal strategies among severe traumatic brain injury patients.

Background: Trauma teams are often faced with patients on antithrombotic (AT) drugs, which is challenging when bleeding occurs. We sought to compare the effects of different AT medications on head injury severity and hypothesized that AT reversal would not improve mortality in severe traumatic brain injury (TBI) patients.

Methods: An Eastern Association for the Surgery of Trauma-sponsored prospective, multicentered, observational study of 15 trauma centers was performed.

Endorphinergic Enhancement Attenuation of Post-traumatic Stress Disorder (PTSD) Activation of Neuro-immunological Function in the Face of a Viral Pandemic.

Introduction: Polymorphic gene variants, particularly the genetic determinants of low dopamine function (hypodopaminergia), are known to associate with Substance Use Disorder (SUD) and a predisposition to PTSD. Addiction research and molecular genetic applied technologies supported by the National Institutes of Health (NIH) have revealed the complex functions of brain reward circuitry and its crucial role in addiction and PTSD symptomatology.

Discussion: It is noteworthy that Israeli researchers compared mice with a normal immune system with mice lacking adaptive immunity and found that the incidence of PTSD increased several-fold.

Immune Profile of the Normal Maternal-Fetal Interface in Rhesus Macaques and Its Alteration Following Zika Virus Infection.

The maternal decidua is an immunologically complex environment that balances maintenance of immune tolerance to fetal paternal antigens with protection of the fetus against vertical transmission of maternal pathogens. To better understand host immune determinants of congenital infection at the maternal-fetal tissue interface, we performed a comparative analysis of innate and adaptive immune cell subsets in the peripheral blood and decidua of healthy rhesus macaque pregnancies across all trimesters of gestation and determined changes after Zika virus (ZIKV) infection. Using one 28-color and one 18-color polychromatic flow cytometry panel we simultaneously analyzed the frequency, phenotype, activation status and trafficking properties of αβ T, γδ T, iNKT, regulatory T (Treg), NK cells, B lymphocytes, monocytes, macrophages, and dendritic cells (DC).

A multi-center retrospective cohort study defines the spectrum of kidney pathology in Coronavirus 2019 Disease (COVID-19).

Kidney failure is common in patients with Coronavirus Disease-19 (COVID-19), resulting in increased morbidity and mortality. In an international collaboration, 284 kidney biopsies were evaluated to improve understanding of kidney disease in COVID-19. Diagnoses were compared to five years of 63,575 native biopsies prior to the pandemic and 13,955 allograft biopsies to identify diseases that have increased in patients with COVID-19.

Apparent Treatment-Resistant Hypertension Assessed by Office and Ambulatory Blood Pressure in Chronic Kidney Disease-A Report from the Chronic Renal Insufficiency Cohort Study.

Background: Apparent treatment-resistant hypertension is common in patients with CKD. Whether measurement of 24-hour ambulatory BP monitoring is valuable for risk-stratifying patients with resistant hypertension and CKD is unclear.

Methods: We analyzed data from the Chronic Renal Insufficiency Cohort study, a prospective study of participants (=1186) with CKD.

Cancer and COVID-19: analysis of patient outcomes.

We sought to investigate the outcomes associated with COVID-19 disease in cancer patients. We conducted a retrospective cohort study of laboratory-confirmed COVID-19 patients. Of the 206 patients included, 57 had at least one preexisting malignancy.

A Case Report of COVID-19 in New Orleans, Louisiana: Highlighting the Complexities of Prognostication in a Critically Ill Patient.

Palliative care teams and intensive care teams have experience providing goals-of-care guidance for critically ill patients and families. Critical coronavirus disease 2019 (COVID-19) infection is defined as infection requiring intensive care unit care, respiratory support, and often multiorgan involvement. This case presents a 53-year-old critically ill COVID-19 patient in multisystem organ failure who appeared hours from death despite best medical efforts.

Simulations of increased glomerular capillary wall strain in the 5/6-nephrectomized rat.

Objective: Chronic glomerular hypertension is associated with glomerular injury and sclerosis; however, the mechanism by which increases in pressure damage glomerular podocytes remains unclear. We tested the hypothesis that increases in glomerular pressure may deleteriously affect podocyte structural integrity by increasing the strain of the glomerular capillary walls, and that glomerular capillary wall strain may play a significant role in the perpetuation of glomerular injury in disease states that are associated with glomerular hypertension.

Methods: We developed an anatomically accurate mathematical model of a compliant, filtering rat glomerulus to quantify the strain of the glomerular capillary walls in a remnant glomerulus of the 5/6-nephrectomized rat model of chronic kidney disease.

A New Natural Defense Against Airborne Pathogens.

We propose the nasal administration of calcium-enriched physiological salts as a new hygienic intervention with possible therapeutic application as a response to the rapid and tenacious spread of COVID-19. We test the effectiveness of these salts against viral and bacterial pathogens in animals and humans. We find that aerosol administration of these salts to the airways diminishes the exhalation of the small particles that face masks fail to filter and, in the case of an influenza swine model, completely block airborne transmission of disease.

Bi-allelic variants in the ER quality-control mannosidase gene EDEM3 cause a congenital disorder of glycosylation.

EDEM3 encodes a protein that converts ManGlcNAc isomer B to ManGlcNAc. It is involved in the endoplasmic reticulum-associated degradation pathway, responsible for the recognition of misfolded proteins that will be targeted and translocated to the cytosol and degraded by the proteasome. In this study, through a combination of exome sequencing and gene matching, we have identified seven independent families with 11 individuals with bi-allelic protein-truncating variants and one individual with a compound heterozygous missense variant in EDEM3.

Patterns of enrollment in a New Orleans women's substance use rehabilitation center.

Background: Research has told us little about the demographics of individuals entering substance use programs in New Orleans, Louisiana, especially women accessing treatment programs. Considering that New Orleans is a predominantly Black city and both substance use treatment and research have historically left out Black patients, this study evaluates the age, race, insurance status, education level, and substance of choice for patients entering Grace House Rehabilitation Center, an all women nonprofit substance use treatment program in New Orleans, Louisiana.

Methods: Since 2013, Tulane School of Medicine students have held weekly primary care clinics at Grace House.