Efficacy of topical capsaicin for cannabinoid hyperemesis syndrome in a pediatric and adult emergency department.

Introduction: Cannabinoid hyperemesis syndrome (CHS) is a clinical diagnosis characterized by symptoms of recurrent nausea, vomiting, and severe abdominal pain in the setting of chronic cannabis use. Symptoms of CHS are frequently unresponsive to standard antiemetic therapy. Topical capsaicin applied to the abdomen has been cited as a potential effective agent for CHS however robust evidence is lacking.

"Innocent as a LAMS": Does Spontaneous Fistula Closure (Secondary Intention), After EUS-Directed Transgastric ERCP (EDGE) via 20-mm Lumen-Apposing Metal Stent, Confer an Increased Risk of Persistent Fistula and Unintentional Weight Gain?

Background And Aims: Persistent gastrogastric or jejunogastric fistula is theoretically a concerning sequela of EUS-directed transgastric ERCP/EUS (EDGE), as it may functionally reverse the malabsorptive mechanism of Roux-en-Y gastric bypass (RYGB). Prior EDGE studies, using predominantly 15-mm (diameter) lumen-apposing metal stents (LAMS) and fistula closure by primary intent, collectively report 9% persistent fistula rate, without a clear weight gain association. Our study determines the incidence of persistent fistula, and its association with unintentional weight gain, among recipients of EDGE via 20-mm LAMS followed by spontaneous fistula closure (secondary intent).

Long-term cerebrovascular dysfunction in the offspring from maternal electronic cigarette use during pregnancy.

Electronic cigarettes (E-cigs) have been promoted as harm-free or less risky than smoking, even for women during pregnancy. These claims are made largely on E-cig aerosol having fewer number of toxic chemicals compared with cigarette smoke. Given that even low levels of smoking are found to produce adverse birth outcomes, we sought to test the hypothesis that vaping during pregnancy (with or without nicotine) would not be harm-free and would result in vascular dysfunction that would be evident in offspring during adolescent and/or adult life.

Formulation and In Vitro Characterization of PLGA/PLGA-PEG Nanoparticles Loaded with Murine Granulocyte-Macrophage Colony-Stimulating Factor.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) has demonstrated notable clinical activity in cancer immunotherapy, but it is limited by systemic toxicities, poor bioavailability, rapid clearance, and instability in vivo. Nanoparticles (NPs) may overcome these limitations and provide a mechanism for passive targeting of tumors. This study aimed to develop GM-CSF-loaded PLGA/PLGA-PEG NPs and evaluate them in vitro as a potential candidate for in vivo administration.

Association of Body Mass Index With Clinical Outcomes in Patients With Heart Failure With Reduced Ejection Fraction Treated With Sacubitril/Valsartan.

Background: Only limited data are available that address the association between body mass index (BMI) and clinical outcomes in patients with heart failure with reduced ejection fraction who are receiving sacubitril/valsartan.

Methods: We performed a retrospective multi-center cohort study in which we compared 3 body mass index groups (normal, overweight and obese groups) in patients with heart failure with reduced ejection fraction receiving sacubitril/valsartan. The follow-up period was at least 1 year.

Clinical Characteristics and Outcomes of COVID-19 in West Virginia.

This study examines the clinical characteristics, outcomes and types of management in SARS-CoV-2 infected patients, in the hospitals affiliated with West Virginia University. We included patients from West Virginia with SARS-CoV-2 infection between 15 April to 30 December 2020. Descriptive analysis was performed to summarize the characteristics of patients.

Time-of-day as a critical biological variable.

Time-of-day is a crucial, yet often overlooked, biological variable in biomedical research. We examined the top 25 most cited papers in several domains of behavioral neuroscience to determine whether time-of-day information was reported. The majority of studies report behavioral testing conducted during the day, which does not coincide with the optimal time to perform the testing from an functional perspective of the animals being tested.

Deep brain stimulation of the nucleus accumbens/ventral capsule for severe and intractable opioid and benzodiazepine use disorder.

Given high relapse rates and the prevalence of overdose deaths, novel treatments for substance use disorder (SUD) are desperately needed for those who are treatment refractory. The objective of this study was to evaluate the safety of deep brain stimulation (DBS) for SUD and the effects of DBS on substance use, substance craving, emotional symptoms, and frontal/executive functions. DBS electrodes were implanted bilaterally within the Nucleus Accumbens/Ventral anterior internal capsule (NAc/VC) of a man in his early 30s with >10-year history of severe treatment refractory opioid and benzodiazepine use disorders.

COVID-19 and neuroinflammation: a literature review of relevant neuroimaging and CSF markers in central nervous system inflammatory disorders from SARS-COV2.

Background: The literature on neurological manifestations in COVID-19 patients has been rapidly increasing with the pandemic. However, data on CNS inflammatory disorders in COVID-19 are still evolving. We performed a literature review of CNS inflammatory disorders associated with coronavirus disease-2019 (COVID-19).

Mortality risk associated with endophthalmitis in West Virginia.

Purpose: To explore how endophthalmitis presented from 2009 to 2019 in a West Virginia population particularly affected by the national opioid crisis. The analysis explores the relationship between the type of endophthalmitis and mortality, accounting for factors including age, gender, type of organism, and intravenous drug use (IVDU).

Methods: The electronic health record of West Virginia University (WVU) Medicine was queried for all patients managed for endophthalmitis from October 2009 to October 2019.

Longitudinal assessment of a Dental and Medical Student Service program in Appalachia: Successes and lessons learned.

Objectives: Recruiting/retaining healthcare professionals within rural and underserved communities in the United States remains a challenge. The West Virginia University Institute for Community and Rural Health implemented a service scholarship program in 2011 to address a lack of dental and primary care.

Methods: Dental and medical students commit to practice 12-months full time following graduation in a Health Profession Shortage Area (HPSA) or Rural Urban Commuting Area (RUCA) in West Virginia for each $25,000 received.

Overcoming the Elusiveness of Neurosarcoidosis: Learning from Five Complex Cases.

The involvement of the central nervous system in sarcoidosis can manifest with a variety of neurological symptoms, and most of them can be nonspecific. The diagnosis of neurosarcoidosis (NS) can therefore be very challenging without a tissue biopsy. Both computed tomography (CT) and magnetic resonance imaging (MRI) are important imaging modalities in the diagnosis of NS, and MRI is the modality of choice due to its superior soft-tissue contrast resolution.

Association Between Alopecia Areata and Natural Hair Color Among White Individuals.

Importance: Alopecia areata (AA) is a complex immune-mediated disorder that causes nonscarring hair loss. Previous reports have documented preferential targeting of pigmented hair follicles with sparing of gray, nonpigmented hair follicles in alopecia lesions. Thus, immune targeting of melanogenesis-associated proteins in melanocytes and keratinocytes represents a potential mechanism for the inflammation that targets anagen hairs in alopecia areata.

Localized Versus Generalized Granuloma Annulare: A Retrospective Review of 407 Patients.

Background: Granuloma annulare has been linked to diabetes, dyslipidemia, thyroid disease, collagen vascular disease, malignancies, infectious hepatitis, and systemic infections. However, these associations have not been systematically investigated when categorized by its clinical variants.

Objective: To evaluate disease associations of localized and generalized granuloma annulare.

The opioid crisis and HIV in the USA: deadly synergies.

The opioid epidemic is one of the greatest public health problems that the USA faces. Opioid overdose death rates have increased steadily for more than a decade and doubled in 2013-17, as the highly potent synthetic opioid fentanyl entered the drug supply. Demographics of new HIV diagnoses among people who inject drugs are also changing, with more new HIV diagnoses occurring among White people, young people (aged 13-34 years), and people who reside outside large central metropolitan areas.

Validating the Matching of Patients in the Linkage of a Large Hospital System's EHR with State and National Death Databases.

Background: Though electronic health record (EHR) data have been linked to national and state death registries, such linkages have rarely been validated for an entire hospital system's EHR.

Objectives: The aim of the study is to validate West Virginia University Medicine's (WVU Medicine) linkage of its EHR to three external death registries: the Social Security Death Masterfile (SSDMF), the national death index (NDI), the West Virginia Department of Health and Human Resources (DHHR).

Methods: Probabilistic matching was used to link patients to NDI and deterministic matching for the SSDMF and DHHR vital statistics records (WVDMF).

Assessing the impact of a restrictive opioid prescribing law in West Virginia.

Background: The Opioid Reduction Act (SB 273) took effect in West Virginia in June 2018. This legislation limited ongoing chronic opioid prescriptions to 30 days' supply, and first-time opioid prescriptions to 7 days' supply for surgeons and 3 days' for emergency rooms and dentists. The purpose of this study was to determine the effect of this legislation on reducing opioid prescriptions in West Virginia, with the goal of informing future similar policy efforts.

A Comprehensive Systematic Review of CSF analysis that defines Neurological Manifestations of COVID-19.

Background: Limited literature exists on Cerebrospinal fluid (CSF) findings in COVID-19 patients with neurological symptoms. In this review, we conducted a descriptive analysis of CSF findings in patients with COVID-19 to understand prognosis and explore therapeutic options.

Methods: We searched PubMed, Google Scholar, and Scopus databases using the keywords "SARS-CoV-2 in cerebrospinal fluid" and "SARS-CoV-2 and CNS Complications"" for reports of CSF findings in COVID-19 related neurological manifestations.

Coronary Artery Disease Phenotype Detection in an Academic Hospital System Setting.

Background: The United States, and especially West Virginia, have a tremendous burden of coronary artery disease (CAD). Undiagnosed familial hypercholesterolemia (FH) is an important factor for CAD in the U.S.

High prevalence of co-occurring substance use in individuals with opioid use disorder.

Objective: Funding to address the current opioid epidemic has focused on treatment of opioid use disorder (OUD); however, rates of other substance use disorders (SUDs) remain high and non-opioid related overdoses account for nearly 30% of overdoses. This study assesses the prevalence of co-occurring substance use in West Virginia (WV) to inform treatment strategies. The objective of this study was to assess the prevalence of, and demographic and clinical characteristics (including age, gender, hepatitis C virus (HCV) status) associated with, co-occurring substance use among patients with OUD in WV.

The effect of a low-nickel diet and nickel sensitization on gastroesophageal reflux disease: A pilot study.

Background/aims: Gastroesophageal reflux disease (GERD) is a common medical condition, frequently refractory to medical therapy. Nickel is a leading cause of allergic contact dermatitis. Although nickel is widely found in foods, the effect of nickel on GERD is unknown.

Transmetatarsal Amputation Outcomes When Utilized to Address Foot Gangrene and Infection: A Retrospective Chart Review.

A transmetatarsal amputation (TMA) is a widely utilized procedure to address foot gangrene and infection. Although a common procedure, so too are the associated complications. The purpose of this review was to evaluate TMA healing and to explore if there were associated variables correlating with healed vs.