ita Laughter May Work Like Meditation in the Brain By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: Laughter May Work Like Meditation in the BrainCategory: Health NewsCreated: 4/27/2014 12:35:00 PMLast Editorial Review: 4/28/2014 12:00:00 AM Full Article
ita Smoke-Free Laws May Help Prevent COPD Hospitalizations By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: Smoke-Free Laws May Help Prevent COPD HospitalizationsCategory: Health NewsCreated: 4/25/2014 2:35:00 PMLast Editorial Review: 4/28/2014 12:00:00 AM Full Article
ita ADHD Drug Ritalin Boosted Self-Control in Tests By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: ADHD Drug Ritalin Boosted Self-Control in TestsCategory: Health NewsCreated: 4/25/2014 12:35:00 PMLast Editorial Review: 4/28/2014 12:00:00 AM Full Article
ita Lung Cancer Surgery May Be Safest at High-Volume Hospitals, Study Finds By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: Lung Cancer Surgery May Be Safest at High-Volume Hospitals, Study FindsCategory: Health NewsCreated: 4/29/2014 12:35:00 PMLast Editorial Review: 4/30/2014 12:00:00 AM Full Article
ita Pediatricians Issue New Guidelines for Hospital Release of Newborns By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: Pediatricians Issue New Guidelines for Hospital Release of NewbornsCategory: Health NewsCreated: 4/27/2015 12:00:00 AMLast Editorial Review: 4/27/2015 12:00:00 AM Full Article
ita C-Section Rates Drop Slightly With Hospital Review Program By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: C-Section Rates Drop Slightly With Hospital Review ProgramCategory: Health NewsCreated: 4/29/2015 12:00:00 AMLast Editorial Review: 4/30/2015 12:00:00 AM Full Article
ita Half of U.S. Hospitals Could Do More to Prevent Serious Infections, Study Finds By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: Half of U.S. Hospitals Could Do More to Prevent Serious Infections, Study FindsCategory: Health NewsCreated: 4/29/2015 12:00:00 AMLast Editorial Review: 4/30/2015 12:00:00 AM Full Article
ita New Guidelines Issued on Breast, Genital Plastic Surgery for Teen Girls By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: New Guidelines Issued on Breast, Genital Plastic Surgery for Teen GirlsCategory: Health NewsCreated: 4/22/2016 12:00:00 AMLast Editorial Review: 4/25/2016 12:00:00 AM Full Article
ita 1 in 4 Hospitalized Newborns Gets Heartburn Drugs, Despite Risks By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: 1 in 4 Hospitalized Newborns Gets Heartburn Drugs, Despite RisksCategory: Health NewsCreated: 4/27/2016 12:00:00 AMLast Editorial Review: 4/28/2016 12:00:00 AM Full Article
ita Exercise and Vitamin D: A Heart-Healthy Combo By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: Exercise and Vitamin D: A Heart-Healthy ComboCategory: Health NewsCreated: 5/1/2017 12:00:00 AMLast Editorial Review: 5/1/2017 12:00:00 AM Full Article
ita Guns Send About 16 U.S. Kids to the Hospital Every Day By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: Guns Send About 16 U.S. Kids to the Hospital Every DayCategory: Health NewsCreated: 5/4/2017 12:00:00 AMLast Editorial Review: 5/5/2017 12:00:00 AM Full Article
ita VA Clinic Investigating Unsanitary Treatment Room By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: VA Clinic Investigating Unsanitary Treatment RoomCategory: Health NewsCreated: 5/1/2018 12:00:00 AMLast Editorial Review: 5/1/2018 12:00:00 AM Full Article
ita Music May Calm the Agitation of Alzheimer's By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: Music May Calm the Agitation of Alzheimer'sCategory: Health NewsCreated: 4/30/2018 12:00:00 AMLast Editorial Review: 5/1/2018 12:00:00 AM Full Article
ita The Other Opioid Crisis: Shortages at U.S. Hospitals By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: The Other Opioid Crisis: Shortages at U.S. HospitalsCategory: Health NewsCreated: 5/2/2018 12:00:00 AMLast Editorial Review: 5/2/2018 12:00:00 AM Full Article
ita Care at VA Hospitals as Good or Better Than Elsewhere in U.S.: Report By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: Care at VA Hospitals as Good or Better Than Elsewhere in U.S.: ReportCategory: Health NewsCreated: 5/4/2018 12:00:00 AMLast Editorial Review: 5/4/2018 12:00:00 AM Full Article
ita Could You Be Short on Vitamin B12? By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: Could You Be Short on Vitamin B12?Category: Health NewsCreated: 5/2/2019 12:00:00 AMLast Editorial Review: 5/2/2019 12:00:00 AM Full Article
ita Out-of-Hospital Cardiac Arrests On the Rise During COVID-19 Crisis By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: Out-of-Hospital Cardiac Arrests On the Rise During COVID-19 CrisisCategory: Health NewsCreated: 4/30/2020 12:00:00 AMLast Editorial Review: 5/1/2020 12:00:00 AM Full Article
ita How Is the Infraorbital Nerve Block Performed? By www.medicinenet.com Published On :: Tue, 21 Apr 2020 00:00:00 PDT Title: How Is the Infraorbital Nerve Block Performed?Category: Procedures and TestsCreated: 4/21/2020 12:00:00 AMLast Editorial Review: 4/21/2020 12:00:00 AM Full Article
ita Early Oxygen Therapy Vital for Pregnant Patients With COVID-19 By www.webmd.com Published On :: Wed, 06 May 2020 12:36:12 EST Adjust oxygen and fluid therapy thresholds for pregnant patients with severe disease, experts advise; early use of a high-flow nasal cannula and prone positioning may help avoid mechanical ventilation. Full Article
ita Justice Ginsberg Joins Court Call from Hospital By www.webmd.com Published On :: Wed, 06 May 2020 14:36:12 EST Ginsberg joined in from the Maryland hospital where she's being treated for an infection caused by a gall stone. Full Article
ita Alcohol Abuse Agitated by COVID-19 Stirring Liver Concerns By www.webmd.com Published On :: Thu, 07 May 2020 10:35:22 EST Hospitals are seeing an increase in admissions related to alcohol abuse as recovery centers are shutting down and people are drinking more during the pandemic. Full Article
ita Supreme Court Justice Ginsburg Home From Hospital By www.webmd.com Published On :: Thu, 07 May 2020 11:29:44 EST Ginsburg had gone to the hospital for outpatient tests that revealed an infection caused by a gall stone. Full Article
ita Citation Exporter Feature Now Available By www.ncbi.nlm.nih.gov Published On :: Tue, 18 Nov 2014 08:00:00 EST PMC is happy to announce the addition of a citation exporter feature. This feature makes it easy to retrieve either styled citations that you can copy/paste into your manuscripts, or to download them into a format compatible with your bibliographic reference manager software.When viewing an Entrez search results page, each result summary will now include a "Citation" link. When, clicked, this will open a pop-up window that you can use to easily copy/paste citations formatted in one of three popular styles: AMA (American Medical Association), MLA (Modern Language Association), or APA (American Psychological Association). In addition, the box has links at the bottom that can be used to download the citation information in one of three machine-readable formats, which most bibliographic reference management software can import.The same citation box can also be invoked from an individual article, either in classic view (with the "Citation" link among the list of formats) or the PubReader view, by clicking on the citation information just below the article title in the banner.These human-readable styled citations, and machine-readable formats, will be available through a public API, and we will be providing more details about that in another announcement, on the pmc-utils-announce mailing list. Please subscribe to that list if you are interested. Full Article
ita The New PubMed Updated: Summary Display with Full Author List, Send to: Citation manager, PubMed Format, and More By www.nlm.nih.gov Published On :: Tue, 17 Mar 2020 10:00:00 EST The New PubMed Updated: Summary display includes the full author list and other citation details; Send to: Citation manager is available; RIS format is replaced by PubMed format; Search details include individual term translations; Citations in the Clipboard have been added to History as search number #0. Full Article
ita Indoor Athletes Often Lacking in Vitamin D By www.medicinenet.com Published On :: Wed, 25 Mar 2020 00:00:00 PDT Title: Indoor Athletes Often Lacking in Vitamin DCategory: Health NewsCreated: 3/24/2020 12:00:00 AMLast Editorial Review: 3/25/2020 12:00:00 AM Full Article
ita Raking Your Leaves to the Edge of Your Yard an Invitation to Ticks By www.medicinenet.com Published On :: Mon, 23 Mar 2020 00:00:00 PDT Title: Raking Your Leaves to the Edge of Your Yard an Invitation to TicksCategory: Health NewsCreated: 3/22/2020 12:00:00 AMLast Editorial Review: 3/23/2020 12:00:00 AM Full Article
ita Pneumonia More Deadly Than Hip Fractures for Hospitalized Seniors By www.medicinenet.com Published On :: Fri, 24 Apr 2020 00:00:00 PDT Title: Pneumonia More Deadly Than Hip Fractures for Hospitalized SeniorsCategory: Health NewsCreated: 4/23/2020 12:00:00 AMLast Editorial Review: 4/24/2020 12:00:00 AM Full Article
ita Biktarvy (bictegravir, emtricitabine, and tenofovir alafenamide) By www.medicinenet.com Published On :: Thu, 16 Apr 2020 00:00:00 PDT Title: Biktarvy (bictegravir, emtricitabine, and tenofovir alafenamide)Category: MedicationsCreated: 4/16/2020 12:00:00 AMLast Editorial Review: 4/16/2020 12:00:00 AM Full Article
ita Genvoya (elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide) By www.medicinenet.com Published On :: Fri, 17 Apr 2020 00:00:00 PDT Title: Genvoya (elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide)Category: MedicationsCreated: 4/17/2020 12:00:00 AMLast Editorial Review: 4/17/2020 12:00:00 AM Full Article
ita Vitamin D Might Aid Seniors' Recovery From Hip Fracture: Study By www.medicinenet.com Published On :: Fri, 3 Apr 2020 00:00:00 PDT Title: Vitamin D Might Aid Seniors' Recovery From Hip Fracture: StudyCategory: Health NewsCreated: 4/2/2020 12:00:00 AMLast Editorial Review: 4/3/2020 12:00:00 AM Full Article
ita Many Seniors Leave Hospital With New Disabilities By www.medicinenet.com Published On :: Tue, 3 Mar 2020 00:00:00 PDT Title: Many Seniors Leave Hospital With New DisabilitiesCategory: Health NewsCreated: 3/2/2020 12:00:00 AMLast Editorial Review: 3/3/2020 12:00:00 AM Full Article
ita Helping Seniors Manage Meds After Hospital Reduces Readmission: Study By www.medicinenet.com Published On :: Wed, 4 Mar 2020 00:00:00 PDT Title: Helping Seniors Manage Meds After Hospital Reduces Readmission: StudyCategory: Health NewsCreated: 3/3/2020 12:00:00 AMLast Editorial Review: 3/4/2020 12:00:00 AM Full Article
ita Citalopram (Celexa) By www.medicinenet.com Published On :: Wed, 12 Feb 2020 00:00:00 PDT Title: Citalopram (Celexa)Category: MedicationsCreated: 2/2/1999 12:00:00 AMLast Editorial Review: 2/12/2020 12:00:00 AM Full Article
ita Lexapro (escitalopram) By www.medicinenet.com Published On :: Mon, 24 Feb 2020 00:00:00 PDT Title: Lexapro (escitalopram)Category: MedicationsCreated: 3/16/2003 12:00:00 AMLast Editorial Review: 2/24/2020 12:00:00 AM Full Article
ita Decitabine Response in Breast Cancer Requires Efficient Drug Processing and Is Not Limited by Multidrug Resistance By mct.aacrjournals.org Published On :: 2020-05-04T05:39:42-07:00 Dysregulation of DNA methylation is an established feature of breast cancers. DNA demethylating therapies like decitabine are proposed for the treatment of triple-negative breast cancers (TNBC) and indicators of response need to be identified. For this purpose, we characterized the effects of decitabine in a panel of 10 breast cancer cell lines and observed a range of sensitivity to decitabine that was not subtype specific. Knockdown of potential key effectors demonstrated the requirement of deoxycytidine kinase (DCK) for decitabine response in breast cancer cells. In treatment-naïve breast tumors, DCK was higher in TNBCs, and DCK levels were sustained or increased post chemotherapy treatment. This suggests that limited DCK levels will not be a barrier to response in patients with TNBC treated with decitabine as a second-line treatment or in a clinical trial. Methylome analysis revealed that genome-wide, region-specific, tumor suppressor gene–specific methylation, and decitabine-induced demethylation did not predict response to decitabine. Gene set enrichment analysis of transcriptome data demonstrated that decitabine induced genes within apoptosis, cell cycle, stress, and immune pathways. Induced genes included those characterized by the viral mimicry response; however, knockdown of key effectors of the pathway did not affect decitabine sensitivity suggesting that breast cancer growth suppression by decitabine is independent of viral mimicry. Finally, taxol-resistant breast cancer cells expressing high levels of multidrug resistance transporter ABCB1 remained sensitive to decitabine, suggesting that the drug could be used as second-line treatment for chemoresistant patients. Full Article
ita Evaluation of an Automated Digital Scoring System of Dental Plaque By jdh.adha.org Published On :: 2020-04-30T12:39:03-07:00 Purpose: Measurement of dental plaque is frequently used as an indicator of overall oral health. The purpose of this study was to compare a manual (visual) plaque scoring system (University of Mississippi Oral Hygiene Index, UM-OHI) with an innovative automated digital scoring system.Methods: Mechanically ventilated, intensive care unit (ICU) patients (n=79) were the study population. Informed consent was given by the subject's legally authorized representative. Digital images of dental plaque were taken using an intraoral camera; and the quantity of dental plaque was scored using the UM-OHI and with a digitized automated scoring system. Distributions of dental plaque scores from both methods were plotted. Pearson correlation coefficients and intra-class coefficients were calculated between the two methods.Results: Participant mean age was 57.3 years; respiratory failure was the most prevalent admission diagnosis (55.7%). The mean percentage of dental plaque calculated by the manual method was found to be remarkably higher (67.3% ± 18.7%) than the percentage of dental plaque calculated by the automated scoring method (23.7% ± 15.2%) (p<0.0001). Despite remarkably different distributions of plaque scores, both the automated and manual scoring systems demostrated relatively high correlation (r=0.62) and good reliability (ICC=0.63).Conclusion: The automated digital scoring system resulted in a significantly lower overall percentage of total dental plaque as compared to the UM-OHI manual scoring system. While the automated digital scoring system may be more precise than a manual (visual) scoring system, its use should be weighed against the added effort, cost, and expertise required for the method. Further study is needed to determine whether an automated digital scoring system can be commercialized and is warranted for use outside of research settings. Full Article
ita Vitamin E does not prevent Western diet-induced NASH progression and increases metabolic flux dysregulation in mice [Research Articles] By www.jlr.org Published On :: 2020-05-01T00:05:27-07:00 Fatty liver involves ectopic lipid accumulation and dysregulated hepatic oxidative metabolism, which can progress to a state of elevated inflammation and fibrosis referred to as nonalcoholic steatohepatitis (NASH). The factors that control progression from simple steatosis to NASH are not fully known. Here, we tested the hypothesis that dietary vitamin E (VitE) supplementation would prevent NASH progression and associated metabolic alterations induced by a Western diet (WD). Hyperphagic melanocortin-4 receptor-deficient (MC4R–/–) mice were fed chow, chow+VitE, WD, or WD+VitE starting at 8 or 20 weeks of age. All groups exhibited extensive hepatic steatosis by the end of the study (28 weeks of age). WD feeding exacerbated liver disease severity without inducing proportional changes in liver triglycerides. Eight weeks of WD accelerated liver pyruvate cycling, and 20 weeks of WD extensively upregulated liver glucose and oxidative metabolism assessed by 2H/13C flux analysis. VitE supplementation failed to reduce the histological features of NASH. Rather, WD+VitE increased the abundance and saturation of liver ceramides and accelerated metabolic flux dysregulation compared with 8 weeks of WD alone. In summary, VitE did not limit NASH pathogenesis in genetically obese mice, but instead increased some indicators of metabolic dysfunction. Full Article
ita Lipid rafts and pathogens: the art of deception and exploitation [Thematic Reviews] By www.jlr.org Published On :: 2020-05-01T00:05:27-07:00 Lipid rafts, solid regions of the plasma membrane enriched in cholesterol and glycosphingolipids, are essential parts of a cell. Functionally, lipid rafts present a platform that facilitates interaction of cells with the outside world. However, the unique properties of lipid rafts required to fulfill this function at the same time make them susceptible to exploitation by pathogens. Many steps of pathogen interaction with host cells, and sometimes all steps within the entire lifecycle of various pathogens, rely on host lipid rafts. Such steps as binding of pathogens to the host cells, invasion of intracellular parasites into the cell, the intracellular dwelling of parasites, microbial assembly and exit from the host cell, and microbe transfer from one cell to another all involve lipid rafts. Interaction also includes modification of lipid rafts in host cells, inflicted by pathogens from both inside and outside the cell, through contact or remotely, to advance pathogen replication, to utilize cellular resources, and/or to mitigate immune response. Here, we provide a systematic overview of how and why pathogens interact with and exploit host lipid rafts, as well as the consequences of this interaction for the host, locally and systemically, and for the microbe. We also raise the possibility of modulation of lipid rafts as a therapeutic approach against a variety of infectious agents. Full Article
ita Gamma Interferon Is Required for Chlamydia Clearance but Is Dispensable for T Cell Homing to the Genital Tract By mbio.asm.org Published On :: 2020-03-17T01:30:14-07:00 ABSTRACT While there is no effective vaccine against Chlamydia trachomatis infection, previous work has demonstrated the importance of C. trachomatis-specific CD4+ T cells (NR1 T cells) in pathogen clearance. Specifically, NR1 T cells have been shown to be protective in mice, and this protection depends on the host’s ability to sense the cytokine gamma interferon (IFN-). However, it is unclear what role NR1 production or sensing of IFN- plays in T cell homing to the genital tract or T cell-mediated protection against C. trachomatis. Using two-photon microscopy and flow cytometry, we found that naive wild-type (WT), IFN-–/–, and IFN-R–/– NR1 T cells specifically home to sections in the genital tract that contain C. trachomatis. We also determined that protection against infection requires production of IFN- from either NR1 T cells or endogenous cells, further highlighting the importance of IFN- in clearing C. trachomatis infection. IMPORTANCE Chlamydia trachomatis is an important mucosal pathogen that is the leading cause of sexually transmitted bacterial infections in the United States. Despite this, there is no vaccine currently available. In order to develop such a vaccine, it is necessary to understand the components of the immune response that can lead to protection against this pathogen. It is well known that antigen-specific CD4+ T cells are critical for Chlamydia clearance, but the contexts in which they are protective or not protective are unknown. Here, we aimed to characterize the importance of gamma interferon production and sensing by T cells and the effects on the immune response to C. trachomatis. Our work here helps to define the contexts in which antigen-specific T cells can be protective, which is critical to our ability to design an effective and protective vaccine against C. trachomatis. Full Article
ita Metabolism of Gluconeogenic Substrates by an Intracellular Fungal Pathogen Circumvents Nutritional Limitations within Macrophages By mbio.asm.org Published On :: 2020-04-07T01:31:16-07:00 ABSTRACT Microbial pathogens exploit host nutrients to proliferate and cause disease. Intracellular pathogens, particularly those exclusively living in the phagosome such as Histoplasma capsulatum, must adapt and acquire nutrients within the nutrient-limited phagosomal environment. In this study, we investigated which host nutrients could be utilized by Histoplasma as carbon sources to proliferate within macrophages. Histoplasma yeasts can grow on hexoses and amino acids but not fatty acids as the carbon source in vitro. Transcriptional analysis and metabolism profiling showed that Histoplasma yeasts downregulate glycolysis and fatty acid utilization but upregulate gluconeogenesis within macrophages. Depletion of glycolysis or fatty acid utilization pathways does not prevent Histoplasma growth within macrophages or impair virulence in vivo. However, loss of function in Pck1, the enzyme catalyzing the first committed step of gluconeogenesis, impairs Histoplasma growth within macrophages and severely attenuates virulence in vivo, indicating that Histoplasma yeasts rely on catabolism of gluconeogenic substrates (e.g., amino acids) to proliferate within macrophages. IMPORTANCE Histoplasma is a primary human fungal pathogen that survives and proliferates within host immune cells, particularly within the macrophage phagosome compartment. The phagosome compartment is a nutrient-limited environment, requiring Histoplasma yeasts to be able to assimilate available carbon sources within the phagosome to meet their nutritional needs. In this study, we showed that Histoplasma yeasts do not utilize fatty acids or hexoses for growth within macrophages. Instead, Histoplasma yeasts consume gluconeogenic substrates to proliferate in macrophages. These findings reveal the phagosome composition from a nutrient standpoint and highlight essential metabolic pathways that are required for a phagosomal pathogen to proliferate in this intracellular environment. Full Article
ita Human Serum Albumin Facilitates Heme-Iron Utilization by Fungi By mbio.asm.org Published On :: 2020-04-21T01:31:26-07:00 ABSTRACT A large portion of biological iron is found in the form of an iron-protoporphyrin IX complex, or heme. In the human host environment, which is exceptionally poor in free iron, heme iron, particularly from hemoglobin, constitutes a major source of iron for invading microbial pathogens. Several fungi were shown to utilize free heme, and Candida albicans, a major opportunistic pathogen, is able both to capture free heme and to extract heme from hemoglobin using a network of extracellular hemophores. Human serum albumin (HSA) is the most abundant host heme-scavenging protein. Tight binding of heme by HSA restricts its toxic chemical reactivity and could diminish its availability as an iron source for pathogenic microbes. We found, however, that rather than inhibiting heme utilization, HSA greatly increases availability of heme as an iron source for C. albicans and other fungi. In contrast, hemopexin, a low-abundance but high-affinity heme-scavenging serum protein, does inhibit heme utilization by C. albicans. However, inhibition by hemopexin is mitigated in the presence of HSA. Utilization of albumin-bound heme requires the same hemophore cascade as that which mediates hemoglobin-iron utilization. Accordingly, we found that the C. albicans hemophores are able to extract heme bound to HSA in vitro. Since many common drugs are known to bind to HSA, we tested whether they could interfere with heme-iron utilization. We show that utilization of albumin-bound heme by C. albicans can be inhibited by the anti-inflammatory drugs naproxen and salicylic acid. IMPORTANCE Heme constitutes a major iron source for microorganisms and particularly for pathogenic microbes; to overcome the iron scarcity in the animal host, many pathogenic bacteria and fungi have developed systems to extract and take up heme from host proteins such as hemoglobin. Microbial heme uptake mechanisms are usually studied using growth media containing free heme or hemoglobin as a sole iron source. However, the animal host contains heme-scavenging proteins that could prevent this uptake. In the human host in particular, the most abundant serum heme-binding protein is albumin. Surprisingly, however, we found that in the case of fungi of the Candida species family, albumin promoted rather than prevented heme utilization. Albumin thus constitutes a human-specific factor that can affect heme-iron utilization and could serve as target for preventing heme-iron utilization by fungal pathogens. As a proof of principle, we identify two drugs that can inhibit albumin-stimulated heme utilization. Full Article
ita Vital Directions for Health & Health Care: The North Carolina Experience By www.ncmedicaljournal.com Published On :: 2020-05-04T06:50:30-07:00 In 2019, the National Academy of Medicine (NAM) turned to the all-important state level to draw insights on the status of health and health care within the context of the NAM Vital Directions for Health and Health Care initiative. The NAM held a two-day symposium in the Research Triangle to bring together various stakeholders to better understand actions that states and localities are taking to achieve—and the barriers they face in pursuing—more affordable, value-driven quality care and health outcomes. The NAM purposefully chose to pivot to the state level with North Carolina given that it has been at the forefront of health care transformation and illustrates the promise but also the challenges facing US health and health care nationally. A 19-member planning committee, cochaired by NAM President Victor Dzau and Secretary Mandy Cohen of the North Carolina Department of Health and Human Services, selected topics that resonate with the state's activities within the context of the Vital Directions framework, ranging from empowering people and connecting care through the integration of social, physical, and behavioral health to payer alignment though the advancement of new payment models (Figure 1). The priorities discussed during the symposium continue to be central to health reform in North Carolina and are further explored in the commentaries in this issue. Full Article
ita Gathering Trauma Narratives: A Qualitative Study on the Impact of Self-Identified Traumas on People Living with HIV (PLWH) By www.ncmedicaljournal.com Published On :: 2020-05-04T06:50:30-07:00 BACKGROUND Trauma—emotional, physical, and psychological—is common and associated with increased risk behaviors, low rates of care engagement and viral suppression, and overall poor health outcomes for people living with HIV (PLWH). This article presents the results of 15 in-depth, semi-structured interviews with PLWH in the Southeastern United States in which participants identified a trauma and described its long-lasting impact on their lives. Participants' trauma narratives described a wide range of traumas, including childhood sexual abuse, the loss of a loved one, and their HIV diagnosis. METHODS Systematic qualitative analysis was used to delineate beliefs about causes, symptoms, treatments, quality of life, and health implications of trauma. RESULTS: Fifteen participants completed semi-structured interviews that lasted on average 32 minutes. Participants described a wide spectrum of personal trauma that occurred both prior and subsequent to their HIV diagnosis. The types of trauma identified included physical, sexual, and psychological abuse inflicted by intimate partners, family members, and/or strangers. LIMITATIONS A chief limitation of this study is selection bias. Additionally, the participant selection and content of the trauma narratives might have been affected by the surrounding context of the parent study centered on HIV, aging, and psychosocial stress. It is also difficult to interpret the distinction between discrete trauma experiences and the diagnosis of HIV, leading to potential information bias. CONCLUSION This study highlights the importance of social support in coping with trauma and the effect of trauma on health-related behaviors. It also illustrates the need for additional research on the topic of trauma and trauma-informed care for PLWH. Understanding how different types of trauma affect individuals' lives is necessary to inform recommendations to provide better care for PLWH. Full Article
ita Biallelic LINE insertion mutation in HACD1 causing congenital myopathy By ng.neurology.org Published On :: 2020-04-13T12:45:09-07:00 Congenital myopathies are clinically and genetically heterogeneous, resulting from mutations in at least 30 different genes.1 The classical presentation is neonatal hypotonia and nonprogressive weakness with normal creatine phosphokinase, although there is a broad range in terms of age at onset and clinical presentation. Historically, congenital myopathies have been defined and diagnosed based on muscle biopsy. However, with advances in genomics, genetics have taken primacy in the diagnostic pathway.2 Full Article
ita Overcoming Algal Vitamin B12 Auxotrophy by Experimental Evolution By www.plantphysiol.org Published On :: 2020-05-08T08:30:48-07:00 Full Article
ita Factors associated with 30-day readmission for patients hospitalized for seizures By cp.neurology.org Published On :: 2020-04-06T12:45:20-07:00 Background We sought to determine the cumulative incidence of readmissions after a seizure-related hospitalization and identify risk factors and readmission diagnoses. Methods We performed a retrospective cohort study of adult patients hospitalized with a primary discharge diagnosis of seizure (International Classification of Diseases, Ninth Edition, Clinical Modification codes 345.xx and 780.3x) using the State Inpatient Databases across 11 states from 2009 to 2012. Hospital and community characteristics were obtained from the American Hospital Association and Robert Wood Johnson Foundation. We performed logistic regressions to explore effects of patient, hospital, and community factors on readmissions within 30 days of discharge. Results Of 98,712 patients, 13,929 (14%) were readmitted within 30 days. Reasons for readmission included epilepsy/convulsions (30% of readmitted patients), mood disorders (5%), schizophrenia (4%), and septicemia (4%). The strongest predictors of readmission were diagnoses of CNS tumor (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.9–2.4) or psychosis (OR 1.8, 95% CI 1.7–1.8), urgent index admission (OR 2.0, 95% CI 1.8–2.2), transfer to nonacute facilities (OR 1.7, 95% CI 1.6–1.8), long length of stay (OR 1.7, 95% CI 1.6–1.8), and for-profit hospitals (OR 1.7, 95% CI 1.6–1.8). Our main model's c-statistic was 0.66. Predictors of readmission for status epilepticus included index admission for status epilepticus (OR 3.5, 95% CI 2.6–4.7), low hospital epilepsy volume (OR 0.4, 95% CI 0.3–0.7), and rural hospitals (OR 4.8, 95% CI 2.1–10.9). Conclusion Readmission is common after hospitalization for seizures. Prevention strategies should focus on recurrent seizures, the most common readmission diagnosis. Many factors were associated with readmission, although readmissions remain challenging to predict. Full Article
ita Initial Resuscitation Algorithm for Children By pediatrics.aappublications.org Published On :: 2020-05-01T01:00:46-07:00 Full Article
ita The Time Is Now: Standardized Sedation Training for Pediatric Hospitalists By pediatrics.aappublications.org Published On :: 2020-05-01T01:00:46-07:00 Full Article
ita Enhancing CPR During Transition From Prehospital to Emergency Department: A QI Initiative By pediatrics.aappublications.org Published On :: 2020-05-01T01:00:46-07:00 BACKGROUND AND OBJECTIVES: High-quality cardiopulmonary resuscitation (CPR) increases the likelihood of survival of pediatric out-of-hospital cardiac arrest (OHCA). Maintenance of high-quality CPR during transition of care between prehospital and pediatric emergency department (PED) providers is challenging. Our objective for this initiative was to minimize pauses in compressions, in alignment with American Heart Association recommendations, for patients with OHCA during the handoffs from prehospital to PED providers. We aimed to decrease interruptions in compressions during the first 2 minutes of PED care from 17 seconds (baseline data) to 10 seconds over 12 months. Our secondary aims were to decrease the length of the longest pause in compressions to <10 seconds and eliminate encounters in which time to defibrillator pad placement was >120 seconds. METHODS: Our multidisciplinary team outlined our theory for improvement and designed interventions aimed at key drivers. Interventions included specific roles and responsibilities, CPR handoff choreography, and empowerment of frontline providers. Data were abstracted from video recordings of patients with OHCA receiving manual CPR on arrival. RESULTS: We analyzed 33 encounters between March 2018 and July 2019. We decreased total interruptions from 17 to 12 seconds during the first 2 minutes and decreased the time of the longest single pause from 14 to 7 seconds. We saw a decrease in variability of time to defibrillator pad placement. CONCLUSIONS: Implementation of a quality improvement initiative involving CPR transition choreography resulted in decreased interruptions in compressions and decreased variability of time to defibrillator pad placement. Full Article
ita The Genetics of Mating Song Evolution Underlying Rapid Speciation: Linking Quantitative Variation to Candidate Genes for Behavioral Isolation [Corrigendum] By www.genetics.org Published On :: 2020-05-05T06:43:41-07:00 Full Article