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Enhancing Text Message Support With Media Literacy and Financial Incentives for Vaping Cessation in Young Adults: Protocol for a Pilot Randomized Controlled Trial
Full text linkBackground: The persistent high prevalence of e-cigarette use among young adults remains a significant public health concern, with limited evidence and guidance on effective vaping cessation programs targeting this population.
Objective: This study aims to outline the study design and protocol of a pilot randomized controlled trial aimed at investigating feasibility and assessing whether media literacy education or financial incentives enhance the effectiveness of evidence-based text message support in promoting vaping abstinence among young adult e-cigarette users.
Methods: The pilot study uses a 4-arm (1:1:1:1) randomized controlled trial design to assess the potential impact of different combinations of media literacy education, financial incentives, and text message support on vaping abstinence over a 3-month period. The first month serves as a preparatory phase for quitting, followed by 2 months focused on abstinence. A total of 80 individuals, aged 19-29 years, who have used e-cigarettes within the past 30 days, have internet access, and express interest in quitting vaping within the next 30 days, will be enrolled. Eligible individuals will be randomized into one of the four study groups: (1) Text Message, (2) Media Literacy, (3) Financial Incentive, and (4) Combined. All participants, regardless of group assignment, will receive text message support. Participants will be followed for 12 weeks, with abstinence status assessed at week 12, as well as during remote check-ins at weeks 6, 8, and 10. Feasibility measures include recruitment rate, reach, engagement, and retention. Other outcomes of interest include self-reported 7-day abstinence and changes in nicotine dependence and media literacy scores. Exit interviews will be conducted with those who complete the study to explore facilitators of and barriers to participation and engagement in vaping cessation, which will inform future program refinement and uptake.
Results: Recruitment for the study commenced in December 2023 and concluded in August 2024. A total of 40 participants were randomized into these groups: 9 for Text Message, 11 for Media Literacy, 10 for Financial Incentive, and 10 for the Combined group. The final assessment was completed in November 2024, and analyses are currently ongoing.
Conclusions: The findings from this trial could provide valuable insights into the design and uptake of vaping cessation strategies among the young adult population
Comparing Intubation Techniques of Klippel-Feil Syndrome Patients in the Last 10 Years: A Systematic Review
Full text linkContext: Klippel-Feil syndrome (KFS) is a rare congenital abnormality characterized by cervical vertebral fusion. Patients typically present with a triad of short neck, low posterior hairline, and limited cervical range of motion. The location and quantity of vertebral fusions in KFS makes airway management challenging in the field of anesthesia. Anesthesiologists select intubation methods based on perceived difficulty, making this paper essential to the field.
Objectives: The purpose of this study is to analyze first-attempt intubation success rates of KFS patients by intubation technique and stratified by location and quantity of cervical fusions and a Mallampati score if reported.
Methods: This is a systematic review of all case reports on PubMed in the last 10 years utilizing the keywords KFS, and subsequently screened searching anesthesia and intubation. Examiners reviewed the remaining 27 articles for fusion abnormalities and intubation techniques utilized. The articles detail fiberoptic, direct, laryngeal mask airway (LMA), and video-guided intubation techniques, and the success rates were analyzed.
Results: Of the 1234 KFS articles found, 657 were case reports with 157 being in the last 10 years. After review, 27 case reports presenting 30 cases were included. The average age reported was 25.4 ± 21.6 and 73.3 % were female. Direct (n=10), fiberoptic (n=12), video-guided (n=6), and LMA (n=2) were the chosen first-attempt intubation maneuvers. Fiberoptic and video-guided intubations reported 83 % success, while direct and LMA reported 50 % success. Higher success rates were found in patients with two cervical segment fusions (70 %) when compared to three or more fusions (33 %). Inferior vertebral fusions (C5-T1) reported higher success than midcervical fusions (C3-C5), 100 % and 33 %, respectively. Mallampati class 4 had the highest success (100 %), although further analysis showed fiberoptic intubation was utilized in each of these cases, skewing the data.
Conclusions: Fiberoptic and video-guided intubation in KFS patients offers the highest success rates of intubation. There were limitations in this study due to the number of case reports available. Although there may be confounding variables to consider based on the case presentation and surgery performed, fiberoptic endotracheal intubation should be considered the gold standard when intubating KFS patients
Infant Colic Symptoms and Amino Acid Formula: Insights from a Prospective Cohort Study
Full text linkBackground/Objectives: Infant functional disorders, including colic, irritability, and sleep disturbances, often overlap with symptoms of cow’s milk protein allergy (CMPA). While extensively hydrolyzed formulas are commonly used to address these issues, the short-term efficacy of amino acid formulas (AAF) for managing colic remains understudied. This secondary analysis of a previously published prospective cohort, the largest of its kind in the United States, evaluated the short-term impact of AAF in improving colic and associated symptoms in infants under six months of age with suspected CMPA. Methods: This real-world prospective cohort study analyzed data from 138 infants with suspected CMPA initiated on AAF at Visit 1. After excluding 34 infants due to incomplete data or treatment changes, 104 infants were included in the final analysis. Symptom severity and resolution were assessed through outcomes across two visits, with care provided by general pediatricians (82%) and pediatric gastroenterologists (18%). Results: At baseline, the most common symptoms were colic (n = 83), gassiness (n = 72), fussiness (n = 66), and sleep disturbances (n = 58). By the next follow-up visit (Visit 2), parents reported symptom improvements in colic (94%), gassiness (81%), fussiness (83%), and sleep disturbances (86%). Complete symptom resolution was observed in 73% of infants with colic, 68% with gassiness, 65% with fussiness, and 81% with sleep difficulties. By Visit 2, no infants had severe symptoms, with only mild residual symptoms reported. Conclusions: AAF was associated with significant short-term improvements in colic and related symptoms in infants with suspected CMPA. These preliminary findings highlight AAF as a promising dietary intervention during early infancy. Larger controlled studies are necessary to confirm these results and explore long-term outcomes
Lipid Dysregulation in Sebaceous Gland Disorders and the Impact of Sphingolipid Metabolism on Acne Pathogenesis
Full text linkLipid dysregulation within sebaceous glands is a critical factor underlying the pathogenesis of sebaceous gland disorders, particularly acne vulgaris. Sebaceous glands synthesize and secrete a complex mixture of lipids, including triglycerides, wax esters, free fatty acids, and sphingolipids, which contribute to skin barrier function and microbial homeostasis. Dysregulated lipid production, characterized by increased sebum secretion and altered lipid composition, has been implicated in promoting Cutibacterium acnes proliferation, hyperkeratinization, and inflammation, key processes in acne pathogenesis. Recent research highlights the pivotal role of sphingolipid metabolism, particularly ceramides, in modulating sebaceous gland activity and skin inflammation. Ceramide deficiencies in acne-prone skin contribute to compromised barrier integrity, increased microbial colonization, and an exaggerated inflammatory response. Furthermore, sphingolipid intermediates such as sphingosine-1-phosphate (S1P) influence sebocyte differentiation, lipid synthesis, and cytokine release, linking sphingolipid metabolism to sebaceous gland homeostasis. Emerging therapeutic strategies targeting sphingolipid pathways offer new opportunities for managing sebaceous gland disorders. Topical and systemic therapies designed to restore ceramide levels and modulate S1P signaling have shown promise in preclinical studies, with potential to reduce sebum production, enhance barrier function, and attenuate inflammation. Additionally, sphingolipid-targeted formulations combined with established treatments, such as retinoids and antimicrobial agents, may enhance therapeutic outcomes while minimizing side effects. The dysregulation of sebaceous lipid metabolism, particularly sphingolipid pathways, plays a central role in acne pathogenesis, and emerging insights into these mechanisms are shaping innovative strategies for the treatment and prevention of sebaceous gland disorders
Psychedelics for Substance Use Disorders: Updates for the Psychiatric Trainee
No full textPsychedelics have recently gained attention as potential therapeutic agents for treating patients with substance use disorders, with studies showing promise of psychedelics for reducing substance use and cravings. Despite a limited number of well-controlled modern trials examining psilocybin treatment for alcohol or tobacco use disorder, the available evidence suggests that many serotonergic psychedelics may have benefits for managing various substance use disorders. In this narrative review, the authors aimed to critically evaluate the literature on the use of psychedelics for substance use disorders, including evidence for their efficacy, safety, and potential risks
Rapid Recovery From Bell\u27s Palsy Using Transcranial Magnetic Stimulation of the Facial Nerve: A Case Report
Full text linkTranscranial magnetic stimulation (TMS), a non-invasive tool that uses magnetic fields to stimulate specific regions within the brain, has emerged as a versatile treatment modality in both research and clinical settings. While its utilization in psychiatry for treatment-resistant depression is well established, TMS is increasingly gaining traction for its use in diverse neurological conditions, including idiopathic facial nerve palsy, post-stroke rehabilitation, autism spectrum disorder, and hereditary ataxia. Through its ability to trigger neuronal plasticity and potentiate synaptic transmission, it is able to provide significant therapeutic potential. This paper seeks to explore and add to the rising research in treating idiopathic facial nerve palsy with the use of peripheral TMS. A 26-year-old woman with no prior history of facial palsy or related conditions presented with acute-onset left-sided facial paralysis upon awakening, following a strenuous hiking trip the previous day. Based on the modified House-Brackmann scale, she was determined to have grade V facial paralysis (severe facial weakness with barely perceptible motion). After 10 treatments over the course of two weeks, the patient\u27s facial paralysis improved to grade III (obvious, moderate facial weakness, complete eye closure with maximal effort, and good forehead movement). At one-week post-TMS treatment, the patient reported full recovery to all facial expressions and no adverse effects were noted. This case report aims to show the effectiveness of utilizing TMS as a treatment option for idiopathic facial nerve palsy
Impact of Point-of-Care Testing on Diagnosis, Treatment, and Surveillance of Vaccine-Preventable Viral Infections
Full text linkWith the advent of a variety of vaccines against viral infections, there are multiple viruses that can be prevented via vaccination. However, breakthrough infections or uncovered strains can still cause vaccine-preventable viral infections (VPVIs). Therefore, timely diagnosis, treatment, and surveillance of these viruses is critical to patient care and public health. Point-of-care (POC) viral diagnostics tools have brought significant improvements in the detection and management of VPVIs. These cutting-edge technologies enable prompt and accurate results, enhancing patient care by facilitating timely treatment decisions. This review delves into the advancements in POC testing, including antigen/antibody detection and molecular assays, while focusing on their impact on the diagnosis, treatment, and surveillance of VPVIs such as mpox, viral hepatitis, influenza, flaviviruses (dengue, Zika, and yellow fever virus), and COVID-19. The role of POC tests in monitoring viral infection is crucial for tracking disease progression and managing outbreaks. Furthermore, the application of POC diagnostics has shown to be vital for public health strategies. In this review, we also highlight emerging POC technologies such as CRISPR-based diagnostics and smartphone-integrated POC devices, which have proven particularly beneficial in resource-limited settings. We underscore the importance of continued research to optimize these diagnostic tools for wider global use for mpox, viral hepatitis, influenza, dengue, and COVID-19, while also addressing current challenges related to their sensitivity, specificity, availability, efficiency, and more
Exploring the Association Between Psoriasis and Subclinical Atherosclerosis Defined by Carotid Intima-Media Thickness (CIMT) in Patients with Psoriasis Vulgaris: A Systematic Review and Meta-Analysis
No full textBackground: Psoriasis is a chronic inflammatory condition that increases the risk of vascular issues, ranging from mild artery damage to severe events such as heart attacks and strokes. This systematic review and meta-analysis aimed to evaluate the relationship between psoriasis and carotid intima-media thickness (CIMT), a marker of subclinical atherosclerosis.
Methods: A comprehensive search of Embase, PubMed/Medline, Scopus, and CINAHL via EBSCO was conducted up until June 2023 using the terms Atherosclerosis AND Psoriasis. Studies measuring CIMT to assess atherosclerosis in psoriasis patients were included. A meta-analysis and subgroup analysis were performed to calculate the overall mean difference in CIMT between psoriasis patients and control groups. Studies published between 2009 and 2023 were reviewed, including 28 case-control, 18 cross-sectional, and two prospective cohort studies.
Results: The total sample size was 15,914 participants, with individual study sizes ranging from 32 to 8271. Of the included studies, 44 revealed a significant association between psoriasis and CIMT, suggesting a higher risk of subclinical atherosclerosis in psoriasis patients. The meta-analysis found that psoriasis patients had a CIMT 0.17 mm higher than the control group (95% CI 0.12- 0.22). However, six studies did not show a statistically significant mean difference.
Conclusions: This study emphasizes the importance of assessing cardiovascular risk in psoriasis patients, particularly those with moderate-to-severe disease. It highlights the need for tailored interventions to manage the increased risk of atherosclerosis in this population
