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What Role Does Theology Play in COVID-19 Vaccine Willingness in African Americans?
No full textThis study examined the influence of theology and belief in God on COVID-19 vaccine decision-making among African Americans. It investigated how religious beliefs, spiritual practices, and church leadership shape vaccine attitudes. The research utilized a qualitative design. Focus group questions assessed how theology influences African Americans\u27 opinions and attitudes toward the COVID-19 vaccine and how religion, spirituality, or faith may have contributed to vaccine decision-making in this same group. The study identified four key hypotheses: 1) Trusted spiritual leaders and personal theological convictions significantly influence vaccine perceptions; 2) Church denominational views shape willingness and hesitancy toward vaccination; 3) Age differences potentially affect the theological impact on vaccine decision-making, though data was insufficient for a conclusive analysis; 4) Political views intertwine with theological beliefs to affect vaccine choices. Additionally, findings revealed a nuanced interplay between faith, rationality, political ideologies, and cultural humility, emphasizing the critical role of Religious Determinants of Health (ReDoH) in public health strategies. Despite challenges such as sample diversity and limitations, this research underscores the necessity of integrating ReDoH into public health frameworks. It offers insightful contributions to understanding the complex nature of theological influences on health behaviors among African Americans and advocates for culturally sensitive healthcare interventions and inclusive research practices
Dose and Style of Yoga as Variables in Eating Disorder Interventions: A Systematic Narrative Literature Review
No full textA clinical problem exists when yoga interventions for eating disorders (EDs) are not manualized for the purpose of research or clinical application. To combat this issue, a systematic narrative literature review was required to examine the variables of dose and style of yoga and impacts on body dissatisfaction. Articles published between the years 2003-2023 relevant to eating disorders, yoga, and body dissatisfaction were reviewed. APA PsychINFO, Google Scholar, Psychology & Behavioral Sciences Collection, Medline/PubMed databases were searched with the following keywords: Yoga [All Fields] and Body Satisfaction [All Fields], Eating Disorders [All Fields] and Yoga [All Fields] keywords. The PRISMA method of reporting was used to examine the independent variables of dose and style of yoga, relating to the dependent variable of body dissatisfaction, in articles published after 2003. Results indicated that regardless of the two variables examined, yoga reduces body dissatisfaction. When yoga was practiced alone, 24 sessions ashtanga yoga significantly reduced body dissatisfaction. A discussion of clinical implications and patient appropriateness was included. Lastly, a manualized clinical intervention was created and included to address the clinical problem
Hand Amputation
No full textHand amputation is a complex surgical procedure that involves the removal of all or part of the hand due to trauma, infection, or disease. With over 1.7 million people affected in the United States, the prevalence of hand amputations is significant and expected to rise. Approximately 70% of upper extremity amputations occur below the elbow, with 10% at the hand or wrist. While historically viewed as a last resort, modern techniques in hand amputation focus on preserving limb length, maximizing residual function, and minimizing complications such as phantom pain and neuroma formation.
This activity for healthcare professionals enhances knowledge of the intricate anatomy and physiology of the hand, improves their surgical and nonsurgical management strategies, and refines their skills in patient-centered care. The activity provides valuable insights into the latest techniques in hand amputation, postoperative care, and rehabilitation, equipping healthcare professionals with the knowledge to optimize patient outcomes, ensure safety, and coordinate effectively within a multidisciplinary team
A Systematic Review of Phenibut Withdrawals
Get PDFPhenibut is an anxiolytic agent that was originally used as a treatment for anxiety, depression, post-traumatic stress disorder (PTSD), and insomnia. It is a gamma-aminobutyric acid (GABA) mimetic, which stimulates GABA receptors in the brain. This increases the inhibitory effects of GABA leading to a greater chance of a sedative response and risk for abuse. It is not currently registered in Western countries but is easily accessible online as a supplement. This is a systematic review of case reports of phenibut patients with withdrawal symptoms published in the PubMed database between January 2010 and October 2023. Following the inclusion criteria application, 15 articles were included. Descriptive statistics were used to analyze the results. The average age of patients with phenibut withdrawals was 31.8 years (SD=12.66 years), and 13 cases (87%) were males. The average dosage was 13.6 g/day (SD=8 g), ranging from 1.5 to 28.5 g/day. Nine cases (60%) presented at an emergency department, and three cases (17%) were presented at a clinic setting facility. The most common history of patients who took phenibut was alcohol or drug abuse (73%). A history of anxiety and depression (60%) was also seen in the majority of patient presentations. Phenibut is never prescribed in the United States, and there are no official guidelines for phenibut use. Educating all physicians about the potentially harmful supplements available to patients and their biological mechanisms is essential. This review highlights the importance of collecting a thorough patient history, including supplements, to help prevent phenibut misuse and subsequent withdrawals
The Effect of Antibiotic Premedication on Postoperative Complications Following Dental Extractions
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We aimed to evaluate the association between antibiotic prophylaxis and adverse outcomes following tooth extraction within the Veterans Affairs Healthcare System.
Methods
We conducted a retrospective cohort study of patients undergoing dental extractions in 2015–2019. The primary exposure was antibiotic prophylaxis. The primary outcome was post-extraction complication within 7 days (e.g., alveolar osteitis and surgical site infection); the secondary outcome was subsequent medical care relating to a post-extraction oral complication within 7 days. Multivariable logistic regression models assessed the independent effect of antibiotic prophylaxis on each outcome.
Results
Of 385,880 visits with a dental extraction, 122,810 (31.8%) received antibiotic prophylaxis. Overall, 3387 (0.9%) experienced a post-extraction complication and 350 (0.09%) received medical care relating to a post-extraction oral complication within 7 days. In multivariable regression, diabetes was a statistically significant (p = 0.01) effect modifier of the association between antibiotic prophylaxis and post-extraction complication. Among visits for patients without diabetes, antibiotic prophylaxis was significantly associated with an increased odds of post-extraction complication (odds ratio [OR] = 1.25, 95% confidence interval [CI]: 1.13–1.38), but among visits for patients with diabetes no significant effect was observed (OR = 1.03, 95% CI: 0.92–1.15). Antibiotic prophylaxis was not significantly associated with post-extraction medical care (OR = 1.04; 95% CI: 0.83–1.30).
Conclusions
In this large retrospective cohort, we observed no significant protective effect of antibiotic prophylaxis on post-extraction complications or subsequent medical care utilization in a setting with low complication rates. These data suggest that use of antibiotic prophylaxis in similar settings may need to be re-evaluated to minimize unnecessary antibiotic use
A Comparison of the 2022 Versus 2011 National Institute of Child Health and Human Development Web-Based Risk Estimator for Bronchopulmonary Dysplasia
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To compare the predictive accuracy of the 2022 vs 2011 National Institute of Child Health and Human Development estimator for identifying infants at high risk for bronchopulmonary dysplasia (BPD).
Methods
We conducted a single-center retrospective study of infants ≤28 weeks\u27 gestation. Demographic and respiratory support data were used to calculate risk for BPD or death by the BPD estimators. Our outcomes of interest included (1) treatment with systemic steroids for BPD and (2) composite outcome of death or highest severity of BPD at 36 weeks’ postmenstrual age. We used c-statistics and area under receiver operator characteristic curves (AUC) to compare accuracy of the BPD estimators.
Results
A total of 159 infants (mean gestational age, 26 weeks; mean birth weight, 837 g) were included. Steroid treatment for BPD occurred in 61 infants. We found that predictive accuracy was similar for both 2022 and 2011 BPD estimators, with c-statistics ranging from 0.77 to 0.89, indicating good-to-excellent accuracy for predicting steroid treatment. Twenty-one infants had death or grade 3 BPD based on definitions used in the 2022 estimator, and 68 infants had death or severe BPD based on definitions used in the 2011 estimator. Overall, we found both BPD estimators had poor AUC for predicting infants at high risk for death or highest severity of BPD, with the exception of the 2022 estimator, which had an acceptable AUC of 0.773 on postnatal day of life 28.
Conclusions
The 2022 and 2011 BPD estimators both demonstrate similar good-to-excellent accuracy for identifying infants at high risk for steroid treatment, but poor-to-fair accuracy for predicting death or highest severity of BPD at 36 weeks’ postmenstrual age
Acute Appendicitis in the Setting of Infectious Mononucleosis: A Case Report
Get PDFInfectious mononucleosis (IM) is a viral illness caused by the Epstein-Barr virus that typically manifests with pharyngitis, lymphadenopathy, and fatigue. In rare cases, IM can cause acute appendicitis. We present the case of an 18-year-old female who arrived at the emergency department with worsening abdominal pain and an ongoing cough. Initial imaging showed a questionably dilated appendix, and a follow-up examination revealed cervical lymphadenopathy. She later returned to the ED with severe abdominal pain, clinical signs of acute appendicitis, and a positive monospot test, which led to an appendectomy. This case illustrates the need for complete history taking and thorough physical examination in patients with acute appendicitis, as their condition may be due to an atypical underlying cause
Single-Port Robotic-Assisted Excision of the Urachal Remnant in an Adult Female: A Case Report
Get PDFUrachal anomalies and their associated disease processes are quite rare in pediatric populations and even rarer in adults. Although often asymptomatic, patients with symptoms can be treated with a combination of surveillance, antibiotics, and sometimes surgical resection. In this case, we describe our experience using the single-port robotic approach for the excision of a symptomatic urachal remnant. The patient presented with a chief complaint of urinary frequency, dysuria, intermittent hematuria, and right flank pain. A CT scan of the abdomen and pelvis revealed a bladder wall thickening at the dome of the bladder measuring 2.6 x 3.6 x 1.5 cm with concerns for adenocarcinoma. The patient subsequently underwent a biopsy, which was benign. The patient\u27s symptoms persisted, and she elected to undergo surgical resection. Postoperatively, her symptoms resolved, and she was satisfied with her treatment outcome. This case exemplifies the feasibility of the single-port robotic approach to urachal remnant excision, with further applicability to simple transabdominal robotic bladder surgery
An Atypical Presentation of Osseous Choristoma in a 63-Year-Old Male: A Lesion Beyond the Common Demographic and Anatomical Norms
Get PDFOsseous choristomas, characterized by ectopic bone, are rare and typically found in the head and neck, particularly on the tongue. This report describes a unique case of an osseous choristoma in a 63-year-old male with an unusual posterior tongue location. An incidental base of tongue (BOT) mass was discovered during a bronchoscopy for lung biopsy. Physical examination revealed a 3-4 cm pedunculated mass at the root of the tongue posterior to the foramen cecum. The patient had a significant 60-pack-year smoking history. A biopsy confirmed the diagnosis of osseous choristoma. The mass was surgically debulked using an intraoral approach. Histopathology revealed findings consistent with osseous choristoma. Intraoral osseous choristomas are exceedingly rare, with fewer than 100 cases reported. This case is unusual due to the patient\u27s older age, male gender, and the mass\u27s posterior location. Surgical excision remains the treatment of choice, with recurrence being rare. This case adds to the limited literature on osseous choristomas by documenting an atypical presentation. The report underscores the importance of considering choristomas in differential diagnoses, regardless of patient age or lesion location, and highlights the efficacy of patient-centered surgical approaches in managing these rare lesions