A 63-Year-Old Woman with a History of Non-Hodgkin Lymphoma with Persistent SARS-CoV-2 Infection Who Was Seronegative and Treated with Convalescent Plasma.

BACKGROUND This is a case report of an immunocompromised patient with a history of non-Hodgkin lymphoma and persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who was seronegative and successfully treated with convalescent plasma. CASE REPORT A 63-year-old woman with a past medical history of non-Hodgkin lymphoma in remission while on maintenance therapy with the anti-CD20 monoclonal antibody, obinutuzumab, tested positive for SARS-CoV-2 via nasopharyngeal reverse transcription polymerase chain reaction (RT-PCR) testing over 12 weeks and persistently tested seronegative for immunoglobulin G (IgG) antibodies using SARS-CoV-2 IgG chemiluminescent microparticle immunoassay technology. During this time, the patient experienced waxing and waning of symptoms, which included fever, myalgia, and non-productive cough, but never acquired severe respiratory distress. She was admitted to our hospital on illness day 88, and her symptoms resolved after the administration of convalescent plasma. CONCLUSIONS As the understanding of the pathogenesis of SARS-CoV-2 continues to evolve, we can currently only speculate about the occurrence of chronic infection vs. reinfection. The protective role of antibodies and their longevity against SARS-CoV-2 remain unclear. Since humoral immunity has an integral role in SARS-CoV-2 infection, various phase 3 vaccine trials are underway. In the context of this pandemic, the present case demonstrates the challenges in our understanding of testing and treating immunocompromised patients.

Osteopathic Philosophy and Manipulation Enhancement Program: Influence on Osteopathic Medical Students' Interest in Osteopathic Manipulative Medicine.

CONTEXT: Interest in osteopathic manipulative medicine (OMM) among first- and second-year osteopathic medical students typically declines toward the end of the second year of medical school. An osteopathic philosophy and manipulation enhancement (OPME) program was implemented for osteopathic medical students to gain additional exposure to OMM at the Touro College of Osteopathic Medicine in New York, New York. OBJECTIVE: To assess how additional exposure to OMM through the OPME program influenced first- and second-year students' interest in using OMM. METHODS: A survey of first- and second-year osteopathic medical students was conducted at the end of the school years to evaluate students' demographics, exposure to OMM before matriculation, reasons for participating in the OPME program, and level of interest in OMM before and after participating in the OPME program. RESULTS: Of 390 students, 204 returned the survey. Respondents reported that their exposure to OMM before enrollment was mostly from reading about OMM philosophy (112 [54.9%]). Respondents also gained exposure from learning about OMM from family members or friends who had been treated by an osteopathic physician (37 [18.1%]), shadowing an osteopathic physician before matriculation (33 [16.2%]), and being treated by an osteopathic physician themselves (22 [10.8%]). After the OPME sessions, respondents reported improved practical skills (98 of 170 [57.6%]) and increased level of confidence in applying OMM (87 of 170 [51.2%]). Nearly half of respondents reported that being treated by a faculty member (100 [49.0%]) was very likely to increase their level of interest in OMM, followed by treating other classmates (77 [37.7%]) and being treated by classmates (73 [35.8%]). CONCLUSION: The OPME program improved students' interest in OMM and can be modified and implemented in any college of osteopathic medicine.

Endgame for polio eradication? Options for overcoming social and political factors in the progress to eradicating polio.

In 1988, the Global Polio Eradication Initiative (GPEI) was launched with the goal of eradicating polio by the year 2000. After 25 years, several dynamics still challenge this large public health campaign with new cases of polio being reported annually. We examine the roots of this initiative to eradicate polio, its scope, the successes and setbacks during the last 25 years and reflect on the current state of affairs. We examine the social and political factors that are barriers to polio eradication. Options are discussed for solving the current impasse of polio eradication: using force, respecting individual freedoms and gaining support from those vulnerable to fundamentalist 'propaganda'. The travails of the GPEI indicate the need for expanding the Convention on the Rights of the Child to address situations of war and civic strife. Such a cultural and structural reference will provide the basis for global stakeholders to engage belligerent local actors whose local political conflicts are barriers to the eradication of polio. Disregard for these actors will result in stagnation of polio eradication policy, delaying eradication beyond 2018.