Alcohol-Induced Sudden Cardiac Death in a Teenager With PPA2 Gene Mutations.

ABSTRACT: The PPA2 gene encodes a mitochondrial pyrophosphatase protein. Mutations in the gene are inherited in an autosomal recessive fashion and, when mutated, function to induce mitochondrial ATP production failure resulting in increased stress on the heart and sudden cardiac death, especially when combined with alcohol. Herein, we describe a case of a 19-year-old female patient with a history of "alcohol intolerance" who was found unexpectedly deceased after consuming a minimal amount of alcohol. Histological examination of her heart revealed widespread fibrosis of the left ventricle and the interventricular septum. Other findings include hypertrophied myocytes, including some with pleomorphic nuclei. Genetic studies were performed on postmortem blood, revealing heterozygous PPA2 gene mutations, the pathogenic variant c.683C>T (p.Pro228Leu), and the other variant c.814C>T (p.His272Tyr), a novel variant of undetermined significance. We propose that the variant of undetermined significance is likely a pathogenic mutation due to the decedent's phenotype.

Spontaneous Multiple Arterial Dissection in a COVID-19-Positive Decedent.

ABSTRACT: Spontaneous multiple arterial dissection (SMAD) is a rarely reported phenomenon and has been previously linked to connective tissue diseases and specifically the genetic mutations in SMAD3 and COL3A1. Herein we describe a case of SMAD with scattered thrombi in a COVID-19-positive patient with a history of unspecified mitochondrial myopathy. Vasculopathy involved the splenic artery, inferior mesenteric artery, internal mammary arteries, omental arteries, mesenteric arteries, and small renal arteries. Dissections were confirmed by histology in the splenic artery, inferior mesenteric artery, and bilateral renal medullary arteries. Genetic studies were done to rule out SMAD3 and COL3A1 mutations. Because the Smad3 protein has been previously implicated in COVID-19-associated tissue fibrosis, it may play a role in endothelial dysfunction as well.

Global access to aging information and the gerontology healthy ageing portal.

Nursing, gerontology, and information communications technologies are well positioned to influence gerontological health system development by promoting global access to evidence-based best practices that facilitate local access to knowledge. Gerontological nurses, as members of the global community, are encouraged to become partners in promoting active and healthy aging. One mechanism is by participating in the development of a Gerontology Healthy Ageing Portal in the eGranary Digital Library, an "Internet in a Box"™ that provides offline digital resources to institutions and individuals where Internet access is lacking or undependable.

Office-based approach to the implementation of a hepatitis immunization program.

To achieve high immunization levels among populations indicated to receive hepatitis A and/or B vaccine, strategies must be implemented to integrate vaccination into routine medical care. Such strategies must address the educational needs and communication skills of providers, patients' awareness of the diseases and the vaccines, the complexity of existing office systems, documentation issues including the use of immunization registries, reimbursement and third-party coverage issues, and ongoing office-based quality assurance. This article describes office-based approaches to implementing hepatitis vaccination programs and some of the tools available to facilitate this process.

Basic care I: the effect of dementia-specific training on certified nursing assistants and other staff.

This study evaluates the effectiveness of Basic Care I, a dementia-specific training course offered by the St. Louis Alzheimer's Association. Using three standardized measures, the effects of the course on knowledge gain, stress level, and sense of work-related self-esteem are examined Findings suggest that participation in Basic Care I increases retained learning, as 76.4 percent of the sample showed improvement on dementia knowledge scores. The outcomes of stress and self-esteem measures are inconclusive but indicate areas for future study. Implications for program planning are discussed.

The role of the student professional association in mentoring dental hygiene students for the future.

The purpose of this study was to determine the role of the Student American Dental Hygienists' Association (SADHA) in mentoring/developing dental hygiene students for the future. This project also assessed attitudes and practices of SADHA advisors towards the utilization of SADHA as a mechanism for mentoring dental hygiene students' professional development to meet the oral health needs of the public, and the goals of the ADHA. These goals include promotion of education beyond the baccalaureate level to develop qualified faculty, encouraging dental hygiene research, and promoting leadership. The study also evaluated if geographic region and academic setting impacted the utilization of SADHA. After IRB exemption, a pilot-tested questionnaire was administered using Survey Monkey, an online survey website, to 277 individual contacts at Commission on Dental Accreditation (CODA) accredited dental hygiene programs. A response rate of 68% was achieved with 186 individual responses. Eighty percent of respondents indicated offering no mentoring opportunities outside of the curriculum, while incongruously, 58.3% felt they actively mentor through SADHA. When asked what the main focus of SADHA should be, SADHA advisors ranked community service/philanthropy as number one. SADHA chapters at institutions that offer a Bachelor of Science in Dental Hygiene (BSDH) degree completion program offer more mentoring opportunities (p= or <.001). Programs offering the BSDH offer a wider variety of topics from guest speakers (p=.038). SADHA chapters in Western states have a higher graduate membership conversion rate than other regions (p=.018). SADHA advisors do not agree on how SADHA should be utilized. The majority of SADHA chapters are not offering mentoring opportunities outside of the traditional curriculum for leadership and career development. What is clear is that both students and advisors desire more interaction with the local ADHA components and constituents. In order to address these issues, efforts should be made to provide networking support among SADHA advisors and increase faculty perception of the importance of the professional association and the role of students in its future. The ADHA should consider developing a mentoring program that builds strong partnerships among all state constituent and components and SADHA.