Pain Complaints and Intubation Risk in COVID-19: A Retrospective Cohort Study.

Background Since coronavirus disease 2019 (COVID-19) emerged, increasing cases have been identified worldwide. COVID-19 continues to lead to significant morbidity and mortality, despite developing a vaccination for the disease. While much has been studied regarding the initial presentation and treatment of patients with COVID-19, to our knowledge, no study has uncovered that COVID-19-positive patients with abdominal pain are at a higher risk of requiring intubation. Methodology In this retrospective cohort study, we identified 104 patients who presented to the emergency room of a single tertiary care center with laboratory-confirmed COVID-19 between February 1, 2020, and April 27, 2020, and collected data on reported pain complaints. Results In this retrospective cohort study, the most common pain complaints were chest pain (25.5%), myalgia (23.4%), and abdominal pain (17.0%). Less common pain complaints included headaches (14.9%) and neck/back pain (6.3%). Of these pain complaints, only patients who reported having abdominal pain were more likely to be intubated (37.5% of patients with abdominal pain were intubated compared to 8.3% of patients without abdominal pain, with a p-value of 0.001). Conclusions Abdominal pain in a patient with COVID-19 infection significantly increases their chances of requiring intubation based on the results of this study.

The Impact of Non-opioid Analgesic Usage on Total Opioid Load During Traumatic Brain Injury Rehabilitation: A Retrospective Study.

Background Patients staying in acute rehabilitation often use large amounts of opioids during their stay. There are a number of reasons for this increased opioid exposure, including but not limited to daily exercises with physical and occupational therapists, increased demand on a healing body, and use of previously atrophying musculature. Some physiatrists have noticed that patients who concurrently are prescribed medications such as Robaxin seem to require fewer opioids during their stay in acute rehabilitation. This study aimed to determine the association between non-opioid analgesic use and total opioid load, as measured using morphine milligram equivalents (MMEs), during inpatient rehabilitation for traumatic brain injury. Methodology A retrospective study of individuals with a diagnosis of traumatic brain injury admitted to an acute inpatient rehabilitation program was performed. Non-opioid medications that were reviewed in the study included acetaminophen, amitriptyline, baclofen, diclofenac, gabapentin, ibuprofen, lidocaine, methocarbamol, nortriptyline, and pregabalin. Five of the most-used non-opioid medications (acetaminophen, diclofenac, gabapentin, lidocaine, and methocarbamol) were statistically analyzed using regression and analysis of variance to evaluate for any significant variables. Results Results showed that the average daily dose of acetaminophen has a significant effect on the average daily MME and that the average daily dose of gabapentin and methocarbamol each have a significant effect on the change of daily MME usage from admission to discharge from acute rehab (ΔMME). Results also showed that the mere presence of methocarbamol (regardless of daily or total dosage) had a significant effect on the ΔMME. Conclusions Based on these findings, physicians may want to consider prescribing acetaminophen, gabapentin, or methocarbamol for patients admitted for inpatient rehabilitation following traumatic brain injury who require high amounts of opioids.

AC frequency characteristics of coplanar impedance sensors as design parameters.

Glass-based microchannel chips were fabricated using photolithographic technology, and Pt thin-film microelectrodes, as coplanar impedance sensors, were integrated on them. Longitudinal design parameters, such as interelectrode spacing and electrode width, of coplanar impedance sensors were changed to determine AC frequency characteristics as design parameters. Through developing total impedance equations and modeling equivalent circuits, the dominant components in each frequency region were illustrated for coplanar impedance sensors and the measured results were compared with fitted values. As the ionic concentration increased, the value of the frequency-independent region decreased and cut-off frequencies increased. As the interelectrode spacing increased, cut-off frequencies decreased and total impedance increased. However, the width of each frequency-independent region was similar. As the electrode area increased, f(low) decreased but f(high) was fixed. We think that the decrease in R(Sol) dominated over the influence of other components, which resulted in heightening f(low) and f(high). The interelectrode spacing is a more significant parameter than the electrode area in the frequency characteristics of coplanar sensors. The deviation of experimentally obtained results from theoretically predicted values may result from the fringing effect of coplanar electrode structure and parasitic capacitance due to dielectric substrates. We suggest the guidelines of dominant components for sensing as design parameters.

Segments missing from the draft human genome sequence can be isolated by transformation-associated recombination cloning in yeast.

The reported draft human genome sequence includes many contigs that are separated by gaps of unknown sequence. These gaps may be due to chromosomal regions that are not present in the Escherichia coli libraries used for DNA sequencing because they cannot be cloned efficiently, if at all, in bacteria. Using a yeast artificial chromosome (YAC)/ bacterial artificial chromosome (BAC) library generated in yeast, we found that approximately 6% of human DNA sequences tested transformed E. coli cells less efficiently than yeast cells, and were less stable in E. coli than in yeast. When the ends of several YAC/BAC isolates cloned in yeast were sequenced and compared with the reported draft sequence, major inconsistencies were found with the sequences of those YAC/BAC isolates that transformed E. coli cells inefficiently. Two human genomic fragments were re-isolated from human DNA by transformation-associated recombination (TAR) cloning. Re-sequencing of these regions showed that the errors in the draft are the results of both missassembly and loss of specific DNA sequences during cloning in E. coli. These results show that TAR cloning might be a valuable method that could be widely used during the final stages of the Human Genome Project.