More Than a Health Fair: Preventive Health Care During COVID-19 Vaccine Events.

Background: During the initial phase of the COVID-19 pandemic, facilities transformed some medical care to virtual appointments. There was a subsequent decline in chronic disease screening and management, as well as cancer screening rates. Observations: COVID-19 vaccine events offered an opportunity to provide face-to-face preventive care to veterans, and mobile vaccine events enabled us to reach rural veterans. In this quality improvement project, we partnered with state and community organizations to reach veterans at large vaccine events, as well as in rural sites and homeless housing. The program resulted in the successful provision of preventive care to 115 veterans at these events, with high follow-up for recommended medical care. In all, 404 clinical reminders were completed and 10 new veterans were enrolled for health care. Important clinical findings included an invasive colorectal cancer, positive HIV point-of-care test, diabetic retinal disease, uncontrolled hypertension, and depression. Conclusions: Vaccine events offer a venue for chronic disease screening, referral, and cancer screening.

Potential anti-inflammatory phenolic glycosides from the medicinal plant Moringa oleifera fruits.

Bioassay-guided isolation and purification of the ethyl acetate extract of Moringa oleifera fruits yielded three new phenolic glycosides; 4-[(2'-O-acetyl-alpha-l-rhamnosyloxy) benzyl]isothiocyanate (1), 4-[(3'-O-acetyl-alpha-l-rhamnosyloxy)benzyl]isothiocyanate (2), and S-methyl-N-{4-[(alpha-l-rhamnosyloxy)benzyl]}thiocarbamate (3), together with five known phenolic glycosides (4-8). The structures of the new metabolites were determined on the basis of spectroscopic analyses including 1D- and 2D-NMR and mass spectrometry. The anti-inflammatory activity of isolated compounds was investigated with the lipopolysaccharide (LPS)-induced murine macrophage RAW 264.7 cell line. It was found that 4-[(2'-O-acetyl-alpha-l-rhamnosyloxy)benzyl]isothiocyanate (1) possessed potent NO-inhibitory activity with an IC(50) value of 1.67 microM, followed by 2 (IC(50)=2.66 microM), 4 (IC(50)=2.71 microM), and 5 (IC(50)=14.4 microM), respectively. Western blots demonstrated these compounds reduced LPS-mediated iNOS expression. In the concentration range of the IC(50) values, no significant cytotoxicity was noted. Structure-activity relationships following NO-release indicated: (1) the isothiocyanate group was essential for activity, (2) acetylation of the isothiocyanate derivatives at C-2' or at C-3' of rhamnose led to higher activity, (3) un-acetylated isothiocyanate derivatives displayed eight times less activity than the acetylated derivatives, and (4) acetylation of the thiocarbamate derivatives enhanced activity. These data indicate compounds 1, 2, 4 and 5 are responsible for the reported NO-inhibitory effect of Moringa oleifera fruits, and further studies are warranted.