Pharmacotherapy causing weight gain and metabolic alteration in those with obesity and obesity-related conditions: A review.

This review aims to summarize pharmacological interventions that may affect adiposity and metabolic equilibrium in individuals with obesity. Pharmacological therapy is frequently used to treat medical conditions that are both directly related to obesity (such as hypertension and type 2 diabetes) and indirectly related to obesity (such as asthma, insomnia, and type 1 diabetes). This pharmacological therapy may result in weight gain and alterations in the metabolic profile. Many medication classes are implicated in the pharmacologic causes of weight gain, including antipsychotics, glucocorticoids, beta-adrenergic blockers, tricyclic antidepressants, antihistamines, insulin, neuropathic agents, sleep agents, and steroids. This article describes the mechanisms of action and pathways of pharmacological interventions causing obesity.

Virtual Surgical Skills Training in a High School Summer Program.

BACKGROUND: The COVID-19 pandemic has disrupted components of traditional education with shifts toward virtual platforms. This report describes the virtual approach to basic surgical skills training during a high school program in the summers of 2020 and 2021. METHODS: Two 2-week sessions were held by Zoom (Zoom Video Communications) with 99 students in 2020 and 198 students in 2021. Each student was sent surgical supplies and instruments. Interactive lectures were held each morning, and basic surgical skills instruction was provided each afternoon. After the session, survey links were distributed to students to complete an anonymous 37-item questionnaire regarding surgical skills confidence, simulation kit satisfaction, and technical difficulties. RESULTS: Of the 297 students, 270 (90.9%) completed the questionnaire, including 91 (91.9%) in 2020 and 179 (90.4%) in 2021. On a scale of 1 (fair) to 5 (excellent), students in 2020 and 2021 reported similar confidence in instrument handling (4-5: 90.0% vs 86.3%; P = .38), suturing skin (4-5: 88.9% vs 82.8%; P = .19), and thoracic aorta suturing (4-5: 73.3% vs 73.6%; P = .97). Students reported greater confidence in 2020 in knot tying (4-5: 98.9% vs 87.9%; P = .002), coronary vessel suturing (4-5: 82.2% vs 65.5%; P < .001), and valve model suturing (4-5: 68.5% vs 50.3%; P = .005) than students in 2021. Students had similar satisfaction rates with the program (extremely or somewhat satisfied: 92.3% vs 86.0%; p = .51) between 2020 and 2021. CONCLUSIONS: Virtual education carries the potential for basic surgical skills training for a more widespread audience with less access to direct surgical education. Further research is needed to optimize teaching finer surgical skills.

Socioeconomic disparities in healthcare utilization for atherosclerotic cardiovascular disease.

BACKGROUND: The impact of the social determinants of health on healthcare utilization for patients with atherosclerotic cardiovascular disease (ASCVD) remains incompletely characterized. METHODS: We queried the National Health Interview Survey from 2000-2018 to examine disparities in healthcare utilization metrics by education, income-to-poverty ratio, and health insurance coverage for adults with self-reported ASCVD. RESULTS: We show that, while education and income-to-poverty ratios demonstrated significant disparities for provider visits and preventive screenings, the largest disparities were noted for health insurance coverage. CONCLUSIONS: These trends suggest that efforts to expand private or government insurance to improve coverage for patients with ASCVD may address healthcare utilization-based disparities.