ABSTRACT
Background Television and media have a profound effect on viewers' understanding and interpretation of the world we live in. Reality television can be even more influential to viewers given its depiction of "real life". Materials and methods Every episode (n=46) was analyzed from five medical reality television shows. Hopkins, Boston Med, NY Med, Vanderbilt MDs, and Lenox Hill were selected based on criteria requiring the show to be a reality show or docuseries that recorded unscripted patient interactions in the inpatient setting or emergency department. Results Of the 185 physicians shown on medical reality television, most were male (76.8%), white (80.0%), and surgeons (62.2%). Of the 417 patients shown on television, 72 patients had a traumatic mechanism of injury. Traumatic mechanisms included injury due to motor vehicle accident (29.2%), firearm (26.4%), cutting/piercing (12.5%), fall (12.5%), and fire/flame/hot substance (6.9%). Twenty-two of the 417 patients required cardiopulmonary resuscitation (CPR). Seven patients (31.8%) experienced cardiac arrest due to a traumatic mechanism of injury. Conclusions There was an overrepresentation of male physicians, white physicians, and surgeons on medical reality television compared to current demographic data on physicians (p<0.01). Traumatic mechanisms of injury by firearm, cutting/piercing, fire/flame/hot substance and traumatic causes of cardiac arrest were over-represented on television compared to current trauma and CPR registry data (p<0.01). This skewed "reality" of medicine as a non-diverse landscape riddled with trauma has the potential to profoundly impact viewers' understanding of medical professionals and the medical field.
ABSTRACT
Concussion is a heterogeneous injury that relies predominantly on subjective symptom reports for patient assessment and treatment. Developing an objective, biological test could aid phenotypic categorization of concussion patients, leading to advances in personalized treatment. This prospective multi-center study employed saliva micro-ribonucleic acid (miRNA) levels to stratify 251 individuals with concussion into biological subgroups. Using miRNA biological clusters, our objective was to assess for differences in medical/demographic characteristics, symptoms, and functional measures of balance and cognition. The miRNAs that best defined each cluster were used to identify physiological pathways that characterized each cluster. The 251 participants (mean age: 18 ± 7 years; 57% male) were optimally grouped into 10 clusters based on 22 miRNA levels. The clusters differed in age (χ2 = 19.1, p = 0.024), days post-injury at the time of saliva collection (χ2 = 22.6; p = 0.007), and number of prior concussions (χ2 = 17.6, p = 0.040). The clusters also differed in symptom reports for fatigue (χ2 = 17.7; p = 0.039), confusion (χ2 = 22.3; p = 0.008), difficulty remembering (χ2 = 22.0; p = 0.009), and trouble falling asleep (χ2 = 17.2; p = 0.046), but not objective balance or cognitive performance (p > 0.05). The miRNAs that defined concussion clusters regulate 16 physiological pathways, including adrenergic signaling, estrogen signaling, fatty acid metabolism, GABAergic signaling, synaptic vesicle cycling, and transforming growth factor (TGF)-ß signaling. These results show that saliva miRNA levels may stratify individuals with concussion based on underlying biological perturbations that are relevant to both symptomology and pharmacological targets. If validated in a larger cohort, miRNA assessment could aid individualized, biology-driven concussion treatment.
Subject(s)
Brain Concussion , MicroRNAs , Brain Concussion/psychology , Female , Humans , Male , Phenotype , Prospective Studies , SalivaABSTRACT
Cefepime is a renally excreted, fourth-generation cephalosporin used in the treatment of severe abdominal, skin, soft tissue, and urinary tract infections due to its broad-spectrum coverage. Cefepime-induced neurotoxicity is a rare but serious side effect that has increased in recent years likely due to increased antibiotic use, increased drug resistance, and increased symptom recognition. While decreased glomerular filtration rate is an important risk factor for developing elevated serum cefepime levels, recent literature has suggested that a significant proportion of patients with normal renal function can also develop neurotoxicity from cefepime. Here, we present a case of cefepime-induced neurotoxicity to demonstrate the importance of monitoring mental status changes in all patients being treated with cefepime.
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The annotation of six cluster N Mycobacterium smegmatis phages (Kevin1, Nenae, Parmesanjohn, ShrimpFriedEgg, Smurph, and SpongeBob) reveals regions of genomic diversity, particularly within the central region of the genome. The genome of Kevin1 includes two orphams (genes with no similarity to other phage genes), with one predicted to encode an AAA-ATPase.
ABSTRACT
Mycobacteriophages Chancellor, Mitti, and Wintermute infect Mycobacterium smegmatis mc2155 and are closely related to phages Cheetobro and Fionnbharth in subcluster K4. Genome sizes range from 57,697 bp to 58,046 bp. Phages are predicted to be temperate and to infect the pathogen Mycobacterium tuberculosis.
