Geriatric Genital Dermatology.

As women age, hormonal changes set the stage for a variety of vulvovaginal pathologies. Health care providers in long-term care facilities should be able to recognize and treat these conditions, especially because residents may be unable to communicate their discomfort. The objective of this article is to highlight the major vulvovaginal conditions affecting older women and provide up-to-date information on treatment for providers in long-term care facilities.

Prolonged hyperglycemia in three patients with type 2 diabetes after COVID-19 infection: A case series.

Three independent cases of adult patients are described who had relative control of their type 2 diabetes prior to infection with COVID-19. Each of the described patients had different levels of severity of COVID-19 but all experienced significant and prolonged hyperglycemia for at least 1-2 months after resolution of their COVID-19 infection. Two of the three patients required intensifying insulin regimens for two months after COVID-19 infection. The case study helps to inform primary care providers about the possible need for the intensification of antihyperglycemic medications for several weeks to months after the resolution of COVID-19 infection to minimize prolonged hyperglycemia.

The Impact of Eliminating Backward Navigation on Computerized Examination Scores and Completion Time.

Objective. To determine whether elimination of backward navigation during an examination resulted in changes in examination score or time to complete the examination.Methods. Student performance on six examinations in which backward navigation was eliminated was compared to performance on examinations administered to pharmacy students the previous year when backwards navigation was allowed. The primary comparison of interest was change in student performance on a subset of identical questions included on both examinations. Secondary outcomes included change in total examination score and completion time.Results. No significant reduction in examination scores was observed as a result of eliminating backward navigation. The average time that students spent on a question was significantly reduced on two of the six examinations.Conclusion. Restricting pharmacy students' ability to revisit questions previously answered (elimination of backward navigation) on an examination had no adverse effect on scores or testing time when assessed across three years of the didactic pharmacy curriculum.

Marjolin's Ulcer of the Pleural Surface Within a Long-Standing Eloesser Flap.

Marjolin's ulcers typically result from long-term chronic inflammation of a squamous surface, most often related to burns and other scars. This report describes a squamous cell carcinoma arising from the pleural surface in a patient with a chronically neglected Eloesser flap.

Evidence for hippocampus-dependent contextual learning at postnatal day 17 in the rat.

Long-term memory for fear of an environment (contextual fear conditioning) emerges later in development (postnatal day; PD 23) than long-term memory for fear of discrete stimuli (PD 17). As contextual, but not explicit cue, fear conditioning relies on the hippocampus; this has been interpreted as evidence that the hippocampus is not fully developed until PD 23. Alternatively, the hippocampus may be functional prior to PD 23, but unable to cooperate with the amygdala for fearful learning. The current experiments investigate this by separating the phases of conditioning across developmental stages. Rats were allowed to learn about the context on one day and to form the fearful association on another. Rats exposed to the context on PD 17 exhibited significant fear only when trained and tested a week later (PD 23, 24), but not on consecutive days (PD 18, 19), demonstrating that rats can learn about a context as early as PD 17. Further experiments clarify that it is associative mechanisms that are developing between PD 18 and 23. Finally, the hippocampus was lesioned prior to training to ensure the task is being solved in a hippocampus-dependent manner. These data provide compelling evidence that the hippocampus is functional for contextual learning as early as PD 17, however, its connection to the amygdala or other relevant brain structures may not yet be fully developed.

Thermoregulatory and metabolic responses of Japanese quail to hypoxia.

Common responses to hypoxia include decreased body temperature (Tb) and decreased energy metabolism. In this study, the effects of hypoxia and hypercapnia on Tb and metabolic oxygen consumption (VO2) were investigated in Japanese quail (Coturnix japonica). When exposed to hypoxia (15, 13, 11 and 9% O2), Tb decreased only at 11% and 9% O2 compared to normoxia; quail were better able to maintain Tb during acute hypoxia after a one-week acclimation to 10% O2. VO2 also decreased during hypoxia, but at 9% O2 this was partially offset by increased anaerobic metabolism. Tb and VO2 responses to 9% O2 were exaggerated at lower ambient temperature (Ta), reflecting a decreased lower critical temperature during hypoxia. Conversely, hypoxia had little effect on T(b) or VO2 at higher Ta (36 degrees C). We conclude that Japanese quail respond to hypoxia in much the same way as mammals, by reducing both Tb and VO2. No relationship was found between the magnitudes of decreases in Tb and VO2 during 9% O2, however. Since metabolism is the source of heat generation, this suggests that Japanese quail increase thermolysis to reduce Tb. During hypercapnia (3, 6 and 9% CO2), Tb was reduced only at 9% CO2 while VO2 was unchanged.