Unfavorable hydroxychloroquine COVID-19 research associated with authors having a history of political party donations.

We explored the degree to which political bias in medicine and study authors could explain the stark variation in Hydroxychloroquine (HCQ)/Chloroquine (CQ) study favorability in the US compared to the rest of the world. COVID-19/SARS-CoV-2 preprint and published papers between January 1, 2020-July 26, 2020 with Hydroxychloroquine and/or Chloroquine; 267 met study criteria, 68 from the US. A control subset was selected. HCQ/CQ study result favorability (favorable, unfavorable, or neutral) was noted. First and last main authors of each US study were entered into FollowTheMoney.org Website, extracting any history of political party donation. Of all US studies (68 total), 39/68 (57.4%) were unfavorable, with only 7/68 (10.3%) of US studies yielding favorable results-compared to 199 non-US studies, 66/199 (33.2%) unfavorable, 69/199 (34.7%) favorable, and 64/199 (32.2%) neutral. Studies with at least one US main author were 20.4% (SE 0.053, P < 0.05) more likely to report unfavorable results than non-US studies. US Studies with at least one main author donating to any political party were 25.6% (SE 0.085, P < 0.01) more likely to have unfavorable results. US studies with at least one author donating to the Democratic party were 20.4% (SE 0.045, P < 0.05) more likely to have unfavorable results. US authors were more likely to publish studies with medically harmful conclusions than non-US authors. Cardiology-specific HCQ/CQ studies were 44.2% more likely to yield harmful conclusions (P < 0.01). Inaccurate propagation of HCQ/CQ cardiac adverse effects with individual scientific author political bias has contributed to unfavorable US HCQ/CQ publication patterns and political polarization of the medications.

Physician Body Mass Index and Bias Toward Obesity Documentation Patterns.

BACKGROUND: Many healthcare professionals consider obese individuals to be unmotivated and to lack the willpower to follow through with weight-loss plans. This attitude may result in less effort put into diagnosing, documenting, and treating obesity. Our aim was to assess documentation patterns of obesity and hypertension overall, by primary care specialty, and in relation to provider body mass index (BMI). METHODS: Twenty-two physicians from one outpatient community practice were included: 10 internal medicine and 12 family practice practitioners. We conducted a retrospective review of medical records from a 1-year period to determine provider documentation of obesity and hypertension. RESULTS: A total of 3,275 obese patients were under the care of 6 physicians with normal BMI, yielding an obesity documentation rate of 23.2%. The 10 overweight physicians had 6,218 obese patients and a documentation rate of 33.5%. The 6 obese physicians had 4,014 patients with obesity and a documentation rate of 21.7%. Obesity documentation rates differed between nonobese physicians (BMI 20-29.9 kg/m2) (30.0%) and obese (BMI ≥30 kg/m2) physicians (21.7%) (P<0.001). We found no difference (P=0.132) between documentation rates of normal-weight BMI physicians and obese physicians. The overall documentation rate of obesity (27.5%) was significantly different than the overall documentation rate of hypertension (83.3%) (P<0.001). CONCLUSION: In our study, nonobese physicians were more likely to document obesity, and documentation of obesity lagged significantly in comparison to hypertension. Addressing weight loss in obese patients starts at the provider level. Steps include documenting obesity on the problem list and providing weight-loss advice during each patient encounter.

Embedded pork bone causing esophageal perforation and an esophagus-innominate artery fistula.

Chronically embedded foreign bodies can lead to perforations, mediastinitis, and abscess, amongst a host of other complications. A 20-year-old mentally challenged female presented with "something stuck in her throat," severe dysphagia, and recurrent vomiting. Initial imaging was unremarkable; however, subsequent imaging and esophagogastroduodenoscopy two weeks later revealed an embedded pork bone. Surgery was performed to remove the bone and fix the subsequent esophageal perforation and esophagus-innominate artery fistula. This case helps reinforce the urgency in removing an ingested foreign body and the ramifications that may arise with chronically embedded foreign bodies.