Survey respondents were supportive of universal alcohol screening in school, although few were doing so at the time. When respondents identified students using alcohol, their interventions were closely aligned with clinical recommendations for brief intervention. Implementation of SBIRT that focuses on standardized, annual screening has the potential to deliver high-quality care in this setting.
S45 77 ± 8%(hTERT +); p < 0.05) and cardiomyocyte (cTnT+, 8 ± 1% vs 18 ± 4%(hTERT +); ␣-actinin+, 14 ± 2% vs 31 ± 4%(hTERT +); p < 0.05) differentiation compared to R␣+CPCs. RNA sequencing identified increased cell differentiation, proliferation/survival and angiogenesis related genes in hTERT + R␣+CPCs. Transplantation of 5 × 10 6 cells in athymic-rats (N = 8-9/group) four weeks after induced myocardial infarction (MI) showed hTERT + R␣+CPCs significantly increased LV ejection fraction (LVEF, 32 ± 2%) and reduced scar area (14 ± 1%) compared to non-transduced R␣+CPCs (26 ± 2%, p = 0.06 (LVEF); 17 ± 2%, p = 0.27 (scar)) or vehicle controls (25 ± 2%, p = 0.045 (LVEF); 20 ± 2%, p = 0.024 (scar)). Conclusion: hTERT over-expression rejuvenates R␣+CPCs from aged and diseased hearts. Transplantation of hTERT + R␣+CPCs is a novel therapeutic strategy to enhance cardiac function after MI.
Objective: Alcohol use can worsen attention-deficit/hyperactivity disorder (ADHD) symptoms, interfere with treatment, and worsen outcomes. Our objective was to describe parental perceptions of alcohol use for their adolescents with ADHD. Methods: Parents of adolescents with ADHD completed an online survey about perceptions of adolescent alcohol use for adolescents with ADHD. We described the level of parental concern about the impacts of alcohol use on their adolescent's functioning. We assessed whether specific covariates were associated with the level of parental concern. Results: Of 290 parents who completed the survey, 96.5% were women, and 66.1% had an educational attainment of college degree or higher. Most adolescents (75.4%) took ADHD medication, and 59.9% had comorbid anxiety or depression. Almost one-third (30.3%) of parents perceived that their adolescent was more likely to use alcohol because of ADHD, whereas 34.8% of parents disagreed with this and 34.8% of parents were neutral. Parents who suspected their adolescent regularly used alcohol were less likely to report concern about the impact of alcohol on their adolescent's school performance or ADHD medication effectiveness compared with parents who did not suspect regular adolescent alcohol use. Almost half of the parents (48.5%) did not report discussing the impact of alcohol use on ADHD with their adolescent. Conclusion: Many parents of adolescents with ADHD do not understand the unique risks of alcohol use for their adolescents. In addition, if alcohol use harm is not obvious, parents may not perceive there to be concerns about alcohol use on functioning. Parental education about alcohol use and ADHD is needed.
Introduction: Hepatitis is acute inflammation of the liver, and it is most often caused by viral infections (Hepatitis A, B, C), as well as by alcohol, toxins, and other causes. This can be acute or chronic in nature, and will often present with symptoms including fatigue, nausea and vomiting, and jaundice. Elevated liver enzymes will aid in diagnosis. However, when some of the most common causes have been ruled out, additional evaluation is performed into less common causes. We present a case of acute hepatitis secondary to syphilis. Case Description/Methods: The patient is a 38-year-old male who presented with increasing fatigue and abnormal liver enzymes. He also noted lower extremity swelling as well as the presence of a new rash all over his body. He denied any nausea, vomiting, fevers, abdominal pain, constipation or diarrhea. He denied any recent medication changes, and denies smoking, alcohol use, and illicit drug use. Family history was unremarkable. There was no history of blood transfusion. The patient reports being sexually active with multiple female partners in the past. A CMP was significant for an ALP of 451, AST 155, and ALT 240. Bilirubin was normal. A CBC showed a hemoglobin of 11.7 with an MCV of 76.8. His most recent CBC and LFTs from four months prior were normal. Of note, Hep B/C, HIV, HSV, GC, and Chlamydia all recently tested negative. Serologic studies for ANA, ASMA, ceruloplasmin, alpha-1 antitrypsin, and iron panel all were normal. The patient states that he tested positive for syphilis during plasma donation. A red, macular rash was present on the palms of his hands, soles, and lower legs. Treatment with IM Penicillin G was initiated. Following treatment, his LFTs were trended, which revealed ALP of 438, AST 54, and ALT 114. The patient was advised to follow-up with his PCP to assess for symptom resolution. Discussion: Syphilis is an infection that can present with a variety of different symptoms. Though syphilis and hepatitis has been rarely associated in the past, it is a rare cause, and delayed diagnosis can result in significant patient morbidity. Many patients will note a characteristic painless, genital lesion. However, this can go unnoticed or underreported by the patient as it self-resolves. While it is incredibly sensitive to penicillin, prompt diagnosis can be challenging, and late stages of syphilis can result in irreversible complications.
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