Studies have identified demographic, clinical, psychosocial, and perioperative variables associated with persistent pain after a variety of surgeries. This study aimed to perform a systematic review and meta-analysis of factors associated with persistent pain after total knee replacement (TKR) and total hip replacement (THR) surgeries. To meet the inclusion criteria, studies were required to assess variables before or at the time of surgery, include a persistent postsurgical pain (PPSP) outcome measure at least 2 months after a TKR or THR surgery, and include a statistical analysis of the effect of the risk factor(s) on the outcome measure. Outcomes from studies implementing univariate and multivariable statistical models were analyzed separately. Where possible, data from univariate analyses on the same factors were combined in a meta-analysis. Eighty-one studies involving 171,354 patients were included in the review. Because of the heterogeneity of assessment methods, only 44% of the studies allowed meaningful meta-analysis. In meta-analyses, state anxiety (but not trait anxiety) scores and higher depression scores on the Beck Depression Inventory were associated with an increased risk of PPSP after TKR. In the qualitative summary of multivariable analyses, higher preoperative pain scores were associated with PPSP after TKR or THR. This review systematically assessed factors associated with an increased risk of PPSP after TKR and THR and highlights current knowledge gaps that can be addressed by future research.

Microorganisms and associated conditions make up some of the world’s leading causes of death and have the potential to cause a significant societal effect during pandemic states. Despite such significance in the healthcare field, attention and funding directed towards microbiological research lags its cohorts in cancer and cardiovascular disease. In the current SAR-CoV-2 pandemic, the importance of practicing clinicians and providers to remain knowledgeable on antimicrobial therapy for their patients is higher than ever before. The scope of this review is to provide clinicians a semi-comprehensive, up-to-date understanding of the mechanisms of action among antimicrobial agents as well as key distinctions in clinical manifestations of pathogens.

Introduction. The internet is an ever-evolving resource to improve healthcare literacy among patients. The nature of the internet can make it difficult to condense educational materials in a manner applicable to a worldwide patient audience. Within the realm of endocrinology, there is a lack of a comprehensive analysis regarding these pathologies in addition to educational materials related to their medical workup and management. The aim of this study is to assess contemporary online patient education material in endocrinology and management of care. Methods. Analysis of the readability of 1500 unique online education materials was performed utilizing 7 readability measures: Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index Readability Formula (FOG), Simple Measure of Gobbledygook Index (SMOG), Coleman-Liau Index (CLI), automated readability index (ARI), and Linsear Write Formula (LWF). Results. The average grade level readability scores from 6 measures (FKGL, FOG, SMOG, CLI, ARI, LWF) was ≥11 which corresponds to a reading level at or above the 11th grade. The average FRE between adrenal, diabetes and thyroid-related education material ranged between “fairly difficult” to “very difficult”. Conclusions. The current readability of contemporary online endocrine education material does not meet current readability recommendations for appropriate comprehension of the general audience.

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Alzheimer’s disease remains a prevailing neurodegenerative condition which has an array physical, emotional, and financial consequences to patients and society. In the past decade, there has been a greater degree of investigation on therapeutic small peptides. This group of biomolecules have a profile of fundamentally sound characteristics which make them an intriguing area for drug development. Among these biomolecules, there are four modulatory mechanisms of interest in this review: alpha-, beta-, gamma-secretases, and amylin. These protease-based biomolecules all have a contributory role in the amyloid cascade hypothesis. Moreover, the involvement of various biochemical pathways intertwines these peptides such that they have shared regulators (i.e., retinoids). Further clinical and translational investigation must occur to gain a greater understanding of its potential application in patient care. The aim of this narrative review is to evaluate the contemporary literature on these protease biomolecule modulators and determine its utility in the treatment of Alzheimer’s disease.