On the Cutting Edge of Medical Education

From the beginning, our community-based medical school has relied on our strong clinical partnerships to allow our students to train with a unique and diverse patient base within University Health, Children's Mercy, St. Luke's Health system, Research Medical Center, the Center for Behavioral Medicine, the Kansas City VA, Advent Health, and Liberty Hospital. [...]in 2021 we launched our additional campus and welcomed our newest affiliate, Mosaic Life Care, to recruit, prepare, and encourage the students training in the St. Joseph community to become part of the primary health workforce in rural Missouri counties. UMKC's faculty perfected digital learning, and our students became part of the COVID diagnosis, treatment, and vaccine teams, and actively engaged in behavioral intervention-based health studies research to identify and eliminate healthcare disparities for those living in our community. Sophie Bernstein, class of 2024, was selected for the 2022 Excellence in Public Health Award from the U.S. Public Health Service Physician Professional Advisory Committee, on the basis of her national efforts to address food insecurity.

Finding Hope

Limiting viral transmission, improving treatment, and vaccine development are the top priorities, while assuring healthcare capacity and the economic health of our communities, as cases continue to increase, present competing priorities. Since the onset of the pandemic in the U.S. on January 22, 2020, the fall-out has changed what "normal life" looks like. [...]as students entered back into the healthcare environment to continue their clinical phase of training on June 20, we are facing challenges like no other as we tackle a surge in cases. Since the pandemic onset 178 days ago, July 18 brought with it, a global record for number of new cases-260,000 in one day with 74,000 of those new cases across the U.S. Hospitalizations and deaths from COVID-19 are again on the rise as the median age of those infected decreases owing to a rise in cases in younger people. Limiting viral transmission, improving treatment, and vaccine development are the top priorities, while assuring healthcare capacity and the economic health of our communities, as cases continue to increase, present competing priorities.

Differences in pediatric SARS-CoV-2 symptomology and Co-infection rates among COVID-19 Pandemic waves.

An estimated 12.8 million pediatric SARS-CoV-2 infections have occurred within the United States as of March 1 2022, with multiple epidemic waves due to emergence of several SARS-CoV-2 variants. The aim of this study was to compare demographics, clinical presentation, and detected respiratory co-infections during COVID-19 waves to better understand changes in pediatric SARS-CoV-2 epidemiology over time.

Preliminary Assessment of a Telehealth Approach to Evaluating, Treating, and Discharging Low-Acuity Patients With Suspected COVID-19.

BACKGROUND: Telemedicine is uniquely positioned to address challenges posed to emergency departments (EDs) by the Coronavirus Disease 2019 (COVID-19) pandemic. By reducing in-person contact, it should decrease provider risk of infection and preserve personal protective equipment (PPE). OBJECTIVES: To describe and assess the early results of a novel telehealth workflow in which remote providers collaborate with in-person nursing to evaluate and discharge well-appearing, low-risk ED patients with suspected COVID-19 infection. METHODS: Retrospective chart review was completed 3 weeks after implementation. Metrics include the number of patients evaluated, number of patients discharged without in-person contact, telehealth wait time and duration, collection of testing, ED length of stay (ED-LOS), 72-h return, number of in-person health care provider contacts, and associated PPE use. RESULTS: Among 302 patients evaluated by telehealth, 153 patients were evaluated and discharged by a telehealth provider with reductions in ED-LOS, PPE use, and close contact with health care personnel. These patients had a 62.5% shorter ED-LOS compared with other Emergency Severity Index level 4 patients seen over the same time period. Telehealth use for these 153 patients saved 413 sets of PPE. We observed a 3.9% 72-h revisit rate. One patient discharged after telehealth evaluation was hospitalized on a return visit 9 days later. CONCLUSION: Telehealth can be safely and efficiently used to evaluate, treat, test, and discharge ED patients suspected to have COVID-19. This workflow reduces infection risks to health care providers, PPE use, and ED-LOS. Additionally, it allows quarantined but otherwise well clinicians to continue working.

MmpL3 Inhibition: A New Approach to Treat Nontuberculous Mycobacterial Infections.

Outside of Mycobacterium tuberculosis and Mycobacterium leprae, nontuberculous mycobacteria (NTM) are environmental mycobacteria (>190 species) and are classified as slow- or rapid-growing mycobacteria. Infections caused by NTM show an increased incidence in immunocompromised patients and patients with underlying structural lung disease. The true global prevalence of NTM infections remains unknown because many countries do not require mandatory reporting of the infection. This is coupled with a challenging diagnosis and identification of the species. Current therapies for treatment of NTM infections require multidrug regimens for a minimum of 18 months and are associated with serious adverse reactions, infection relapse, and high reinfection rates, necessitating discovery of novel antimycobacterial agents. Robust drug discovery processes have discovered inhibitors targeting mycobacterial membrane protein large 3 (MmpL3), a protein responsible for translocating mycolic acids from the inner membrane to periplasm in the biosynthesis of the mycobacterial cell membrane. This review focuses on promising new chemical scaffolds that inhibit MmpL3 function and represent interesting and promising putative drug candidates for the treatment of NTM infections. Additionally, agents (FS-1, SMARt-420, C10) that promote reversion of drug resistance are also reviewed.