Genital VZV in a Third Trimester Pregnancy and the Critical Role of Interdisciplinary Planning.

Introduction: Herpes simplex (HSV) and varicella zoster (VZV) viruses are harmful infectious agents in pregnancy due to their ability to impact maternal-fetal dyads through various modalities including vertical transmission, neonatal infection, and maternal morbidity. As a result, accurate diagnosis and prompt treatment of these infections in pregnancy is critical. Case: A 19-year-old primigravida presented to our tertiary care center at 30 weeks' gestation with vulvar swelling, burning, and pain. Workup included direct PCR testing of a particularly erythematous area of the vulva which returned positive for VZV. The patient was treated with a 10-day course of acyclovir with resolution of her symptoms. She later had a full-term spontaneous vaginal delivery outside of the infectious window with no significant morbidity for either her or her neonate. Conclusion: Although a rare presentation, the presence of a genital lesion or labial swelling during pregnancy warrants workup for VZV, particularly among patients known to be varicella nonimmune. If genital VZV is diagnosed during pregnancy, the development of contingency plans through interdisciplinary collaboration should be pursued to ensure a safe delivery and postpartum course for both the maternal-fetal dyad as well as other patients on the unit and the provider care team.

The Role of Patient-Reported Social Factors in Promoting Buprenorphine Consistency.

Background: While medications for opioid use disorder (MOUD) reduce overdose risk, inconsistent use can lead to substance use recurrence and compromise achieving optimal opioid use disorder (OUD) treatment outcomes. Research is limited on patient-reported perspectives on consistency of MOUD self-administration at home and its related social factors. Objectives: The primary aim was to report on rates of patient-reported buprenorphine consistency among a sample receiving outpatient OUD treatment. The secondary aim was to explore differences in social determinants of health (SDOH) between patients reporting and not reporting lapses in buprenorphine dosing. Methods: This is a secondary analysis from a cross-sectional survey and medical record abstraction study (N=96). The primary outcome was patient-reported buprenorphine consistency, as defined as no lapses in buprenorphine dosing in a preceding 28-day period. SDOH survey items were adapted from the Healthy People 2030 framework. Results: Participants (n= 96) were three quarters female (74.0%); most identified as white (54.2%) or Black (38.9%). Most reported not missing any buprenorphine doses over the preceding 28-days (88.5%). Demographic and clinical variables were similar between buprenorphine consistency groups. Participants reporting no missed doses reported few negative social determinants of health (examples: 90% not needing help reading hospital materials and not being afraid that they would be hurt in their apartment building or house). Discussion: These findings reinforce the known role of SDOH as strong predictors of treatment outcomes for chronic diseases (like substance use disorders), beyond contributions by demographic or clinical variables alone. Conclusions: Future MOUD research should incorporate patient perspectives with the goal of informing patient-centered interventions. Scientific Significance: Promoting consistency in buprenorphine dosing using strategies grounded in patient experience could be an avenue to promote positive OUD treatment outcomes.

Adsorption of Amyloid Beta Peptide by Metal-Organic Frameworks.

Metal-organic frameworks (MOFs) are capable of adsorbing a wide range of molecules. In addition to the more commonly investigated small molecules, researchers have demonstrated that MOFs adsorb much larger molecules, such as proteins and peptides. We have investigated whether MOFs are capable of adsorbing amyloid beta peptide. Amyloid beta plays a pivotal role in the progression of Alzheimer's disease because individual copies of the peptides can aggregate, forming neurotoxic oligomers and the amyloid plaques found in brains of Alzheimer's patients. After synthesizing a number of commonly studied MOFs, their adsorption capabilities were tested. We found that the MOFs tested readily adsorbed small amounts of amyloid beta (as determined by gel electrophoresis). It was determined that in most cases, adsorption occurs rapidly, with complete adsorption within minutes of incubation. Overall adsorption capacity was found to vary between different MOFs as well. Once adsorbed, amyloid beta peptide can subsequently be eluted from some MOFs by treatment with acetonitrile/water solutions, though retention strength varied between different MOFs. In some cases, MOFs that showed complete adsorption also saw high levels of peptide elution, but others showed little to no elution of the peptide. Together these data can help us begin to understand the interactions between amyloid beta and MOFs.