Therapeutic interventions after spinal cord injury (SCI) routinely are designed to address multiple aspects of the primary and/or secondary damage that occurs. Exercise has a demonstrated efficacy for post-SCI complications such as cardiovascular dysfunction, neuropathic pain, and chronic inflammation, yet there is little understanding of the mechanisms by which improvements might result from this non-invasive approach. Here we review several of our observations of molecular and cellular changes within the injured spinal cord following acute or delayed exercise regimens that illustrate the potential for positive effects on neuroprotection and rehabilitation. Further, we provide new information about the role of exercise in promoting the regeneration of spinal axons into peripheral nerve grafts (PNGs) placed immediately or 6 weeks after injury. Acute and chronically injured propriospinal neurons within the lumbar spinal cord displayed the greatest propensity for enhanced regeneration after exercise, which correlates with the direct sensory input to this region from exercised hindlimb muscles. Future studies will extend these observations by testing whether exercise will boost the regenerative effort of axons to extend beyond the graft, interact with intraspinal targets, and establish functional connections across a lesion.

Lane Hamilton Syndrome is the rare association of idiopathic pulmonary hemosiderosis and Celiac Disease. The definitive pathophysiologic link is unknown, but the syndrome has been described as co-occurring along with other diseases. We describe the first reported case of Lane Hamilton Syndrome and idiopathic membranous nephropathy. We also hypothesize the possibility of an immune-mediated connection between the pathologies and propose a potential link of the phospholipase A2 receptor.

High-risk patients over the age of 65, who had chronic medical conditions, and had not yet had a primary care visit within 2020 were identified. A subgroup of patients participated in a survey to assess social determinants of health (SDOH) in the setting of a pandemic. Outcomes of those who participated in the survey, and those who did not participate were compared. Notably, those who were surveyed and lived within zip codes with low socioeconomic status had significantly decreased emergency department visits, which we defined as a discharge from the emergency department without hospitalization, as compared to those who did not receive outreach. Rates of inpatient hospitalization did not differ significantly. These findings suggest that patient outreach to evaluate SDOH during a pandemic leads to more appropriate emergency department and hospital resource utilization. This finding is particularly impactful given the current pandemic, which may place a strain on emergency department, and healthcare resources.

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Background Currently, the world has found itself in a global pandemic with coronavirus. At its start, to limit the spread of this virus, countries, states, and counties have implemented stay-at-home orders and shutdowns. These shutdowns had great impacts on people's well-being and exacerbated social determinants of health. This project aims to identify patient social determinants of health and their associations during the COVID-19 pandemic via telemedicine. Methods A total of 104 patients were surveyed within Pittsburgh, Pennsylvania, who had not been seen for at least 4 weeks before March 23, 2020 and who did not have a scheduled visit within 4 weeks of the initial survey. Based on a patient's specific response, resources were then allocated to them. Results Most patients surveyed identified at least 1 social determinant of health, the most common being financial issues (27%), mental health issues (26%), and access to food (19%). A statistically significant relationship was found between patients who identified finances with access to food, access to medication with struggling to care for themselves or others, and physical wellness with mental health. Lastly, an association was found between those who did not identify any difficulties and wanting more information. Conclusions By identifying needed barriers via telemedicine, we can properly allocate resources to those who need it the most and hope to decrease the potential long-term effects of this current pandemic.