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01). Skin and muscle fascia were significantly thicker in patients vs. controls (p less then 0.001). Conclusion SSc involves more than increased skin and fascial thickness which is not fully represented by mRSS. Elasticity differs in muscles with and without SSc. The former shows higher SWV and increased heterogeneity in transversal planes of muscular fibers.Introduction Laryngeal burn from hot food ingestion is a rare but potentially life-threatening presentation. It is essential that clinicians have a high index of suspicion of potential airway obstruction in such cases. NSC 644468 chemical structure To our knowledge, this is the only case of fatal laryngeal oedema caused by hot solid food ingestion reported in the literature. Presentation of case A 51 year old male presented to the Emergency Department complaining of a burn to the throat following ingestion of a piping hot fish cake. On initial assessment he reported only mild pain and increased saliva production. There was no evidence of stridor, dysphagia, dyspnoea or aspiration and hence the patient was discharged and advised to return if he experienced any worsening of his symptoms. 2 h later the patient collapsed at home and died due to airway obstruction from delayed laryngeal oedema. Discussion 27 cases of laryngeal burn from ingestion of hot food or liquid were identified in the literature. Only one fatality following ingestion of hot liquid has been reported. This is the first documented fatal laryngeal burn due to ingestion of hot solid food. At present, there are no guidelines for the assessment and management of laryngeal contact burns. Conclusion Patients may be relatively asymptomatic immediately after thermal injury to the larynx. Endoscopic examination of the larynx is required to identify laryngeal oedema. Any sign of thermal injury to the laryngeal mucosa warrants admission for observation and definitive management of the airway should be considered.Objectives (1) To describe an innovative medication-assisted therapy (MAT) opioid use disorder (OUD) protocol in an independent community pharmacy, (2) to assess patient retention of the protocol, and (3) to describe the implementation of pharmacist-initiated hepatitis C virus (HCV) screenings of patients enrolled in the protocol. Setting Independent pharmacy affiliated with a detox and rehabilitation center in Louisville, KY. Practice description A postgraduate year 1 (PGY-1) pharmacy resident-led OUD and HCV screening protocol. Practice innovation Under the Kentucky MAT OUD protocol, pharmacists at St. Matthews Community Pharmacy recognized the lack of HCV screening as a protocol requirement. To provide comprehensive care, the pharmacists added an HCV screening assessment for all patients enrolled in the pharmacy MAT OUD program. Evaluation The pharmacy was the first in Kentucky to implement the MAT OUD protocol after state board approval in January 2018. Patient retention rates of the MAT OUD protocol were evaluated during the 2018-2019 PGY-1 pharmacy residency program. HCV screening was implemented and assessed during this time. Results The service was implemented by the pharmacy practice resident with 77 patients enrolled in the MAT OUD program and 36 consenting to the HCV screening assessments. More than half (52%) of the study participants remained in the MAT OUD program for the recommended duration of 6 months or more. All study participants (n = 36) had recent HCV screenings. Conclusion This practice innovation, led through the PGY-1 pharmacy residency program, allowed patients to enroll in a MAT OUD program in the privacy of their community pharmacy. The patient retention rate was similar to those found in physician-provided OUD programs. HCV positive screenings were found in individuals with no previous history of intravenous drug use. This provides reasoning to consider adding HCV screenings as a requirement to OUD protocols.Objectives Cisplatin is one of the common chemotherapy drugs for bladder cancer, and resistance to this drug is one of the major obstacles to effective chemotherapy. MicroRNAs (miRNAs) are a category of small noncoding RNAs that can regulate the expression of numerous genes. Recent studies showed that miRNAs can act as a powerful regulator of chemo-sensitivity in cancer cells. Hence, this study aimed to investigate the effects of miRNA-486-5p on cisplatin-sensitivity of different bladder cancer cells. Material and methods The 5637 and EJ138 cancer cells were treated with miRNA-486-5p and cisplatin, individually or in combination. Results Afterward, the cytotoxicity effects of these treatments were determined by MTT assay and the increased cisplatin-sensitivity observed in both cell lines, especially, 5637 cells. Moreover, subG1 phase cell cycle arrest, changes in the expression of caspase-9, caspase-3, P53, SIRT1, OLFM4, SMAD2, and Bcl-2 genes and nuclear fragmentation also revealed the induction of apoptosis in all treatments, which increased in combination groups. Also, the combination of miRNA-486-5p with cisplatin significantly down-regulated the expression of migration associated genes including ROCK, CD44, and MMP-9 as compared with cisplatin alone. Conclusion Altogether, these results indicated that the miRNA-486-5p could induce apoptosis and inhibit cell migration ability of the cells. It seems that pre-electroporation of cells with miRNA-486-5p has useful results in the enhancement of cisplatin sensitivity of 5637 and EJ138 cancer cells and this combination may be a promising treatment strategy for bladder cancer therapy.A 63-year-old diabetic smoker with alcoholism was the first mortality case of coronavirus disease 2019 (COVID-19) in Taiwan. As concurrently infected with Klebsiella pneumoniae and subsequently with Klebsiella aerogenes, he was exposed by a national survey of patients with critically influenza-negative pneumonia. We recommend COVID-19 screening for patients with severe flu-like syndrome and protecting health-care workers from being infected.The first case of COVID-19 was reported on 31 December 2019 in Wuhan, China. Ever since there has been unprecedented and growing interest in learning about all aspects of this new disease. Debate has been generated as to the association between antihypertensive therapy with renin-angiotensin-aldosterone system (RAAS) inhibitors and SARS-CoV-2 infection. While many questions as yet remain unanswered, the aim of this report is to inform health professionals about the current state of knowledge. Because this is an ever-evolving topic, the recommendation is that it be updated as new evidence becomes available. Below, we provide a review of pre-clinical and clinical studies that link coronavirus to the RAAS.