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Articles 4591 - 4620 of 62657
Full-Text Articles in Medicine and Health Sciences
Attitudes Of New York State Pediatric Dentists Toward Treating Hasidic Patients, Gideon Turk Dmd, Michelle Goldstein Dmd
Attitudes Of New York State Pediatric Dentists Toward Treating Hasidic Patients, Gideon Turk Dmd, Michelle Goldstein Dmd
The New York State Dental Journal
Purpose: This survey investigated variations in practices among pediatric dentists and dental residents in New York State concerning the treatment of Hasidic, Haredi or Ultra-Orthodox Jewish (HHUOJ) patients.
Methods and Results: The 16-question survey was distributed to 641 AAPD pediatric dentists and residents via email. Results were analyzed across six variables using the Mann-Whitney U Test. Statistically significant differences were observed in the responses to 14 of 16 questions.
Conclusion: The study revealed statistically significant variations in various aspects related to the treatment of HHUOJ patients, suggesting the need for further education among providers in New York State.
Revolutionizing Dental Operatories: How Do We Do More Using Less?, Michael Zidile D.D.S., Brian Choi D.D.S.
Revolutionizing Dental Operatories: How Do We Do More Using Less?, Michael Zidile D.D.S., Brian Choi D.D.S.
The New York State Dental Journal
The authors present a transformative approach to modernizing dental operatories as part of their practice’s recent expansion. Aimed at enhancing efficiency and patient-centered care, the project reimagines traditional operatory design by eliminating ergonomic and hygienic barriers, notably, the use of keyboards and mice. Key innovations include the implementation of touchscreen PC displays, high-power PCs with graphics cards, magnetic USB cables for rapid data transfer, omnidirectional microphones linked to AI scribes and wireless intraoral scanning. The design prioritizes a standardized, clutter-free layout across eight operatories, utilizing A-Dec Inspire Series cabinets for ergonomic supply management. By removing countertops and pullout trays, the …
An Update On Non-Cigarette Nicotine-Containing Products And The Periodontal Patient, Brendan Keeney D.D.S., Ryan Schure Dds, Msc, Frcd
An Update On Non-Cigarette Nicotine-Containing Products And The Periodontal Patient, Brendan Keeney D.D.S., Ryan Schure Dds, Msc, Frcd
The New York State Dental Journal
The adverse general and oral health effects from traditional cigarette smoking are supported by decades of research. However, the use of cigarettes in the United States is on the decline, and current research and literature is relatively lacking with respect to novel nicotine consumption methods. Given the increasing and significant use of non-cigarette nicotine-containing products, such as electronic cigarettes, oral nicotine pouches and hookah pipes, attention from oral healthcare providers is warranted. An understanding of the potential negative periodontal outcomes related to these newer nicotine delivery systems is crucial to properly educating and treating patients today.
N Y State Dent J November 2025
N Y State Dent J November 2025
The New York State Dental Journal
In the November 2025 issue, the reader will find the following feature articles:
- "Attitudes of New York State Pediatric Dentists Toward Treating Hasidic Patients"
- "A Qualitative Assessment of the Role of Dental Specialists in U.S. Opioid Epidemic"
- "Revolutionizing Dental Operatories"
- "An Update on Non-Cigarette Nicotine-Containing Products and the Periodontal Patient"
This issue includes regular columns with regional news impacting the New York membership including: editorial and legal columns, association activities, component news, continuing education opportunities, and classifieds.
J Mich Dent Assoc November 2025
J Mich Dent Assoc November 2025
The Journal of the Michigan Dental Association
Each month, the Journal of the Michigan Dental Association delivers news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It remains the main publication reaching Michigan dentists and is available worldwide through ADA Commons.
The November 2025 (Volume 107, No. 11) issue of the Journal is published in both hard copy and with a digital-only format to provide updates and insights for Michigan's oral health community and MDA members. Print editions will resume in November.
The November issue focuses on membership along with a reprinted clinical article on the Oral Manifestations …
The Effect Of Proton Pump Inhibitors On Bone Mineralisation: A Systematic Review With Focus On Phospho1, Célia Baudin, Ricardo Faria-Almeida
The Effect Of Proton Pump Inhibitors On Bone Mineralisation: A Systematic Review With Focus On Phospho1, Célia Baudin, Ricardo Faria-Almeida
Sultan Qaboos University Medical Journal
Objectives: Proton pump inhibitors (PPIs) are among the most widely prescribed drugs for long-term suppression of gastric acid. Though generally considered safe, increasing evidence links their use to altered bone metabolism. This systematic review investigates the hypothesis that PPI-induced inhibition on PHOSPHO1-a bone-specific phosphatase- impairs bone mineralisation. Methods: A systematic electronic search was conducted for experimental studies from January 2000 to January 2025. The screening and selection followed PRISMA guidelines. Results: Of 20 articles identified, 3 met the inclusion criteria: two in-vitro studies and one combining both in-vitro and in-vivo data. All three examined the effects of PPIs on bone …
Comparison Of Metal Nanoparticles As Antifungal Agents: Efficacy, Mechanisms, And Toxicity Against Candida, Aspergillus, And Cryptococcus, Ahmed Falah Imran, Hayder Hameed Saeed, Khaldoon Jasim Mohammed
Comparison Of Metal Nanoparticles As Antifungal Agents: Efficacy, Mechanisms, And Toxicity Against Candida, Aspergillus, And Cryptococcus, Ahmed Falah Imran, Hayder Hameed Saeed, Khaldoon Jasim Mohammed
AUIQ Complementary Biological System
Candida albicans, Aspergillus fumigatus, and Cryptococcus neoformans are the invasive fungi whose diseases are becoming a growing health issue in the global community, particularly in immunocompromised people. The increasing resistance of the conventional antifungals and the shortage of the existing treatment methods require alternative methods. The present review is an evaluation of the antifungal activity of metal-based nanoparticles, including silver (Ag), copper (Cu), zinc oxide (ZnO), titanium dioxide (TiO2), and selenium (Se) in relation to the three predominant pathogenic fungi. It also talks about their mode of action, relative efficacy, toxicity and their possible future clinical …
Telepsychiatry For Substance Use Disorders: Evolution From Rapid Covid-19 Pandemic Adoption To Sustainable Integration, Jack Wang
Marshall Journal of Medicine
ABSTRACT
Introduction: Prior to the COVID-19 pandemic, telepsychiatry for substance use disorder (SUD) management was generally an underutilized modality, mainly due to regulatory constraints. Through the pandemic, governmental deregulations rapidly and massively expanded their adoption, bringing out their significant potential to expand access, overcome barriers, and mitigate stigma for individuals seeking addiction care, particularly for rural and underserved populations. This narrative review consolidates the recent research on the growing adoption of telepsychiatry in the management of SUDs. It aims to explore the evidence-based benefits, identify common challenges, and underscore key considerations for its effective and equitable integration into SUD treatment …
Lyme Disease Presenting As A Dermal Hypersensitivity Reaction, William T. Snider, Ian Depew, Rebecca Hicks, Shane Cook
Lyme Disease Presenting As A Dermal Hypersensitivity Reaction, William T. Snider, Ian Depew, Rebecca Hicks, Shane Cook
Marshall Journal of Medicine
Background:
Lyme disease is a well-recognized illness commonly associated with skin manifestations such as erythema migrans. However, atypical presentations can complicate diagnosis, particularly when they deviate from classic clinical and histological findings.
Methods:
We report a potential case of Lyme disease presenting as a dermal hypersensitivity reaction (DHR), with clinical findings resembling urticaria rather than urticarial vasculitis. Skin biopsy findings were reviewed, and Lyme serology testing was performed.
Results:
The biopsy did not demonstrate the characteristic superficial perivascular lymphocytic infiltrate typically seen with erythema migrans. The patient's history included prior tick exposures, but while Lyme IgM was positive, the Lyme …
Diagnosis And Surgical Management Of Lymphoproliferative Unicentric Castleman Disease, Kristen E. Bowman, Jonathan Evans, Yancy Short, David Webb
Diagnosis And Surgical Management Of Lymphoproliferative Unicentric Castleman Disease, Kristen E. Bowman, Jonathan Evans, Yancy Short, David Webb
Marshall Journal of Medicine
Castleman Disease (CD) describes a group of complex lymphoproliferative disorders that share common histopathological features. Classification largely centers around the number of affected lymph nodes and the presence or absence of Human Herpesvirus 8 (HHV-8). Unicentric CD (UCD) is estimated to make up 40% of all CD cases with the remaining 60% being multicentric CD (MCD), involving several regions of the body and increasing concern for HHV-8 involvement. While UCD is often discovered through incidental imaging or routine examination, swift confirmation via pathological diagnostics can often lead to a cure through simple resection. Presented here is the case of a …
A Severe And Unusual Case Of Propriospinal Myoclonus, Mouhannad Azzouz, Robert Young, Ammar Md Bata, Thaiddeus Dillie, Anam Sabzwari
A Severe And Unusual Case Of Propriospinal Myoclonus, Mouhannad Azzouz, Robert Young, Ammar Md Bata, Thaiddeus Dillie, Anam Sabzwari
Marshall Journal of Medicine
Propriospinal myoclonus (PSM) is a rare disorder characterized by axial muscle jerks originating in the thoracoabdominal region; medical management of this disease is extremely challenging given the paucity of trials and few reported cases only. Chronic cough has not been described in the literature in association with PSM. We describe a 51 year old female presenting with chronic unexplained cough along with myoclonic jerking, ultimately diagnosed with severe PSM. Fortunately our case after different medication trials showed great response to lacasomide which has been rarely reported in PSM management.
Mirm In An Adolescent Male: A Diagnostic Challenge And Review Of The Literature, Emily Saurborn, Savannah Carty, Shane Cook, Lauren Tufts
Mirm In An Adolescent Male: A Diagnostic Challenge And Review Of The Literature, Emily Saurborn, Savannah Carty, Shane Cook, Lauren Tufts
Marshall Journal of Medicine
Mycoplasma-Induced Rash and Mucositis (MIRM) is a subset of Reactive Infectious Mucocutaneous Eruption (RIME), most commonly associated with Mycoplasma pneumoniae. MIRM commonly presents with significant mucositis and mild or absent cutaneous involvement. MIRM exists on a spectrum with Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). Due to the significant clinical overlap, early diagnosis of MIRM can be challenging. We report a case of a 19-year-old male who presented with a two-day history of worsening throat pain and decreased oral intake after initiating Augmentin for treatment of community acquired pneumonia. During hospitalization, he developed progressive ocular, oral and genital …
Diagnosis Of Kasabach-Merritt Phenomenon In A Newborn, Kiersten Ricci, Sara Basala, Edward Raykhelson, Aaron Mcguffin
Diagnosis Of Kasabach-Merritt Phenomenon In A Newborn, Kiersten Ricci, Sara Basala, Edward Raykhelson, Aaron Mcguffin
Marshall Journal of Medicine
Kasabach-Merritt Phenomenon (KMP) is a rare and potentially life-threatening coagulopathy that has high bleeding risk and is characterized by severe thrombocytopenia and hypofibrinogenemia. Timely diagnosis and intervention are essential, as untreated kaposiform hemangioendothelioma (KHE) or tufted angioma (TA) associated with Kasabach-Merritt phenomenon (KMP) can result in significant morbidity and mortality..
We report a case of a full-term female neonate who was noted to have a large vascular scalp mass at birth. The tumor was initially misidentified as an infantile and a congenital hemangioma. Upon specialty evaluation at a vascular anomaly center and additional diagnostics, the child was diagnosed with KHE …
A Rare Case Of Porokeratosis Arising In Association With A Verruca, Kiran Patel, Robert Levi Snedegar, Walaa Hammad
A Rare Case Of Porokeratosis Arising In Association With A Verruca, Kiran Patel, Robert Levi Snedegar, Walaa Hammad
Marshall Journal of Medicine
Porokeratosis is a rare keratinizing disorder of the epidermis that carries an increased risk of malignant transformation. Among its less common variants is verrucous porokeratosis, which can mimic benign skin conditions such as verruca vulgaris. We present the case of a 57-year-old male who developed a lesion on the posterior heel, initially treated as a verruca, which recurred and was later diagnosed via shave biopsy as porokeratosis arising in association with a verruca. A literature search of PubMed and Google Scholar did not identify any prior reports of porokeratosis arising in association with a verruca on the posterior heel. The …
Unaccompanied Migrant Minors: A Psychiatric Case Series Review, Cecilia De Vargas, Eden Hernandez Robles, Fernando Doval Perez, Leslie Salazar-Hinojosa, Danielle Parker, Javier Segovia, Aleli Campbell, Deborah J. Clegg
Unaccompanied Migrant Minors: A Psychiatric Case Series Review, Cecilia De Vargas, Eden Hernandez Robles, Fernando Doval Perez, Leslie Salazar-Hinojosa, Danielle Parker, Javier Segovia, Aleli Campbell, Deborah J. Clegg
International Journal on Responsibility
Unaccompanied children and adolescents who migrate from Central America and Mexico into the United States (U.S.) are exposed to and experience trauma throughout the process of migration. These traumatic experiences result in an increasing prevalence of psychiatric illnesses and challenges to treatment. This study presents a psychiatric patient record review of minors and their complex trauma. Unaccompanied migrant minors (UMM) ages 12-17 (28 males and 22 females; n = 50) received comprehensive psychiatric assessments at the El Paso Texas Tech Child and Adolescent Psychiatry outpatient clinic. Their charts were reviewed for psychiatric diagnosis, treatment progress, and trauma experiences before, during, …
Is It Retaliation Or Remediation? Educating Our Learners On The Difference, France M. Leandre, Almari Ginory
Is It Retaliation Or Remediation? Educating Our Learners On The Difference, France M. Leandre, Almari Ginory
HCA Healthcare Journal of Medicine
The goal of this article is to discuss 1 of the questions in the Accreditation Council for Graduate Medical Education Resident/Fellow Survey, which assesses the fear of retaliation in a program. To better understand the needs of residents and facilitate the reporting of concerns, programs must evaluate and educate residents on the difference between remediation and retaliation.
The Mahec Research Certificate Program: A Brief And Introductory Exposure To Key Research Topics For Diverse Learners, Grace E. Flinchum, Emily S. Mazure, Chelsea C. Atkins, Wendy Nuzzo, C Micha Belden, Edward C. Jauch, Jacqueline R. Halladay
The Mahec Research Certificate Program: A Brief And Introductory Exposure To Key Research Topics For Diverse Learners, Grace E. Flinchum, Emily S. Mazure, Chelsea C. Atkins, Wendy Nuzzo, C Micha Belden, Edward C. Jauch, Jacqueline R. Halladay
HCA Healthcare Journal of Medicine
Background
Research is a core component of health profession training programs, but few efficient training resources exist that provide introductory research training that is brief, freely accessible, and supportive of learners with varying levels of research experience.
Methods
We set out to create the Mountain Area Health Education Center (MAHEC) Research Certificate program to support Graduate Medical Education (GME) residents and other learners. We initially explored existing curricula used to instruct medical and doctor of pharmacy students in order to identify foundational research topics to include in our introductory research program. We were guided by stakeholders to create a curriculum …
Nonglomerular Hypocomplementemic Interstitial Nephritis, Tyler Hemphill, Yogesh Sanghvi
Nonglomerular Hypocomplementemic Interstitial Nephritis, Tyler Hemphill, Yogesh Sanghvi
HCA Healthcare Journal of Medicine
Background
Acute interstitial nephritis (AIN) is the most common cause of acute kidney injury (AKI) with subsequent renal impairment and is often underdiagnosed. Acute interstitial nephritis presents with a decline in kidney function and is characterized by an inflammatory infiltrate in the kidney interstitium. It is most often induced by drug therapy and is sometimes followed by infections with unknown causes. In a typical presentation of AIN, there is no evidence of hypocomplementemia; low complement is associated most commonly with autoimmune etiologies. Renal biopsy serves as the most definitive test for both the diagnosis and prognosis of AIN.
Case Presentation …
Spontaneous Pneumomediastinum Following Ingestion Of Bleach, Dish Soap, And Laundry Detergent And Inhalation Of Methamphetamines, Marshall Johnson, Matthew Boss, Alayna S. Buzzetta, Barbara L. Gracious
Spontaneous Pneumomediastinum Following Ingestion Of Bleach, Dish Soap, And Laundry Detergent And Inhalation Of Methamphetamines, Marshall Johnson, Matthew Boss, Alayna S. Buzzetta, Barbara L. Gracious
HCA Healthcare Journal of Medicine
Introduction
Spontaneous pneumomediastinum (SPM) is a rare condition defined by the presence of air in the mediastinum in patients without an observable traumatic cause. Pneumomediastinum is a somewhat rare condition that occurs 1 in every 25 000 individuals, aged 5 to 34 years old, with 76% occurring in men. Pneumomediastinum can further be divided into 2 categories: SPM and traumatic pneumomediastinum. Traumatic pneumomediastinum is most commonly seen with blunt force trauma or any iatrogenic procedures to the chest wall. Spontaneous pneumomediastinum frequently occurs due to air leaking through small alveolar sacs, which rupture within the surrounding bronchovascular sheath. Spontaneous pneumomediastinum …
Use Of Topical Hemostatic Agents In A Gynecologic Patient With Coagulopathy, Alexis O'Connell, Syeda Zainab Shah
Use Of Topical Hemostatic Agents In A Gynecologic Patient With Coagulopathy, Alexis O'Connell, Syeda Zainab Shah
HCA Healthcare Journal of Medicine
Introduction
The use of topical hemostatic agents has become common during surgical interventions. There is a wide variety of substances available to augment clotting, ranging from physical agents to topical thrombin combinations. Application of these agents in gynecologic surgery in patients with existing coagulopathies has not been studied.
Case Presentation
A 62-year-old woman with an inferior vena cava filter and a history of multiple deep vein thromboses presented to the clinic with pelvic pain, stress urinary incontinence, and uterovaginal prolapse. She underwent a total vaginal hysterectomy, sacral colpopexy, tension-free vaginal tape sling, and cystourethroscopy. Warfarin was cross titrated to enoxaparin …
Utilizing Femoral Metaphyseal Sleeves In Primary Total Knee Arthroplasty For Post-Traumatic Osteoarthritis: A Case Report, Zachary Sukin, Adam Dentinger, Jeremiah Earl
Utilizing Femoral Metaphyseal Sleeves In Primary Total Knee Arthroplasty For Post-Traumatic Osteoarthritis: A Case Report, Zachary Sukin, Adam Dentinger, Jeremiah Earl
HCA Healthcare Journal of Medicine
Background
Total knee arthroplasty in younger patients presents a heightened risk of postoperative complications and implant failures compared to older populations, particularly in those with posttraumatic arthritis. These challenges necessitate careful consideration and specialized approaches to optimize the outcomes in this patient demographic.
Case Presentation
A 43-year-old man presented with left knee pain resulting from a traumatic lawn mower injury, causing an intraarticular distal femur, at the age of 6. The injury led to a limb-length discrepancy for which he underwent 2 limb-lengthening procedures in his early 20s. Radiographs demonstrated advanced posttraumatic osteoarthritis, and the patient elected to proceed with …
Upper Respiratory Tract Infection Leading To A New Diagnosis Of Sweet Syndrome And Monoclonal Gammopathy Of Unknown Significance, Nidhi Rawat, Meron Gebrehiwot, Jason Raw, Jeyaprakash Ramachandran
Upper Respiratory Tract Infection Leading To A New Diagnosis Of Sweet Syndrome And Monoclonal Gammopathy Of Unknown Significance, Nidhi Rawat, Meron Gebrehiwot, Jason Raw, Jeyaprakash Ramachandran
HCA Healthcare Journal of Medicine
Background
We present a rare case of Sweet syndrome with underlying monoclonal gammopathy of unknown significance (MGUS) which initially presented as upper respiratory tract infection.
Case Presentation
A 52-year-old woman presented with a complaint of sore throat for 6 days, productive cough and fever for 5 days, and red, pruritic, circular, tender rashes on face, arms and trunk for 2 days. There was a past history of similar self-limiting rashes presenting intermittently for 1.5 years. She also reported to be taking tablet ibuprofen, as required for the past 1-2 years, for cervical spondylosis. On integumentary examination, widespread, red, tender, annular …
Capacity Over Cognition: A Case Of High-Risk Disease And Homelessness, Mikalah E. Maury, Avery M. Duncan, Rebecca A. Taylor, Mary Ann Beil, Maulikkumar A. Patel
Capacity Over Cognition: A Case Of High-Risk Disease And Homelessness, Mikalah E. Maury, Avery M. Duncan, Rebecca A. Taylor, Mary Ann Beil, Maulikkumar A. Patel
HCA Healthcare Journal of Medicine
Background
Medical decision-making in indigent patients with baseline cognitive deficits and lack of supportive resources is a difficult problem that reveals many ethical issues. Performing high-level medical procedures (eg, invasive surgery, chemotherapy, radiation therapy) on these patients without supportive resources brings into question the efficacy and necessity of treatment if it places the patient at higher risk of additional complications and mortality.
Case Presentation
In this article, we present a case of a 62-year-old indigent man with a long history of encephalopathy secondary to alcohol abuse, presenting with an aggressive head and neck cancer impacting his quality of life.
Conclusion …
Rapid Percutaneous Nephrostomy Stent Encrustation In Pregnancy: Navigating Your Stone Challenge, Victor M. Feldbaum, Roberto Morales, Shawn R. Ramsey, Michael L. Douso
Rapid Percutaneous Nephrostomy Stent Encrustation In Pregnancy: Navigating Your Stone Challenge, Victor M. Feldbaum, Roberto Morales, Shawn R. Ramsey, Michael L. Douso
HCA Healthcare Journal of Medicine
Background
Surgical management of kidney stones in pregnancy can be a serious problem for both mother and fetus.
Case Presentation
A 20-year-old woman with a second trimester pregnancy presented to the emergency room with renal calculi. She required surgical intervention and a left nephrostomy tube after consultation with urology. Five weeks later, her tube was solidified in place unbeknownst to her care team. She required several surgeries, dealt with encrustation remnants, infections, radiation exposure, persistent infection requiring antibiotic management, and, ultimately, an early delivery at 37 weeks.
Conclusion
At the time of writing, this was the first case to describe …
Rectal Fidaxomicin As Salvage Therapy In Fulminant Clostridioides Difficile Infection After Total Colectomy: A Case Report, Akankcha Alok, Mohamed Ismail, Stephanie Pino Fabara, Mohammed Al Said, Vidya Sagar Kollu
Rectal Fidaxomicin As Salvage Therapy In Fulminant Clostridioides Difficile Infection After Total Colectomy: A Case Report, Akankcha Alok, Mohamed Ismail, Stephanie Pino Fabara, Mohammed Al Said, Vidya Sagar Kollu
HCA Healthcare Journal of Medicine
Introduction
Clostridioides difficile infection (CDI) is a significant cause of antibiotic-associated diarrhea and colitis, ranging from mild to severe and potentially life-threatening conditions, like fulminant colitis with toxic megacolon and bowel perforation. The 2021 guidelines from the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) recommend vancomycin and metronidazole for fulminant CDI (FCDI), with consideration of rectal vancomycin for cases with ileus. Fidaxomicin, though preferred for initial and recurrent CDI treatment, is not the first line for FCDI due to limited evidence. Fidaxomicin has a narrow spectrum of activity only targeting C difficile and …
Clinical Images Of Cutaneous Horns In Patients Presenting To A Family Medicine Residency Practice, Julia Fashner, Tillie Schumann
Clinical Images Of Cutaneous Horns In Patients Presenting To A Family Medicine Residency Practice, Julia Fashner, Tillie Schumann
HCA Healthcare Journal of Medicine
We detail 2 cases of cutaneous horn, also referred to as cornu cutaneum, which is a hard-compacted linear outgrowth of keratin that projects above the skin. We present these images to increase awareness for all medical specialties who may see a patient with this skin lesion.
Clinical Characteristics Associated With Hospital Mortality And Length Of Stay Among Older Adults Admitted With Delirium: Retrospective Analysis, Se Won Lee, Jeff J. Kim, Cole Kretchmar, Napatkamon Ayutyanont, Mooyeon Oh-Park
Clinical Characteristics Associated With Hospital Mortality And Length Of Stay Among Older Adults Admitted With Delirium: Retrospective Analysis, Se Won Lee, Jeff J. Kim, Cole Kretchmar, Napatkamon Ayutyanont, Mooyeon Oh-Park
HCA Healthcare Journal of Medicine
Background
Limited information exists on the characteristics of older adults admitted with delirium at risk of poor hospital outcomes. This study aims to identify risk factors present on admission that are associated with hospital mortality and length of stay (LOS) among older adults admitted with delirium.
Methods
This is a retrospective study of 5598 patients 65 years of age or older who were admitted to acute care units at 8 community hospitals with an International Statistical Classification of Diseases, Tenth Revision code of delirium.
Results
Multivariate regression analyses revealed that in-hospital mortality increase was associated with increased age, Asian race, …
Can The Combination Of White Blood Cell Count And C-Reactive Protein Rule Out Pediatric Appendicitis, A Retrospective Analysis?, Scott Gutovitz, Samantha Stoner, Jarrett Koper, Sarah Kleist
Can The Combination Of White Blood Cell Count And C-Reactive Protein Rule Out Pediatric Appendicitis, A Retrospective Analysis?, Scott Gutovitz, Samantha Stoner, Jarrett Koper, Sarah Kleist
HCA Healthcare Journal of Medicine
Background
Pediatric appendicitis (PA) is the most frequent cause of pediatric emergency surgery. Standard PA scoring systems incorporate inflammatory biomarkers (white blood cell count [WBC] or C-reactive protein [CRP]); however, the individual biomarker sensitivities have not been reported beyond single-center sites. We aimed to measure the individual and combined sensitivities of WBC and CRP to rule out PA in a large multicenter hospital system.
Methods
We did a retrospective study of pediatric emergency department patients (age <18) with abdominal pain, using a deidentified electronic health database from a 175-hospital system in the United States, comparing PA versus non-PA patients. Pediatric appendicitis patients were identified by ICD-10 diagnosis codes and had advanced imaging, whereas non-PA patients had advanced imaging and were discharged home with the ICD-10 code for abdominal pain. Using matched propensity matching, we calculated receiver operator characteristics and Youden’s index to find the optimal cutpoints. Sensitivity was calculated at the optimal and traditional cutpoints for each biomarker, also combined in parallel fashion.
Results
We identified 7414 subjects (3707 PA matched to 3707 controls). The WBC in PA patients was 14.99 ± 5.00 k/mm3 versus 9.63 …
18)>Beyond The Norm: Decoding Spontaneous Coronary Artery Dissection As An Unusual Cause Of Acute Coronary Syndrome, Holden Zimmerman, Himanshi Banker, Inder P. Kaur, Jaskaran Munjal, Vasu Gupta, Ayushi Garg, Nikita Garg, Meet Patel, Rohit Jain
Beyond The Norm: Decoding Spontaneous Coronary Artery Dissection As An Unusual Cause Of Acute Coronary Syndrome, Holden Zimmerman, Himanshi Banker, Inder P. Kaur, Jaskaran Munjal, Vasu Gupta, Ayushi Garg, Nikita Garg, Meet Patel, Rohit Jain
HCA Healthcare Journal of Medicine
Spontaneous coronary artery dissection (SCAD) is a rare nonatherosclerotic cause of myocardial infarction among young women, particularly during pregnancy. As the name suggests, SCAD is caused by the spontaneous formation of the false lumen within the coronary artery wall, thus compromising the blood flow to the myocardium. Unlike atherosclerotic acute coronary syndromes, SCAD is not directly associated with diabetes or hypertension; moreover, underlying connective tissue defects and inflammation are considered more contributory towards its etiology. Although its pathophysiology is not well understood, multiple theories have been proposed. Clinically, SCAD has a similar presentation to acute coronary syndromes, including substernal chest …
Response: Letter To The Editor, Exercise Is A Vital Sign, Megan Dannemiller, Anthony Shadiack, Marvin Sineath Jr, Andrew Baird, Marc Poirier, Kevin Thomas, Michael G. Flynn
Response: Letter To The Editor, Exercise Is A Vital Sign, Megan Dannemiller, Anthony Shadiack, Marvin Sineath Jr, Andrew Baird, Marc Poirier, Kevin Thomas, Michael G. Flynn
HCA Healthcare Journal of Medicine
This letter is submitted in response to the letter to the editor regarding the authors’ article “Exercise Is a Vital Sign.”