52426 research outputs found
Sort by
Impact of Obesity Class on Severe Maternal Morbidity in Pregnancies with Postpartum Hemorrhage
No full textA rare case of
No full textINTRODUCTION:
CASE PRESENTATION: We present the case of a 62-year-old woman who developed septic shock secondary to polymicrobial hepatic abscesses. Imaging revealed two large multiloculated abscesses in the right hepatic lobe. Blood cultures grew
DISCUSSION: This case represents the eleventh reported episode of
CONCLUSION: Clinicians should conside
Gabapentinoid Dispensing to Children and Adolescents in the U.S.
No full textINTRODUCTION: Gabapentin and pregabalin (gabapentinoids) are increasingly prescribed to children and adolescents off label for various conditions despite limited data and concerns for adverse outcomes including misuse and overdose. The extent of gabapentinoid use in children and adolescents is unknown.
METHODS: Nationally representative retail pharmacy dispensing data from IQVIA was used to describe trends in gabapentinoid dispensing to children and adolescents aged ≤19 years from April 2017 through September 2023. The analysis was performed in 2024. Trends by patient age and sex and by prescriber specialty are presented along with median quarterly rates (MQR) and quarterly percentage changes (QPC).
RESULTS: Over the study period, the gabapentinoid dispensing rate was 4534.9/100,000 individuals. The MQR was 168.9/100,000. Between Q2 2017 and Q2 2021, the QPC was not significant (QPC=0.08; 95% CI= -2.9, 0.8) but became significant between Q2 2021 and Q3 2023 (QPC=2.8; 95% CI=1.2, 8.4). Dispensing rates were highest for adolescents aged 10-19 years (MQR=267.3/100,000) and females (MQR=187.6/100,000). Nurse practitioners prescribed the highest percent of gabapentinoids dispensed (17.8%). The total number of gabapentinoids dispensed increased from 2018 to 2022 across all specialties except psychiatry (-14.8%) and internal medicine (-9.2%), with nurse practitioners (48.2%), surgical specialists (48.0%), and addiction medicine specialists (51.2%) representing the largest increases.
CONCLUSIONS: Gabapentinoid receipt among U.S. children and adolescents has increased. Future research can explore factors associated with prescribing including changing epidemiology of pain and psychiatric diagnoses in children and adolescents. Prescribing clinicians should carefully consider the potential risks and benefits of gabapentinoids in clinical practice
Relationship and natural history of focal areas of signal intensity (FASI) and non-optic gliomas on MRI in Neurofibromatosis Type 1
No full text
Late pandemic COVID-19 positivity at the time of thrombectomy is associated with poor outcomes and tandem carotid pathology.
No full textOBJECTIVES: COVID-19 is an independent risk factor for ischemic stroke. Studies from early in the pandemic show increased rates of unfavorable recanalization, poor outcomes, and mortality in patients who were COVID-19 positive at the time of mechanical thrombectomy. However, there are currently no studies examining these parameters during the later pandemic when circulating variants were less virulent.
MATERIALS AND METHODS: We performed a retrospective review of mechanical thrombectomies from 12/2020 to 3/2023. Patients who were COVID-19 positive at the time of thrombectomy were included. Demographic, procedural, and 90-day functional outcomes were evaluated.
RESULTS: Of 306 patients undergoing mechanical thrombectomy for acute ischemic stroke between 12/2020 and 3/2023, 18 were COVID-19 positive. Compared with the COVID-19 negative cohort, there were lower rates of favorable recanalization (73% vs. 92%,
CONCLUSION: Late in the pandemic, outcomes remained comparable to those observed in the early pandemic for patients positive for COVID-19 at the time of mechanical thrombectomy. This case series also demonstrates increased tandem carotid pathology in the COVID-19 cohort. While COVID-19 may not influence outcome to the degree that age and NIHSS do, the excess mortality continues to suggest a negative effect despite lower virulence
