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The Efficacy and Frequency of Early Left Heart Catheterization After Out of Hospital Cardiac Arrest Over The Last Decade
Get PDFIntroduction:
The efficacy of early coronary intervention after return of spontaneous circulation (ROSC) from out of hospital cardiac arrest (OHCA) is debated. We aimed to nationally study the effect of early LHC on survival with good neurological outcome and describe the rate and timing of LHC in OHCA.
Methods:
The observational study included patients enrolled in the national CARES registry from 2013-21. Outcome was cerebral performance category, (CPC) (good \u3c3 vs. poor \u3e 3) at hospital discharge. For the outcome of LHC by year, chi square analysis was performed. A propensity score (PS) model was constructed using variables predictive of LHC and good outcome to determine probability of LHC. The PS was then used in an inverse weighted random effects logistic regression model to determine the independent effect of early LHC on outcome.
Results:
132,789 individual cases identified. Median age=60.3 years. (SD=16.6), 61.8% were male. Early coronary angiography performed in 26,999 (20.3%) patients. Patients who underwent early angiography had shockable rhythms (78% vs 34%), suffered the OHCA in a public location (36.9% vs 26.1%), and were witnessed cardiac arrests (80% vs 48%). For the full model, the OR for a good outcome after early LHC was 2.54 (95% CI 2.36 – 2.73). Only initial shockable rhythm was more predictive of a good outcome with an OR of 3.9
Conclusion:
Early LHC had a strong association with a good functional outcome in this population. The use of early left heart catheterization declined from previous years
Regional and Socioeconomic Factors Impacting Pediatric Victims of Cranial Gunshot Wounds: Analysis of the Kids’ Inpatient Database (KID)
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Injury by firearms among the pediatric population is a growing concern in the United States. This paper investigates demographic factors associated with pediatric cranial gunshot wounds (GSW).
Methods
A query of the KID databases from 1997-2019 was run for cranial GSW and craniotomy ICD-9 and ICD-10 codes. ANOVA and chi-squared tests were performed to analyze demographics and outcomes by injury type.
Results
Our query resulted in 2990 cranial GSW patients; 86.1% were male. Mean age was 16.48 years; accidental victims were the youngest and intentional the oldest (14.88±5.2, 17.2±2.3, p\u3c 0.001). Blacks, Hispanics, and Asian-Pacific-Islanders (minorities) were most commonly victims of assault; Whites were most commonly victims of intentional GSW (p\u3c 0.001). Victims mostly had Medicaid except for intentional victims who were more likely to have private insurance (p\u3c 0.001). Assault was the predominant injury type in all regions, especially in the West (33.7%). The South had the most accidental (51.9%) and intentional (44.6%) injuries. In 1997 and 2019 the predominant GSW type was accidental; in all other years assault predominated. Accidental victims were most likely to undergo craniotomy and intentional were least likely (p\u3c 0.001). Inpatient mortality was 46.4% with intentional victims having the highest rate (68.6%) then undetermined (60.3%) and law enforcement-related (57.7%).
Conclusion
Victims of assault were more likely to be minorities and reside in densely populated regions. Understanding socioeconomic factors is crucial for developing targeted prevention strategies to mitigate morbidity and mortality from pediatric gun violence
Exploring Arab Americans’ Preferences Towards Telemedicine as a Mental Health Treatment
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Arab Americans—a large minority group in the United States—experience higher rates of mental illness and relatively lower rates of treatment compared to the general population. While some factors leading to this disparity have been proposed, data in the literature remains lacking. This study aims to explore Arab-American mental health perspectives with regards to their preferences towards telemental health as a treatment option.
Methods
Responses were collected through an anonymous bilingual Qualtrics survey from both Arab and non-Arab participants (n=294, ages 18+). Participants’ perceptions towards telemental health and mental illness stigma were assessed, performing comparisons between Arabs and non-Arabs, as well as among Arab subgroups. Data analysis was conducted in SPSS using Chi-squared tests, ANCOVA, and t-tests.
Results
Arabs were less likely than non-Arabs to prefer telemental health, although that was not statistically significant (p=0.090), and having a private environment was the most frequently listed cause by Arabs for choosing telemental health. When correlating stigma towards mental illness to telemental health, stigma was positively and significantly correlated with preference towards telemental health in the entire sample (p=0.010). Within the Arab sample, males were significantly more likely than females (p=0.036) and older Muslims were significantly more likely than older Christians (p=0.032) to prefer telemedicine.
Conclusions
Our results provide unique insights into Arab-American mental health perspectives pertaining to telemental health preferences, adding a novel perspective on the mental health preferences of subgroups within the populations especially regarding gender and age differences. Use of telemedicine as a treatment option has been shown to be potentially beneficial in previous studies in Arab countries and with Arab Australians, noting that the virtual setting might be destigmatizing. To our knowledge, this is the first study exploring telemental health preferences of Arab-Americans and might offer important preliminary results. This study highlights the Arab-American population as a nuanced and diverse group, emphasizing the importance of future studies to show a more complete picture of Arab-American mental health
Integration of a Social Needs Program into an Urban Student Run Free Clinic
Get PDFBackground/Problem Statement
The Cass Clinic in Detroit, MI is a student-run free clinic (SRFC) that provides care for an underserved, underrepresented population. Our patients experience a high incidence of chronic health conditions accompanied by poverty, homelessness, and food insecurity which complicate care. Integrating social well-being into primary care creates a two-pronged approach to improving patient outcomes: medical care and disease prevention. A social needs program was implemented at Cass Clinic in order to address such social determinants of health.
Methods
A social needs screening modality was created and integrated into a medical encounter triage form. Two AAFP social needs screening questions were asked to identify and triage patients who may benefit from social needs services. After triage, patients were connected with social needs personnel to assist with personally identified short or long-term goals, such as obtaining a bus pass or low-income housing assistance.
Results
Implementation of this initiative was achievable with limited challenges. Of all patients surveyed (n=12), 42% reported concern at least some of the time with their current food and/or housing situation. All patient social needs visits (n=4) addressed diverse social determinants of health including housing insecurity (n=4), clothing (n=3), food insecurity (n=2), and bus pass/transportation (n=1).
Discussion
To provide holistic healthcare and assist in the long-term management of chronic medical conditions, SRFC should identify and address social determinants of health. Integrating social well-being serves a vital role in the prevention and management of chronic health conditions
Safety and cost effectiveness of immediate sequential bilateral cataracts surgery
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Rush SW, Gerald AE, Smith JC, Rush AJ, Rush RB. Prospective analysis of outcomes and economic factors of same-day bilateral cataract surgery in the United States. Journal of Cataract and Refractive Surgery. 2015;41(4):732-739. https://doi.org/10.1016/j.jcrs.2014.07.034
for a patient with bilateral cataracts
Preliminary Validation of the Multidimensional Father Involvement Scale for Low-Income Fathers
No full textThe current study represents a preliminary validation of the Multidimensional Father Involvement Scale (MFIS), a measure to assess father involvement among cohabiting and non-cohabiting low-income fathers of children (6 months– 11 years old). The 43-item scale includes items modified from the Inventory of Father Involvement (A. Hawkins et al., 2002) and Early Childhood Longitudinal Study–Birth Cohort (Bronte-Tinkew et al., 2007) and additional items to assess indirect behavioral and nonbehavioral (affective, cognitive, and ethical) involvement. Study 1, which included interviews with low-income fathers (15 Black and 4 Latino), supported face and construct validity. Study 2, which included 125 (61.6% White, 16.8% Black, and 15.2% Latino) low-income cohabiting fathers, supported concurrent and discriminant validity. Although confirmatory factor analysis did not support the hypothesized factors, the MFIS had strong internal consistency (α = .95) and appears to be a promising measure for assessing a broad range of father involvement among low-income and racial minority fathers
Pier Paolo Pasolini’s The Trilogy of Life: Il Decameron/The Decameron; I racconti di Canterbury/The Canterbury Tales; Il fiore delle mille e una notte/Arabian Nights: Guest Editor Introduction
No full textInvestigation Of The Prevalence Of IFITM3 Polymorphisms (rs12252 and rs34481144) In Turkish Population: A Pilot Study And Survey Conducted During The COVID-19 Pandemic
Get PDFInterferon-induced Transmembrane Protein 3 (IFITM3) plays a substantial role in the immune system by repressing viral entry into host cells and restricting virus replication. Recent research suggests that IFITM3/rs34481144 and IFITM3/rs12252 contribute to susceptibility to viral infections across populations dependent on their population frequencies, which needs further clarification. Here, we conducted a population-based study to determine the prevalence of two regulator SNPs in the Turkish population and evaluated genotype and allele frequencies in individuals stratified into groups based on a pilot survey conducted during the COVID-19 pandemic. The Tetra-Primer Arms PCR (TPA-PCR) assays and Sanger sequencing methods were used for genotyping rs34481144 and rs12252, and all participants (n=200) participated in a questionnaire consisting of items related to individual experiences during COVID-19 pandemic. Distributions of genotype frequencies and pairwise linkage disequilibrium (LD) correlations were calculated and compared to publicly available data from worldwide populations. The frequency of minor alleles of rs12252-G and rs34481144-T were found to be 0.128 and 0.324, respectively, in the total sample. Our preliminary data obtained from a self-reported survey gave no concrete evidence for the correlation of the analyzed SNPs with COVID-19 severity or vaccine side effects yet pinpointed a trend for an association of rs12252-G with symptom burdens which requires further investigation. Overall, our results present genotype and allele distributions of two IFITM3 polymorphisms in the Turkish population and provide present preliminary data on the previously propounded correlations of the genotypes with COVID-19 in our population
Ontogenesis of the Sella Turcica among Egyptians: Forensic and Radiological Study
No full textThe sella turcica has gained importance as a stable bony landmark in cephalometric studies. This study explored the changes that accompany postnatal ontogeny of the sella turcica until full development and verified its contribution in age estimation and sexual assignment among Egyptians. Six selected measurements of the sella turcica of 215 Egyptian patients were assessed using multidetector computed tomography. The patients represented different ages and were referred to the Diagnostic and Interventional Radiological Department, Faculty of Medicine, Alexandria University. The gathered data were then subjected to statistical analysis, including correlation and regression analysis. The measurements of the sella showed a strong correlation with age. Three selected measurements demonstrated significant sexual dimorphism: sella width and anterior and median height in subjects 20–25 years old. Six regression equations were derived. The accuracy achieved by the combined parameters in the younger group (\u3c25 years old) was higher than that in the older individuals. This study provides useful tools in the determination of age and sex in both forensic and bioarcheological disciplines. However, further studies concerning the shape are strongly suggested
