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Food Insecurity in Hidradenitis Suppurativa: A Cross-Sectional Analysis from the Population-Based All of Us Research Program
No full textBACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory cutaneous disease associated with obesity and low socioeconomic status that can have a significant impact on quality of life. Food insecurity (FI) is associated with a higher likelihood of having a chronic health condition. This cross-sectional study was undertaken to assess the association between HS and FI. SUMMARY: We performed secondary analysis of a cross-sectional survey of individuals 18 years and older registered in the National Institutes of Health\u27s All of Us Research Program in May 2024. The study sample was limited to those who had completed the Children\u27s HealthWatch Hunger Vital Sign™ FI screening survey, validated for use in adults in 2017. HS status was assessed among study participants based on ICD-9/10 diagnosis code (705.83 or L73.2). Multivariable logistic regression was used to characterize the association between HS diagnosis and food security status, adjusting for sex, race and ethnicity, age, and income. Among participants with HS, 37/134 (27.6%) screened positive for FI. In comparison, among those without HS, 6,278/56,967 (11%) screened positive. In an adjusted multivariable logistic regression, HS was associated with significantly higher odds of FI (OR: 1.70, 95% CI: 1.09-2.60). KEY MESSAGES: Study results demonstrated a significant association between HS and FI. Further research is needed to understand specific factors mediating the relationship between HS and FI. The study highlights an opportunity for dermatologists to take an active role in screening for FI in patients with HS and in providing resources as necessary
Inflammation of the Rectal Cuff is Associated With Strictures and Fistulas in Patients With Ulcerative Colitis who Have an Ileal Pouch-Anal Anastomosis
No full textBACKGROUND: Patients with medically refractory ulcerative colitis (UC) may undergo colectomy with ileal pouch-anal anastomosis (IPAA). Rectal cuff inflammation following surgery is common and may be associated with pouch failure, but the mechanisms underlying this association remain unclear. We assessed whether endoscopic cuff inflammation is associated with fistula and stricture development. METHODS: This cohort study included adults with UC who were grouped based on whether they had cuff inflammation with mucosal breaks on any endoscopy following IPAA. Endoscopic, clinical, and imaging data were reviewed for all patients to identify the development of strictures and/or fistulas. Multivariable Cox proportional hazard models were used to compare time to development of each outcome. Sub-analyses were conducted to determine whether persistent inflammation, new onset mucosal breaks, and resolution of mucosal breaks predicted the development of each outcome. RESULTS: A total of 324 patients met eligibility criteria with 96 (29.6%) patients with cuff inflammation and 228 (70.4%) of patients without inflammation. Patients with cuff inflammation had a higher risk of strictures of the pouch/pre-pouch ileum (adjusted hazard ratio [aHR] = 3.27; 95% CI, 1.70-6.33; P \u3c .001) and fistulas of the pouch or rectal cuff (aHR = 4.24; 95% CI, 1.83-9.83; P = .001). Individuals with persistent, but not single-instance, inflammation were at higher risk of pouch strictures, fistulas, and pouch failure, and both durations were associated with a higher risk of anastomotic strictures. CONCLUSIONS: Endoscopic cuff inflammation is associated with strictures and fistulas of the IPAA, and individuals with persistent inflammation appear to have the highest risk
A Narrative Inquiry Into Problematic Internet Use Among Young Adults: A Narrative Review
No full textThe inescapable influence of the internet and social media has fundamentally transformed human interaction and behavior, leading to a profound digital dependency in a constantly connected contemporary society. This narrative review explores the surge in internet and social media usage globally, driven by the proliferation of new applications and the ubiquity of smart devices. The evolving landscape of digital platforms, exemplified by the rise of TikTok and the multifunctionality of apps like LinkedIn and Notion, blurs the lines between virtual and physical realms, offering diverse avenues for engagement and interaction. Internet addiction, particularly prevalent among young adults, stems from the allure of instant connection and immersive virtual experiences, shaping behavioral patterns and consumption habits from an early age. Beyond individual boundaries, excessive internet usage poses a societal concern with far-reaching consequences, including detrimental effects on mental health, interpersonal relationships, and overall well-being. This review underscores the urgent need to address internet addiction as a pressing public health issue, highlighting its impact on brain regions associated with addiction and emotional regulation. Understanding the psychological impacts of internet and social media usage is paramount in addressing this prevalent problem, with research linking excessive internet use to various psychological struggles, including depression, anxiety disorders, and disordered eating patterns. As internet addiction increasingly affects daily life, this review explores the underlying causes and trends related to emerging applications. It also highlights the importance of promoting digital well-being and addressing the negative impacts of internet addiction on both individuals and communities
The Epidemiology of Sports and Recreation Related Toe Fractures in the United States
Get PDFBACKGROUND: Fractures of the toes are among the most frequently diagnosed lower extremity fractures. In sports, toe fractures may present after diverse mechanisms of injury, varying severity, and varying implications for management. This study aimed to discern trends in toe fractures presenting to US emergency departments (EDs) particularly in association with sports and recreational activities. An additional aim of the study was to identify if rates of toe fracture presentation significantly decreased during the year 2020 at the height of the COVID-19 pandemic. METHODS: We queried the National Electronic Injury Surveillance System (NEISS) database to identify toe fractures presented to US EDs from 2013 to 2022. The data outputs were analyzed by age group, sex, sport/recreational activity, and year. US Census data were used for calculation of incidence rates (IR) in 100,000 person-years. χ tests and regression analyses were performed to determine significance. Grubbs\u27s test was performed to determine significant yearly outliers with particular attention to the year 2020. RESULTS: A total of 921,033 toe fractures were identified across US EDs, with 175,864 cases associated with sports and recreation. Exercise (IR = 140.3) had the leading IR among sports/recreation followed by cycling (IR = 136.8), basketball (IR = 136.8), and football (IR = 94.9). Males accounted for 40.8% of fractures (IR = 23.0), whereas females contributed 59.2% (IR = 32.8). Toe fractures peaked in the 10- to 14-year-old age group in both males and females. Sports- and recreation-related toe fractures did not significantly decrease from 2013 to 2022, although all-cause toe fractures did significantly decrease as shown by a P value of .0037 from linear regression analysis of yearly trend in all toe fractures. The year 2020 was a significant outlier with a decrease in sports-related toe fractures though there was no significant decrease in all-cause toe fractures in 2020. CONCLUSION: Sports- and recreation-related toe fractures did not significantly decrease from 2013 to 2022, although a significant decrease in all-cause toe fractures was observed. Toe fractures continue to peak in the pediatric age groups, particularly 10-14 year-olds. Youth sports and recreation officials should be aware of the risks of toe fractures to aid in prevention. Level III, epidemiologic database, retrospective cohort studies
A-MACE-Ing: A Real-World Analysis of Semaglutide\u27s Impact on Major Adverse Cardiovascular Events (MACE) in Patients With Hidradenitis Suppurativa
No full textSyndromic vs Nonsyndromic Management of Multisuture Craniosynostosis: A Single-Center Experience
No full textBACKGROUND AND OBJECTIVES:Multisuture craniosynostosis (CS) involves the fusion of 2 or more cranial sutures, and, rarely, fusion of most sutures results in pansynostosis. Patients with multisuture CS can be further subdivided into syndromic and nonsyndromic CS. The objective was to describe and analyze the incidence, management, and outcomes of syndromic and nonsyndromic multisuture CS patients at a single-center institution.METHODS:Retrospective study of all multisuture CS pediatric patients who received care at a large tertiary hospital between September 2009 and August 2023. Demographic and clinical data, diagnoses, imaging studies, operative interventions, complications, and clinical follow-up were evaluated.RESULTS:Seventy-five multisuture CS children were included. There were more male (n = 44) and Hispanic (n = 37) patients. The median number of surgeries was 2 [Q1-Q3: 1-2], and the average age at first cranial surgery was 11 [Q1-Q3: 3-29.75] months. The most common type of procedure was frontal-orbital advancement (n = 30), followed by open and endoscopic suturectomies (n = 28). There were 36 syndromic children (48%) and 39 nonsyndromic children (52%). Compared with nonsyndromic children, patients with syndromic multisuture CS had a higher median number of CS surgeries (P =.0027) and differed in the types of sutures fused at the time of the index surgery (P =.001). There was no statical significant difference between the incidence of craniocervical pathology in syndromic and nonsyndromic children (38.9% vs 23.1%; P =.137). One of 3 syndromic patients (33.3%) had a shunt placed (P =.0148).CONCLUSION:The evaluation and treatment plan for multisuture CS is complex and requires multidisciplinary care. The authors described their experience and outcomes of syndromic and nonsyndromic multisuture CS children at a single high-volume institution. Syndromic children had a higher total median number of surgeries, were younger at index surgery, and had a higher incidence of shunt placement
Provider-Identified Barriers and Facilitators to Telehealth Adoption among Homeless-Experienced Veterans in Rural Areas
No full textTelehealth, vital for improving healthcare access in rural areas, has become more widespread, especially after the COVID-19 pandemic, accelerated advancements in healthcare technology. Despite challenges, telehealth has successfully helped people in rural areas and those experiencing homelessness access healthcare. The Veterans Health Administration (VHA) has been a leader in using telehealth to reach vulnerable populations, including homeless-experienced veterans (HEVs). Ongoing examination of telehealth technologies is crucial to ensure effective healthcare access. This study focuses on understanding the challenges and benefits of telehealth use among providers who serve HEVs in rural areas, aiming to deepen our insight into their experiences and unique challenges in these locations. We conducted an inductive secondary thematic analysis of interview data originally collected by Cusack et al. (2022), who conducted 32 semi-structured interviews with Veterans Health Administration providers between May 2021 and February 2022. Ten providers were from Veteran Affairs Medical Centers and 22 providers from Community-Based Outpatient Clinics. The interviews included questions eliciting providers’ perspectives regarding veterans facing housing instability in rural areas; VHA services, policies, and culture; the community setting and available resources; network and communication; and suggestions for potential changes and enhancements. Using open coding and a descriptive phenomenological approach, we identified new themes to address our research. question. The analysis revealed three themes: (1) access to and support for telehealth services by rural HEVs and their providers, (2) advantages of using telehealth, and (3) obstacles to telehealth adoption. We found that more than half of the respondents accessed programs offering technological devices for HEVs. Respondents described the advantages of telehealth in rural areas, including virtual connections and increased flexibility for both providers and HEVs. Respondents acknowledged a learning curve for both themselves and older Veterans when using telehealth services, particularly in the context of challenges faced by rural Veterans, such as limited resources and low technology literacy. Finally, the primary challenges reported by respondents encompassed insufficient training and equipment for telehealth services, which affected their ability to connect effectively with veterans and deliver remote care in rural areas. Study findings suggest that healthcare providers in rural areas support telehealth services when assisting rural HEVs. However, barriers persist in the adoption of telehealth among both service providers and veterans. To address this issue, we suggest implementing telehealth training programs specifically designed to accommodate the unique characteristics and circumstances encountered by rural-based providers and HEVs. Such initiatives could enhance the utilization of telehealth technology by both providers and veterans, facilitating their access to essential healthcare services
Hurricane Katrina Archive: Faculty Publications Bibliography 2015-2019
Get PDFThis bibliography includes 19 articles about Hurricane Katrina written by authors affiliated with LSU Health – New Orleans between January 2015 and December 2019.https://digitalscholar.lsuhsc.edu/biblio/1002/thumbnail.jp
REBOA is Here to Stay: How to Manage the Resulting Complications
No full textResuscitative endovascular balloon occlusion of the aorta (REBOA) has emerged as a critical adjunct in the management of trauma-related shock, serving as a temporizing measure to preserve vital organ perfusion and allow time to achieve definitive hemorrhagic control. However, the increasing adoption of REBOA into clinical practice is associated with a spectrum of potential complications that significantly increase morbidity and mortality in the setting of acute traumatic injury. There is little existing research to guide clinical decision-making and monitoring for these feared complications, especially iatrogenic vascular injuries. This paper synthesizes the current evidence on the classification, frequency, and management of vascular complications following REBOA insertion in the setting of trauma in addition to our observations and experiences as a level I trauma center
Medical Student Awareness of Pediatric Ophthalmology as a Potential, Future Vocation
No full textPURPOSE: To explore whether earlier exposure to the pediatric ophthalmology subspecialty could help foster interest and enhance recruitment efforts among medical students to more effectively develop and connect with potential, future pediatric ophthalmologists. METHODS: A 22-question survey was administered via Qualtrics to medical students at 13 different accredited medical schools. RESULTS: The survey garnered 392 complete responses. Demographically, respondents included 34% men and 66% women, with the largest participant category being MS-2 level (44%) in the survey. Three-quarters of students expressed potential interest in working with children as practicing physicians. Notably, only 8% of students had encountered pediatric ophthalmology rotations during their training, and 40% were uninformed about the training necessary to pursue a pediatric ophthalmology fellowship. The following associations with higher awareness of pediatric ophthalmology were found to be statistically significant: female gender identity, individuals with a family member or friend who is an ophthalmologist, and students with a personal medical history involving an ophthalmologist. CONCLUSIONS: This study highlights the significant deficiency in medical student exposure and education concerning pediatric ophthalmology. By recognizing this knowledge gap, this study underscores the necessity of enhancing pediatric ophthalmology exposure for medical students as a viable and rewarding career option