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Journal of Patient-Centered Research and Reviews
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  This is an Open Access Journal Open Access journal
ISSN (Print) 2330-068X - ISSN (Online) 2330-0698
Published by Aurora Health Care Homepage  [1 journal]
  • Abstracts From the 2022 Health Care Systems Research Network (HCSRN)
           Annual Conference

    • Abstract: The Health Care Systems Research Network (HCSRN) is comprised of 20 health systems with embedded research units. The network’s annual conference serves as a forum for research teams from member institutions to disseminate scientific findings, explore new collaborations, and share insights about conducting research in real-world care delivery settings. Abstracts accepted for presentation at HCSRN 2022 are published in this supplement of Journal of Patient-Centered Research and Reviews, the official journal of HCSRN’s annual conference proceedings.
      PubDate: Sun, 17 Jul 2022 07:03:08 PDT
       
  • Partnering to Advance Health Equity and a Welcome Opportunity to Gather:
           Proceedings From the 28th Annual Conference of the Health Care Systems
           Research Network

    • Authors: Robert T. Greenlee
      Abstract: In April 2022, the Health Care Systems Research Network (HCSRN) — a consortium of 20 research institutions affiliated with large health systems spread across the United States (and one in Israel) — held its 28th annual conference in Pasadena, California, with 275 researchers, health care colleagues, and external academic partners in attendance. With a conference theme of “Promoting Collaboration and Partnerships to Advance Health Equity,” the scientific program was assembled by a multisite planning committee with input from representatives of informal local host Kaiser Permanente Southern California. Objectives of the annual conference are to showcase scientific findings from HCSRN projects and to spur collaboration on research initiatives that improve health and health care for individuals and populations. To those ends, the NIH Pragmatic Trials Collaboratory sponsored a preconference workshop on the essentials of embedded pragmatic clinical trials, and more than a dozen scientific interest groups and active research project teams held ancillary sessions throughout the conference. This welcome opportunity for network members to meet in-person followed a 2-year hiatus necessitated by the COVID-19 pandemic, during which HCSRN conference proceedings were conducted through virtual and written communication platforms.
      PubDate: Sun, 17 Jul 2022 07:03:04 PDT
       
  • Heart to Heart, Mom to Mom

    • Authors: Karis L. Tekwani
      Abstract: This essay describes the human connection forged between two young moms, one the physician and one the patient, when their paths collided one night in the emergency department of a busy hospital. It describes a challenging and most memorable care experience in the career of a young emergency physician, the clinical outcome, and the patient’s appreciative follow-up message years later.
      PubDate: Sun, 17 Jul 2022 07:02:56 PDT
       
  • Is Home Blood Pressure Monitoring Effective at Controlling Hypertension in
           African American Patients' A Clin-IQ

    • Authors: Rebecca Nye et al.
      Abstract: African Americans are disproportionately affected by hypertension, a modifiable contributor to multiple chronic diseases and premature death. Primary care physicians play an important role in hypertension control. Home blood pressure monitoring (HBPM) is an evidence-based method for confirming diagnosis and monitoring hypertension over time. Some studies have found that HBPM may lead to clinically relevant reductions in blood pressure when combined with additional interventions, but few studies have focused specifically on African American populations. Evidence of effectiveness could increase clinical recommendation of HBPM. This clinical inquiry examined whether HBPM improves blood pressure control in African Americans with uncontrolled hypertension. Reviewed studies included 4 randomized controlled trials and 2 comparative research studies. Because these studies often were coupled with various co-interventions, ascertaining the independent effects of HBPM was difficult. When examining reviews of HBPM without a co-intervention and conducted independent of race, HBPM alone was insufficient to achieve long-term changes in hypertension control. More research focused on African Americans, with use of control groups, is needed to determine the true role for HBPM in controlling hypertension in this at-risk patient population.
      PubDate: Sun, 17 Jul 2022 07:02:46 PDT
       
  • Cardiac Metastasis After Curative Treatment of Hepatocellular Carcinoma:
           Risk Factors, Treatment Options, and Prognosis

    • Authors: Gaurav Jain et al.
      Abstract: Hepatocellular carcinoma (HCC) is primary hepatic malignancy with a high incidence of recurrence. The risk of recurrence directly correlates to patient’s overall prognosis. Management of advanced HCC involves a combination of surgical resection, locoregional therapy, and systemic treatment. Distant metastases are rare, and intraventricular cardiac metastases are even more infrequent. This brief review details an illustrative case of cardiac metastasis after curative treatment of primary HCC and then summarizes the literature on risk factors, treatment options, and patient prognosis in the setting of distant metastases from HCC. Prognosis of metastasis to the heart is generally poor, and available evidence emphasizes the importance of maintaining regular posttreatment screening for metastases in patients with HCC. Given the variable presentation and high risk of recurrence, it is critical to have individualized multimodality treatment plans.
      PubDate: Sun, 17 Jul 2022 07:02:34 PDT
       
  • Can Variables From the Electronic Health Record Identify Delirium at
           Bedside'

    • Authors: Ariba Khan et al.
      Abstract: Delirium, a common and serious disorder in older hospitalized patients, remains underrecognized. While several delirium predictive models have been developed, only a handful have focused on electronic health record (EHR) data. This prospective cohort study of older inpatients (≥ 65 years old) aimed to determine if variables within our health system’s EHR could be used to identify delirium among hospitalized patients at the bedside. Trained researchers screened daily for delirium using the 3-minute diagnostic Confusion Assessment Method (3D-CAM). Patient demographic and clinical variables were extracted from the EHR. Among 408 participants, mean age was 75 years, 60.8% were female, and 82.6% were Black. Overall rate of delirium was 16.7%. Patients with delirium were older and more likely to have an infection diagnosis, prior dementia, higher Charlson comorbidity severity of illness score, lower Braden Scale score, and higher Morse Fall Scale score in the EHR (P < 0.01 for all). On multivariable analysis, a prior diagnosis of dementia (odds ratio: 5.0, 95% CI: 2.5–10.3) and a Braden score of < 18 (odds ratio: 2.8, 95% CI: 1.5–5.1) remained significantly associated with delirium among hospitalized patients. Further research in the development of an automated delirium prediction model is needed.
      PubDate: Sun, 17 Jul 2022 07:02:23 PDT
       
  • Asking the Question ‘What Matters to You'’ in a London
           Intensive Care Unit

    • Authors: Harriet Pittaway et al.
      Abstract: Purpose: At the heart of the paradigm shift in approach to patient care from paternalism toward shared decision-making lies the international “What Matters To You'” (WMTY) movement. However, WMTY principles are not frequently applied to the critical care setting. The aim of this quality improvement project work was to design and integrate a tool for all patients admitted to the intensive care unit (ICU) that helped answer WMTY.Methods: Using Plan-Do-Study-Act (PDSA) methodology across 8 cycles, a multidisciplinary team designed and integrated a bedside poster into the ICU. Quantitative and qualitative data were collected via a bedside audit process on a regular basis during each of the study phases comprising PDSA cycles.Results: Project results confirmed that the introduction of this poster/tool, alongside resource- and staff engagement-focused interventions, enabled the ICU to offer more than 50% of patients a WMTY conversation, as compared to zero at the start of the project. Consistently, 100% of staff surveyed (n = 46 over all cycles) felt the posters were a useful addition to the ICU and confirmed they learned something new about their patients that they didn’t know already.Conclusions: This novel poster design successfully summarized patients’ responses to the question “What matters to you'” for ICU staff and would be transferable to other ICUs.
      PubDate: Sun, 17 Jul 2022 07:02:10 PDT
       
  • Virtual Behavioral Health Treatment Satisfaction and Outcomes Across Time

    • Authors: Mindy R. Waite et al.
      Abstract: Purpose: The COVID-19 pandemic continues to have major and long-lasting impacts on health care delivery and mental health. As health care shifted to telehealth, legislation was adjusted to expand telehealth allowances, creating a unique opportunity to elucidate outcomes. The aim of this study was to assess long-term patient and clinician satisfaction and outcomes with virtual behavioral health.Methods: Data were obtained over 16 months from surveys to patients and clinicians receiving/providing virtual treatment. Outcomes data also were collected from medical records of adults receiving in-person and virtual behavioral health treatment. Data were summarized using descriptive statistics. Groups were compared using various chi-squared tests for categorical variables, Likert response trends over time, and conditional independence, with Wilcoxon rank-sum or Jonckheere trend test used to assess continuous variables. P-values of ≤ 0.05 were considered statistically significant.Results: Patients gave high ratings to virtual treatment and indicated a preference for virtual formats. Both patient and clinician preference for virtual visits increased significantly with time, and many clinicians perceived virtual services to be equally effective to in-person. Virtual programs had higher completion rates, attendance rates, and number of treatment visits, suggesting that virtual behavioral health had equivalent or better outcomes to in-person treatment and that attitudes toward telehealth changed over time.Conclusions: If trends found in this study continue, telehealth may emerge as a preferred option long term This is important considering the increase in mental health needs associated with the COVID-19 pandemic and the eventuality that in-person restrictions ease as the pandemic subsides.
      PubDate: Sun, 17 Jul 2022 07:02:00 PDT
       
  • Real-World Third COVID-19 Vaccine Dosing and Antibody Response in Patients
           With Hematologic Malignancies

    • Authors: Michael A. Thompson et al.
      Abstract: Purpose: This study sought to describe the changes in immune response to a third dose of either Pfizer’s or Moderna’s COVID-19 mRNA vaccine (3V) among patients with hematologic malignancies, as well as associated characteristicsMethods: This retrospective cohort study analyzed pre-3V and post-3V data on 493 patients diagnosed with hematologic malignancies across a large Midwestern health system between August 28, 2021, and November 1, 2021. For antibody testing, S1 spike antigen of the SARS-CoV-2 virus titer was used to determine serostatus.Results: Among 493 participants, 274 (55.6%) were seropositive both pre- and post-3V (+/+) while 115 (23.3%) seroconverted to positive from prior negative following the third dose (-/+). The remaining 104 (21.1%) were seronegative both before and after 3V (-/-). No participant was seropositive pre-3V and seronegative post-3V (+/-). Results showed a statistically significant increase in the proportion of seropositivity after receiving a third COVID-19 vaccine (P < 0.00001). Response to 3V was significantly associated with the 3V vaccine type (P = 0.0006), previous COVID-19 infection (P = 0.0453), and malignancy diagnosis (P < 0.0001). Likelihood of seroconversion (-/+) after 3V was higher in the group of patients with multiple myeloma or related disorders compared to patients with lymphoid leukemias (odds ratio: 8.22, 95% CI: 2.12–31.79; P = 0.0008).Conclusions: A third COVID-19 vaccination is effective in producing measurable seroconversion in many patients with hematologic malignancies. Oncologists should actively encourage all their patients, especially those with multiple myeloma, to receive a 3V, given the high likelihood of seroconversion.
      PubDate: Sun, 17 Jul 2022 07:01:45 PDT
       
  • Sitting

    • Authors: John Brill
      Abstract: A family physician volunteers for a hospital shift as a patient sitter and reflects on the experience in this creative writing article. Freed from clinical responsibilities in a hospital setting, sitting and observing the patient’s interactions with health care professionals and staff reinforced the importance of human connection to recovery.
      PubDate: Mon, 18 Apr 2022 09:38:28 PDT
       
  • Clinical Characteristics, Risk Factors, and Outcomes Among a Large
           Midwestern U.S. Cohort of Patients Hospitalized With COVID-19 Prior to
           Vaccine Availability

    • Authors: Viviana Zlochiver et al.
      Abstract: Purpose: The COVID-19 pandemic posed unprecedented demands on health care. This study aimed to characterize COVID-19 inpatients and examine trends and risk factors associated with hospitalization duration, intensive care unit (ICU) admission, and in-hospital mortality.Methods: This retrospective study analyzed patients with SARS-CoV-2 infection hospitalized at an integrated health system between February 2, 2020, and December 12, 2020. Patient characteristics and clinical outcomes were obtained from medical records. Backward stepwise logistic regression analyses were used to identify independent risk factors of ICU admission and in-hospital mortality. Cox proportional hazards models were used to evaluate relationships between ICU admission and in-hospital mortality. Results: Overall, 9647 patients were analyzed. Mean age was 64.6 ± 18 years. A linear decrease was observed for hospitalization duration (0.13 days/week, R2 = 0.71; P < 0.0001), ICU admissions (0.35%/week, R2 = 0.44; P < 0.001), and hospital mortality (0.16%/week, R2 = 0.31; P < 0.01). Bacterial co-infections, male sex, history of chronic lung and heart disease, diabetes, and Hispanic ethnicity were identified as independent predictors of ICU admission (P < 0.001). ICU admission and age of ≥65 years were the strongest independent risk factors associated with in-hospital mortality (P < 0.001). The in-hospital mortality rate was 8.3% (27.4% in ICU patients, 2.6% in non-ICU patients; P < 0.001).Conclusions: Results indicate that, over the pandemic’s first 10 months, COVID-19 carried a heavy burden of morbidity and mortality in older patients (> 65 years), males, Hispanics, and those with bacterial co-infections and chronic comorbidities. Although disease severity has steadily declined following administration of COVID-19 vaccines along with improved understanding of effective COVID-19 interventions, these study findings reflect a “natural history” for this novel infectious disease in the U.S. Midwest.
      PubDate: Mon, 18 Apr 2022 09:38:04 PDT
       
  • Association of Natural Waterways and Legionella pneumophila Infection in
           Eastern Wisconsin: A Case-Control Study

    • Authors: Hannah M. William et al.
      Abstract: Preliminary research has suggested possible associations between natural waterways and Legionella infection, and we previously explored these associations in eastern Wisconsin using positive L. pneumophila serogroup 1 urine antigen tests (LUAT) as diagnostic. This case-control study was a secondary analysis of home address data from patients who underwent LUAT at a single eastern Wisconsin health system from 2013 to 2017. Only zip codes within the health system’s catchment area that registered ≥ 3 positive cases and ≥ 50 completed tests, as well as geographically adjacent zip codes with ≥ 2 positive cases and ≥ 50 tests, were included. A 1:3 ratio of cases to randomly selected controls was used. Home addresses were geocoded and mapped using ArcGIS software (Esri); nearest waterway and distance to home was identified. Distance to nearest waterway according to ArcGIS was verified/corrected using Google Maps incognito. Distances were analyzed using chi-squared and 2-sample t-tests. Overall, mean distance to nearest waterway did not differ between cases (2958 ± 2049 ft) and controls (2856 ± 2018 ft; P = 0.701). However, in a subset of nonurban zip codes, cases were closer to nearest waterway than controls (1165 ± 905 ft vs 2113 ± 1710 ft; P = 0.019). No association was found between cases and type of waterway. Further research is needed to investigate associations and differences between natural and built environmental water sources in relation to legionellosis.
      PubDate: Mon, 18 Apr 2022 09:37:57 PDT
       
  • Vitamin D Level Testing in an Urban Midwest Clinic: To Test or Not to
           Test'

    • Authors: Daniel Mundt et al.
      Abstract: Vitamin D deficiency (VDD) is significantly higher among urban populations in the U.S. Midwest, with African Americans being disproportionately affected. There is ongoing debate surrounding who and how often individuals should be screened for VDD. This study aimed to understand the prevalence of VDD, associated risk factors, and discrepancies in testing at an urban-based internal medicine residency clinic. Data were retrospectively collected on all adult patients seen by the clinic during 2018 and descriptive statistical analysis performed. Among 3976 total patients (mean age: 53 years), 18% (n = 698) had vitamin D levels analyzed, with deficiency found in 71% of those tested. Mean age of the tested cohort was 59 years, and women (68%) and African Americans (72%) were found more likely to be tested. Women and patients with certain medical conditions were more likely to be tested (P < 0.02 for all) but were not more likely to have VDD. Individuals with a diagnosis of chronic kidney disease were less likely to have VDD (P = 0.002). Vitamin D levels typically showed improvement after retesting. A low testing rate could contribute to missed diagnoses. Overall, this study revealed that differences in rate of testing do not necessarily correlate to patients’ demographical risk of VDD. Clinicians may benefit from a standardized vitamin D testing protocol.
      PubDate: Mon, 18 Apr 2022 09:37:50 PDT
       
  • Responding to Sexual Abuse in Health Care: Development of a Guide for
           Patients

    • Authors: Tristan McIntosh et al.
      Abstract: This report details the development of a stakeholder- and evidence-informed online resource guide for patients that provides information to raise awareness about sexual abuse in health care, the value of chaperones, and options for responding to sexual abuse. The guide was developed to reflect lessons learned from 10 years of researching physician wrongdoing (ie, sexual violations, improper prescribing, and unnecessary invasive procedures), a 5-year National Institutes of Health-funded mixed-methods study of 280 cases of egregious wrongdoing in medicine, and an expert working group. Focus groups were conducted with 22 patients from diverse backgrounds to obtain feedback on the acceptability of the guide. Thematic analysis of the focus groups yielded 6 key themes: 1) empowering patients, 2) recognizing and responding to sexual abuse, 3) educating patients about reporting options, 4) educating patients on availability of chaperones, 5) balancing trust and mistrust, and 6) using simple language. Qualitative data from the focus groups (ie, audio files and detailed notes taken by the research team) suggested that the guide effectively informed and empowered patients to recognize and effectively respond to sexual misconduct in health care. The guide is publicly available and has been disseminated nationally to patient health advocates and public health agencies.
      PubDate: Mon, 18 Apr 2022 09:37:37 PDT
       
  • Stroke Network of Wisconsin (SNOW) Scale Predicts Large Vessel Occlusion
           Stroke in the Prehospital Setting

    • Authors: Kessarin Panichpisal et al.
      Abstract: Purpose: In previous trials, the Stroke Network of Wisconsin (SNOW) scale accurately predicted large vessel occlusion (LVO) stroke in the hospital setting. This study evaluated SNOW scale performance in the prehospital setting and its ability to predict LVO or distal medium vessel occlusion (DMVO) in patients suspected of having acute ischemic stroke (AIS), a scenario in which transport time to an endovascular treatment-capable facility (ECSC) is critical.Methods: All potential AIS patients with last-known-well time of ≤ 24 hours were assessed by Milwaukee County Emergency Medical Services for LVO using SNOW. Patients with a positive SNOW score were transferred to the nearest ECSC. One such facility, Aurora St. Luke’s Medical Center (ASLMC), was the source of all patient data analyzed in this study. LVO was defined as occlusion of the intracranial carotid artery, middle cerebral artery (M1) segment, or basilar artery.Results: From March 2018 to February 2019, 345 AIS-suspected patients were transported to ASLMC; 19 patients were excluded because no vascular imaging was performed. Of 326 patients, 32 had confirmed LVO and 21 DMVO. For identifying LVO, SNOW scale sensitivity was 0.88, specificity 0.40, positive predictive value (PPV) 0.14, negative predictive value (NPV) 0.97, and area under the curve (AUC) 0.64. Ability to predict DMVO was similar. Overall, the SNOW scale showed sensitivity of 0.83, specificity of 0.39, PPV of 0.10, NPV of 0.97, and AUC of 0.60 in identifying candidates for endovascular thrombectomy.Conclusions: In a prehospital setting, the SNOW scale has high sensitivity in identifying candidates for endovascular thrombectomy and proved highly reliable in ruling out stroke due to LVO.
      PubDate: Mon, 18 Apr 2022 09:37:22 PDT
       
  • Electrocardiogram-Based Machine Learning Emulator Model for Predicting
           Novel Echocardiography-Derived Phenogroups for Cardiac
           Risk-Stratification: A Prospective Multicenter Cohort Study

    • Authors: Heenaben B. Patel et al.
      Abstract: Purpose: Electrocardiography (ECG)-derived machine learning models can predict echocardiography (echo)-derived indices of systolic or diastolic function. However, systolic and diastolic dysfunction frequently coexists, which necessitates an integrated assessment for optimal risk-stratification. We explored an ECG-derived model that emulates an echo-derived model that combines multiple parameters for identifying patient phenogroups at risk for major adverse cardiac events (MACE).Methods: In this substudy of a prospective, multicenter study, patients from 3 institutions (n = 727) formed an internal cohort, and the fourth institution was reserved as an external test set (n = 518). A previously validated patient similarity analysis model was used for labeling the patients as low-/high-risk phenogroups. These labels were utilized for training an ECG-derived deep neural network model to predict MACE risk per phenogroup. After 5-fold cross-validation training, the model was tested on the reserved external dataset.Results: Our ECG-derived model showed robust classification of patients, with area under the receiver operating characteristic curve of 0.86 (95% CI: 0.79–0.91) and 0.84 (95% CI: 0.80–0.87), sensitivity of 80% and 76%, and specificity of 88% and 75% for the internal and external test sets, respectively. The ECG-derived model demonstrated an increased probability for MACE in high-risk vs low-risk patients (21% vs 3%; P < 0.001), which was similar to the echo-trained model (21% vs 5%; P < 0.001), suggesting comparable utility.Conclusions: This novel ECG-derived machine learning model provides a cost-effective strategy for predicting patient subgroups in whom an integrated milieu of systolic and diastolic dysfunction is associated with a high risk of MACE.
      PubDate: Mon, 18 Apr 2022 09:37:05 PDT
       
  • Associations Between Residential Greenspace, Socioeconomic Status, and
           Stroke: A Matched Case-Control Study

    • Authors: Heloise Cheruvalath et al.
      Abstract: Purpose: Studies have shown increased residential greenspace is associated with improved outcome following stroke. This study sought to determine if residential greenspace is an independent stroke risk factor.Methods: A retrospective 1:4 matched case-control study involving 1174 stroke and 4696 control patients over a 3-year period from Milwaukee County, Wisconsin, was conducted. Greenspace was determined using normalized difference vegetation index (NDVI) for a 250-meter radius surrounding a subject’s residence. The area deprivation index (ADI) for the census block tract of a subject’s residence was obtained from the Neighborhood Atlas® (University of Wisconsin School of Medicine and Public Health). Relationship between greenspace, ADI, and stroke was determined using conditional logistic regression. Relationships among NDVI, state and national ADI, and proximity to public parks were determined using Spearman’s rank-order correlation.Results: NDVI and stroke risk were inversely correlated (odds ratio [OR]: 0.33, 95% CI: 0.111–0.975; P = 0.045), with 19% lowered odds of stroke for patients living in the highest greenspace quartile compared to the lowest quartile (OR: 0.81, 95% CI: 0.672–0.984; P = 0.045). Patients living in the most deprived ADI quartile had 28% greater stroke risk than those living in the least deprived ADI quartile (OR: 1.28, 95% CI: 1.02–1.6; P = 0.029). Non-Hispanic Black patients lived in residential areas with lower greenspace (P < 0.001) and neighborhoods of greater state and national ADI (P < 0.001 for both) than non-Hispanic White patients.Conclusions: In Milwaukee County, living with greater surrounding greenspace or areas of lower deprivation is associated with lower odds of stroke. NDVI represents an independent risk factor for stroke, not simply a proxy for socioeconomic status.
      PubDate: Mon, 18 Apr 2022 09:36:51 PDT
       
  • In Gratitude of 2021 JPCRR Peer Reviewers

    • Abstract: Peer review plays an important role in maintaining the integrity of scientific literature. The Journal of Patient-Centered Research and Reviews calls on a diverse stable of reviewers to evaluate and enhance original submissions to the journal. In this supplement, JPCRR's editorial team gratefully acknowledges its volunteer experts for their generous contributions during the past 12 months.
      PubDate: Tue, 18 Jan 2022 10:23:31 PST
       
  • Seroprevalence of COVID-19 IgG Antibody in Resident and Fellow Physicians
           in Milwaukee, Wisconsin: Analysis of a Cross-Sectional Survey

    • Authors: Dennis J. Baumgardner et al.
      Abstract: Purpose: Medical trainees are likely at differential risk of exposure to COVID-19 per respective clinical activity. We sought to determine the seroprevalence of COVID-19 antibody (Ab) among resident and fellow physicians with varying degrees of exposure to COVID-19.Methods: A cross-sectional study of Milwaukee-based resident and fellow physicians, encompassing December 2019–June 2020, was conducted. Relevant variables of interest were ascertained by survey and payroll data, and Abbott ARCHITECT Ab test (index cut-off of ≥ 1.4) was performed. Descriptive statistics were generated, with 95% CI calculated for the study’s primary outcome of seroprevalence.Results: Among survey respondents (92 of 148, 62%), 61% were male, 44% were non-White, mean age was 31 years, 94% had no underlying conditions, and 52% were either family or internal medicine residents. During the study period, ≥ 32% reported cough, headache, or sore throat and 62% traveled outside of Wisconsin. Overall, 83% thought they had a COVID-19 exposure at work and 33% outside of work; 100% expressed any exposure. Of those exposed at work, 56% received COVID-19 pay, variously receiving 69 mean hours (range: 0–452). Ultimately, 82% (75 of 92) had an Ab test completed; 1 individual (1.3%; 95% CI: 0.0–3.9) tested seropositive, was not previously diagnosed, and had received COVID-19 pay.Conclusions: The low Ab seroprevalence found in resident and fellow physicians was similar to the concurrently reported 3.7% Ab-positive rate among 2456 Milwaukee-based staff in the same integrated health system. Ultimately, COVID-19 seroconversion may be nominal in properly protected resident and fellow physicians despite known potential exposures.
      PubDate: Mon, 17 Jan 2022 07:43:00 PST
       
  • Prevalence of Endocrine Disorders Among 6078 Individuals With Down
           Syndrome in the United States

    • Authors: Anne Rivelli et al.
      Abstract: Findings from a recent study describing prevalence of common disease conditions in the largest documented cohort of individuals with Down syndrome (DS) in the United States strongly suggested significant disparity in endocrine disorders among these individuals when compared with age- and sex-matched individuals without DS. This retrospective, descriptive study is a follow-up report documenting prevalence of 21 endocrine disorder conditions, across 28 years of data, from 6078 individuals with DS and 30,326 age- and sex-matched controls, abstracted from electronic medical records within a large integrated health system. Overall, individuals with DS experienced higher prevalence of adrenal insufficiency and Addison’s disease; thyroid disorders, including hypothyroidism, hyperthyroidism, Hashimoto’s disease, and Graves’ disease; prolactinoma/hyperprolactinemia; diabetes insipidus; type I diabetes mellitus; and gout. Conversely, those with DS had lower prevalence of polycystic ovary syndrome and type II diabetes mellitus. Many prevalences of endocrine conditions seen in individuals with DS significantly differ relative to their non-DS matched counterparts. These varied findings warrant further exploration into how screening for and treatment of endocrine conditions may need to be approached differently for individuals with DS.
      PubDate: Mon, 17 Jan 2022 07:42:47 PST
       
 
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