Strategies to engage lost to follow-up patients with phenylketonuria in the United States: Best practice recommendations

Surgical Site Infections

Archives of Infectious Diseases & Therapy ◽

10.33140/aidt.03.02.1 ◽

2019 ◽

Vol 3 (2) ◽

Keyword(s):

United States ◽

Best Practice ◽

Surgical Site Infections ◽

The United States ◽

Recent Analysis ◽

Poor Countries ◽

Practice Recommendations ◽

Healthcare Improvement ◽

Valid Data ◽

The Many

Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. Surgical site infection (SSI) rates are used extensively by hospitals as a basis for quality improvement. A 30-day postdischarge SSI as per CDC definitions of SSI should be consider in order to have a valid data inside the hospital Surgical site infections are not just a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at a cost of an additional US$ 10 billion per year., An SSI develops in 2% to 5% of patients undergoing surgical procedures each year in the United States which mean 500,000 and 750,000 SSIs occur annually, Institute of Healthcare Improvement has estimated that 40-60% of all SSIs are preventable. Mean attributable costs for SSI were $25,546 in a recent analysis of published studies on SSI costs, however, among the many measures to prevent SSI, only some are based on strong evidence we need to provide best practice recommendations for SSI management and prevention in hospitals and community care.

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Patient Perceptions of Cardiac Electrophysiology Procedural Postponement at an Urban Center During the SARS-CoV-2 Pandemic

Journal of Patient Experience ◽

10.1177/23743735211048054 ◽

2021 ◽

Vol 8 ◽

pp. 237437352110480

Author(s):

Anne-Sophie Lacharite-Roberge ◽

Abdullah Haddad ◽

Benjamin Khazan ◽

Joseph Noto ◽

Lauren E. Tragesser ◽

...

Keyword(s):

United States ◽

Cardiac Electrophysiology ◽

Telephone Survey ◽

The United States ◽

Patient Perceptions ◽

Urban Center ◽

Hospital Resources ◽

Lost To Follow Up

To curb transmission of SARS-CoV-2 and preserve hospital resources, elective procedures were postponed in the United States, affecting patients previously scheduled for electrophysiology (EP) procedures. We aimed to understand patients’ perceptions related to procedural postponements during the first wave of the SARS-CoV-2 pandemic. We performed a telephone survey between May 1-15 2020, of consecutive patients who experienced procedural postponement from March-April. Of 112 patients, 20% may have been lost to follow up and 12% lost interest in having their procedures done. The level of anxiety related to postponement was moderate to high in more than two thirds of patients.

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Exploring Best Practice for Municipal E-Scooter Policy in the United States

SSRN Electronic Journal ◽

10.2139/ssrn.3512725 ◽

2020 ◽

Author(s):

William Riggs ◽

Matthew Kawashima

Keyword(s):

United States ◽

Best Practice ◽

The United States

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Natural History and Evolution of Anti-Interferon-γ Autoantibody-Associated Immunodeficiency Syndrome in Thailand and the United States

Clinical Infectious Diseases ◽

10.1093/cid/ciz786 ◽

2019 ◽

Vol 71 (1) ◽

pp. 53-62 ◽

Cited By ~ 3

Author(s):

Gloria H Hong ◽

Ana M Ortega-Villa ◽

Sally Hunsberger ◽

Ploenchan Chetchotisakd ◽

Siriluck Anunnatsiri ◽

...

Keyword(s):

United States ◽

Natural History ◽

The United States ◽

Interferon Γ ◽

Mycobacterium Abscessus ◽

Annual Data ◽

Persistent Infections ◽

Ifn Γ ◽

Immunodeficiency Syndrome

Abstract Background The natural history of anti-interferon-γ (IFN-γ) autoantibody-associated immunodeficiency syndrome is not well understood. Methods Data of 74 patients with anti-IFN-γ autoantibodies at Srinagarind Hospital, Thailand, were collected annually (median follow-up duration, 7.5 years). Annual data for 19 patients and initial data for 4 patients with anti-IFN-γ autoantibodies at the US National Institutes of Health were collected (median follow-up duration, 4.5 years). Anti-IFN-γ autoantibody levels were measured in plasma samples. Results Ninety-one percent of US patients were of Southeast Asian descent; there was a stronger female predominance (91%) in US than Thai (64%) patients. Mycobacterium abscessus (34%) and Mycobacterium avium complex (83%) were the most common nontuberculous mycobacteria in Thailand and the United States, respectively. Skin infections were more common in Thailand (P = .001), whereas bone (P < .0001), lung (P = .002), and central nervous system (P = .03) infections were more common in the United States. Twenty-four percent of Thai patients died, most from infections. None of the 19 US patients with follow-up data died. Anti-IFN-γ autoantibody levels decreased over time in Thailand (P < .001) and the United States (P = .017), with either cyclophosphamide (P = .01) or rituximab therapy (P = .001). Conclusions Patients with anti-IFN-γ autoantibodies in Thailand and the United States had distinct demographic and clinical features. While titers generally decreased with time, anti-IFN-γ autoantibody disease had a chronic clinical course with persistent infections and death. Close long-term surveillance for new infections is recommended.

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SAT0172 UTILIZATION OF HYDROXYCHLOROQUINE AND CORTICOSTEROIDS AMONG LUPUS PATIENTS WITH INCIDENT END-STAGE RENAL DISEASE (ESRD) ONSET: A LONGITUDINAL STUDY USING USRDS REGISTRY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5103 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1027.2-1027

Author(s):

A. R. Broder ◽

W. Mowrey ◽

A. Valle ◽

B. Goilav ◽

K. Yoshida ◽

...

Keyword(s):

United States ◽

Lupus Nephritis ◽

Renal Disease ◽

International Classification Of Diseases ◽

The United States ◽

Diagnostic Code ◽

Prescribing Practices ◽

Part D ◽

Stage Renal Disease

Background:The development of ESRD due to lupus nephritis is one of the most common and serious complications of SLE. Mortality among SLE ESRD patients is 4-fold higher compared to lupus nephritis patients with preserved renal function1Mortality in SLE ESRD is also twice as high compared with non-SLE ESRD, even though SLE patients develop ESRD at a significantly younger age. In the absence of ESRD specific guidelines, medication utilization in SLE ESRD is unknown.Objectives:The objective of this study was to investigate the real-world current US-wide patterns of medication prescribing among lupus nephritis patients with new onset ESRD enrolled in the United States Renal Disease Systems (USRDS) registry. We specifically focused on HCQ and corticosteroids (CS) as the most used medications to treat SLE.Methods:Inclusion: USRDS patients 18 years and above with SLE as a primary cause of ESRD (International Classification of Diseases, 9thRevision (ICD9) diagnostic code 710.0, previously validated2). who developed ESRD between January 1st, 2006 and July 31, 2011 (to ensure at least 6 months of follow-up in the USRDS). Patients had to be enrolled in Medicare Part D (to capture pharmacy claims). The last follow-up date was defined as either the last date of continuous part D coverage or the end of the study period, Dec 31, 2013.Results:Of the 2579 patients included, 1708 (66%) were HCQ- at baseline, and 871 (34%) were HCQ+ at baseline. HCQ+ patients at baseline had a slightly lower duration of follow-up compared to HCQ- patients at baseline, median (IQR) of 2.32 (1.33, 3.97) years and 2.55 (1.44, 4.25) years, respectively, p= 0.02. During follow-up period, only 778 (30%) continued HCQ either intermittently or continuously to the last follow-up date, 1306 (51%) were never prescribed HCQ after baseline, and 495 (19%) discontinued HCQ before the last follow-up date. Of the 1801 patients who were either never prescribed or discontinued HCQ early after ESRD onset, 713 (40%) were prescribed CS to the end of the follow-up period: 55% were receiving a low dose <10mg/daily, and 43 were receiving moderate dose (10-20mg daily)Conclusion:HCQ may be underprescribed and CS may be overprescribed in SLE ESRD. Changing the current prescribing practices may improve outcomes in SLE ESRDReferences:[1]Yap DY et al., NDT 2012.[2]Broder A et al., AC&R 2016.Acknowledgments :The data reported here have been supplied by the United States Renal Data System (USRDS). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy or interpretation of the U.S. government.Funding: :NIH/NIAMS K23 AR068441 (A Broder), NIH/NIAMS R01 AR 057327 and K24 AR 066109 (KH Costenbader)Disclosure of Interests: :Anna R. Broder: None declared, Wenzhu Mowrey: None declared, Anna Valle: None declared, Beatrice Goilav: None declared, Kazuki Yoshida: None declared, Karen Costenbader Grant/research support from: Merck, Consultant of: Astra-Zeneca

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A 26-Year Study of Restraint Fatalities Among Children and Adolescents in the United States: A Failure of Organizational Structures and Processes

Child & Youth Care Forum ◽

10.1007/s10566-021-09646-w ◽

2021 ◽

Author(s):

Michael A. Nunno ◽

Lisa A. McCabe ◽

Charles V. Izzo ◽

Elliott G. Smith ◽

Deborah E. Sellers ◽

...

Keyword(s):

United States ◽

Physical Restraint ◽

Organizational Structures ◽

The United States ◽

Community Schools ◽

Disability Services ◽

Advocacy Groups ◽

Governmental Agencies ◽

Practice Recommendations ◽

Mechanical Restraints

Abstract Background Physical and mechanical restraints used in treatment, care, education, and corrections programs for children are high-risk interventions primarily due to their adverse physical, emotional, and fatal consequences. Objective This study explores the conditions and circumstances of restraint-related fatalities in the United States by asking (1) Who are the children that died due to physical restraint? and (2) How did they die? Method The study employs internet search systems to discover and compile information about restraint-related fatalities of children and youth up to 18 years of age from reputable journalism sources, advocacy groups, activists, and governmental and non-governmental agencies. The child cohort from a published study of restraint fatalities in the United States from 1993 to 2003 is combined with restraint fatalities from 2004 to 2018. This study’s scope has expanded to include restraint deaths in community schools, as well as undiscovered restraint deaths from 1993 to 2003 not in the 2006 study. Results Seventy-nine restraint-related fatalities occurred over the 26-year period from across a spectrum of children’s out-of-home child welfare, corrections, mental health and disability services. The research provides a data snapshot and examples of how fatalities unfold and their consequences for staff and agencies. Practice recommendations are offered to increase safety and transparency. Conclusions The study postulates that restraint fatalities result from a confluence of medical, psychological, and organizational causes; such as cultures prioritizing control, ignoring risk, using dangerous techniques, as well as agencies that lack structures, processes, procedures, and resources to promote learning and to ensure physical and psychological safety.

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