Disparities in Prenatal Care Utilization Among U.S. Versus Foreign-Born Women with Chronic Conditions.

We examined disparities in prenatal care utilization (PNCU) among U.S. and foreign-born women with chronic conditions.

Adequacy of Current State Setbacks for Directional High-Volume Hydraulic Fracturing in the Marcellus, Barnett, and Niobrara Shale Plays.

Background: There is an increasing awareness of the multiple potential pathways leading to human health risks from hydraulic fracturing. Setback distances are a legislative method to mitigate potential risks.

Objectives: We attempted to determine whether legal setback distances between well-pad sites and the public are adequate in three shale plays.

The impact of fragmentation of hospitalist care on length of stay.

Background: Different hospitalist staffing models provide different levels of inpatient continuity of care, which may impact length of stay (LOS).

Objective: To determine if fragmentation of care (FOC) by hospitalist physicians is associated with LOS.

Design: Concurrent control study.

Utilization of elective hip and knee arthroplasty by age and payer.

Elective joint arthroplasty improves the quality of life for patients with severe arthritis. In the United States, utilization of services varies with insurance status. We asked the following questions: (1) Is there an increase in the utilization of elective hip and knee arthroplasty after age 65? (2) Does the difference in utilization between the insured and general populations decrease at age 65 (the age at which Medicare provides near universal coverage)? (3) Does Medicare become the primary payer of elective hip and knee arthroplasty after the age of 65? We used the National Inpatient Sample to identify patients and payers of elective hip and knee arthroplasties by age.

Extended use of urinary catheters in older surgical patients: a patient safety problem?

Objectives: To explore the relationship between the extended postoperative use of indwelling urinary catheters and outcomes for older patients who have undergone cardiac, vascular, gastrointestinal, or orthopedic surgery in skilled nursing facilities and to describe patient and hospital characteristics associated with the extended use of indwelling urinary catheters.

Design: Retrospective cohort study.

Setting: US acute care hospitals and skilled nursing facilities.

Effects of vitamin therapy on plasma total homocysteine, endothelial injury markers, and fibrinolysis in stroke patients.

Hyperhomocystinemia linked to B-vitamin deficiency is prevalent and associated with increased risk for stroke. While in vitro studies suggest homocysteine directly injures vascular endothelial thrombomodulin (TM), inhibits vonWillebrand factor (vWF) synthesis, and blocks tissue plasminogen activator (t-PA) receptor binding, these mechanisms and their reversibility by vitamin therapy are not established in humans. We investigated the effects of high-dose B-vitamin therapy on endogenous fibrinolysis and endothelial injury markers by randomizing 50 nonvitamin users with prior ischemic stroke to 3 months of treatment with multivitamins either containing folate (5 mg), B6 (100 mg), and B12 (1 mg), or lacking these components.

Extended use of indwelling urinary catheters in postoperative hip fracture patients.

Background: Indwelling urinary catheters are used postoperatively in hip fracture care. Their use beyond the immediate postoperative period may result in excess nosocomial infections.

Objectives: The objectives of this study were to explore the relationship between extended indwelling urinary catheterization and outcomes for patients sustaining hip fracture discharged to skilled nursing facilities (SNFs), and to describe patient and hospital predictors of extended indwelling urinary catheterization.