A retrospective multi-site examination of chronic kidney disease using longitudinal laboratory results and metadata to identify clinical and financial risk.

Background: A retrospective observational study was conducted at 3 health care organizations to identify clinical gaps in care for patients with stage 3 or 4 chronic kidney disease (CKD), and financial opportunity from U.S. risk adjustment payment systems.

Intrapartum Electronic Cigarette Use and Birth Outcomes: Evidence from a Population-Based Study.

The harms of combustible cigarette (CC) use in pregnancy for fetal development are well studied. Less understood are the potential impacts of newer non-combustible cigarette alternatives, including electronic cigarettes (ECs). Our goal was to examine whether EC use during pregnancy predicts increased risk of adverse birth outcomes.

Fetal Growth Following Electronic Cigarette Use in Pregnancy.

Electronic cigarette (e-cig) use in pregnancy is common, but potential effects on fetal development are largely unknown. This study's goal was to examine the association between e-cig exposure and fetal growth. Data were extracted from medical charts in this single-site retrospective study.

Impact of in utero tobacco exposure on fetal growth: Amount of exposure and second trimester fetal growth measurements.

Background: Research reveals small and inconsistent findings linking prenatal tobacco exposure and early fetal growth, but failure to consider confounding and amount of exposure many explain inconsistencies.

Goal: To examine whether fetal growth effects following exposure to tobacco are evident in the second trimester, specific to certain growth parameters, and dose dependent.

Methods: Participants were pregnant women (64 smokers, 100 controls) with no other drug use.

Birth outcomes following in utero co-exposure to tobacco and marijuana.

Background: With recent changes in tobacco and marijuana use patterns, it becomes crucial to understand how the prenatal co-use of these substances impacts birth outcomes. The goal of this study was to examine the risk of adverse birth outcomes among infants born to women who used tobacco and marijuana concurrently throughout pregnancy compared to infants of women who used tobacco alone.

Methods: This study involved a retrospective chart review of pregnant women identified via self-report or biochemical testing who used tobacco products alone (N = 71) or tobacco and marijuana simultaneously (N = 127) at any point throughout pregnancy.

The COVID-19 pandemic and the experience of postpartum depression.

Early studies assessing peripartum mood disorders during the COVID-19 pandemic have conflicting results. The primary aim was to examine if postpartum depression (PPD) was more common or more severe during the COVID-19 pandemic compared to earlier periods, and to assess what individual factors may worsen the impact of the pandemic. Electronic health records at an academic pediatric practice in Michigan identified 242 biological mother-child dyads with delivery between 1/1/2017 and 12/31/2021.

The Impact of Pregnancy on Diabetic Retinopathy: A Single-Site Study of Clinical Risk Factors.

Introduction: This study aimed to provide information on modifiable and non-modifiable risk factors for the progression and development of diabetic retinopathy (DR) and diabetic macular edema (DME). This retrospective chart review case-control study was designed to provide perspective on clinical variables.

Methods: Single-center study analysis was completed with chart review, identifying 50 patients (100 eyes) ultimately included in the final analysis.

Sociodemographic Disparities in the Diagnosis and Prognosis of Patients With Cervical Cancer: An Analysis of the Surveillance, Epidemiology, and End Results Program.

Background While the incidence and mortality rates of cervical cancer are declining due to improved prevention, screening, and treatment, inequitable access to care may contribute to worse patient outcomes. Therefore, we sought to evaluate sociodemographic disparities in the diagnosis and prognosis of patients with cervical cancer. Methodology The Surveillance, Epidemiology, and End Results (SEER) database was queried for adult women diagnosed with cervical cancer from 2010 to 2015.

Polypharmacy Prevalence and Perceptions of Deprescribing in Elderly Patients Among Community Primary Care Providers in Mid-Michigan Practices.

Introduction: Polypharmacy is common among the elderly and can predispose them to increased morbidity and higher healthcare expenditures. Deprescribing is an important aspect of preventative medicine to minimize polypharmacy-related adverse effects. Mid-Michigan has historically been considered a medically underserved area.

The impact of timing of in utero marijuana exposure on fetal growth.

Objective: To examine whether timing of marijuana exposure independently and negatively impacts fetal growth, and if these effects are global or specific to certain growth parameters.

Study Design: The two study groups were marijuana users ( = 109) and a randomly selected control group of biochemically verified non-users ( = 171). Study data were obtained manual abstraction of electronic medical records.

Can umbilical cord testing add to maternal urine drug screen for evaluation of infants at risk of neonatal opioid withdrawal syndrome?

Objective: This study evaluated maternal urine drug screen (UDS) at delivery and umbilical cord drug testing and its association with neonatal opioid withdrawal syndrome (NOWS) diagnosis and severity following opioid exposed pregnancy.

Methods: A retrospective chart review of 770 mother-infant dyads at five birthing hospitals in the United States Appalachian region for a five-year period was performed. Variables of interest included dyad demographics, results of maternal UDS at delivery and umbilical cord drug testing, and three neonatal outcomes: NOWS diagnosis, pharmacologic treatment administered for NOWS, and length of hospital stay (LOS) of the newborn.

Evidence for concealed fasciculo-ventricular connections as revealed by His bundle pacing.

Background: It is almost 100 years ago since Mahaim described the so-called paraspecific connections between the ventricular conduction axis and the crest of the muscular ventricular septum, believing such pathways to be ubiquitous. These pathways, however, have yet to be considered as potential pathways for septal activation during His bundle pacing.

Materials: So as to explore the hypothesis that specialised septal pathways might provide the substrate for septal activation during His bundle pacing, we compared the findings from 22 serially sectioned histological datasets and 34 different individuals undergoing His bundle pacing.

Prenatal marijuana exposure and visual perception in toddlers: Evidence of a sensory processing deficit.

Background: Research has identified a link between prenatal marijuana exposure and multiple outcomes in children, including cognitive development. Several studies have found specific differences in sensory processing and attention, with visual perception especially impacted in school age children. The current study explored whether this effect is evident at an earlier age, and thus our goal was to investigate the relationship between marijuana exposure and sensory processing capabilities in toddlers.

Sexual Coercion, Intimate Partner Violence, and Homicide: A Scoping Literature Review.

The specific relationship between sexual coercion, intimate partner violence (IPV) during pregnancy, and intimate partner homicide (IPH) is poorly understood. Through a scoping literature review, we identified 101 studies on sexual coercion, IPV during pregnancy, and IPH and created a conceptual model suggesting unintended pregnancies may serve as both a risk factor for and a product of IPV that may escalate to IPH. We illustrate a healthcare systems intervention implication of this model in the context of the Colorado Family Planning Initiative (CFPI).

Comparative admission rates and infection severity of COVID-19 among unvaccinated and vaccinated patients.

Vaccination efforts have limited the burden of the pandemic caused by the coronavirus disease 2019 (COVID-19) with substantial evidence showing reduced hospitalization rates among vaccinated populations. However, few studies have explored correlations between vaccination status and inpatient COVID-19 outcomes. This observational case-control study involved a retrospective chart review of adult patients hospitalized for COVID-19 infection at a medium-sized hospital in Central Michigan between May 1, 2021 and September 30, 2021.

Eating disorder risk in rural US adolescents: What do we know and where do we go?

Adolescence is a vulnerable period for the development of eating disorders, but there are disparities in eating disorder risk among adolescents. One population that may be at increased risk but is vastly understudied, is adolescents residing in rural regions within the United States. Rural communities face many mental and physical health disparities; however, the literature on rural adolescent eating disorder risk is nearly nonexistent.

Prenatal Buprenorphine/Naloxone or Methadone Use on Neonatal Outcomes in Michigan.

Background Maternal opioid exposure during pregnancy has various effects on neonatal health. Buprenorphine/naloxone and methadone are examples of medications for opioid use disorder (MOUD) used for the treatment of opioid use disorder (OUD). Research comparing the impacts of these MOUD modalities on neonatal outcomes when used to treat pregnant people with OUD remains limited.

Risk factors for the development or progression of diabetic retinopathy in pregnancy: Meta-analysis and systematic review.

Background: Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population, and it increases in severity during pregnancy.

Methods: Systematic review of literature from PubMed, Cochrane Library and Web of Science using keywords 'diabetic retinopathy' and 'pregnancy' and 'progression' from inception to 2021 was completed. Included studies were (1) peer-reviewed observational studies addressing progression/development of DR in pregnancy, (2) provided the number of diabetic patients that developed/progressed in DR during pregnancy, and (3) included differential data on variables between progression and non-progression groups.

Prevalence of Opioid Use and Intimate Partner Violence among Pregnant Women in South-Central Appalachia, USA.

Recent research indicates that pregnant women in rural communities are at increased risk of experiencing IPV and comorbid illicit opioid use compared to urban-residing pregnant women. Few studies of the interactions among rurality, substance use, and victimization in pregnant women exist. The current study sought to examine the relationship between IPV and opioid use and the interaction effects of rurality in Appalachian pregnant women.

The Effect of Infection Precautions on Extended-Spectrum Beta-Lactamase Enterobacteriaceae Colonization Among Nurses in Three Beirut Hospitals.

Background and objective Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) are rapidly emerging worldwide. This study aimed to assess the effect of contact precaution (CP) on ESBL-PE-colonization rates among nurses in three hospitals in Beirut, Lebanon, where ESBL is endemic, in order to define the risk factors for colonization. Accordingly, the ongoing use of CP to prevent ESBL-PE transmission to healthy nurses was evaluated.

Impact of opioid exposure on newborn outcomes: beyond neonatal opioid withdrawal syndrome.

Background And Objectives: Research on in utero opioid exposure impacts has focused on Neonatal Opioid Withdrawal Syndrome (NOWS). However, possible impacts on fetal growth and newborn wellbeing have emerged, with inconsistencies likely driven by methodological issues. Our goal was to compare birth outcomes between newborns with prenatal opioid exposure and a matched control group.

Investigation of factors that predict risk for hospital readmission following delivery of pregnancies complicated by hypertensive disorders of pregnancy.

Objective: The aim of this study was to evaluate specific risk factors and their impact on hospital readmission risk following delivery in pregnancies affected by the hypertensive disease of pregnancy (HDP).

Methods: We performed a 10-year case-control study for patients who delivered at our institution and whose antenatal courses were complicated by HDP. The primary outcome was the identification of specific patient factors contributing to readmission.

Does it matter when I quit? Could I just cut down some? Links between trimester-specific smoking amount, preterm birth, and low birth weight.

Background: Substantial evidence demonstrates the harms of pregnancy smoking. Due to the need for very large data sets, less data exist to inform decisions about when quitting should occur, or whether a certain amount of reduction is beneficial.

Objectives: Our goal was to examine the effect of timing and amount of pregnancy smoking on low birth weight (LBW) and preterm birth (PTB).

Marijuana use in opioid exposed pregnancy increases risk of preterm birth.

Background: The prevalence of opioid use disorder has increased across the United States, but the rural population of Appalachia has been disproportionately impacted. Concurrently, the slow, but steady progress in the legalization of marijuana may be affecting perception of marijuana use in pregnancy. However, marijuana use in pregnancy has been associated with adverse perinatal outcomes.