Perceived Discrimination During Prenatal Care at a Community Health Center.

Introduction: Discrimination in healthcare is associated with fetal growth restriction, preterm birth, and postpartum depression. A community-based participatory research study was designed to measure perceived discrimination and healthcare quality during prenatal care and delivery by a community health center, where the majority of patients served belong to historically marginalized ethnic and racial groups.

Methods: A 34-question phone survey was administered to women 18 years and older who received prenatal care at the study site during 2020-2021.

Integrating a Multidisciplinary Pain Team and Chiropractic Care in a Community Health Center: An Observational Study of Managing Chronic Spinal Pain.

Background: Chronic spinal pain is one of the most common diseases in the United States. Underserved patients are most affected, and disproportionately may use opioid medications as they lack access to other therapies. It is therefore important to develop systems to treat spinal pain within the primary medical home.

Programmatic Effectiveness of Latent Tuberculosis Care Cascade in a Community Health Center.

Our aim was to quantify successful completion of steps of the latent tuberculosis (LTBI) care cascade in a community health center (CHC) with a large foreign-born population. We conducted a retrospective cohort study of individuals with a positive test for tuberculosis (TB) infection from 2015 to 2017 at Baltimore Medical Systems (BMS). During the study period, 3,984 individuals were tested for TB.

Beyond Medical "Missions" to Impact-Driven Short-Term Experiences in Global Health (STEGHs): Ethical Principles to Optimize Community Benefit and Learner Experience.

Increasing demand for global health education in medical training has driven the growth of educational programs predicated on a model of short-term medical service abroad. Almost two-thirds of matriculating medical students expect to participate in a global health experience during medical school, continuing into residency and early careers. Despite positive intent, such short-term experiences in global health (STEGHs) may exacerbate global health inequities and even cause harm.

Prevalence of osteoporosis in community-dwelling individuals with intellectual and/or developmental disabilities.

Objective: Measure central bone mineral density (BMD) in community-dwelling individuals with intellectual and/or developmental disabilities.

Design: A cross-sectional study.

Setting: A regional center providing outpatient medical, residential, and day activity services for individuals with intellectual and/or developmental disabilities.

Medical care of adults with mental retardation.

Persons with mental retardation are living longer and integrating into their communities. Primary medical care of persons with mental retardation should involve continuity of care, maintenance of comprehensive treatment documentation, routine periodic health screening, and an understanding of the unique medical and behavioral disorders common to this population. Office visits can be successful if physicians familiarize patients with the office and staff, plan for difficult behaviors, and administer mild sedation when appropriate.

Successful Pain Management for the Recovering Addicted Patient.

Successful pain management in the recovering addict provides primary care physicians with unique challenges. Pain control can be achieved in these individuals if physicians follow basic guidelines such as those put forward by the Joint Commission on Accreditation of Healthcare Organizations in their standards for pain management as well as by the World Health Organization in their stepladder approach to pain treatment. Legal concerns with using pain medications in addicted patients can be dealt with by clear documentation of indication for the medication, dose, dosing interval, and amount provided.

Formation and urinary excretion of arsenic triglutathione and methylarsenic diglutathione.

Taking advantage of mice deficient in gamma-glutamyl transpeptidase that are unable to metabolize glutathione (GSH), we have identified two previously unrecognized urinary metabolites of arsenite: arsenic triglutathione and methylarsenic diglutathione. Following administration of sodium arsenite to these mice, approximately 60-70% of urinary arsenic is present as one of these GSH conjugates. We did not detect the dimethyl derivative, dimethyl arsenic GSH; however, dimethyl arsenic (DMAV) represented approximately 30% of urinary arsenic.

Identification and characterization of HtsA, a second heme-binding protein made by Streptococcus pyogenes.

Group A streptococci (GAS) can use heme and hemoproteins as sources of iron. However, the machinery for heme acquisition in GAS has not been firmly revealed. Recently, we identified a novel heme-associated cell surface protein (Shp) made by GAS.

Autism: a medical primer.

Autistic disorder, a pervasive developmental disorder resulting in social, language, or sensorimotor deficits, occurs in approximately seven of 10,000 persons. Early detection and intervention significantly improve outcome, with about one third of autistic persons achieving some degree of independent living. Indications for developmental evaluation include no babbling, pointing, or use of other gestures by 12 months of age, no single words by 16 months of age, no two-word spontaneous phrases by 24 months of age, and loss of previously learned language or social skills at any age.