Eculizumab treatment during pregnancy in a patient with AQP4-IgG-seropositive NMOSD: A case report.

Eculizumab proved a strong anti-inflammatory effect in neuromyelitis optica spectrum disorders (NMOSD), rare autoimmune diseases affecting the central nervous system in which aquaporin 4-immunoglobulin G (AQP4-IgG) is the main pathogenic antibody. Pregnancy in NMOSD patients is considered at high-risk for neurological and gynecological outcomes, requiring a careful consideration about treatment maintenance. In this case report, we describe a successful pregnancy, resulting in the birth of a healthy child, in a young woman with AQP4-IgG-seropositive NMOSD who was maintained on eculizumab during all pregnancy.

Real-world evidence in extensive disease small cell lung cancer: The missing piece of the puzzle.

Small cell lung cancer (SCLC) is a highly aggressive disease, often diagnosed at an advanced stage and with limited treatment options. In recent years, immunotherapy has been approved in combination with chemotherapy in the first line setting of extensive stage disease (ES-SCLC). However, only 10-15 % of patients with ES-SCLC treated with chemoimmunotherapy (CT-IO) experience a long-term benefit.

Etiology and antimicrobial susceptibility patterns of bacteria causing pneumonia among adult patients with signs and symptoms of lower respiratory tract infections during the COVID-19 pandemic in Mwanza, Tanzania: a cross-sectional study.

Background: Bacterial pneumonia is among the leading causes of morbidity and mortality worldwide. The extensive misuse and overuse of antibiotics observed during the Corona Virus Disease 2019 (COVID-19) pandemic may have changed the patterns of pathogens causing bacterial pneumonia and their antibiotic susceptibility profiles. This study was designed to establish the prevalence of culture-confirmed bacterial pneumonia and describe their antimicrobial susceptibility profile in adult patients who presented with signs and symptoms of lower respiratory tract infections (LRTIs) during the COVID-19 pandemic.

Variation in dentist participation between dental medicaid managed care organizations.

Objectives: Dentists' Medicaid participation is a critical factor affecting dental care access for Medicaid beneficiaries. An important gap in existing literature is the variation in participation across Medicaid dental Managed Care Organizations (MCOs) in states with more than one. This study examined the variation in participation overall and in predictors of dentist participation between two MCOs in Iowa's Dental Medicaid program.

Medicaid Dental Benefits for Pregnant People and Dental Care Use Among Very Young Children.

Objectives: The aim of this study was to examine the association between Medicaid dental benefits for pregnant people and dental care use among very young children in Medicaid. We hypothesized that children living in states with more generous dental benefits for Medicaid-enrolled pregnant people would be more likely to have a recent dental visit.

Methods: This national cross-sectional study used pooled 2017-2019 data from the National Survey of Children's Health, as well as state Medicaid policy data.

The High Seropositivity of Mumps Virus IgG Antibodies among School-Aged Children in Rural Areas of the Mbarali District in the Mbeya Region, Tanzania: It Is High Time for Consideration in the National Immunization Program.

Mumps is an acute contagious viral disease caused by paramyxovirus characterized by complications that include orchitis, oophoritis, aseptic meningitis, and spontaneous abortion among many others. This study reports high mumps IgG seropositivity among school-aged children in rural areas of the Mbeya region, information that might be useful in understanding the epidemiology of mumps and instituting appropriate control measures including vaccination. Between May and July 2023, a cross-sectional study involving 196 enrolled children aged 5-13 years was conducted.

Quality equivalence and in-vitro antibiotic activity test of different brands of amoxicillin/clavulanic acid tablets in Mwanza, Tanzania: A cross sectional study.

Background: Each film coated tablet of amoxicillin/clavulanic acid contains 500 mg of amoxicillin as an active pharmaceutical ingredient and 125 mg of clavulanic acid. Different brands have the same active ingredients but different excipients, which may cause differences in efficacy. With the emergence of generic antibiotics post-patent expiration, the antibiotic activity of generics is in question in comparison to the innovator.

Patterns and outcomes of health-care associated infections in the medical wards at Bugando medical centre: a longitudinal cohort study.

Background: The burden of healthcare associated infections (HCAIs) in low- and middle-income countries (LMICs) remains underestimated due to diagnostic complexity and lack of quality surveillance systems. We designed this study to determine clinical diagnosis, laboratory-confirmed, associated factors and risks of HCAIs.

Methods: This hospital-based longitudinal cohort study was conducted between March and June 2022 among adults (≥ 18 years) admitted in medical wards at BMC in Mwanza, Tanzania.

Perceived social status, socioeconomic status, and preventive dental utilization among a low-income Medicaid adult population.

Objectives: Perceived Social Status (PSS) is a measure of cumulative socioeconomic circumstances that takes perceived self-control into account. It is hypothesized to better capture social class compared to socioeconomic status (SES) measures (i.e.

Efficacy of disinfectants on control and clinical bacteria strains at a zonal referral hospital in Mwanza, Tanzania: a cross sectional hospital-based study.

Contaminated-hospital surfaces are an important source of pathogenic bacteria causing health-care associated infection (HCAIs). Monitoring the performance of disinfectants that are routinely used to clean hospital surfaces is critical for prevention and control of HCAIs. Nevertheless, the evaluation of the performance of disinfectants and their efficacy are not routinely practiced in most resource-limited countries.

The Patient-Centered Dental Home: A Framework for Quality Measurement, Improvement, and Integration.

Objective: This study completed the development of a standardized patient-centered dental home (PCDH) framework to align and integrate with the patient-centered medical home. This study identified measure concepts and specific measures and standards to complete the 4-level measurement framework to implement and evaluate a PCDH. This study built on prior model development, which identified the PCDH definition and characteristics and the components nested within those characteristics.

Dentist-reported differences in services provided to patients with public vs. private dental insurance.

Introduction: Variation in dentists' provision of types of dental services based on patients' insurance may impact population access to comprehensive care. The aim of this study was to describe differences in the types of services provided to adult patients with Medicaid versus private insurance among private practice general dentists.

Methods: The data source was a 2019 survey of private practice dentists in Iowa, and the study sample included general dentists with current or recent participation in Iowa's Medicaid program for adults (n = 264).

Association of Medicaid expansion with dental emergency department visits overall and by states' Medicaid dental benefits provision.

Background: Evidence on the association of Medicaid expansion with dental emergency department (ED) utilization is limited, while even less is known on policy-related changes in dental ED visits by Medicaid programs' dental benefits generosity. The objective of this study was to estimate the association of Medicaid expansion with changes in dental ED visits overall and by states' benefits generosity.

Methods: We used the Healthcare Cost and Utilization Project's Fast Stats Database from 2010 to 2015 for non-elderly adults (19 to 64 years of age) across 23 States, 11 of which expanded Medicaid in January 2014 while 12 did not.

Dentist attitudes toward an annual benefit maximum in Iowa's adult Medicaid program.

Objectives: The Dental Wellness Plan (DWP) provides dental coverage for adult Medicaid enrollees in Iowa. In September 2018, a $1000 annual benefit maximum (ABM) was implemented in the DWP program. The aim of this study was to explore private dentists' attitudes toward ABMs and factors associated with ABM attitudes.

Variation in General Dentists' Patterns of Sealant Use in Children with Elevated Caries Risk.

Introduction: Strong evidence supports use of dental sealants to prevent tooth decay, and professional guidelines recommend use in children with elevated caries risk. However, not all children indicated for sealants receive this preventive intervention, even when they use routine dental care.

Objective: The aim of this study was to explore the extent to which dentists' use of sealants varied in pediatric patients with elevated caries risk.

Predominance of Other Pathogenic Bacteria among Presumptive Tuberculosis Cases Attending Tuberculosis Clinics in Mwanza, Tanzania: A Cross-Sectional Laboratory-Based Study.

This study was designed to determine the prevalence and co-infection of Mycobacterium tuberculosis and other pathogenic bacteria among presumptive cases of tuberculosis (TB) at selected hospitals in Mwanza, Tanzania. GeneXpert and conventional bacteriological culture and sensitivity were used for the detection of TB and other pathogenic bacteria, respectively. STATA version 13.

Randomized experiment on the effect of incentives and mailing strategy on response rates in a mail survey of dentists.

Objectives: Response rates for mail surveys of dentists and other health care providers have declined appreciably over the past several decades. The objective of this study was to update evidence about the impact use of incentives and different mail strategies on response rates in a mail survey of dentists.

Methods: We randomized private practice dentists in Iowa (N = 1267) into six study groups to test the effects of incentives and mail strategy on response rate.

Patient centered dental home: Building a framework for dental quality measurement and improvement.

Introduction: This article presents results of the second phase of a project to develop a patient-centered dental home (PCDH) model. Aims of PCDH model development include broadening the scope of prior dental home definitions to include populations across the lifespan, developing a quality measurement framework to facilitate quality assessment and improvement, and promoting opportunities for medical-dental integration through alignment with existing PCMH models. This phase determined the components, or conceptual subdivisions, associated with a previously developed PCDH definition and characteristics.

Uncommon single and compound EGFR mutations: clinical outcomes of a heterogeneous subgroup of NSCLC.

Molecular characterization of non-small-cell lung cancer (NSCLC) is essential to define the correct therapeutic algorithm in metastatic disease. Approximately 90% of epidermal growth factor receptor (EGFR) mutations are usually associated with sensitivity to EGFR tyrosine kinase inhibitors (TKIs). The remaining 10% defines a small, extremely heterogeneous subgroup of mutations, with a varied profile of sensitivity and response to target therapies.

The susceptibility of multidrug resistant and biofilm forming and to antiseptic agents used for preoperative skin preparations at zonal referral hospital in Mwanza, Tanzania.

Background: Non-susceptibility of bacteria to antiseptic agents used for preoperative skin preparations threaten the effectiveness of prevention of surgical site infections. Data concerning susceptibility of multidrug resistant bacteria strains to antiseptic agents was limited at our setting. This study presents the susceptibility of extended spectrum β-lactamases producing and (with and without biofilm formation) to antiseptic agents used for preoperative skin preparations at zonal referral hospital in Mwanza, Tanzania.

Applying "Stages of Readiness to Change" Model to Dentists' Decisions to Participate in Medicaid: An Exploratory Study.

Background: The Stages of Readiness to Change (SOC) behavioral model describes behavior change as a process and distinguishes individuals based on their current behavior and readiness to change that behavior. SOC can be used to improve dentists' participation in a state public dental benefit program (Medicaid) by targeting them at different SOC with interventions, strategies, and tools tailored to those stages. Therefore, this study assessed the usefulness of using SOC to describe dentists' attitudes towards and participation in Medicaid.

Food Insecurity Is Prevalent in Iowa's Medicaid Expansion Population.

Background: Food insecurity has been identified as an important social determinant of health and is associated with many health issues prevalent in Medicaid members. Despite this, little research has been done around food insecurity within Medicaid populations.

Objective: Our objective was to estimate the prevalence of household food insecurity and identify factors associated with experiencing food insecurity in Iowa's Medicaid expansion population.

Dental Care in Programs of All-Inclusive Care for the Elderly: Organizational Structures and Protocols.

Objectives: This study uses a national model of community-based long-term services and supports, the Program of All-inclusive Care for the Elderly (PACE), to identify organizational structures and protocols that can facilitate the delivery of dental examinations.

Design: We developed an online survey instrument and conceptual model for this study representing 10 domains believed to characterize a quality PACE dental program.

Setting And Participants: The Qualtrics survey was distributed nationally to all 124 PACE programs in the 31 states PACE was available.