Addressing Binocular Diplopia in a Diabetic Patient: Efficacy of Corticosteroids.

This report outlines an unusual instance involving a 65-year-old man who has a medical history of beta thalassemia minor, diabetes mellitus complicated by retinopathy, and iron deficiency anemia. He presented with binocular diplopia, a condition that frequently presents treatment difficulties. Despite inconclusive magnetic resonance imaging (MRI) findings, the patient's symptoms improved significantly with prednisone treatment.

Trends in the Prescribing of Buprenorphine for Opioid Use Disorder, 2019-2023.

Objective: To evaluate whether access to buprenorphine to treat opioid use disorder (OUD) was associated with the coronavirus disease pandemic, the relaxation of training requirements to obtain an X-Waiver to prescribe buprenorphine (April 2021), and the removal of the X-Waiver (December 2022).

Patients And Methods: The OptumLabs Data Warehouse, which includes claims from Commercial and Medicare Advantage enrollees, was used to evaluate trends in prescription fills from January 1, 2019, to June 30, 2023. We compared fill patterns of buprenorphine for OUD with acamprosate to treat alcohol use disorder and naltrexone to treat alcohol use disorder or OUD.

Disparities in multimorbidity and comorbidities in rheumatoid arthritis by sex across the lifespan.

Objectives: Multimorbidity is burdensome for people with RA. We investigated differences in multimorbidity and comorbidities by sex and age in the RA population.

Methods: This cross-sectional analysis used national administrative claims (OptumLabs® Data Warehouse) from people with RA and non-RA comparators (matched on age, sex, race, census region, index year and length of baseline insurance coverage) from 2010-2019.

Racial and ethnic disparities in emergency department-initiated buprenorphine across five health care systems.

Background: Opioid overdose deaths have disproportionately impacted Black and Hispanic populations, in part due to disparities in treatment access. Emergency departments (EDs) serve as a resource for patients with opioid use disorder (OUD), many of whom have difficulty accessing outpatient addiction programs. However, inequities in ED treatment for OUD remain poorly understood.

The Florida Clinical Skills Collaborative: A New Regional Consortium for the Assessment of Clinical Skills.

Discontinuation of the United States Medical Licensing Examination (USMLE) Step 2 Clinical Skills (CS) exam and Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Level 2 Performance Evaluation (2-PE) raised questions about the ability of medical schools to ensure the clinical skills competence of graduating students. In February 2021, representatives from all Florida, United States, allopathic and osteopathic schools initiated a collaboration to address this critically important issue in the evolving landscape of medical education. A 5-point Likert scale survey of all members (n=18/20 individuals representing 10/10 institutions) reveals that initial interest in joining the collaboration was high among both individuals (mean 4.

Racial Differences in Multimorbidity and Comorbidities in Rheumatoid Arthritis.

Objective: To identify differences in multimorbidity and individual comorbidities among individuals with rheumatoid arthritis (RA), separated by race and ethnicity.

Methods: This case-control study within OptumLabs Data Warehouse from 2010 to 2019 matched RA cases (defined by 2 codes plus prescription of an RA drug) to non-RA controls 1:1 on age, sex, race and ethnicity, region, index date of RA, and insurance coverage duration. We defined multimorbidity as the presence of ≥2 or ≥5 validated comorbidities.

Trends and Disparities in Access to Buprenorphine Treatment Following an Opioid-Related Emergency Department Visit Among an Insured Cohort, 2014-2020.

This cross-sectional study examines trends in access to buprenorphine treatment following an opioid-related emergency department (ED) visit among adults with commercial or Medicare Advantage health insurance between 2014 and 2020.

A longitudinal cross-sectional analysis of substance use treatment trends for individuals experiencing homelessness, criminal justice involvement, both, or neither - United States, 2006-2018.

Background: Individuals experiencing homelessness or criminal justice involvement (CJI) have higher rates of substance use than the general public. Despite documented barriers to accessing treatment, few studies have compared substance use treatment patterns between these groups.

Methods: This paper uses data from the Treatment Episode Dataset-Admissions between 2006 to 2018 to describe characteristics and trends in substance use treatment admissions indicating homelessness (n=2,524,413), CJI (4,764,750), both (509,902), or neither (8,950,797) in the United States.

Survey of Information Exchange and Advanced Use of Other Health Information Technology in Primary Care Settings: Capabilities In and Outside of the Safety Net.

Background: Advanced use of health information technology (IT) functionalities can support more comprehensive, coordinated, and patient-centered primary care services. Safety net practices may benefit disproportionately from these investments, but it is unclear whether IT use in these settings has kept pace and what organizational factors are associated with varying use of these features.

Objective: The aim was to estimate advanced use of health IT use in safety net versus nonsafety net primary care practices.

Using a Hybrid Lecture and Small-Group Standardized Patient Case to Teach the Inclusive Sexual History and Transgender Patient Care.

Objectives: Previous negative experiences with the medical community often leave transgender people reluctant to seek medical care. Inadequate teaching and exposure to transgender health during medical training perpetuates the health disparities experienced by this community. Although undergraduate medical education is uniquely positioned to address these disparities, curricular coverage of these topics remains inadequate.

Accuracy of Smoking Status Reporting: Proxy Information in a Rapidly Fatal Cancer Setting.

Objective: To assess whether patients and relatives can serve as reliable proxy reporters of other family members' cigarette-smoking history.

Patients And Methods: Two samples (325 patients, 707 relatives) were identified from the Mayo Clinic Biospecimen Resource for Pancreas Research, enrolled from November, 6, 2000, to March 15, 2018. Smoking-history data, including categorical (ever/never) and quantitative (packs per day and years smoked) smoking measures, were obtained from self-completed questionnaires by patients and relatives.

Volumetric Microsampling of Capillary Blood Spot vs Whole Blood Sampling for Therapeutic Drug Monitoring of Tacrolimus and Cyclosporin A: Accuracy and Patient Satisfaction.

Background: Immunosuppressant therapeutic drug monitoring (TDM) usually requires outpatient travel to hospitals or phlebotomy sites for venous blood collection; however Mitra® Microsampling Device (MSD) sampling could allow self-collection and shipping of samples to a laboratory for analysis. This study examined the feasibility of using volumetric microsampling by MSD for TDM of tacrolimus (TaC) and cyclosporin A (CsA) in transplant patients, along with their feedback on the process.

Methods: MSD was used to collect TaC and CsA from venous (VB) or capillary (CB) blood.

HOUSES Index as an Innovative Socioeconomic Measure Predicts Graft Failure Among Kidney Transplant Recipients.

Background: Despite extensive evaluation processes to determine candidacy for kidney transplantation, variability in graft failure exists. The role of patient socioeconomic status (SES) in transplantation outcomes is poorly understood because of limitations of conventional SES measures.

Methods: This population-based retrospective cohort study assessed whether a validated objective and individual-level housing-based SES index (HOUSES) would serve as a predictive tool for graft failure in patients (n = 181) who received a kidney transplant in Olmsted County, MN (January 1, 1998 to December 8, 2016).

Tools You'll Have for the Rest of Your Life: A Qualitative Evaluation of a Fitness and Vocational Training Program for Substance Use Recovery.

: Substance use disorder (SUD) is a problem within the United States and warrants attention. Despite growing concerns, there exists a research-to-practice gap in the implementation of evidence-based treatment strategies, particularly in the area of physical activity as a low-cost adjunct to treatment programs. Additionally, people with SUD often face challenges in re-entering the workforce, due to multiple factors including long absences, incarceration, or lack of experience and training.

Cervical Cancer and Its Precursors: A Preventative Approach to Screening, Diagnosis, and Management.

Cervical cancer affects the cells lining the cervix, most commonly occurring in the cells of the transformation zone. Screening for cervical cancer looks to detect preinvasive disease, allowing for intervention before invasive disease develops. an assessment of individual risk factors, Selection of screening method depends on patient age, her screening history and results, and resources available.

Impact of hospital hospitality house programs on quality of life and mood of patients and caregivers after hematopoietic stem cell transplant.

Objective/background: The quality of life (QOL) of hematopoietic stem cell transplant (HSCT) patients and their caregivers decreases during the first 8 days after HSCT.

Methods: This prospective pilot study collected preliminary data on the impact of posttransplant living arrangements (hospital hospitality house [HHH] vs. hotel, apartment, or house ["hotel"]) and other factors on the QOL of HSCT patients and their caregivers.

Design, construction and testing of a low-cost automated (68)Gallium-labeling synthesis unit for clinical use.

The interest in (68)Gallium labeled PET probes continues to increase around the world. Widespread use in Europe and Asia has led to great interest for use at numerous sites in the US. One barrier to entry is the cost of the automated synthesis units for relatively simple labeling procedures.

Code status discussions in psychiatric and medical inpatients.

Background: The Patient Self-Determination Act along with regulatory standards and institutional standards of care highlight the need for collaboration between care providers and patients with respect to goals of care and, in emergency situations, code status and measures to be taken in keeping with patients' wishes. Addressing code status may be lacking in patients who require psychiatric hospitalization due to the nature of psychiatric illness, relative medical stability, and a general expectation of survival. We sought to compare code status documentation and discussion between psychiatric and medical inpatients, as this knowledge will help shape future interventions for process improvement.

Identifying Patients in the Acute Psychiatric Hospital Who May Benefit From a Palliative Care Approach.

Identifying patients who will benefit from a palliative care approach is the first critical step in integrating palliative with curative therapy. Criteria are established that identify hospitalized medical patients who are near end of life, yet there are no criteria with respect to hospitalized patients with psychiatric disorders. The records of 276 consecutive patients admitted to a dedicated inpatient psychiatric unit were reviewed to identify prognostic criteria predictive of mortality.

A gold nanoparticle platform for protein-protein interactions and drug discovery.

Gold nanoparticles hold great promise for studying protein-protein interactions because of their intrinsic optical properties. Pink when in a homogeneous suspension, the solution turns blue-gray when particles are drawn close together, for example, when immobilized proteins specifically interact with each other. However, the nanoparticle stability, size, and method of protein attachment contribute to the unreliable outcome of current assays.