Abortion Surveillance - United States, 2022.

Problem/condition: CDC conducts abortion surveillance to document the number and characteristics of women obtaining legal induced abortions and the number of abortion-related deaths in the United States.

Period Covered: 2022.

Description Of System: Each year, CDC requests abortion data from the central health agencies for the 50 states, the District of Columbia, and New York City.

Competency-Based Cardiology Training: A Simple Approach to Improve Supervisor Completion of Entrustable Professional Activities.

Background: Adult cardiology residency programs formally transitioned to Competency by Design (CBD) in July 2021. CBD was designed to establish clear learning expectations and increase opportunities for coaching; however, cited challenges include inconsistent participation by staff, and variable timelines for receiving feedback. This project was designed to implement a simple intervention to improve expiry rates and completion timelines of entrustable professional activities (EPAs).

Breastfeeding by Disability Status in the United States: Pregnancy Risk Assessment Monitoring System, 2018-2020.

To describe breastfeeding initiation and breastfeeding at 1, 2, and 3 months, and information sources on breastfeeding among women with a recent live birth by disability status. We analyzed October 2018 to December 2020 data from the Pregnancy Risk Assessment Monitoring System for 24 sites in the United States that included the Washington Group Short Set of Questions on Disability (seeing, hearing, walking or climbing stairs, remembering or concentrating, self-care, communicating). We defined disability as reporting "a lot of difficulty" or "cannot do this at all" on any of these questions.

Abortion Surveillance - United States, 2021.

Problem/condition: CDC conducts abortion surveillance to document the number and characteristics of women obtaining legal induced abortions and number of abortion-related deaths in the United States.

Period Covered: 2021.

Description Of System: Each year, CDC requests abortion data from the central health agencies for the 50 states, the District of Columbia, and New York City.

Kidney Transplant Clinicians' Perceptions of Palliative Care for Patients With Failing Allografts in the US: A Mixed Methods Study.

Rationale & Objective: Kidney transplant patients with failing allografts have a physical and psychological symptom burden as well as high morbidity and mortality. Palliative care is underutilized in this vulnerable population. We described kidney transplant clinicians' perceptions of palliative care to delineate their perceived barriers to and facilitators of providing palliative care to this population.

The impact of court-ordered psychiatric treatment on hospital length of stay: balancing legal and clinical concerns.

Purpose: Psychiatric hospital length of stay (LOS) is not affected solely by socio-clinical factors but also by legal procedures. This study examined the associations between legal procedures and LOS.

Methods: Data from 521 patients with psychiatric illnesses hospitalized over 2013-2015 were analyzed.

Alzheimer's Disease Mortality as a Function of Urbanization Level: 1999-2019.

This study investigated Alzheimer's disease (AD) mortality trends by urbanization level and geographical location in the U.S. The CDC's WONDER database was used to investigate AD mortality from 1999-2019 stratified by urbanization level, census division, race, and sex.

Blown Wide Open: An Unusual Case of Torrential Mitral Regurgitation Resolving With a Cough.

Mitral regurgitation can have varying hemodynamic parameters dependent on factors such as pressure gradients, exercise, and/or provocative maneuvers. We present a case of unusual dynamic mitral regurgitation resolved by coughing in a patient with hypertrophic cardiomyopathy. ().

Permission to prescribe: do cardiologists need permission to prescribe diabetes medications that afford cardiovascular benefit?

Purpose Of Review: Antihyperglycemic therapies including sodium glucose contransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) have been demonstrated to confer significant cardiovascular benefit and reduce future events in patients with type 2 diabetes mellitus (T2DM). However, despite positive data from cardiovascular outcome trials, these therapies remain underutilized in a large proportion of patients who have clinical indications and meet coverage guidelines for their initiation. One of the causes of the observed gap between scientific evidence and clinical cardiology practice is therapeutic hesitancy (otherwise known as therapeutic inertia).

Suffering and Symptoms At the End of Life in ICU Patients Undergoing Renal Replacement Therapy.

Background: We know little about the end-of-life suffering and symptoms of intensive care unit (ICU) decedents in general and those who undergo renal replacement therapy (RRT) in particular.

Objectives: To examine differences in end-of-life suffering and various symptoms' contribution to suffering between ICU decedents who did not undergo RRT, those who underwent RRT for end-stage kidney disease (ESKD), and those who underwent RRT for acute kidney injury (AKI).

Methods: This is a cross-sectional study conducted at a quaternary-level referral hospital September 2015-March 2017.

Patient reactions to witnessed medical events in the dialysis center or to the sudden absence of other patients from the center: A qualitative study.

Introduction: Patients receiving in-center maintenance hemodialysis (HD) spend a significant amount of time together. To date, little or no research has examined how these patients perceive and process other patients' medical events in and absences from their centers. We therefore undertook this qualitative study using semi-structured interviews to explore these phenomena from the patient perspective.

Nephrology Provider Surprise Question Response and Hospitalizations in Older Adults with Advanced CKD.

Background: Older adults with advanced non-dialysis-dependent chronic kidney disease (NDD-CKD) face a high risk of hospitalization and related adverse events.

Methods: This prospective cohort study followed nephrology clinic patients ≥60 years old with NDD-CKD stages 4-5. After an eligible patient's office visit, study staff asked the patient's provider to rate the patient's risk of death within the next year using the surprise question ("Would you be surprised if this patient died in the next 12 months?") with a 5-point Likert scale response (1, "definitely not surprised" to 5, "very surprised").

Migrated fractured sternal wire in proximity to the main pulmonary artery: Case report and review.

Background: We present a case of a 83-year-old man with a prior history of coronary artery bypass who presented to his family physician with progressive symptoms that raised concern for heart failure exacerbation. A chest X-ray was performed, which showed a fractured topmost sternal wire in the lateral projection and indicated that the sternal wire had migrated into the anterior mediastinum. An emergent electrocardiogram-gated flash computed tomography angiography confirmed the location of the fractured wire to be in close proximity to the main pulmonary artery.

Inexpensive, High-Fidelity Model to Simulate Ultrasound-Guided Pericardiocentesis for Cardiology Resident Training.

Adult cardiology residency training programs require residents to become proficient at many procedural skills, including pericardiocentesis. However, in many programs, opportunities to perform this procedure are limited. Expensive mannequins have been developed to assist with teaching this skill, however, the associated cost make them impractical for many programs.

The Russian feldsher: A PA prototype in transition.

The feldsher is a physician assistant (PA) prototype. Developed in Russia during the 19th century to serve as healthcare personnel at a time of physician scarcity, feldshers provided medical services throughout the Russian Empire and later Soviet Union. Their medical role from the mid-19th century until the Bolshevik revolution in 1917 was crucial, particularly in rural and underserved regions.

Survival after acute hemodialysis in Pennsylvania, 2005-2007: a retrospective cohort study.

Background: Little is known about acute hemodialysis in the US. Here we describe predictors of receipt of acute hemodialysis in one state and estimate the marginal impact of acute hemodialysis on survival after accounting for confounding due to illness severity.

Materials And Methods: This is a retrospective cohort study of acute-care hospitalizations in Pennsylvania from October 2005 to December 2007 using data from the Pennsylvania Health Care Cost Containment Council.

Percutaneous intrapericardial injection of triamcinolone in a patient with incessant pericarditis: a novel technique.

Incessant pericarditis is an uncommonly encountered clinical problem that can be extremely difficult to manage. We present a case of incessant pericarditis with multiple recurrences during tapering of systemic corticosteroids. We injected intrapericardial triamcinolone, using a technique originally developed to access the epicardium for catheter ablation.

The association of mental health over time with cardiac outcomes in HEMO study patients.

Background And Objectives: Poor mental health over time is significantly associated with cardiovascular morbidity and mortality in the general population, which is the leading cause of death in dialysis patients. Most studies of dialysis patients, however, have investigated the relationship between baseline mental health measurements and all-cause mortality and not mental health measured longitudinally throughout a study and cause-specific mortality.

Design, Setting, Participants, & Measurements: This study examined the association of changes in mental health over time with all-cause and cause-specific deaths and cardiac hospitalizations in the Hemodialysis study patients.