Receiving an opioid prescription during childhood increases the risk of hazardous prescription opioid (PO) use during emerging adulthood. Instruction on how to safely use POs plays an essential role in pediatric patients’ capacity to utilize as well as to discontinue POs appropriately. This study aimed to evaluate pediatric PO label instructions provided to a large sample of pediatric outpatients. Data were extracted from the electronic healthcare records system identifying pediatric patients who received a PO between 2016 and 2019 from pediatric outpatient medical clinics were affiliated with a northwestern United States medical center and children’s hospital. Pediatric patients (n = 12,613) between 0−17 years old who received a PO during outpatient care were included. Patients with chronic health conditions (e.g., cancer) or who received their PO from an inpatient medical setting were excluded. Patient demographics, medication instructions, associated diagnoses, and other prescription information (e.g., name of medication, dose, and quantity dispensed) were examined using automated text classification. Many label instructions did not include any indication/reason for use (20.8%). Virtually none of the POs (>99%) included instructions for how to reduce/wean off POs, contact information for questions about the POs, and/or instructions around how to dispose of the POs. Efforts are needed to ensure that pediatric PO instructions contain essential elements to improve comprehension of when and how to use POs for pediatric patients.
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http://dx.doi.org/10.3390/children9050707 | DOI Listing |
J Bone Joint Surg Am
November 2024
Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY.
Background: An accurate knowledge of a patient's risk of cord-level intraoperative neuromonitoring (IONM) data loss is important for an informed decision-making process prior to deformity correction, but no prediction tool currently exists.
Methods: A total of 1,106 patients with spinal deformity and 205 perioperative variables were included. A stepwise machine-learning (ML) approach using random forest (RF) analysis and multivariable logistic regression was performed.
J Bone Joint Surg Am
November 2024
Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.
Background: Risk factors for gluteal tears include age-related deterioration, female sex, and increased body mass index. As the literature that supports the sagittal relationship between the lumbar spine and the hip is increasing, there may be a parallel relationship between the perturbations in spinopelvic alignment caused by lumbar spine disease and gluteal muscle tears. Because no prior studies other than single-institution series have reported on this phenomenon, we investigated spine-abductor syndrome at the population level.
View Article and Find Full Text PDFJ Acquir Immune Defic Syndr
November 2024
Department of Health Policy & Management, University of North Carolina, Chapel Hill, NC, USA.
Background: Consistent evidence shows stigma impedes healthcare access in people living with HIV (PLWH) and men who have sex with men (MSM). We evaluated the impact of a stigma reduction training for providers whose design was informed by direct observation of their clinical behaviors obtained through visits by incognito standardized patient (SP).
Setting: We conducted this study in in sexually transmitted infection clinics in Guangzhou, China.
Proc Natl Acad Sci U S A
January 2025
Department of Immunology, School of Medicine, UConn Health, Farmington, CT 06030.
Monocytes are critical in controlling tissue infections and inflammation. Monocyte dysfunction contributes to the inflammatory pathogenesis of cystic fibrosis (CF) caused by CF transmembrane conductance regulator (CFTR) mutations, making CF a clinically relevant disease model for studying the contribution of monocytes to inflammation. Although CF monocytes exhibited adhesion defects, the precise mechanism is unclear.
View Article and Find Full Text PDFPLoS One
January 2025
Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, TN, United States of America.
Background: Surveillance cultures to identify patients colonized with methicillin-resistant Staphylococcus aureus (MRSA) is recommended at pediatric intensive care unit (PICU) admission but doesn't capture other methicillin-resistant Staphylococcus and is resource intensive. We determined the prevalence and identified nasal microbiome predictors for methicillin-resistant Staphylococcus colonization at the time of PICU admission.
Study Design: A prospective cohort study was performed in a 20-bed pediatric intensive care unit (PICU) between 2020-2021.
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