J Shoulder Elbow Surg
Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address:
Published: December 2024
Background: Preoperative opioid users experience worse outcomes and higher complication rates compared to opioid-naïve patients following shoulder arthroplasty. This study evaluates the effects of socioeconomic status, as measured by the Distressed Communities Index (DCI), on pre- and postoperative opioid use and its influence on clinical outcomes such as readmission and revision surgery.
Methods: A retrospective review of patients who underwent primary shoulder arthroplasty (Current Procedural Terminology code 23472) from 2014 to 2022 at a single academic institution was performed. Exclusion criteria included arthroplasty for fracture, active malignancy, and revision arthroplasty. Demographics, Charlson Comorbidity Index, DCI, and clinical outcomes including 90-day readmission and revision surgery were collected. Patients were classified according to the DCI score of their zip code. Using the Prescription Drug Monitoring Program database, patient pre- and postoperative opioid use in morphine milligram equivalents was gathered.
Results: Individuals from distressed communities used more opioids within 90 days preoperatively compared to patients from prosperous, comfortable, mid-tier, and at-risk populations, respectively. Patients from distressed communities also used significantly more opioids within 90 days postoperatively compared with prosperous, comfortable, and mid-tier, respectively. Of patients from distressed communities, 35.1% developed prolonged opioid use (filling prescriptions >30 days after surgery), significantly more than all other cohorts. Among all patients, 3.5% were readmitted within 90 days and were more likely to be prolonged opioid users (38.9 vs. 21.3%, P < .001). Similarly, 1.5% of patients underwent revision surgery. Those who underwent revision were significantly more likely to be prolonged opioid users (38.2 vs. 21.7%, P = .002).
Conclusions: Shoulder arthroplasty patients from distressed communities use more opioids within 90 days before and after their surgery and are more likely to become prolonged opioid users, placing them at risk for readmission and revision surgery. Identifying patients at an increased risk for excess opioid use is essential to employ appropriate strategies that minimize the detrimental effects of prolonged use following surgery.
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http://dx.doi.org/10.1016/j.jse.2024.04.016 | DOI Listing |
Clin Transl Gastroenterol
January 2025
Center for Neurointestinal Health, Division of Gastroenterology, Massachusetts General Hospital, Boston, MA 02114.
Introduction: Disorders of gut-brain interaction (DGBIs), like functional dyspepsia (FD), are prevalent and challenging conditions. In other gastrointestinal (GI) disorders, individuals from underserved areas (UAs) have difficulty accessing care. Little is known about UA FD patient perspectives of their care, especially in those with limited English proficiency (LEP).
View Article and Find Full Text PDFTurk Arch Pediatr
January 2025
Department of Forensic Medicine, İstanbul Health and Technology University Faculty of Medicine, İstanbul, Türkiye.
This review synthesizes current research on domestic violence and sexual assault, focusing on their short-term and long-term effects on family dynamics, particularly on the development and well-being of children and adolescents. The article employs a curated body of literature, including surveys, reviews, program evaluations, and international health reports, to elucidate the direct and collateral damage caused by such trauma within families. The review critically examines the intersecting consequences of abuse, including immediate psychological distress and long-term socio-economic and educational disruptions for affected youths.
View Article and Find Full Text PDFFront Zool
January 2025
Department of General Zoology and Neurobiology, Institute of Biology and Biotechnology, Ruhr-University Bochum, 44801, Bochum, Germany.
Background: During their nighttime shoaling, the flashlight fish Anomalops katoptron produce fascinating, bioluminescent blink patterns, which have been related to the localization of food, determination of nearest neighbor distance, and initiation of the shoal's movement direction. Information transfer e.g.
View Article and Find Full Text PDFJ Pain
January 2025
Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA; Center to Advance Chronic Pain Research, University of Maryland, Baltimore, USA; Department of Anesthesiology and Psychiatry, University of Maryland School of Medicine, Baltimore, USA; Placebo Beyond Opinions Center, University of Maryland School of Nursing, Baltimore. Electronic address:
Socioeconomic Position (SEP) is a multidimensional construct encompassing education, income, occupation, and neighborhood distress, influencing chronic pain severity, interference, and duration. However, its impact on placebo analgesia, where reduced pain perception occurs due to treatment belief, remains understudied. Using a quasi-experimental approach, we investigated SEP's influence on placebo analgesia in 401 participants with temporomandibular disorder (TMD) and 400 pain-free individuals.
View Article and Find Full Text PDFJ Affect Disord
January 2025
Department of nursing, School of medicine, Kunming University, Kunming, China; Community nursing research team of Kunming University, Kunming, Yunnan, China.
Background: Although previous studies demonstrated an association between fast food intake and anxiety symptoms in adolescents, this relationship has not been studied in Chinese multi-ethnic adolescents. The purpose of this study is to investigate the aforementioned association and the potential moderating effect of regulatory emotional self-efficacy (RESE) among Chinese multi-ethnic adolescents.
Methods: A cluster random sampling of 8500 middle school students from 11 counties in Yunnan province was conducted.
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