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Procedural Prescription Denials and Risk of Acute Care Utilization and Spending Among Medicaid Patients.
JAMA Netw Open
January 2025
Clinical Product Development, Waymark, San Francisco, California.
Importance: Rising prescription medication costs under Medicaid have led to increased procedural prescription denials by health plans. The effect of unresolved denials on chronic condition exacerbation and subsequent acute care utilization remains unclear.
Objective: To examine whether procedural prescription denials are associated with increased net spending through downstream acute care utilization among Medicaid patients not obtaining prescribed medication following a denial.
Management of Psychosis and Schizophrenia by Primary Care GPs: A Cross-Sectional Study in Spain.
J Prim Care Community Health
January 2025
Instituto de Investigación Biomédica de Málaga, Málaga, Spain.
Aim: To investigate the detection and initial management of first psychotic episodes, as well as established schizophrenia, within the primary care of the Andalusian Health System.
Background: Delay in detecting and treating psychosis is associated with slower recovery, higher relapse risk, and poorer long-term outcomes. Often, psychotic episodes go unnoticed for years before a diagnosis is established.
Pathophysiology and diagnostic criteria of PCOS.
Minerva Obstet Gynecol
January 2025
Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Introduction: Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine-metabolic syndrome mainly characterized by ovarian dysfunction, which is only one manifestation of a more complex syndrome with a significant systemic impact.
Evidence Acquisition: We review scientific literature on the pathophysiology and diagnosis of PCOS evaluating the most relevant data from original articles, reviews and meta-analyses published until June 2024.
Evidence Synthesis: From a pathophysiological point of view, the concurrence of both metabolic aspects, such as insulin resistance and obesity, and hormonal alterations, such as hyperandrogenemia, might produce the most relevant clinical signs and/symptoms of this syndrome, for instance menstrual irregularities, hair loss, acne and hirsutism.
Reversibility of acrocyanosis and improvement of capillaroscopic pattern in a patient with polycythemia vera treated with ruxolitinib: a case report.
Blood Res
January 2025
Department of Rheumatology of Lucania - UOSD of Rheumatology, "Madonna Delle Grazie" Hospital, Matera, Italy.
This case report describes the clinical course of a 78-year-old patient diagnosed with polycythemia vera (PV), who presented with pronounced acrocyanosis of the hands in 2021. The patient was treated with hydroxyurea (oncocarbide), and nailfold capillaroscopy revealed an "abnormal pattern" characterized by pronounced architectural disarray and capillary tortuosity, which is uncommon in patients with myeloproliferative neoplasms (MPNs). In 2023, owing to suboptimal symptom management and hematological side effects, the treatment was switched to ruxolitinib, which led to significant clinical improvements by 2024, including near-complete resolution of acrocyanosis and substantial improvement in capillaroscopic abnormalities, with only residual capillary tortuosity noted.
View Article and Find Full Text PDFAnti-melanoma differentiation-associated gene 5 antibody-positive interstitial lung disease masquerading as rheumatoid arthritis-associated interstitial lung disease or overlapping with the same: a phenomenon driven by a probable genetic predisposition.
Clin Rheumatol
January 2025
Department of Pulmonology & Interventional Pulmonology, Caritas Hospital and Institute of Health Sciences, Thellakom, Kottayam, Kerala, India.
Rheumatoid arthritis (RA) is a systemic, progressive illness marked by persistent synovitis that causes substantial functional disability. Treatment delays frequently affect health-related quality of life. Extra-articular features are prevalent findings in RA, which leads to significant morbidity and mortality.
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