Using ICD Codes Alone May Misclassify Overdoses Among Perinatal People.

Introduction: As perinatal drug overdoses continue to rise, reliable approaches are needed to monitor overdose trends during pregnancy and postpartum. This analysis aimed to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ICD-9/10-CM codes for drug overdose events among people in the MATernaL and Infant clinical NetworK (MAT-LINK) with medication for opioid use disorder (MOUD) during pregnancy.

Methods: People included in this analysis had electronic health record (EHR) documentation of MOUD and a known pregnancy outcome from January 1, 2014 through August 31, 2021.

Food Insecurity and Weight Faltering: US Multisite Analysis of Young Children's Weight Trajectory.

Background: Food insecurity is associated with poor health and development among young children, with inconsistent findings related to longitudinal growth.

Objective: To investigate associations between household and child food insecurity and young children's weight trajectory during ages 0-2 years.

Design: Longitudinal survey data were analyzed for years 2009-2018.

Comparing Postprandial Glycemic Control Using Fiasp vs Insulin Aspart in Hospitalized Patients With Type 2 Diabetes.

Objective: Hyperglycemia in hospitalized patients is associated with increased morbidity and mortality. Basal-bolus insulin therapy is the treatment of choice for most patients. The efficacy of an ultrarapid vs rapid-acting insulin in hospitalized patients with diabetes has not been evaluated.

Non-Invasive Ventilation in Acute Asthma Exacerbations: A Systematic Review.

Rationale: Multiple clinical practice guidelines lack recommendations pertaining to non-invasive ventilation (NIV) in acute asthma exacerbations due to a paucity of evidence. However, the evidence syntheses for these guidelines were performed years ago and more recent randomized controlled trials (RCTs) and observational studies have been published.

Objective: Update the evidence syntheses from previous guidelines to further clarify the effects of NIV in acute asthma exacerbations.

Suture Button Fixation in Shoulder Instability Surgery to Achieve Bone Healing: A Critical Analysis Review.

» Suture button fixation has emerged as an effective surgical construct in arthroscopic and open Latarjet and anterior glenoid reconstruction with free autograft bone with high rates of bone block healing.» Biomechanical data suggest that screw and suture button mechanical fixation constructs provide similar load to failure and stability for the Latarjet procedure.» Preliminary bone healing models have identified that flexible fixation may exhibit a higher degree of bone callus maturation, whereas rigid fixation results in excessive callus hyperplasia» Mechanical tensioner use provides consistent tensioning of suture button constructs and improves bone-to-bone healing rates when used for anterior glenoid reconstruction surgery.

A Randomized Trial Comparing Inhaled Insulin Plus Basal Insulin Versus Usual Care in Adults With Type 1 Diabetes.

Objective: To evaluate a regimen of inhaled Technosphere insulin (TI) plus insulin degludec in adults with type 1 diabetes, who prestudy were predominately using either an automated insulin delivery (AID) system or multiple daily insulin injections (MDI) with continuous glucose monitoring.

Research Design And Methods: At 19 sites, adults with type 1 diabetes were randomly assigned to TI plus insulin degludec (N = 62) or usual care (UC) with continuation of prestudy insulin delivery method (N = 61) for 17 weeks.

Results: Prestudy, AID was used by 48% and MDI by 45%.

Advanced Wound, Ischemia, and foot Infection stage is associated with poor outcomes in the BEST-CLI trial.

Objective: Wound, Ischemia, and foot Infection (WIfI) staging was established to provide objective classification in patients with chronic limb-threatening ischemia (CLTI) and to predict 1-year major amputation risk. Our goal was to validate WIfI staging using data from the Best Endovascular vs Best Surgical Therapy in Patients with CLTI (BEST-CLI) trial.

Methods: Data from the BEST-CLI Trial, a prospective randomized trial comparing surgical revascularization (OPEN) and endovascular revascularization (ENDO), were used to assess the association of WIfI stage on long-term outcomes in an intention-to-treat analysis.

Circulating Protein and Metabolite Correlates of Histologically Confirmed Diabetic Kidney Disease.

Rationale & Objective: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease globally. We aim to identify proteomic and metabolomic correlates of histologically confirmed DKD that may improve our understanding of its pathophysiology.

Study Design: A cross-sectional study.

Efficacy of COVID-19 Treatments in Intensive Care Unit: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Examining the cumulative evidence from randomized controlled trials (RCTs), evaluating the use of pharmacological agents for the treatment of COVID-19 infections in patients with critical illness. Databases Medline, Embase, Web of Science, Scopus, CINAHL, and Cochrane. Study Selection: Inclusion criteria were RCTs that enrolled patients with confirmed or suspected COVID-19 infection who are critically ill.

Myopericytoma of the hand.

Myopericytoma is a rare benign smooth-muscle cell neoplasm of the subcutaneous soft tissues that is primarily found in young adults with a male predominance. We present the clinical, radiologic, and histopathologic features of a longstanding myopericytoma of the hand. We emphasize the features that help the radiologist and pathologist to accurately characterize this entity.

Reframing Child Protection in Emergency Medicine.

Child maltreatment remains a concerning source of morbidity and mortality in the United States, where more than 600,000 children are victims of abuse each year, with well-described, long-term consequences for physical and mental health. However, the US child welfare system is characterized by systemic racism and inequity. Black and Native American children are more likely to be evaluated and reported for suspected abuse despite evidence that race does not independently change their risk of being abused.

Accuracy of Medicaid Physician Directories of Board-Certified Pediatric Dermatologists.

Patients may rely on health insurance physician directories to determine who is in-network and inaccuracies in these directories may lead to delayed access to treatment, unexpected out-of-pocket costs, and increased barriers to care. This cross-sectional study quantifies the accuracy of state-specific Medicaid directories regarding board-certified pediatric dermatologists, and compares physicians listed accurately with those listed inaccurately by type of practice and region of practice. The accuracy of all state Medicaid physician directories was 84.

Long-term functional recovery after rib fractures: The impact of frailty.

Background: Previous studies have shown that patients with rib fractures experience long-term functional limitations. However, the specific predictors of these worse long-term functional limitations remain under-characterized.

Methods: We conducted a prospective cohort study including patients ≥18 years with an injury severity score ≥9 and isolated chest injury.

Status of infection prevention and control in Cameroon healthcare facilities: lessons learned from the WHO COVID-19 scorecard tool under the hierarchy of control model.

Background: Infection prevention and control (IPC) helps prevent disease transmission in healthcare facilities. There is a dearth of information on the implementation of IPC during the COVID-19 outbreak in Cameroon using the recommended WHO COVID-19 IPC scorecard tool. The present study assessed healthcare facilities' compliance to IPC by continuous assessments, with an evaluation of the tool using the hierarchy of control theory.