Procedural Prescription Denials and Risk of Acute Care Utilization and Spending Among Medicaid Patients.

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.

The Knowledge, Attitudes, and Practices of Emergency Department Staff to Preparedness of Disaster and Emergency in Saudi Arabia: Multicenter Cross-sectional Study.

Aim: Disasters worldwide are increasing, impacting millions annually. In Saudi Arabia, disaster planning is crucial for emergency department (ED) staff, who must be trained in disaster management plans and operational strategies to handle disasters such as epidemics and Hajj overcrowding.

Methodology: A cross-sectional study targeting ED staff in 92 hospitals all over Saudi Arabia.

"I surely don't call for fun": experiences of being a "frequent caller" to the Danish emergency helpline.

Background: While most Danish citizens never or very rarely call the national emergency helpline, 1-1-2, a few citizens call very often. In this article, we attend to the often-unheard voices of frequent callers, exploring why these citizens call 1-1-2 and why they often do not feel helped.

Methods: The article is based on a mixed-methods study on citizens in the Central Denmark Region who had called 1-1-2 five or more times during a period of six months in 2023.

Organisational factors associated with burnout among emergency and internal medicine physicians: a qualitative study.

Objective: To identify physician perspectives on factors associated with physician burnout, protective factors against burnout, and to seek potential solutions for this pervasive problem.

Design: A qualitative study with semistructured focus group interviews using a systematic framework analysis.

Setting And Participants: Physicians from general internal medicine (GIM) and the emergency department (ED) at two urban tertiary care hospitals in Vancouver, Canada, were recruited.

Anaphylaxis definition, overview, and clinical support tool: 2024 consensus report.

Background: The 2006 National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network (NIAID/FAAN) anaphylaxis criteria are widely used in clinical care and research. In 2020, the World Allergy Organization (WAO) published modified criteria that have not been uniformly adopted. Different criteria contribute to inconsistent care and research outcomes.

Concepts of Suffering at the End of Life Amongst Emergency, Palliative Care and Geriatric Medicine Physicians in Malaysia.

Background: Palliative Care, Geriatrics and Emergency physicians are exposed to death, terminally ill patients and distress of patients and their families. As physicians bear witness to patients' suffering, they are vulnerable to the costs of caring-the emotional distress associated with providing compassionate and empathetic care to patients. If left unattended, this may culminate in burnout and compromise professional identity.

Which Test is Best for Pain in the Chest?

Chest pain is one of the most common chief complaints seen in both the emergency department (ED) and primary care settings.1,2 It is estimated that 20-40% of the general population will suffer from chest pain at some point throughout their lives.3 Interestingly although obstructive coronary artery disease (CAD) prevalence has declined, chest pain as a presenting symptom has become increasingly common over the last decade.

Patterns and Outcomes of Acute Poisoning Among Children Presenting to Emergency Department in AlAhsa, Saudi Arabia.

Introduction Acute poisoning in children is still a global health concern that necessitates visiting the emergency department that might associated with morbidity and mortality. It has an impact on social, economic, and health issues, particularly for children under five who account for the majority of poisonings worldwide. Poisoning can result in mild cases, serious complications, or even death; oral ingestion is the most common way that poisoning occurs in children.

The Clinicians' Guide to Large Language Models: A General Perspective With a Focus on Hallucinations.

Large language models (LLMs) are artificial intelligence tools that have the prospect of profoundly changing how we practice all aspects of medicine. Considering the incredible potential of LLMs in medicine and the interest of many health care stakeholders for implementation into routine practice, it is therefore essential that clinicians be aware of the basic risks associated with the use of these models. Namely, a significant risk associated with the use of LLMs is their potential to create hallucinations.

Bilateral corneal endothelial decompensation following airbag-induced trauma.

Approximately 3% of individuals in road traffic accidents suffer ocular injuries. We present a case of a man in his late 80s who presented with bilateral corneal decompensation following airbag deployment during a road traffic accident. Ocular examination revealed multilevel ocular injury with severe bilateral corneal oedema.

Risk stratification for violent behavior in critically ill patients: Current assessment tools.

Background: Workplace violence (WPV) presents challenges in intensive care units (ICUs) calling for reliable prediction of violence. This narrative review aimed to identify and evaluate risk assessment tools from acute care settings which are or might be used to predict violent behavior in adult ICU patients focusing on their performance and clinical utility.

Methods: A screening of PubMed, Scopus and Google Scholar was conducted to identify risk scores used in the acute care setting such as emergency departments, hospitals and ICUs.

Using evidence-based imaging referral guidelines to facilitate appropriate imaging: Are they all the same?

Rationale And Objectives: Countries worldwide have selected, adopted, adapted, and translated evidence-based imaging referral guidelines from radiology professional bodies. This study establishes the concordance of three imaging referral guidelines from the ACR, ESR, and RCR, and examines the emergency department cervical spine imaging appropriateness rates.

Materials And Methods: A retrospective analysis of the electronic medical records was performed between October 1st to December 31st, 2022, evaluating 452 radiography and 153 CT imaging referrals.

[Expert consensus on visualized tele-round and quality control management based on the improvement of clinical practice ability].

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor's professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China.

Prevalence and predictors of sub-optimal laboratory monitoring of selected higher risk medicines in Irish general practice: a 5-year retrospective cohort study of community-dwelling older adults.

Objectives: To describe the prevalence of sub-optimal monitoring for selected higher-risk medicines in older community-dwelling adults and to evaluate patient characteristics and outcomes associated with sub-optimal monitoring.

Study Design: Retrospective observational study (2011-2015) using historical general practice-based cohort data and linked dispensing data from a national pharmacy claims database.

Setting: Irish primary care.

Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence Survey.

: A tracheostomy is a frequently performed surgical intervention in intensive care units (ICUs) for patients requiring prolonged mechanical ventilation. This procedure can offer significant benefits, including reduced sedation requirements, improved patient comfort, and enhanced airway management. However, it is also associated with various risks, and the absence of standardized clinical guidelines complicates its implementation.

Controversies in the Application of AI in Radiology-Is There Medico-Legal Support? Aspects from Romanian Practice.

: Artificial intelligence (AI) is gaining an increasing amount of influence in various fields, including medicine. In radiology, where diagnoses are based on collaboration between diagnostic devices and the professional experience of radiologists, AI intervention seems much easier than in other fields, but this is often not the case. Many times, the patients orient themselves according to the doctor, which is not applicable in the case of AI.

The impact of the COVID-19 pandemic on mental coping and emergency ability of public health emergency in COVID-19 department healthcare workers in ICU nurses of Beijing in China.

Background: The COVID-19 pandemic has brought various opportunities and challenges to critical care nurses, whose emergency abilities in caring for critically ill patients are related to their safety, clinical effectiveness, and improved prognosis. Currently, there is a lack of research on the actual situation and influencing factors of ICU nurses' emergency ability during the COVID-19 pandemic. Although empirical observations from different departments can provide valuable basis for the health system to formulate preventive measures, efficient training programs and future public emergencies.

Noninvasive diagnosis model for predicting significant liver inflammation in patients with chronic hepatitis B in the immune-tolerant phase.

The presence of significant liver inflammation is an important indication for antiviral therapy in immune-tolerant (IT)phase with chronic hepatitis B(CHB) patients. This study aims to establish a non-invasive model to assess significant liver inflammation in the IT-phase of CHB patients. This multicenter retrospective study included a total of 535 IT-phase CHB patients who underwent liver biopsy, and were randomly divided into a training and a validation set.

Discontinuation of anticoagulants and occurrence of bleeding and thromboembolic events in vitamin K antagonist users with a life-limiting disease.

Background: Data on risks and benefits of long-term anticoagulants in patients with a life-limiting disease are limited. This cohort study aims to describe (dis)continuation of anticoagulants and incidences of bleeding and thromboembolic events in vitamin K antagonist (VKA) users with a life-limiting disease.

Methods: Data from five Dutch anticoagulation clinics were linked to data from Statistics Netherlands and the Netherlands Cancer registry.

Developing a comprehensive inventory to define harm reduction housing.

Background: The City of Boston has faced unprecedented challenges with substance use amidst changes to the illicit drug supply and increased visibility of homelessness. Among its responses, Boston developed six low threshold harm reduction housing (HRH) sites geared towards supporting the housing needs of people who use drugs (PWUD) and addressing health and safety concerns around geographically concentrated tent encampments. HRH sites are transitional supportive housing that adhere to a "housing first" approach where abstinence is not required and harm reduction services and supports are co-located.

Nephrectomy in Autosomal Dominant Polycystic Kidney Disease: A consensus statement of the ERA Genes & Kidney Working Group.

A substantial number of patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) undergo a nephrectomy, especially in work-up for a kidney transplantation. Currently, there is no evidence-based algorithm to guide clinicians which patients should undergo nephrectomy, the optimal timing of this procedure, or the preferred surgical technique. This systematic review-based consensus statement aimed to answer important questions regarding nephrectomy in ADPKD.

Comparison of colorectal cancer surgery patients in intensive care between rural and metropolitan hospitals in Australia: a national cohort study.

Purpose: A small proportion of colorectal cancer (CRC) surgical patients will require an admission to an intensive care unit (ICU) within the early postoperative period. This study aimed to compare the characteristics and outcomes of patients admitted to an ICU following CRC surgery per hospital type (metropolitan vs. rural) over a decade in Australia.

The Brussels consensus for non-invasive ICP monitoring when invasive systems are not available in the care of TBI patients (the B-ICONIC consensus, recommendations, and management algorithm).

Background: Invasive systems are commonly used for monitoring intracranial pressure (ICP) in traumatic brain injury (TBI) and are considered the gold standard. The availability of invasive ICP monitoring is heterogeneous, and in low- and middle-income settings, these systems are not routinely employed due to high cost or limited accessibility. The aim of this consensus was to develop recommendations to guide monitoring and ICP-driven therapies in TBI using non-invasive ICP (nICP) systems.

Multi-omics perspective: mechanisms of gastrointestinal injury repair.

In this review, we examine the significance of multi-omics technologies in understanding the plethora of intricate processes that activate gastrointestinal (GI) injury repair. Multi-omics, which includes genomics, transcriptomics, proteomics, and metabolomics, allows intricate mapping of cellular responses and molecular pathways involved in GI repair. We highlight the potential of multi-omics to discover previously unknown therapeutic targets or elucidate the molecular basis of the pathogenesis of GI.