Outpatient Dermatology Productivity Measures by Patient Race, Sex, and Age.

Importance: Clinical productivity measures may incentivize clinical care to specific patient populations and thus perpetuate inequitable care. Before the 2021 Medicare physician fee schedule changes, outpatient dermatology encounters for patients who were younger, female, and races other than White systematically generated fewer work relative value units (wRVUs).

Objective: To examine the association of patient race, age, and sex with wRVUs generated by outpatient dermatology encounters after 2021.

Viral Acute Lower Respiratory Tract Infections (ALRI) in Rural Bangladeshi Children Prior to the COVID-19 Pandemic.

Background: Acute lower respiratory tract infections (ALRIs) remain the leading infectious cause of death among children < 5 years, with viruses contributing to a large proportion of cases. Little is known about the epidemiology and etiology of viral ALRI in rural Bangladesh.

Methods: We enrolled 3- to 23-month-old children with ALRIs attending a subdistrict hospital outpatient clinic in Sylhet district in Bangladesh.

Multimorbidity Trajectories From Early to Middle Adulthood and Physical Activity.

Introduction: Multimorbidity is associated with lower physical function in older adults. Less is known about multimorbidity and physical activity earlier in the life course. This study examined multimorbidity trajectories across adulthood with physical activity and explores if multimorbidity accelerates age-related activity decline.

Does 24/7 care result in better outcomes for adults with eating disorders? A comparison of inpatient/residential care to partial hospitalization/intensive outpatient care for patients at low BMIs.

Background: Higher level of care (HLOC) treatment for eating disorders (EDs) is sometimes necessary, but research is lacking on whether HLOCs are actually more effective than less structured, lower levels of care. The purpose of the current study was to compare outcomes for patients with EDs at low weights who entered 24/7 care (inpatient and residential) to those entering non-24/7 care (partial hospitalization programming and intensive outpatient programming).

Methods: Participants were 1104 adults with body mass indices (BMI) between 14 and 17 receiving treatment for an ED at a large multisite treatment facility offering HLOCs between August 2019 and February 2024.

Enteral and Parenteral Nutrition Timing in eICU Collaborative Research Database by Race: A Retrospective Observational Study.

Introduction: Racial and ethnic disparities in malnutrition are well-known, but it is unknown if there are disparities in early nutrition delivery for intensive care unit (ICU) patients, which is associated with better outcomes. We investigated the timing of enteral nutrition (EN) and parenteral nutrition (PN) initiation in the ICU, examining for racial differences.

Methods: Using the eICU-Collaborative Research Database (eICU-CRD) from 2014 to 2015, we analyzed patients eligible for EN and PN from 208 hospitals.

Lessons on Telemedicine in Rheumatology: Thinking beyond the Coronavirus Disease 2019 Pandemic.

During the COVID-19 pandemic, telemedicine was rapidly deployed to meet the clinical needs of patients with rheumatic diseases worldwide. Rheumatologists were forced to care for patients with all rheumatic diseases, regardless of disease activity, and limited evidence was available to guide provider decision-making regarding telemedicine appropriateness for outpatient rheumatology encounters. As the COVID-19 pandemic progressed, the ongoing provision of rheumatology telemedicine care in the U.

Outcomes of Community-Acquired Acute Kidney Injury: A Cohort Study of US Veterans.

Background: Community-acquired acute kidney injury (CA-AKI) occurs outside of the hospital and is the most common form of AKI. CA-AKI is not well understood, which hinders efforts to prevent, identify, and manage CA-AKI.

Objective: Examine 30-day outcomes following CA-AKI using national administrative and lab data from the Veterans Health Administration (VA).

Head and neck cancer mortality in the United States: Regional differences in hospice use and place of death.

Background: With more than 15,000 annual deaths from head and neck cancer (HNC), an important aspect of end-of-life care for these patients is place of death. Recent evidence suggests an increasing preference for home/hospice at end of life; however, it is unclear whether there is variation in home/hospice use based on region or urban status. We described differences in the place of death of HNC patients based on their region and urban status.

Vaccinations in older adults: Optimization, strategies, and latest guidelines.

This article is a summary of the first AGS Symposium entitled "Update on Vaccination Strategies for Older Adults: Matching the Approach to the Individual and the Care Setting." Given declines in host defenses and immune function with aging, vaccinations play a pivotal role in fortifying older adults against preventable infections, resulting diseases, disability, and death. Current guidelines generally list recommendations applicable for an average older adult of a given chronological age.

Association of Race and Ethnicity with Genomic Testing at a Comprehensive Cancer Center in North Carolina.

Non-Hispanic Black patients diagnosed with prostate cancer between 2014 and 2019 and treated at a comprehensive cancer center were less likely to use tumor-specific genomic testing compared with non-Hispanic White patients. Disparities in the use of precision oncology technologies should be monitored and addressed to ensure equitable cancer care.

Predictors of treatment outcome in higher levels of care among a large sample of adolescents with heterogeneous eating disorders.

Background: Despite widespread use of higher levels of care in treating eating disorders in adolescents, research supporting the use of these treatments remains limited by small sample sizes and a predominant focus on anorexia nervosa. Further, existing data regarding predictors of outcome have yielded mixed findings. In the current study, we evaluated treatment outcomes and predictors of outcome among a large sample of adolescents with eating disorders presenting to inpatient, residential, partial hospitalization programs, and intensive outpatient programs across the United States.

Prevalence of and Risk Factors for Liver Enzyme Elevation After Hepatitis C Virologic Cure.

A subset of patients with chronic hepatitis C virus (HCV) infection demonstrate liver enzyme elevation (LEE) after achieving sustained virologic response (SVR). Risk factors for LEE are not well characterised. We conducted a single-centre retrospective cohort study of adults with HCV infection in the Duke University Health System who received direct-acting antiviral therapy and achieved SVR.

Long-term Monitoring of Blood Pressure in Older Adults: A Focus on Self-Measured Blood Pressure Monitoring.

Hypertension is among the most common chronic conditions in older adults. Effective treatment exists, yet many older adults do not achieve recommended control of their blood pressure (BP). Self-measured blood pressure (SMBP) monitoring, in which patients check their BP at home, is one underutilized tool for improving hypertension control.

Emergency department discharges directly to hospice: Longitudinal assessment of a streamlined referral program.

Introduction: 80 % of Americans wish to die somewhere other than a hospital, and hospice is an essential resource for providing such care. The emergency department (ED) is an important location for identifying patients with end-of-life care needs and providing access to hospice. The objective of this study was to analyze a quality improvement (QI) program designed to increase the number of patients referred directly to hospice from the ED, without the need for an observation stay and without access to in-hospital hospice.

AGA Clinical Practice Update on Integrating Potassium-Competitive Acid Blockers Into Clinical Practice: Expert Review.

Description: The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update (CPU) is to summarize the available evidence and offer expert Best Practice Advice on the integration of potassium-competitive acid blockers (P-CABs) in the clinical management of foregut disorders, specifically including gastroesophageal reflux disease, Helicobacter pylori infection, and peptic ulcer disease.

Methods: This expert review was commissioned and approved by the AGA Institute Governing Board and CPU Committee to provide timely guidance on a topic of high clinical importance to the AGA membership. This CPU expert review underwent internal peer review by the CPU Committee and external peer review through the standard procedures of Gastroenterology.

EXpanding Technology-Enabled, Nurse-Delivered Chronic Disease Care (EXTEND): Protocol and Baseline Data for a Randomized Trial.

Background: Approximately 10-15 % of individuals with type 2 diabetes have persistently poorly-controlled diabetes mellitus (PPDM) despite receiving available care, and frequently have comorbid hypertension. Mobile monitoring-enabled telehealth has the potential to improve outcomes in treatment-resistant chronic disease by supporting self-management and facilitating patient-clinician contact but must be designed in a manner amenable to real-world use.

Methods: Expanding Technology-Enabled, Nurse-Delivered Chronic Disease Care (EXTEND) is an ongoing randomized trial comparing two 12-month interventions for comorbid PPDM and hypertension: 1) EXTEND, a mobile monitoring-enabled self-management intervention; and 2) EXTEND Plus, a comprehensive, nurse-delivered telehealth program incorporating mobile monitoring, self-management support, and pharmacist-supported medication management.

Weight gain in anorexia nervosa across age groups in higher levels of care.

Eating disorders (EDs) have historically been thought of as afflictions of younger women, but EDs do occur in midlife/older adults, and the incidence of EDs among older women may be increasing. The present study sought to examine outcomes for patients with anorexia nervosa needing to weight restore across four age groups: under 18, 18-25, 26-39, and 40+. Based on prior research, it was hypothesized that there would be no differences between the age groups in percent of expected body weight (%EBW) gained during treatment.

Primary Dermal Melanoma: A Rare Subtype of Melanoma and Clinical Mimicker of Basal Cell Carcinoma.

Primary dermal melanoma (PDM) is a rare variant of melanoma. We present the case of a 76-year-old female diagnosed with PDM following initial suspicion of basal cell carcinoma, prompting extensive workup to exclude metastasis. This case demonstrates the diagnostic challenges and need for rigorous evaluation in suspected PDM cases.