Added Value of Contrast-enhanced US for Evaluation of Female Pelvic Disease.

Since the first application of contrast-enhanced US (CEUS) in the late 1960s, the use of US contrast agents has grown tremendously, and this examination has proved to be a valuable adjunct to diagnostic US for detection and characterization of disease. Also, CEUS has emerged as an excellent option for evaluation of indeterminate lesions that require additional imaging, given its excellent safety profile, including that in patients with end-stage renal disease or allergies to contrast material who are unable to undergo contrast-enhanced CT or MRI. US traditionally has been considered the imaging modality of choice for evaluation of the female pelvis, followed by MRI and rarely fluoroscopy, CT, PET, or angiography.

Changes in Food Insecurity and Changes in Patient-Reported Outcomes: a Nationally Representative Cohort Study.

Background: Cross-sectional studies have found that health-related quality of life and mental health are worse among food-insecure compared with food-secure individuals. However, how these outcomes change as food insecurity changes is unclear.

Objective: To evaluate how common patient-reported health-related quality of life and mental health scales change in response to changes in food security.

A-TAPER: A Framework for Deprescribing Medications effectively.

Inappropriate medication use creates avoidable safety issues for older adults. Deprescribing medications that are high risk and/or of minimal benefit is important for reducing morbidity and adverse effects, especially in this population. A variety of deprescribing resources and algorithms are available, but a singular framework to effectively approach and implement the deprescribing of unnecessary medications in practice does not exist.

Food Insecurity and Cardiometabolic Conditions: a Review of Recent Research.

Purpose Of Review: To understand recent literature that examines associations between food insecurity and cardiometabolic conditions and risk factors. We included original research, systematic reviews, and meta-analyses on the topic of food insecurity and cardiometabolic risk published from January 1, 2017, to December 31, 2020. Editorials, perspectives, and case reports were excluded.

Initial experience with HydroPearl microspheres for uterine artery embolization for the treatment of symptomatic uterine fibroids.

Background: Uterine Artery Embolization (UAE) is a minimally invasive procedure used to treat symptomatic uterine fibroids. The HydroPearl Microsphere (Terumo Interventional Systems) is an embolic agent approved for UAE and other embolization procedures. The purpose of this article is to describe our initial experience with HydroPearl for UAE in patients with symptomatic uterine fibroids.

Embolization of uterine arteriovenous malformation causing postpartum hemorrhage using n-butyl cyanoacrylate: A case report.

Uterine artery arteriovenous malformations (AVMs) are rare anomalies that may result in uterine hemorrhage. A 40-year-old G8P5126 woman presented with severe vaginal bleeding and an estimated 2000 mL of blood loss at home. Three weeks prior, she had a vaginal delivery of a term infant resulting in post-partum hemorrhage, with 2700 mL of blood loss.

Ureteroarterial fistula embolization by transradial approach: A case report.

Ureteroarterial fistula is a rare condition wherein a communication develops between a ureter and the common, internal, or external iliac artery. Localizing the fistula can be difficult, as cystoscopy, CT angiography, and conventional angiography have low sensitivity in identifying the fistula. Provocative maneuvers within the ureter, however, can aid in the visualization of fistulae on angiography.

Practice level factors associated with enhanced engagement with practice facilitators; findings from the heart health now study.

Background: Practice facilitation is a promising strategy to enhance care processes and outcomes in primary care settings. It requires that practices and their facilitators engage as teams to drive improvement. In this analysis, we explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month practice facilitation intervention focused on implementing cardiovascular prevention activities in practice.

"I was able to eat what I am supposed to eat"-- patient reflections on a medically-tailored meal intervention: a qualitative analysis.

Background: Medically-tailored meal programs that provide home-delivered medically-appropriate food are an emerging intervention when type 2 diabetes co-occurs with food insecurity (limited or uncertain access to nutritious food owing to cost). We sought to understand the experiences of medically-tailored meal program participants.

Methods: We conducted semi-structured interviews with participants in a randomized trial of medically-tailored meals (NCT02426138) until reaching content saturation.

State-Level and County-Level Estimates of Health Care Costs Associated with Food Insecurity.

Introduction: Food insecurity, or uncertain access to food because of limited financial resources, is associated with higher health care expenditures. However, both food insecurity prevalence and health care spending vary widely in the United States. To inform public policy, we estimated state-level and county-level health care expenditures associated with food insecurity.

Addressing Health-Related Social Needs: Value-Based Care or Values-Based Care?

Health-related social needs, such as food insecurity, housing instability, and lack of transportation, are associated with worse health outcomes, and are increasingly the focus of health-related social needs interventions within healthcare. Adoption of health-related social needs interventions is often justified by the potential to reduce healthcare costs. However, this can present a conundrum to clinicians.

Diabetes and the Built Environment: Evidence and Policies.

Purpose Of Review: To explore the relationship between the built environment and type 2 diabetes, considering both risk factors and policies to reduce risk. The built environment refers to the physical characteristics of the areas in which people live including buildings, streets, open spaces, and infrastructure.

Recent Findings: A review of current literature suggests an association between the built environment and type 2 diabetes, likely driven by two key pathways-physical activity and the food environment.

Oregon's Expansion of Prenatal Care Improved Utilization Among Immigrant Women.

Objectives To determine whether expanding Emergency Medicaid to cover prenatal care in Oregon affected maternal health outcomes for unauthorized immigrants. Methods This study takes place in Oregon from 2003 to 2015 and includes all Emergency Medicaid and Medicaid claims for women aged 12-51 with a pregnancy related claim. To isolate the effect of expanding access to prenatal care, we utilized a difference-in-differences approach that exploits the staggered rollout of the prenatal care program.

Defining normal apical vaginal support: a relook at the POSST study.

Introduction And Hypothesis: The purpose of this study is to reanalyze data from the original 2005 Pelvic Organ Support Study (POSST) data set to define normal values for apical Pelvic Organ Prolapse Quantification (POP-Q) points C and D and total vaginal length (TVL) in an asymptomatic population of women.

Methods: In this retrospective observational data-set review, patient were >18 years presenting for annual gynecologic exams to six centers in the United States. Data included demographics, questions about prolapse symptoms, and POP-Q points.

The stability of gadolinium-based contrast agents in human serum: A reanalysis of literature data and association with clinical outcomes.

Purpose: To reanalyze literature data of gadolinium (Gd)-based contrast agents (GBCAs) in plasma with a kinetic model of dissociation to provide a comprehensive assessment of equilibrium conditions for linear GBCAs.

Methods: Data for the release of Gd from GBCAs in human serum was extracted from a previous report in the literature and fit to a kinetic dissociation/association model. The conditional stabilities (logK) and percent intact over time were calculated using the model rate constants.

Identification of risk factors for inappropriate and suboptimal initiation of direct oral anticoagulants.

Direct Oral Anticoagulants (DOACs) require specific dosing and monitoring to ensure safe and appropriate use. The purpose of this evaluation was to identify patient- and process-related factors that correlate with increased risk of inappropriate prescribing of DOACs. A retrospective chart review was conducted in three outpatient clinics within an academic medical center to identify patients started on DOAC therapy and evaluate the appropriateness of DOAC initiation.

Predictors of Non-Attendance to the Postpartum Follow-up Visit.

Objectives This study aimed to measure the incidence and identify predictors of postpartum visit non-attendance, using medical records of women who received prenatal care and went on to deliver live births at Montefiore Hospital in 2013. Methods Pearson's Chi square tests were used to assess the association between maternal demographics, insurance status, and delivery information with non-attendance of a postpartum visit. Logistic regression and modified Poisson regression models were then used to identify statistically significant predictors of postpartum visit non-attendance.

Can gadolinium be re-chelated in vivo? Considerations from decorporation therapy.

Gadolinium (Gd) and Gd-based contrast agents (GBCAs) have been observed to deposit in tissues of patients following contrast enhanced MR imaging procedures. A conservative approach for chelation therapy of this toxic metal dictates the assumption that minimal intact GBCAs are present. Currently the extent to which these deposits are primarily de-chelated Gd remains uncertain, prevailing knowledge suggests that for linear agents much of the Gd is de-chelated, while for the macrocyclic agents, the Gd may be still largely chelated.

Enhancement of abdominal structures on MRI at 1.5 and 3 T: a retrospective intraindividual crossover comparison.

Objective: To quantitatively compare the extent of enhancement of abdominal structures on MRI in an intraindividual fashion at 1.5 and 3 T.

Methods: HIPAA-compliant, retrospective, longitudinal, intraindividual, crossover study, with waived informed consent, of consecutive individuals scanned at both 1.