Examining childhood and adulthood stressors as risk factors for gestational diabetes mellitus in working pregnant individuals: A prospective cohort study.

Aims: This study aimed to examine the individual and joint associations of adverse childhood experiences (ACEs) and maternal work and non-work related stressors with the risk of gestational diabetes mellitus (GDM).

Methods: Working pregnant individuals (n = 1163) from a United States (U.S.

Panniculus Retractor Use for Visualization of Fetal Anatomy: A Randomized Controlled Trial.

Objective: To evaluate whether use of a panniculus retractor device for pregnant patients with body mass index (BMI) 40 or higher and a panniculus improves the completion rate of the fetal anatomic examination.

Methods: This was a randomized trial in which eligible patients with BMI 40 or higher and a panniculus were randomized to undergo their detailed fetal anatomic examination with a panniculus retractor device in place compared with usual care. The primary outcome was the completion rate of 16 prespecified views from the anatomic examination.

Primary Care of Adult Cancer Survivors.

By 2040, there will be an estimated 26 million cancer survivors in the United States. The essential components of survivorship care are (1) surveillance for cancer recurrence, (2) surveillance for new primary cancers, (3) management of physical and psychological long-term effects of treatment, (4) prevention or mitigation of late treatment effects, and (5) coordination of care between the oncology team and primary care clinicians. Recommendations for surveillance to detect recurrence vary with cancer type and stage at diagnosis.

The Association of Asthma and Metabolic Dysfunction With Outcomes of Hospitalized Patients With COVID-19.

Background: There have been conflicting results on the association of asthma with the severity of coronavirus disease 2019 (COVID-19). Poor metabolic health has been previously associated with both severe COVID-19 and inflammation in asthma.

Objectives: To examine the association between asthma and COVID-19 outcomes and whether these associations are modified by metabolic syndrome.

Clinical Outcomes and Predictors of Advanced Therapy for the Management of Right Heart Thrombus.

Background: The role of advanced therapies (systemic thrombolysis, catheter-based treatment, and surgical thrombectomy) for the management of right heart thrombus is poorly defined. In this study, we assessed the clinical predictors and outcomes of advanced therapy compared with anticoagulation alone for the acute management of right heart thrombus.

Methods: In this observational cohort study, we analyzed consecutive patients who were treated for right heart thrombus.

Cefoxitin for Intra-amniotic Infections and Endometritis: A Retrospective Comparison to Traditional Antimicrobial Therapy Regimens Within a Healthcare System.

Background: Local institutional guidelines and order sets were updated in June 2023 to recommend first-line cefoxitin monotherapy for the treatment of intra-amniotic infections (IAIs) and endometritis. This study evaluated the clinical impact of this change.

Methods: This was a retrospective, observational cohort study in an 11-campus health system comparing clinical outcomes of patients with chorioamnionitis, endometritis, or septic abortion receiving intravenous antimicrobial therapy before and after implementation of first-line cefoxitin monotherapy recommendations for the treatment of these infections.

Inflammatory markers in serum and placenta in a randomized controlled trial of group prenatal care.

Background: Racial and socioeconomic disparities in preterm birth and small for gestational age births are growing in the United States, increasing the burden of morbidity and mortality particularly among Black women and birthing persons and their infants. Group prenatal care is one of the only interventions to show potential to reduce the disparity, but the mechanism is unclear.

Objective: The goal of this project was to identify if group prenatal care, when compared with individual prenatal care, was associated with a reduction in systemic inflammation during pregnancy and a lower prevalence of inflammatory lesions in the placenta at delivery.

Sudden-Onset Disaster Mass-Casualty Incident Response: A Modified Delphi Study on Triage, Prehospital Life Support, and Processes.

The application and provision of prehospital care in disasters and mass-casualty incident response in Europe is currently being explored for opportunities to improve practice. The objective of this translational science study was to align common principles of approach and action and to identify how technology can assist and enhance response. To achieve this objective, the application of a modified Delphi methodology study based on statements derived from key findings of a scoping review was undertaken.

Longitudinal Interleaved Residency Training: A Consensus Definition.

Background And Objectives: Cognitive benefits of longitudinal curricula and interleaving have been demonstrated in several disciplines. However, most residency curricula are structured in a block format. There is no consensus definition as to what constitutes a longitudinal program, making comparative research on curricular efficacy a challenge.

Secondary Public Safety Answering Points Delay the Response to out of Hospital Cardiac Arrest.

National guidelines recommend that high-performing systems process 9-1-1 calls within 60 s and deliver the first telecommunicator cardiopulmonary resuscitation compression within 90 s. The inability of systems employing secondary public safety answering points (PSAPs) to capture the call arrival timestamp at the primary PSAP is a challenge in out-of-hospital cardiac arrest response time research. We sought to measure the interval from call receipt at primary PSAPs to call answer at secondary PSAPs in metropolitan areas.

Incontinence as a catatonic sign.

Background: Incontinence (urinary or fecal) is not included in DSM-5 criteria for catatonia or in most catatonia rating scales. However, there is a historical basis for the inclusion or consideration of incontinence as a catatonic sign.

Methods: We performed a review of the literature and found references to urinary disturbances and fecal incontinence in 19th- and 20th-century literature.

Reinfection and Risk Behaviors After Treatment of Hepatitis C Virus Infection in Persons Receiving Opioid Agonist Therapy : A Cohort Study.

Background: Hepatitis C virus (HCV) reinfection after successful treatment may reduce the benefits of cure among people who inject drugs.

Objective: To evaluate the rate of HCV reinfection for 3 years after successful treatment among people receiving opioid agonist therapy (OAT).

Design: A 3-year, long-term, extension study of persons enrolled in the CO-STAR (Hepatitis C Patients on Opioid Substitution Therapy Antiviral Response) study (ClinicalTrials.

Health-related quality of life in people receiving opioid agonist treatment and treatment for hepatitis C virus infection.

Background: In people with chronic hepatitis C virus (HCV) infection, viral eradication is associated with improved health-related quality of life (HRQOL).

Objective: To assess changes in HRQOL among participants receiving opioid agonist therapy undergoing treatment for HCV infection.

Methods: COSTAR (NCT02251990) was a randomized, double-blind, placebo-controlled study.

Family Medicine Musculoskeletal Medicine Education: A CERA Study.

Background And Objectives: Musculoskeletal (MSK) concerns constitute up to 40% of primary care outpatient visits. Despite Accreditation Council for Graduate Medical Education (ACGME) family medicine program requirements for musculoskeletal medicine and sports medicine training, previous studies have shown that family medicine residency graduates do not have adequate training to manage common musculoskeletal conditions. Factors for this may include deficiencies in education at both the undergraduate and graduate medical education training levels.

Two Years of Darkness: An Autobiographical Case Report of an Emergency Physician With Bilateral Retinal Detachments.

Retinal detachments constitute an emergency ocular condition when the neurosensory retina separates from the retinal pigment epithelium, leading to the death of the tissue. Prompt diagnosis and treatment are essential to avoid significant morbidity, including vision loss and/or blindness associated with this condition. This case report describes the author's challenging journey from a non-ophthalmologist perspective through the terrifying experience of bilateral rhegmatogenous retinal detachments involving seven surgical procedures prior to return to full clinical function.

A 1-year training program in emergency medicine for physicians in Karachi, Pakistan: Evaluation of learner and program outcomes.

Background: Pakistan has an underdeveloped and overburdened emergency care system, with most emergency departments (EDs) staffed by physicians not formally trained in emergency medicine (EM). As of January 2020, only nine Pakistani institutions were providing formal EM specialty training; therefore, a training program of shorter duration is needed in the interim.

Methods: The Certification Program in Emergency Medicine (CPEM) is a 1-year training program in EM consisting of two arms: CPEM-Clinical (CPEM-C), which includes physicians from The Indus Hospital (TIH) ED, and CPEM-Didactic (CPEM-D), including physicians from EDs across Karachi.