Journal of general internal medicine
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Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome that may complicate hematologic malignancies. HLH and malignancies have common clinical features, and HLH diagnostic criteria (HLH-2004/Hscore) were not validated in this specific population. We describe a case of a 72-year-old patient with a history of chronic lymphocytic leukemia stable for over 10 years who presented with fever and cytopenia. ⋯ The patient died 45 days after her presentation. An unusual feature of this case was that HLH was not triggered by infection, disease transformation, or treatment. This case emphasizes the challenges of differentiating the development of overwhelming HLH from other complications associated with hematologic malignancy.
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Care coordination (CC) interventions involve systematic strategies to address fragmentation and enhance continuity of care. However, it remains unclear whether CC can sufficiently address patient needs and improve outcomes. ⋯ CC interventions have inconsistent effects on reducing hospitalizations and ED visits. Future work should address how they should be adapted to different healthcare settings and which tools or approaches are most helpful for implementation.
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Randomized Controlled Trial
Impact of Patient Portal Messaging Reminders with Self-Scheduling Option on Influenza Vaccination Rates: a Prospective, Randomized Trial.
Patient portal messages have been used in a variety of ways to facilitate improved communication between provider and patient. These platforms have shown promise in many ways for improving various health outcomes and overall communication between patient and provider. ⋯ vaccination patient portal messaging influenza.