Southern medical journal
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Southern medical journal · Nov 2018
Late-Stage Melanoma: Be Sure to Screen Uninsured, Unmarried Men.
The purpose of this study was to assess for any associations between individual and social factors and late-stage melanoma in Kentucky from 1995 to 2013. ⋯ The incidence of melanoma is increasing dramatically. With no screening recommendation for the general population from the US Preventive Task Force, clinicians should focus on those at increased risk of late-stage melanoma: unmarried men who are uninsured or receiving Medicaid.
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Southern medical journal · Nov 2018
Prevalence and Impact of Diabetes Mellitus on the Frozen Shoulder.
The objective of this study was to estimate the prevalence of undiagnosed diabetes mellitus in patients with newly diagnosed frozen shoulder (FS) and study whether diabetes mellitus increases the severity of FS disease. ⋯ The prevalence of undiagnosed diabetes mellitus is low in patients with FS and does not differ from the general population. Diabetes mellitus does not seem to affect patients' perceived severity of an FS.
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Southern medical journal · Nov 2018
Outcomes and Predictors of Readmissions with GI Bleeding in Patients with Left Ventricular Assist Devices.
Gastrointestinal (GI) bleeding is a major comorbidity in patients with left ventricular assist devices (LVADs). The study aim was to estimate the rate of hospital readmissions for GI bleeding in patients with LVADs using a nationally representative database. Additionally, we evaluated the etiologies, costs, endoscopy utilization, mortality, and predictors of GI bleeding readmissions in these patients. ⋯ After LVAD implantation, there is a fivefold increased risk of readmission with GI bleeding within 60 days. Gastroduodenal and small intestinal arteriovenous malformations are the most common culprit lesions. These findings suggest that small bowel enteroscopy should be considered as the initial test of choice in patients with suspected upper gastroduodenal bleeding. Readmissions with bleeding in patients with LVADs increase morbidity and cost of care but not mortality. Older patients and those with a history of bleeding during LVAD implantation are at higher risk of bleeding readmission and may benefit from close monitoring and cautious anticoagulation to prevent rebleeding.