Southern medical journal
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Southern medical journal · Feb 2023
Association between Financial Barriers to Healthcare Access and Mental Health Outcomes in Tennessee.
A large number of people cannot afford healthcare services in the United States. Researchers have studied the impact of lack of affordability of health care on the outcomes of various physical conditions. Mental health disorders have emerged as a major public health challenge during the past decade. The lack of affordability of health care also may contribute to the burden of mental health. This research focuses on the association between financial barriers to health care and mental health outcomes in the US state of Tennessee. ⋯ Statistically significant associations were observed between the inability to see a doctor when needed because of cost and increased days of poorer mental health outcomes. This research has potential policy implications in the postcoronavirus disease 2019 era with healthcare transformation and significant financial impact.
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Southern medical journal · Feb 2023
Diagnostic Yield of Endobronchial Ultrasound-Guided Mediastinal Lymph Node Transbronchial Forceps Biopsies (EBUS-TBFB).
The diagnostic accuracy and yield of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is not well established in lymphoma and other mediastinal-related diseases. The objective of this study was to examine the yield of a combined technique of EBUS-TBNA and endobronchial ultrasound-guided transbronchial forceps biopsies (EBUS-TBFB) compared with each modality alone in lymphoma and other mediastinal-related diseases. ⋯ The combination of EBUS-TBFB and EBUS-TBNA is safe and provides a high yield in the diagnosis of mediastinal adenopathy of unknown etiology, especially lymphoma. Furthermore, the larger samples obtained from TBFB increased its sensitivity to detect granulomatous disease and provided specimens for clinical trials of malignancy when needle aspirates were insufficient.
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Southern medical journal · Feb 2023
Extensor Mechanism Reconstruction for Chronic Patellar Tendon Tears.
Reconstruction for a chronic patellar tendon rupture in a native knee is an uncommon surgical procedure. Although there have been case series investigating patient-reported outcomes, there is no systematic review of these studies to date. The purpose of this review is to synthesize the literature on this procedure to better understand its outcomes, complications, and surgical technique options. ⋯ Chronic patellar tendon disruption in a native knee is an uncommon injury that can result in significant limitations for patients. Although more research is needed to better elucidate which graft is best, outcomes after patellar tendon reconstruction for chronic tears appear to be satisfactory with current techniques.
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Southern medical journal · Feb 2023
Retrospective Analysis of Hospitalized Patients with Type 2 Diabetes Mellitus Treated with Glucagon-Like Peptide 1 Receptor Agonist Therapy.
The use and overall benefit of glucagon-like peptide-1 (GLP-1) receptor agonist therapy for hospitalized patients with type 2 diabetes mellitus (DM) with chronic kidney disease (CKD) has limited data regarding impact and safety. We studied the impact and safety of GLP-1 receptor agonist therapy in hospitalized DM patients with CKD. ⋯ The use of GLP-1 receptor agonist therapy had better outcomes in patients with GFR stages 3 to 5 as compared with GFR stages 1 and 2. There were minimal adverse events reported for both GFR groups. This study suggests that the off-label use of GLP-1 receptor agonists for hospitalized DM patients with CKD may be useful.
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Southern medical journal · Feb 2023
Tri-Site Academic Center Experience with Immunotherapy for Metastatic Skin Cancer in Solid Organ Transplant Patients.
Organ transplant recipients have an increased risk of skin cancer, but treatment options for metastatic skin cancer are limited because of their immunosuppressed state. We sought to qualify the clinical experience and patient safety of immune checkpoint inhibitors (ICIs) for skin cancer treatment in transplant recipients at one large academic institution. ⋯ ICIs can be used in organ transplant patients, but the risk of transplant rejection must be carefully discussed because it may be associated with an increased risk of death. A higher risk of rejection exists with anti-programmed cell death 1 and anti-programmed cell death ligand 1 inhibitors.