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Pertussis in Individuals with Co-morbidities: A Systematic Review.

Pertussis is a highly contagious disease of the respiratory tract caused by Bordetella pertussis. Although the burden of pertussis is highest in children, available data suggests that pertussis in the elderly and those with underlying chronic conditions or illnesses can result in significant morbidity, mortality and costs. We undertook a comprehensive review to assess the association between pertussis and chronic conditions/illnesses. A search was undertaken on 17 June 2019 across EMBASE, Medline and BIOSIS. Citations were limited to those in English, in humans and published since 1 January 19

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… The data sources were the MarketScan Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits (1/2006–6/2014) and Medicaid Multi-State (1/2007–12/2013) databases | Asthma or COPD | Primary or secondary diagnosis of pertussis (defined by International Classification of Diseases …

Systemic Lupus Erythematosus in Primary Care: An Update and Practical Messages for the General Practitioner.

Systemic Lupus Erythematosus (SLE) is a complex chronic autoimmune disease that manifests a wide range of organ involvement. Traditionally, the diagnosis and management of SLE is provided at secondary and tertiary centers to ensure prompt initiation of treatment, adequate control of flares and prevention of irreversible organ damage. Notwithstanding, the role of primary care in SLE is also emerging as there are still significant unmet needs such as the diagnostic delay at the community level and the high burden of therapy- and disease-related comorbidities. In the present review, we summarize

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… Epidemiology and sociodemographics of systemic lupus erythematosus and lupus nephritis among US adults with Medicaid coverage, 2000-2004. Arthritis Rheum. (2013) 65:753–63. 10.1002/art.37795 34. Fernandez M, Alarcon GS, Calvo-Alen J, Andrade R, McGwin G, Jr, Vila LM, et al. …

Cancer in Pregnancy: Therapeutic Decisions at the Intersection of Two Lives.

Background: Cancer during pregnancy is a rare but increasingly encountered condition due to delayed childbearing and improved survival of women with cancer. The coexistence of malignancy and pregnancy poses complex diagnostic and therapeutic challenges, requiring careful balance between maternal prognosis and fetal safety. Objective: This review aims to summarize current evidence on the diagnosis and multidisciplinary management of cancer during pregnancy, focusing on the safe use of oncologic therapies, obstetric decision-making, and maternal and fetal outcomes. Methods: A narrative review wa

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… In the largest available population-based study, using Medicaid data, first-trimester exposure to ondansetron was not associated with an increased risk of overall or cardiac malformations after adjustment for relevant confounders; however, a small absolute increase in the risk of oral clefts was observed …

Cancer disparities: an extensive review.

Cancer disparities are persistently a significant public health burden worldwide and disproportionately impact the underserved populations. To effectively combat cancer disparities, a clear understanding of their causes and patterns is essential. Currently, government data and peer-reviewed research journals display a wide range of data to describe the extent of different cancer disparities. However, there are still gaps in understanding the scope and patterns of these disparities and in adopting practical approaches to eliminate them adequately. Accordingly, we examine essential topics that a

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… These disparities appear to be part of broader socioeconomic barriers to care, as factors such as Medicaid coverage, lower education levels and distance from treatment facilities also contribute to increased TTI. …

A brief clinical genetics review: stepwise diagnostic processes of a monogenic disorder-hypertriglyceridemia.

The completion of the Human Genome Project and tremendous advances in automated high-throughput genetic analysis technologies have enabled explosive progress in the field of genetics, which resulted in countless discoveries of novel genes and pathways. Many phenotype- or disease-associated single nucleotide polymorphisms (SNPs) with a high statistical significance have been identified through numerous genome-wide association studies (GWAS), and various polygenic risk scoring (PRS) schemes have been proposed to identify individuals with a high risk for a certain trait or disorder. Meanwhile, me

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… There are several federal agencies that are responsible for regulating clinical genetic tests in the US: the Food and Drug Administration (FDA), the Centers for Medicare and Medicaid Services (CMS), and the Federal Trade Commission (FTC). …

Patient Navigation in Cancer Treatment: A Systematic Review.

Purpose of reviewPatient navigation promotes access to timely treatment of chronic diseases by eliminating barriers to care. Patient navigation programs have been well-established in improving screening rates and diagnostic resolution. This systematic review aimed to characterize the multifaceted role of patient navigators within the realm of cancer treatment.Recent findingsA comprehensive electronic literature review of PubMed and Embase databases was conducted to identify relevant studies investigating the role of patient navigators in cancer treatment from August 1, 2009 to March 27, 2023.

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… The recent decision by the Centers for Medicare and Medicaid Services (CMS) to reimburse patient navigation services for cancer patients is a significant step forward in enhancing the quality of care for individuals grappling with cancer [ 92 ]. …

HIV-Associated Lymphomas: Updates from Pathogenesis to Treatment Strategies.

HIV-associated lymphoma (HAL) is an aggressive malignancy directly linked to HIV infection and accounts for more than 30% of cancer-related deaths in people living with HIV (PLWH). HAL subtypes, including diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), primary effusion lymphoma (PEL), and plasmablastic lymphoma (PBL), exhibit five to ten times higher incidence rates and distinct molecular profiles compared to HIV-negative lymphomas. Pathogenesis involves HIV-driven CD4+ T-cell depletion, chronic B-cell activation, and oncogenic viral coinfection. First-line therapy combines antir

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… The problem with work requirements for medicaid. JAMA. 2018;319(7):646–647. doi: 10.1001/jama.2018.0420. 13. Zhu S., Wang W., He J., et al. Higher cardiovascular disease risks in people living with HIV: A systematic review and meta-analysis. J. Glob. …

Digital Health Portals for Individuals Living With or Beyond Cancer: Patient-Driven Scoping Review.

BackgroundDigital health portals are online platforms allowing individuals to access their personal information and communicate with health care providers. While digital health portals have been associated with improved health outcomes and more streamlined health care processes, their impact on individuals living with or beyond cancer remains underexplored.ObjectiveThis scoping review aimed to (1) identify the portal functionalities reported in studies involving individuals living with or beyond cancer, as well as the outcomes assessed, and (2) explore the diversity of participant characterist

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… with the portal [ 35 ] No significant impact of household status on the portal use [ 36 ] Middle-income earners (US $30,000-$99,999) were more frequent users compared to higher-income earners [ 37 ] The patients with managed care were more likely to use e-messaging compared to those with Medicare or Medicaid …

Albuminuria as a diagnostic criterion and a therapeutic target in heart failure and other cardiovascular disease.

The high disease burden and bidirectional relationship of chronic kidney disease (CKD), heart failure (HF) and other cardiovascular disease (CVD) necessitate the need for early diagnosis of these diseases. While current screening and detection methods are recommended by CKD and CVD guidelines, their adoption in practice is low. Urine albumin-to-creatinine ratio (uACR) is recognized as a diagnostic marker for CKD and a prognostic marker for CKD progression, HF and CVD outcomes, therefore albuminuria changes have been accepted as a surrogate outcome for kidney and cardiovascular endpoints. Furth

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… Screening rates in people with chronic kidney disease and diabetes In the US, uACR screening rates are suboptimal among patients with T2D and do not meet current guideline recommendation that all patients should have annual screenings. 128 Specifically, uACR and albumin testing among Medicare and Medicaid …

Novel diagnostic options for endometriosis - Based on the glycome and microbiome.

BackgroundEndometriosis is a chronic gynaecological disease whose aetiology is still unknown. Despite its prevalence among women of reproductive age, the pathology of the disease has not yet been elucidated and only symptomatic treatment is available. Endometriosis has high latency and diagnostic methods are both limited and invasive.Aim of reviewThe aim of this review is to summarise minimally invasive or non-invasive diagnostic methods for endometriosis and their diagnostic efficiencies. Furthermore, we discuss the identification and diagnostic potential of novel disease biomarkers of microb

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… Health care utilization and costs associated with endometriosis among women with medicaid insurance. J Manage Care Spec Pharm. 2019;25(5):566–572. doi: 10.18553/jmcp.2019.25.5.566. 4. Bianconi L., Hummelshoj L., Coccia M.E., Vigano P., Vittori G., Veit J. …

Bone Disease in HIV: Need for Early Diagnosis and Prevention.

The transformation of HIV into a manageable chronic condition has unveiled new clinical challenges associated with aging-related pathologies, including bone disease. This review explores the intricate relationship between HIV, antiretroviral therapy (ART), and bone disease, highlighting the necessity of early diagnosis and preventative strategies to mitigate the increased risk of osteopenia, osteoporosis, and fractures in people living with HIV (PLWHIV). It synthesizes the current literature to elucidate the multifactorial etiology of bone pathology in this population, that includes direct vir

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… A comprehensive study of the Medicaid population of multiple US states, conducted during a period of 7 years, highlighted that the incidence of hip fracture was notably higher in patients coinfected with HIV and HCV (3.06 events per 1000 person-years) compared to those with HCV alone (2.69 events per …

A novel method for handling pre-existing conditions in multivariate prediction model development for COVID-19 death in the Department of Veterans Affairs.

Many mathematical models have been proposed to predict death following the Coronavirus Disease 2019 (COVID-19); all started with comorbidity subsets for this still-little understood disease. Thus, we derived a novel predicted probability of death model (PDeathDx) upon all diagnostic codes documented in the Department of Veterans Affairs. We present the conceptual underpinnings and analytic approach in estimating the independent contribution of pre-existing conditions. This is the largest study to-date following patients with COVID-19 to predict mortality. Cases were identified with at least on

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… International Classification of Diseases, Ninth Revision (ICD-9) codes were converted to ICD-10 using a crosswalk provided by the Centers for Medicare & Medicaid Services (CMS). …

Living with or beyond lymphoma: A rapid review of the unmet needs of lymphoma survivors.

ObjectiveTo establish an understanding of the unmet needs of people living with or beyond a lymphoma diagnosis. Survivors of lymphoma are at increased risk of unmet needs due to cancer, treatment-related toxicities and extended survivorship. Despite the rapidly growing numbers of lymphoma survivors, their needs and research priorities are underserved and undervalued, therefore left largely unaddressed.MethodsA rapid review method and reflexive thematic analysis approach assimilated current knowledge. Eligibility criteria included quantitative, qualitative, or mixed approaches employing cross-s

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… . ⁃ Each additional comorbidity (β 0.26, p = 0.003) and being dually eligible for Medicaid (β 0.43, p = 0.03) were significantly associated with a higher adjusted personal doctor rating. …

Exploring Affordable Curative Therapy for Sickle Cell Disease in Africa: A Comprehensive Overview.

The practical aspects of developing curative treatments for sickle cell disease (SCD) in Africa, such as gene therapy and hematopoietic stem cell transplantation, involve strengthening healthcare infrastructure, training healthcare professionals, establishing regional treatment centers, and creating national SCD programs. The costs associated with gene therapy and stem cell transplants can be prohibitive, especially in low- and middle-income countries. Strategies to address affordability, including local manufacturing, government funding, and partnerships with global health agencies, are essen

Cardiac Amyloidosis: Tribulations and New Frontiers.

This review article aims to provide an overview of the pathophysiology, diagnosis, and contemporary management of cardiac amyloidosis (CA) as well as identify the knowledge gaps and areas of potential research. CA can be divided into two main groups: transthyretin cardiac amyloidosis (ATTR-CA) and light chain cardiac amyloidosis (AL-CA). The former further separates into wild-type transthyretin (ATTRwt) and hereditary transthyretin (ATTRv). African Americans, males, and people older than 75 are the most common demographics affected by this disease. Thanks to an increased understanding of this

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… In the United States, Medicare and Medicaid data show ATTR-CA increased in prevalence from 8 cases per 100,000 person years to 17 cases per 100,000 s persons from 2000–2012 [ 3 ]. Older people (>75 years of age), blacks, and males were the dominant demographic groups of ATTR-CA. …

Heart disease and stroke statistics--2011 update: a report from the American Heart Association.

UNLABELLED: Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the Nationa … m for acute stroke. Similar data from the Veterans Healthcare Administration, national Medicare and Medicaid data and National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network - “Get With The Guidelines” Registry data are also reviewed. These data show impressive adherence with guideline recommendations for many, but …

Acute Pneumonia

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Inequity in Cardio-Oncology: Identifying Disparities in Cardiotoxicity and Links to Cardiac and Cancer Outcomes.

Minority and underresourced communities experience disproportionately high rates of fatal cancer and cardiovascular disease. The intersection of these disparities within the multidisciplinary field of cardio-oncology is in critical need of examination, given the risk of perpetuating health inequities in the growing vulnerable population of patients with cancer and cardiovascular disease. This review identifies 13 cohort studies and 2 meta-analyses investigating disparate outcomes in treatment-associated cardiotoxicity and situates these data within the context of oncologic disparities, preexis

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… Many people with cancer still do not have access to health insurance: among states that did not pursue Affordable Care Act Medicaid expansions, 1 in 5 survivors of cancer remains uninsured. 78 Even among those with insurance, cardio‐oncology specialists are not readily accessible to most people. …

Adolescent and Young Adult (AYA) Cancer Survivorship Practices: An Overview.

Worldwide, more than 1.2 million adolescents and young adults (AYAs; those aged 15-39 years) are diagnosed with cancer each year. Although considerable variability exists according to cancer site and stage of disease, the 5-year relative survival at the time of diagnosis has been estimated at >80% for all AYA patients with cancer combined. Extensive survivorship research in recent decades has focused on patients diagnosed with cancer as children (39 years), yet few studies to date have reported outcomes specifically for patients diagnosed as AYAs. With increasing incidence and improving surviv

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… However, given the nature of heath care provided (governmental primarily in Europe and Canada; private insurance and Medicaid in US), much of the access to care and financial toxicities will differ between continents and countries, although there will also be overlapping issues. …

Machine learning for acute kidney injury: Changing the traditional disease prediction mode.

Acute kidney injury (AKI) is a serious clinical comorbidity with clear short-term and long-term prognostic implications for inpatients. The diversity of risk factors for AKI has been recognized in previous studies, and a series of predictive models have been developed using traditional statistical methods in conjunction with its preventability, but they have failed to meet the expectations in limited clinical applications, the rapid spread of electronic health records and artificial intelligence machine learning technology has brought new hope for the construction of AKI prediction models. In

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… Massachusetts, USA | 889 | 0.79 | Contrast agents | LASSO regression | None | KDIGO: Creatinine Okawa et al. ( 85 ) | Fujita Health University Hospital, Japan | 1,014 | 0.76 | Cisplatin | Neural networks Gradient boosting decision tree | None | KDIGO: Creatinine Yang et al. ( 86 ) | Center for Medicare and Medicaid …