Journal of Investigative Medicine最新文献_第2页

Implementation of telepsychiatry in an urban pediatric satellite emergency department.

IF 2.5 4区医学

Journal of Investigative Medicine Pub Date : 2025-04-01 Epub Date: 2025-02-26 DOI: 10.1177/10815589251318621

Jillian E Nickerson, Alexandra Rucker, Molly Walker, Christopher Gable, Tanika Jones, Theresa Ryan Schultz, Shireen Atabaki

{"title":"Implementation of telepsychiatry in an urban pediatric satellite emergency department.","authors":"Jillian E Nickerson, Alexandra Rucker, Molly Walker, Christopher Gable, Tanika Jones, Theresa Ryan Schultz, Shireen Atabaki","doi":"10.1177/10815589251318621","DOIUrl":"10.1177/10815589251318621","url":null,"abstract":"While pediatric mental health emergencies are increasing in frequency and severity, psychiatric resources remain concentrated in tertiary care facilities. Telepsychiatry has successfully mitigated these challenges in rural emergency departments (EDs), suggesting potential benefits for urban EDs that lack psychiatric resources. We implemented telepsychiatry in an urban ED to reduce ED length of stay and the need for transferring pediatric patients with mental and behavioral health complaints. We conducted a retrospective review of patients aged 0-17 presenting from July 1, 2018 to May 31, 2020 (PRE-intervention) and from June 1, 2020 to June 30, 2023 (POST-intervention) for psychiatric evaluation, suicidal ideation, homicidal ideation, behavioral issues, intentional ingestion, or altered mental status. Our outcomes of interest were ED length of stay, proportion transferred, and proportion with a repeat visit within 30 days for a mental health complaint. There were 199 patients; 74 PRE and 125 POST. Post-intervention, 91% (114 patients) were evaluated completely via telepsychiatry; thus only 11 (9%) required transfer. The median age was 14 years (range 8-17). The most common complaints were suicidal ideation, intentional ingestion, and behavioral problems. Seventy-four percent of patients (n = 84) evaluated by telepsychiatry were discharged from the satellite ED. The median length of stay decreased significantly from 473 min (95% CI: 431-733) to 275 min (95% CI: 316-462) after implementation. Repeat visits for mental health complaints within 30 days decreased from 23% to 10%. Implementing a telepsychiatry evaluation program in an urban pediatric satellite ED reduced transfers and decreased patient length of stay.","PeriodicalId":16112,"journal":{"name":"Journal of Investigative Medicine","volume":" ","pages":"345-352"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The American Federation for Medical Research maintains commitment to decades of support of vaccine and vaccination research to improve public health.

IF 2.5 4区医学

Journal of Investigative Medicine Pub Date : 2025-04-01 Epub Date: 2025-03-01 DOI: 10.1177/10815589251327504

Zanthia Wiley, Sidharth Mahapatra, Gaurav Agarwal, Stephanie Baer, Syed Bukhari, Jorge Cervantes, Ricardo Correa, Steven Crosby, Samrat Das, Joshua De Leon, John Dickinson, Janice P Dutcher, Sebastien Fuchs, Andrea Hahn, Octavian C Ioachimescu, Sheetal Kandiah, Mimi S Kim, Anupam Kotwal, Richard McCallum, Christina A Muzny, Viranuj Sueblinvong, Jeffrey Salomon, David A Stevenson, Attaya Suvannasankha, Laneshia K Tague, Theo Trandafirescu, Peter H Wiernik

引用次数: 0

EXPRESS: Response to: Faculty should be cautiously optimistic about the role of generative AI in medical education.

IF 2.5 4区医学

Journal of Investigative Medicine Pub Date : 2025-03-28 DOI: 10.1177/10815589251333745

Jorge L Cervantes

引用次数: 0

EXPRESS: Response to: Applicant essays and recommendation letters in residency selection: How generative artificial intelligence is changing them.

IF 2.5 4区医学

Journal of Investigative Medicine Pub Date : 2025-03-28 DOI: 10.1177/10815589251333743

Jorge L Cervantes

引用次数: 0

EXPRESS: Predictors for Significant Hepatic Fibrosis in Chronic HBV Patients in Daily Clinical Practice: A Prospective Study.

IF 2.5 4区医学

Journal of Investigative Medicine Pub Date : 2025-03-19 DOI: 10.1177/10815589251331892

Fadi Abu Baker, Dorin Nicola, Randa Taher, Saif Abu Mouch, Oren Shibolet

{"title":"EXPRESS: Predictors for Significant Hepatic Fibrosis in Chronic HBV Patients in Daily Clinical Practice: A Prospective Study.","authors":"Fadi Abu Baker, Dorin Nicola, Randa Taher, Saif Abu Mouch, Oren Shibolet","doi":"10.1177/10815589251331892","DOIUrl":"https://doi.org/10.1177/10815589251331892","url":null,"abstract":"Accurate knowledge of fibrosis levels is essential for effective treatment decisions and prognostication in chronic hepatitis B (CHB) infection. Current guidelines recommend liver biopsy and elastography as the most reliable methods for assessing fibrosis in CHB patients. However, these methods are not widely implemented due to the limited availability, high costs, and invasiveness of liver biopsy. Thus, we aimed to identify simple clinical predictors of significant liver fibrosis in CHB patients in daily practice. We prospectively recruited CHB patients to undergo shear wave elastography (SWE), abdominal ultrasound, and blood tests. In parallel, we extracted data on patient demographics, habits, medical backgrounds, medications, and CHB status and treatment. Multivariate logistic regression analyses were used to determine predictors of significant fibrosis. Of the 173 patients included in the final analysis, 40 (23.0%) had evidence of significant fibrosis on two-dimensional SWE. Age> 50 years [odds ratio (OR): 3.53; 95% confidence interval (CI): 1.34-9.25; P= 0.001], alanine aminotransferase > 40 (OR: 8.16; 95%CI: 4.6-15.3; P= 0.001), hepatitis B virus DNA> 2000 (OR: 9.20; 95%CI: 3.4-19.0; P< 0.001), concomitant diabetes mellitus (OR: 3.58; 95%CI: 1.89-5.49; P= 0.040), moderate to severe steatosis on ultrasound (OR: 4.50; 95%CI: 2.35-9.95; P= 0.014), and heavy smoking were independent predictors of significant fibrosis. In conclusion, we identified clinical and laboratory variables that may effectively identify CHB patients at high risk of significant fibrosis. These can aid in resource allocation in daily practice with limited resources.","PeriodicalId":16112,"journal":{"name":"Journal of Investigative Medicine","volume":" ","pages":"10815589251331892"},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EXPRESS: Research on Iron Regulatory Erythroid Factors in Children with β-Thalassemia.

IF 2.5 4区医学

Journal of Investigative Medicine Pub Date : 2025-03-18 DOI: 10.1177/10815589251331618

Yaxuan Cao, Ken Huang, Jianming Luo

{"title":"EXPRESS: Research on Iron Regulatory Erythroid Factors in Children with β-Thalassemia.","authors":"Yaxuan Cao, Ken Huang, Jianming Luo","doi":"10.1177/10815589251331618","DOIUrl":"https://doi.org/10.1177/10815589251331618","url":null,"abstract":"To investigate the differences in relative mRNA expression levels of the novel iron regulatory erythroid factors FAM210B, CCDC115, HO-1, PCBP1, PCBP2, NCOA4, and Nrf2 in children with β-thalassemia major (β-TM) before and after transfusion therapy. A total of 98 children with transfusion-dependent β-thalassemia were recruited from the First Affiliated Hospital of Guangxi Medical University between October 2022 and May 2023. The children were classified based on their hemoglobin (Hb) levels: 57 cases with Hb ≤ 90 g/L and 41 cases with Hb > 90 g/L. Real-time fluorescence quantitative PCR was employed to assess the relative mRNA expression between the groups. The mRNA expression levels of FAM210B, HO-1, and NCOA4 were significantly higher in the Hb ≤ 90 g/L group compared to the Hb > 90 g/L group (P < 0.05). Moreover, higher relative expression levels of FAM210B and NCOA4 correlated with an increased likelihood of requiring blood transfusions in β-TM children. The differences in the remaining factors did not reach statistical significance. FAM210B and NCOA4 may serve as indicators of erythropoiesis and the degree of anemia in children with β-TM. Further research is warranted to explore their potential as therapeutic targets for β-thalassemia and other erythropoietic disorders.","PeriodicalId":16112,"journal":{"name":"Journal of Investigative Medicine","volume":" ","pages":"10815589251331618"},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Applicant essays and recommendation letters in residency selection:How generative artificial intelligence is changing them.

IF 2.5 4区医学

Journal of Investigative Medicine Pub Date : 2025-03-18 DOI: 10.1177/10815589251331614

Shigeki Matsubara

引用次数: 0

Cer mortality in patients with systemic lupus erythematosus.

IF 2.5 4区医学

Journal of Investigative Medicine Pub Date : 2025-03-11 DOI: 10.1177/10815589251327522

Jia Yi Tan, Arya Mariam Roy, Michael Guma

{"title":"Cer mortality in patients with systemic lupus erythematosus.","authors":"Jia Yi Tan, Arya Mariam Roy, Michael Guma","doi":"10.1177/10815589251327522","DOIUrl":"10.1177/10815589251327522","url":null,"abstract":"Systemic lupus erythematosus (SLE) is linked with an increased risk of cancers, particularly hematologic malignancies. Cancer mortality among patients with SLE in the United States remains unclear. Our cross-sectional study sought to measure trends in cancer mortality among patients with SLE in the last two decades. Cancer deaths among patients with SLE from 1999 to 2020 were analyzed from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER). Age-adjusted mortality rates (AAMRs) per 1,000,000 individuals were measured. We used joinpoint trend analysis to determine the average annual percent change (AAPC) in AAMR trends. From 1999 to 2020, there were 2481 cancer deaths with comorbid SLE. Overall, the AAMRs of cancer among patients with SLE increased from 0.71 in 1999 to 1.19 per 1,000,000 individuals in 2020, with the AAPC at +1.19. Women had a higher AAMR from cancer death with comorbid SLE than men (1.39 vs 0.29 per 1,000,000 individuals). The highest AAMR was observed among African Americans (1.23 per 1,000,000 individuals), followed by Hispanics (0.61 per 1,000,000 individuals), Whites (0.58 per 1,000,000 individuals), and Asians (0.36 per 1,000,000 individuals). Those who lived in the West region and the rural region had the highest AAMR, respectively (0.69 vs 0.70 per 1,000,000 individuals). The three most common causes of cancer deaths were lung cancer (28.70%), breast cancer (8.83%), and non-Hodgkin lymphoma (4.96%). Cancer mortality in SLE patients has risen, with higher rates among African Americans, highlighting the need for targeted interventions.","PeriodicalId":16112,"journal":{"name":"Journal of Investigative Medicine","volume":" ","pages":"10815589251327522"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes of beta-blocker therapy in methamphetamine users with cardiovascular conditions.

IF 2.5 4区医学

Journal of Investigative Medicine Pub Date : 2025-03-04 DOI: 10.1177/10815589251327524

Anna Bjarvin, Sydney Cross, Stone Holtzman, Judy Kim, Janpreet Bhandohal, Baldeep Mann, Aslan GhandForoush, Fowrooz Joolhar

{"title":"Outcomes of beta-blocker therapy in methamphetamine users with cardiovascular conditions.","authors":"Anna Bjarvin, Sydney Cross, Stone Holtzman, Judy Kim, Janpreet Bhandohal, Baldeep Mann, Aslan GhandForoush, Fowrooz Joolhar","doi":"10.1177/10815589251327524","DOIUrl":"10.1177/10815589251327524","url":null,"abstract":"Methamphetamine use is associated with a range of cardiovascular conditions, including hypertension and heart failure. Beta-blocker use is commonly avoided when treating patients intoxicated with methamphetamines due to a fear of inducing unopposed alpha stimulation and worsening hypertension. We performed a retrospective review of medical records in a county hospital in California with a high prevalence of methamphetamine users. We included adults who tested positive for methamphetamines on urine toxicology, subjects who received beta-blockers within 48 h of their arrival were assigned to the case group, and those who received a non-beta-blocker antihypertensive or no antihypertensive were assigned to the control group. We compared the length of stay (LOS), readmission rate within 30 days, and systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the groups at admission and 24 h. There was no significant difference between LOS and 30-day readmission rates between subjects who received beta-blockers and subjects who did not. Subjects who received carvedilol were compared to subjects in the control group who received another antihypertensive. SBP was significantly higher in the carvedilol group at admission, but there was no significant difference between groups after 24 h, and there was no significant difference in LOS. Treatment with beta-blockers in the case group did not increase LOS or readmission rates compared to the control group, and treatment with carvedilol effectively reduced SBP in patients with hypertension and methamphetamine-induced cardiomyopathy. Our results indicate that beta-blockers, particularly carvedilol, are an effective treatment modality in methamphetamine users.","PeriodicalId":16112,"journal":{"name":"Journal of Investigative Medicine","volume":" ","pages":"10815589251327524"},"PeriodicalIF":2.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Metformin: Its salutary effects beyond diabetes mellitus.

IF 2.5 4区医学

Journal of Investigative Medicine Pub Date : 2025-03-03 DOI: 10.1177/10815589251327511

Khalid Sawalha, Nitesh Gautam, Kalaivani Sivakumar, Hakan Paydak, Jawaher L Mehta

引用次数: 0