The journal of medicine access最新文献

{"title":"Incarceration and emergency department visit frequency as predictors for missing day of cataract surgery at County hospital.","authors":"Patrick Wurster, Margaret Tharp, Kathleen Ho, Jennifer Eikenberry","doi":"10.1177/27550834251359809","DOIUrl":"10.1177/27550834251359809","url":null,"abstract":"<p><strong>Background: </strong>Understanding the factors associated with patient no-shows is essential for healthcare providers to develop strategies to optimize patient care, as these can delay care and increase cost. This retrospective study aimed to identify factors associated with higher likelihood of patients missing their scheduled cataract surgery appointments at a county hospital.</p><p><strong>Methods: </strong>A retrospective chart review was performed using data collected from the surgery schedule and electronic medical record on patients aged 18-100 years scheduled for cataract surgery at Eskenazi Hospital between January 1, 2022, and December 31, 2022. Logistic regression was used to compare factors of age, race, ethnicity, primary spoken and written language, insurance status, best-corrected visual acuity and number of admissions to the emergency department of the same hospital in the preceding year to attendance of cataract surgery on scheduled date.</p><p><strong>Results: </strong>This study found that in the studied population (n = 242), being incarcerated was a statistically significant predictor of missing the scheduled cataract surgery appointment (OR 6.14, 95% CI 1.14-33.16, p = 0.035). In addition, having at least one emergency department visit in the prior year (OR 6.50, CI 1.83-23.1, p = 0.004) was found to be significant, with a greater difference in patients who had at least three emergency department visits in the prior year (OR 13.2, CI 3.21-52.6, p < 0.001). Other studied factors were not found to be statistically significant predictors of missing the surgery appointment, although having best-corrected vision of count fingers or worse neared statistical significance of predicting missing cataract surgery appointment. These findings may potentially direct targeted intervention strategies to improve access to cataract care.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"9 ","pages":"27550834251359809"},"PeriodicalIF":1.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial fibrillation with slow-ventricular response (AF-SVR): A literature review.","authors":"James Choi, Darren Kong, Luka Katic, Vincent A Torelli, Joseph Karpenos, Nebojsa Markovic, Davendra Mehta","doi":"10.1177/27550834251342890","DOIUrl":"10.1177/27550834251342890","url":null,"abstract":"<p><p>Atrial fibrillation is a common cardiac arrhythmia affecting over 33 million individuals globally; however, atrial fibrillation with slow-ventricular response (AF-SVR) remains an underexplored subset. AF-SVR is characterized by an irregular ventricular rate of less than 60 beats per minute without the influence of atrioventricular (AV) blocking agents. This review aims to consolidate current knowledge on AF-SVR, focusing on the epidemiology, pathophysiology, clinical manifestations, complications, diagnosis, and management strategies. AF-SVR is more prevalent in older adults, often attributed to age-related degeneration of the cardiac conduction system. Conditions such as AV nodal block, sick sinus syndrome (SSS), and the effects of certain medications are significant contributors to the development of AF-SVR. The pathophysiology involves complex electrical and structural remodeling of the atria, which can lead to bradycardia and symptomatic conduction delays. Clinically, AF-SVR presents similarly to other forms of bradycardia, with symptoms including fatigue, dizziness, and syncope. Diagnosis is primarily based on electrocardiogram (ECG) findings of AF with a slow-ventricular rate, supplemented by ambulatory ECG monitoring and exercise tolerance testing. Transthoracic echocardiography (TTE) is crucial for identification of underlying structural heart disease. Management of AF-SVR involves first addressing reversible causes such as medication effects, electrolyte imbalances, and underlying ischemia. Pharmacological options including the use of anticholinergic medications such as theophylline and hyoscyamine, which have shown efficacy in reversing bradycardia. Persistent or severe cases often require permanent pacemaker implantation to maintain adequate heart rates and prevent complications. This review highlights the need for further research on AF-SVR, particularly regarding non-invasive treatment options and the long-term outcomes of different management strategies. Understanding the unique challenges of AF-SVR is essential for optimizing patient care and improving clinical outcomes. Future studies should focus on establishing comprehensive guidelines for the diagnosis and management of AF-SVR.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"9 ","pages":"27550834251342890"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guide for educators to implement newly developed course on the risk of substandard and falsified medical products sold online.","authors":"Aysu Selçuk, Zuzana Kusynová, John B Hertig","doi":"10.1177/27550834251342900","DOIUrl":"10.1177/27550834251342900","url":null,"abstract":"","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"9 ","pages":"27550834251342900"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sphenopalatine ganglion (SPG) blocks: Evidence and implementation for acute migraine treatment in the primary care setting.","authors":"Jason Cook, Alexis Flen, Sarah Holdren","doi":"10.1177/27550834251337342","DOIUrl":"10.1177/27550834251337342","url":null,"abstract":"<p><strong>Background: </strong>Sphenopalatine ganglion (SPG) blocks may be effective and affordable treatments for acute migraine but are rarely used in the primary care setting, making them inaccessible treatment for those suffering from migraine.</p><p><strong>Objective: </strong>To outline evidence for the use of SPG block in the treatment of acute migraine. To determine the feasibility and effectiveness of primary care in-office and at-home SPG block administration.</p><p><strong>Methods: </strong>A retrospective chart review of patients receiving in-office or at-home SPG block to treat acute migraine was completed. Pre- and post-treatment pain measurements were the primary outcome, along with patient-reported adverse effects.</p><p><strong>Results: </strong>Results from this study revealed that 87% of SPG block administrations (via catheter and atomizer) resulted in pain relief with minimal adverse effects. Methods and materials for catheter and atomizer administration of SPG blocks are outlined, in addition to tips for integrating this service into primary care practices.</p><p><strong>Conclusions: </strong>This study showed that SPG blocks may be administered effectively in primary care settings or at home with proper patient education and are an effective treatment modality to decrease pain associated with acute migraine.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"9 ","pages":"27550834251337342"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stokes-Adams syndrome, a rarely reported disease.","authors":"Camilo Andrés Rincón Romero, Sebastián Forero Amézquita, Julio César Velasco Castro, Lorena García Agudelo","doi":"10.1177/27550834251322007","DOIUrl":"10.1177/27550834251322007","url":null,"abstract":"<p><p>Stokes-Adams syndrome is defined as a transient loss of consciousness with spontaneous recovery after a decrease in cardiac output that leads to a state of cerebral hypoxia and may cause seizures. It is a rare and poorly documented condition. High-degree atrioventricular block, paroxysmal ventricular arrest, and pulseless ventricular tachycardia have been described as causes, and depending on the case, temporary or permanent pacemaker implantation or cardiac defibrillation may be necessary. We present the case of a 78-year-old male patient with Stokes-Adams syndrome secondary to 2:1 atrioventricular block requiring definitive pacemaker implantation without recurrence of syncopal or convulsive episodes. It is important to consider Stokes-Adams syndrome as a possible cause of syncope or seizures and that the recognition of this disease through an adequate clinical history and interpretation of paraclinical tests can save lives due to the risk of sudden death. There is not much information about this syndrome, since there are few cases reported in the literature.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"9 ","pages":"27550834251322007"},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multifocal brown tumors: A case report and literature review.","authors":"Mainak Roy, Samir Dwidmuthe","doi":"10.1177/27550834251322005","DOIUrl":"10.1177/27550834251322005","url":null,"abstract":"<p><p>Brown tumors, though rare, are significant manifestations of hyperparathyroidism, often presenting with multifocal osteolytic lesions and occasionally leading to pathological fractures. This case report details the presentation and management of a 38-year-old male with multifocal brown tumors, including a right tibial fracture, and provides a comprehensive literature review. The patient exhibited multiple osteolytic lesions in the legs, thighs, and forearms, alongside elevated serum calcium and parathyroid hormone (PTH) levels. Management included conservative fracture treatment, surgical resection of the parathyroid adenoma, and postoperative rehabilitation. Follow-up revealed significant tibial fracture healing and reduction in the size of osteolytic lesions. This report underscores the importance of timely diagnosis and comprehensive management to prevent complications and improve outcomes in patients with multifocal brown tumors.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"9 ","pages":"27550834251322005"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aligning our actions with our words: A systematic review of gender and racial diversity in surgical subspecialties.","authors":"Joshua E Lewis, Lornee C Pride, Hannah G Luk, Kafayat Oyejide, Isha M Wilson, Winston E Tawiah, Cale M Watkins, Wei-Chen Lee","doi":"10.1177/27550834241293022","DOIUrl":"10.1177/27550834241293022","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent racial and gender disparities are prevalent within the higher education and medical training system, notably seen in the underrepresentation of Hispanic or Latinos, Black Americans, and female surgeons compared to their respective population proportions. This study aims to quantify publications addressing ethnic or gender diversity across various surgical specialties, analyze publication trends, and explore specific topics within medical literature.</p><p><strong>Database: </strong>The Database includes PubMed, Google Scholar, and Scopus.</p><p><strong>Methods: </strong>Employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we conducted a systematic literature review utilizing the PubMed, Google Scholar, and Scopus databases. A broad inclusion criterion for both ethnic and gender diversity of plastic surgery, neurosurgery, otolaryngology, dermatology, orthopedic surgery, and gender surgery was utilized. The literature was selected between 2014 and 2024. In the content of our study, diversity in articles was defined as any article that focused on addressing gender or racial/ethnicity in the subspecialty.</p><p><strong>Results: </strong>Of 1529 initially screened articles, 346 were included. Orthopedic surgery had the most diversity publications (n = 86), followed by general surgery (n = 67) and plastic surgery (n = 51). Significant increases in diversity publications were observed across all specialties. Orthopedic surgery showed the highest growth (+0.17 publications/year, p < 0.001), followed by plastic surgery (+0.12, p = 0.002) and general surgery (+0.11, p = 0.003). Race/ethnicity was the primary focus (51.4%), with fewer articles on gender (19.7%) or both (28.9%). Diversity topics included demographics, pipeline/recruitment, application process, training experience, leadership, and workplace treatment.</p><p><strong>Conclusion: </strong>These insights underscore the importance of continued efforts to promote diversity within surgical specialties to enhance patient care and outcomes. Further research and initiatives are needed to ensure equitable representation in surgical fields. Addressing diversity issues in surgical specialties is essential for improving healthcare outcomes and reducing disparities.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"8 ","pages":"27550834241293022"},"PeriodicalIF":0.0,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Out-of-pocket healthcare expenditure in emerging economies: Evidence from panel data analysis.","authors":"Sanju Kaladharan, Dhanya Manayath","doi":"10.1177/27550834241262108","DOIUrl":"10.1177/27550834241262108","url":null,"abstract":"<p><strong>Background: </strong>Achieving universal health coverage is one of the prominent targets of the United Nations' sustainable development goals. Reducing out-of-pocket expenditure (OOPE) is essential because high OOPE can deter the use of healthcare services, which can lead to poor health outcomes and medical impoverishment.</p><p><strong>Objectives: </strong>The study sought to determine the effects of various factors such as Domestic General Government Health Expenditure, Gross Domestic Product, Government schemes and compulsory contributory healthcare financing schemes, and Voluntary health insurance schemes on OOPE per Capita in emerging economies.</p><p><strong>Design: </strong>Econometric methods using panel data.</p><p><strong>Data sources and methods: </strong>The study analyzed the publicly available panel data from the World Health Organization using fixed, random, and dynamic models.</p><p><strong>Results: </strong>Domestic General Government Health Expenditure and Gross Domestic Product are associated with an increase in OOPE. Government schemes, compulsory contributory healthcare financing schemes, and voluntary health insurance programs are linked to a reduction in OOPE.</p><p><strong>Conclusion: </strong>In conclusion, this study, conducted through econometric methods on panel data, sheds light on the critical importance of reducing OOPE to achieve universal health coverage, aligning with the United Nations' sustainable development goals. Countries shall implement a holistic approach focusing on preventive healthcare and health promotion, providing comprehensive health insurance, strengthening public health systems, and regulating medicine prices.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"8 ","pages":"27550834241262108"},"PeriodicalIF":0.0,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11337179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of antiretroviral, antimalarial and antituberculosis medicines in Zambia: Findings of routine post-marketing surveillance.","authors":"Elimas Jere, Derrick Munkombwe, Moses Mukosha, Steward Mudenda, Aubrey Chichonyi Kalungia, Billy Chabalenge","doi":"10.1177/27550834241266755","DOIUrl":"10.1177/27550834241266755","url":null,"abstract":"<p><strong>Background: </strong>There is growing concern in sub-Saharan Africa that poor-quality antimicrobial medicines may negate management of infectious diseases of public health importance should they fail to meet the set criteria of quality, safety and efficacy.</p><p><strong>Objectives: </strong>The objective was to ascertain the quality of antiretroviral, antimalarial and antituberculosis medicines supplied and available in the public health sector in Zambia.</p><p><strong>Design: </strong>A descriptive cross-sectional study was conducted involving the analysis of data from the continuous routine in-country post-marketing surveillance programme in Zambia that assessed the quality of antiretroviral, antimalarial and antituberculosis medicines supplied to public healthcare facilities between January 2018 and June 2023.</p><p><strong>Methods: </strong>Data were extracted from laboratory quality analysis results from samples collected as part of routine post-marketing surveillance by the Zambia Medicines Regulatory Authority between January 2018 and June 2023. The samples were collected from various levels of the pharmaceutical supply chain across Zambia. Samples were analysed according to their respective pharmacopoeia standards at the Medicines Control Authority of Zimbabwe Quality Control Laboratory, a World Health Organization prequalified laboratory. Data were extracted using a structured Excel database and analysed using Microsoft Excel, and GraphPad Prism Software was used for visualizations.</p><p><strong>Results: </strong>Of the 198 samples, 86 (43.43%) were antiretrovirals, 54 (27.27%) antimalarials and 58 (29.29%) antituberculosis medicines. Of these 198 samples, 171 (86.36%) originated from Asia, 19 (9.60%) Africa and 8 (4.04%) Europe. All sampled medicines met their respective quality specifications with respect to tests, which included appearance, identification, assay, uniformity of mass, weight variation, disintegration, dissolution, pH and specific gravity, giving a compliance rate of 100%.</p><p><strong>Conclusion: </strong>Antiretrovirals, antimalarials and antituberculosis medicines obtained from public healthcare facilities in Zambia through routine post-marketing surveillance met their quality standards. This might positively impact treatment outcomes for HIV/AIDS, malaria and tuberculosis. There is a need for large-scale continuous monitoring of the quality of medicines in order to ensure quality is maintained and substandard products removed from the pharmaceutical supply chain.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"8 ","pages":"27550834241266755"},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and barriers in acceptance of telemedicine among healthcare providers in Pakistan: A cross-sectional survey.","authors":"Muhammad Wasi Abbas, Hasan Nawaz Tahir, Nazish Jaffar, Ghana Raza, Syed Aman Ali, Rawshan Jabeen","doi":"10.1177/27550834241266413","DOIUrl":"10.1177/27550834241266413","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess healthcare professionals' awareness and acceptance of telemedicine residing in Pakistan.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted across Pakistan from November 2021 to March 2022. Data entry was done through a self-administered questionnaire. In this survey, the non-probability purposive sampling method was adopted. Medical doctors from all specialties that fall into the age category of 20-60 years were included in this study. Statistical Package for Social Sciences (SPSS) version 22.0 was used for univariate data analysis.</p><p><strong>Results: </strong>Among the 860 healthcare professionals who received the survey, 198 responded (23.0% response rate). The mean ± SD age of the participants was 31.16 ± 8.56. The results were found to be statistically significant for knowledge about telemedicine among healthcare professionals workplace, that is, healthcare professionals working in the private sector indicated a high level of awareness regarding telemedicine as compared to those in the public sector (<i>p</i> = 0.03). A significant difference (<i>p</i>-value ⩽ 0.05) in knowledge was seen among doctors working in the public sector and those working in a private setup. Results indicate significant positive associations between telemedicine utilization and perceived benefits over disadvantages (<i>β</i> = 1.03, <i>p</i> = 0.017), reliance among healthcare professionals (β = 1.22, <i>p</i> = 0.008), and enhancement in healthcare quality (<i>β</i> = 1.42, <i>p</i> = 0.001). Moreover, familiarity with telemedicine correlates strongly with its usage (<i>β</i> = 2.56, <i>p</i> < 0.000).</p><p><strong>Conclusion: </strong>Overall, healthcare professionals exhibited satisfactory knowledge regarding telemedicine and showed an accepting attitude toward telemedicine. Our study recommends enhancing the importance of Telemedicine training at the Healthcare professionals' level to produce quality service delivery in healthcare organizations.</p>","PeriodicalId":75087,"journal":{"name":"The journal of medicine access","volume":"8 ","pages":"27550834241266413"},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}