State and national guidelines recommend that prescribing opioids for chronic pain should be based on patients’ progress towards mutually agreed on, objective treatment goals. Physicians lack practical advice on discussing goals. We lack research on how, when, and why patients with chronic pain discuss treatment goals during clinic visits.
Over a quarter of the world’s population is infected with Tuberculosis (TB)1 and 5-10% of cases of latent TB infection (LTBI) progress to active TB in an individual’s lifetime.Though screening tests are widely utilized for diagnosing LTBI, they are far from perfect.This describes a case of disseminated TB in a patient treated with aggressive immunosuppression after a false-negativeQuantiFERON-TB Gold test.
Endometriosis: ectopic endometrial tissue that responds to cyclical hormonal changes during a normal menstrual cycle, becoming trapped in an endometrioma and causing pain. NHPs have been used to study endometriosis: baboons, cynomolgus, rhesus, and marmoset monkeys.
Approximately 20% of the US adult population experiences chronic pain.1 In one study, 59% of hospitalized patients reported pain, with 10% reporting inadequately controlled pain.2 Yet, little research has been conducted on how physicians communicate with each other about pain, especially during end-of-shift handoffs. Research question: how do resident and attending physicians discuss pain in end-of shift handoffs?
According to the CDC, chlamydia and gonorrhea are the most reported bacterial STIs in the United States and their rates are increasing. The CDC guidelines were updated in December 2020 to suggest a single IM dose of 500mg of ceftriaxone for treatment of gonorrhea, and if chlamydial infection is not excluded, a dual therapy combined with 100mg doxycycline 2x/day for 7 days. Inappropriate antibiotic use has contributed to growing resistance. It is important for health care providers to follow evidence-based treatment guidelines to prevent further AMR and ensure the best possible outcomes for patients. But are providers away of these new guidelines and have they accepted them into their practice? This exploratory study aims to determine how providers with different levels of background and experience will treat gonorrhea and chlamydia infections.
The US Census Bureau reports that 15.8% are living at or below the federal poverty level. Additionally, 6.1% of Sacramento County residents under the age of 65 are without health insurance. California’s Family Planning Access Care and Treatment (Family PACT) program was established to ensure that California residents living at or below 200% of the Federal Poverty Level and who do not qualify for health services under Medi-Cal have access to desired contraceptive services (Early, 2018). However, a 2018 study on the availability of long-acting reversible contraception (LARC) provided by Family PACT clinics in Los Angeles County found that of the 336 clinics listed on the Family PACT program website, only 284 were currently participating in Family PACT. Of those clinics that were currently participating in Family PACT, only 61% were able to provide LARC onsite (Natavio, 2018). Since that time, the Family PACT program has issued new guidance instructing all participating clinics to offer LARC onsite. Yet, more recent studies have demonstrated that wide variation even among LARC services offered in these publicly funded centers still remains (Bornstein, 2018).
Undesired pregnancies are difficult for Californian families and costly for the state which covers 50% of deliveries. California’s Family Planning Access Care and Treatment (Family PACT) program is charged with providing free contraceptive services to uninsured individuals living in California, at or below 200% of the Federal Poverty Level. In theory, eligible individuals can enroll in the Family PACT program at the time of a clinic visit and receive same-day clinical services at no cost.
Up to 25% of US women regret having undergone surgical sterilization. Intrauterine contraception (IUC) can be safely used for up to 20 years offering rapidly-reversible contraception that is as effective as surgical sterilization. FamilyPACT covers service for Californians living at or below 200% of the Federal Poverty Level, who do not meet criteria for Medi-Cal eligibility. Discriminatory medical practices have long-term effects on minority communities’ trust in the healthcare system. California has a problematic history of eugenics practices that spanned over 70 years, until 2010.
• Lower respiratory tract infections are the top cause of infectious disease-related deaths in the world.
• The causative pathogen is detectable in only 38% of adults with community acquired pneumonia.
• Time to diagnosis of pathogen is directly correctly with mortality.
• The widespread use of broad-spectrum empiric treatment contributes to the proliferation of antimicrobial resistance.
• Next Generation Sequencing could offer potential for early identification.
