Background and objectives AA-type kidney amyloidosis is classically associated with chronic autoimmune or inflammatory disorders. However, some urban centers have reported a high prevalence of injection drug use among patients with kidney AA amyloidosis. Previous reports lack control groups to quantify associations and most predate the opioid epidemic in the United States.Design, setting, participants, & measurements We conducted a case-control study of 38 patients with biopsyconfirmed kidney AA amyloidosis and 72 matched control individuals without this condition from two large hospital systems in Seattle, Washington. We ascertained the pattern and duration of heroin use by medical chart review and determined associations using logistic regression.Results Among case patients, 95% had a prior history of heroin use, 87% had skin abscesses, and 76% and 27% had evidence of muscling and skin popping, respectively. After adjustment for age, race, sex, site, and year of biopsy, any heroin use (past or current) was associated with an estimated 170-times higher risk of kidney AA amyloidosis compared with no heroin use (95% confidence interval, 28 to 1018 times higher; P,0.001). Chronic autoimmune disorders were uncommon among case patients in this study. The median time to ESKD among patients with AA amyloidosis was 2.4 years (interquartile range, 0.5-7.5 years).Conclusions Injection heroin use is strongly associated with kidney AA amyloidosis in the Pacific Northwest. Unique aspects of heroin use, in particular geographic regions or frequent associated soft-tissue infections, may be an important cause of this progressive kidney disease.
Airway management is a common and critical procedure in acute settings, such as the Emergency Department (ED) or Intensive Care Unit (ICU) of hospitals. Many of the traditional physical examination methods have limitations in airway assessment. Point-of-care ultrasound (POCUS) has emerged as a promising tool for airway management due to its familiarity, accessibility, safety, and non-invasive nature. It can assist physicians in identifying relevant anatomy of the upper airway with objective measurements of airway parameters, and it can guide airway interventions with dynamic real-time images. To date, ultrasound has been considered highly accurate for assessment of the difficult airway, confirmation of proper endotracheal intubation, prediction of post-extubation laryngeal edema, and preparation for cricothyrotomy by identifying the cricothyroid membrane. This review aims to provide a comprehensive overview of the key evidence on the use of ultrasound in airway management. Databases including PubMed and Embase were systematically searched. A search strategy using a combination of the term “ultrasound” combined with several search terms, i.e., “probe”, “anatomy”, “difficult airway”, “endotracheal intubation”, “laryngeal edema”, and “cricothyrotomy” was performed. In conclusion, POCUS is a valuable tool with multiple applications ranging from pre- and post-intubation management. Clinicians should consider using POCUS in conjunction with traditional exam techniques to manage the airway more efficiently in the acute setting.
This cross-sectional study uses a forecasting model to assess the potential loss of pediatric ophthalmology care in the US due to potential ophthalmologist retirement.
Background Asset mapping is a commonly used method in public health to identify and describe the resources within a community. However, there is currently a lack of standardization in the methods used for asset mapping, which can make it difficult for users to apply the method and compare results between different studies. In this article, we present a new approach called Asset Mapping Score Analysis (AMSA), which is a framework for collecting and organizing data on community assets. We provide an example of the AMSA method through its application in the evaluation of maternal and child health resources in New Orleans, Louisiana. Results The AMSA approach consists of five steps and results in a data collection tool that uses a scoring system to quantify the functional and content areas defined by the users. This method is flexible, reproducible, quantitative, inexpensive, and can be adapted to fit the needs of different geographic areas and fields of study. It can also be repeated over time to monitor changes in systems. We conducted a pilot study to examine the participation of local maternal and child health organizations in four functional areas (education, direct services, policy/advocacy, and research) and 22 content areas. Conclusions In addition to describing the AMSA method and providing an example of its application, we also discuss the methodological issues involved in using the AMSA approach. These include considerations related to study design, data analysis, and interpreting results. We assess the strengths, limitations, and potential future directions of the AMSA method. Finally, we present the results of our AMSA study on maternal and child health organizations in New Orleans to illustrate the utility of this approach. Our findings suggest that the AMSA method is a valuable tool for understanding and characterizing the assets and resources within a community.
Background Asset mapping is a commonly used method in public health to identify and describe the resources within a community. However, there is currently a lack of standardization in the methods used for asset mapping, which can make it difficult for users to apply the method and compare results between different studies. In this article, we present a new approach called Asset Mapping Score Analysis (AMSA), which is a framework for collecting and organizing data on community assets. We provide an example of the AMSA method through its application in the evaluation of maternal and child health resources in New Orleans, Louisiana. Results The AMSA approach consists of five steps and results in a data collection tool that uses a scoring system to quantify the functional and content areas defined by the users. This method is flexible, reproducible, quantitative, inexpensive, and can be adapted to fit the needs of different geographic areas and fields of study. It can also be repeated over time to monitor changes in systems. We conducted a pilot study to examine the participation of local maternal and child health organizations in four functional areas (education, direct services, policy/advocacy, and research) and 22 content areas. Conclusions In addition to describing the AMSA method and providing an example of its application, we also discuss the methodological issues involved in using the AMSA approach. These include considerations related to study design, data analysis, and interpreting results. We assess the strengths, limitations, and potential future directions of the AMSA method. Finally, we present the results of our AMSA study on maternal and child health organizations in New Orleans to illustrate the utility of this approach. Our findings suggest that the AMSA method is a valuable tool for understanding and characterizing the assets and resources within a community.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.