Date Presented 04/03/2025 An estimated 5.2 million veterans face mental health challenges. Cobb County’s Veterans Treatment Court (VTC), established in 2014, offers a diversion program for justice-involved veterans. This study explores staff’s and students’ perceptions of OT services. Primary Author and Speaker: Alexis Hawkins Additional Authors and Speakers: Mary Shotwell, Daphyne Ewings, Yolanda Young Contributing Authors: Daphyne Ewings, Yolanda Young, Mary Shotwell, Emily Riggs, Amy Shaffer
BACKGROUND: There have been conflicting results on the association of asthma with the severity of coronavirus disease 2019 (COVID-19). Poor metabolic health has been previously associated with both severe COVID-19 and inflammation in asthma. OBJECTIVES: To examine the association between asthma and COVID-19 outcomes and whether these associations are modified by metabolic syndrome. METHODS: We performed an international, observational cohort study of adult patients hospitalized for COVID-19 from February 2020 through October 2021. The primary outcome was hospital mortality. RESULTS: The study included 27,660 patients from 164 hospitals, 12,114 (44%) female, with a median (interquartile range) age of 63 years (51-75). After adjusting for age, sex, smoking, race, ethnicity, geographic region, and Elixhauser comorbidity index, we found that patients with asthma were not at greater risk of hospital death when compared with patients with no chronic pulmonary disease (controls) (adjusted odds ratio [aOR], 0.97; 95% CI, 0.90-1.04; P = .40). Patients with asthma, when compared with controls, required higher respiratory support identified by the need for supplemental oxygen (aOR, 1.07; 95% CI, 1.01-1.14; P = .02), high-flow nasal cannula or noninvasive mechanical ventilation (aOR, 1.06; 95% CI, 1.00-1.13; P = .04), and invasive mechanical ventilation (aOR, 1.09; 95% CI, 1.031.16; P = .003). Metabolic syndrome increased the risk of death in patients with asthma, but the magnitude of observed association was similar to controls in stratified analysis (interaction P value .24). CONCLUSIONS: In this international cohort of hospitalized COVID-19 patients, asthma was not associated with mortality but was associated with increased need for respiratory support. Although metabolic dysfunction was associated with increased risks in COVID-19, these risks were similar for patients with or without asthma. (c) 2024 American Academy of Allergy, Asthma & Immunology
ABSTRACT Venous thromboembolism (VTE) is a major issue in trauma patients. Without prophylaxis, the rate of deep venous thrombosis approaches 60% and even with chemoprophylaxis may be nearly 30%. Advances in VTE reduction are imperative to reduce the burden of this issue in the trauma population. Novel approaches in VTE prevention may include new medications, dosing regimens, and extending prophylaxis to the postdischarge phase of care. Standard dosing regimens of low-molecular-weight heparin are insufficient in trauma, shifting our focus toward alternative dosing strategies to improve prophylaxis. Mixed data suggest that anti-Xa–guided dosage, weight-based dosing, and thromboelastography are among these potential strategies. The concern for VTE in trauma does not end upon discharge, however. The risk for VTE in this population extends well beyond hospitalization. Variable extended thromboprophylaxis regimens using aspirin, low-molecular-weight heparin, and direct oral anticoagulants have been suggested to mitigate this prolonged VTE risk, but the ideal approach for outpatient VTE prevention is still unclear. As part of the 2022 Consensus Conference to Implement Optimal Venous Thromboembolism Prophylaxis in Trauma, a multidisciplinary array of participants, including physicians from multiple specialties, pharmacists, nurses, advanced practice providers, and patients met to attack these issues. This paper aims to review the current literature on novel approaches for optimizing VTE prevention in injured patients and identify research gaps that should be investigated to improve VTE rates in trauma.
Slipping rib syndrome has remained a lesser-known entity despite its presence in the medical literature for over 100 years. If left undiagnosed, it can be associated with significant morbidity. Operative repair for the syndrome remains the definitive treatment. Traditional repair involved rib resection which can be technically challenging and have painful recovery. Minimal invasive techniques have been described recently which circumvent these issues. Here, we present our experience with our minimally invasive realignment technique for slipping rib syndrome. Our data suggested early hospital discharge, minimal perioperative complication, and near complete resolution of symptoms. We advocate for further research to enhance timely recognition and management for this entity and additionally recommend minimally invasive operative approach for definitive treatment.
Envenomation syndromes following snakebites can include tissue reaction, coagulopathy, nephrotoxicity, and neurotoxicity. Cardiotoxicity is rare but usually presents with dysrhythmias. Myocardial infarction after envenomation has rarely been reported. We discuss a case of snake bite simulating ST-elevation myocardial infarction (STEMI). Our patient is a 49-year-old male who sustained a snake bite in his left hand. Patient had hemodynamic collapse requiring increasing pressor support; EKG and troponin results confirmed STEMI. Cardiac catheterization did not demonstrate any thrombosis, rather severe cardiomyopathy with left ventricular ejection fraction 20-25%. Even though our patient did not require any coronary intervention, an angiogram was warranted given the clinical presentation. Our case demonstrates severe cardiotoxicity following snake bite. Further research is warranted to study the mechanism behind such phenomena.
