The American journal of medicine
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Limited English proficiency (LEP) is defined as individuals in whom English is not the primary language and who have limited ability to read, speak, write, or understand the English language. Cardiovascular (CV) team members routinely encounter language barriers in their practice. These barriers have a significant impact on the quality of CV care that patients with LEP receive. ⋯ Although well recognized, the initial step will be to continue to highlight the importance of language needs identification and appropriate use of professional interpreter services. In parallel, a health system-level approach is essential that describes initiatives and key policies to ensure a high-level quality of care for a growing LEP population. This review aims to present the topic of LEP during the CV care of older adults, for continued awareness along with practical considerations for clinical use and directions for future research.
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Acute kidney injury is prevalent among hospitalized veterans, and associated with increased risk of death following discharge. However, risk factors for death following acute kidney injury have not been well defined. We developed a mortality prediction model using Veterans Health Administration data. ⋯ We identified risk factors for long-term mortality following acute kidney injury. Our 10-variable model did not include traditional renal variables, suggesting that non-kidney factors contribute to the risk of death more than measures of kidney disease in this population, a finding that may have implications for post-acute kidney injury care.
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Osteoarthritis is a common cause of morbidity in an increasingly aging population. Although the weight-bearing joints of the leg and foot are frequently affected by osteoarthritis, degenerative changes in the joints of the upper extremity are likewise common and can be both particularly debilitating for affected individuals and uniquely challenging for the health care providers managing it. The present review seeks to overview the epidemiology, anatomy, diagnosis, and management of osteoarthritis in the joints of the shoulder, elbow, and hand with the intent of providing accessible and relevant information to the range of medical professionals involved in patient care.