Southern medical journal
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Southern medical journal · Feb 2025
Undervaluation of Perioperative Work for ACL Reconstruction by Relative Value Scale Update Committee Methodology in a Single Surgeon's Practice.
The purpose of this study was to determine the accuracy of the Relative Value Update Committee (RUC) and Centers for Medicare & Medicaid Services current times and work relative value units (wRVUs) for the perioperative work involved in anterior cruciate ligament (ACL) reconstruction by directly timing perioperative tasks as they occur in real time. ⋯ The perioperative wRVU assigned by the RUC underestimates the amount of time assigned to perform the required tasks. The RUC should consider using prospective times collected by physicians to calculate a more accurate wRVU. In addition, the RUC should consider how modern patient care practices and requirements have increased the intensity of work for physicians.
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Understanding the epidemiology of treatment for patients with co-occurring depression and obesity can inform care quality. The objective of the study was to identify how patients with obesity and newly diagnosed depression are treated and whether treatment is associated with body mass index change. ⋯ There is an opportunity to increase treatment for obesity among patients with newly diagnosed depression.
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Southern medical journal · Feb 2025
ReviewAlpelisib-Induced Hyperglycemia in PIK3CA+ Breast Cancer Patients.
Alpelisib is a phosphatidylinositol 3-kinase inhibitor approved by the US Food and Drug Administration for the treatment of hormone receptor-positive metastatic breast cancer with PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit α) mutation. In recent years a number of adverse effects have been observed to be associated with this therapy, the most notable of which is hyperglycemia. A literature search was conducted to include case studies, case series, systematic reviews, and meta-analyses within the last 10 years that evaluated patients with PIK3CA-mutated hormone receptor-positive, human epidermal growth factor receptor 2 negative metastatic breast cancer. ⋯ Hyperglycemia was manageable with antihyperglycemic agents and dose modification/discontinuation of alpelisib with no severe progression. Other notable adverse effects were rash, stomatitis, diarrhea, pneumonitis, reduced appetite, elevated liver enzymes, nausea, fatigue, and rare reports of diabetic ketoacidosis. This literature review aims to highlight the incidence and risk factors of alpelisib-induced hyperglycemia in greater depth.
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Southern medical journal · Feb 2025
Maternal and Infant Outcomes in a Subset of Patients with Sickle Cell Disease in South Carolina.
Sickle cell disease (SCD), which disproportionately affects minorities, increases complications during pregnancy. Severe maternal mortality is increased in women with SCD, including morbidity related to the disease and other nondisease-related complications. It also can have devastating complications for fetuses, with increases in premature birth and low birth weight. This study aimed to describe the characteristics of women with SCD in South Carolina, with a specific focus on fetal and maternal outcomes and complications. The secondary aim of this study was to identify the effect of maternal characteristics on birth outcomes, including social determinants of health. ⋯ High rates of complications to both mother and infant were found in the women with SCD. Although few statistically significant predictors were found, by identifying and addressing specific needs of pregnant women with SCD, we can work toward reducing fetal and maternal mortality in an already vulnerable population.