Buckleysvenstrup3360

African Americans are significantly more likely than non-African Americans to have diabetes, chronic kidney disease, and uncontrolled hypertension, increasing their risk for kidney function decline.

The objective of this study was to compare how African Americans and non-African Americans with diabetes responded to a multifactorial telehealth intervention designed to slow kidney function decline.

Secondary analysis of a randomized trial. Primary care patients (N=281, 56% African American) were allocated to either (1) a multifactorial, pharmacist-delivered phone-based telehealth intervention focused on behavioral and medication management of diabetic kidney disease; or (2) an education control.

The primary study outcome was change in estimated glomerular filtration rate (eGFR). Linear mixed models were used to explore the moderating effect of race on the relationship between study arm and eGFR decline over time; the mean annual rate of eGFR decline was estimated by race and study arm.

Findings demonstrated a differential intervention effect on kidney function over time by race (Pinteraction=0.005). Among African Americans, the intervention arm had significantly greater preservation of eGFR over time than the control arm (difference in the annual rate of eGFR decline=1.5 mL/min/1.73 m; 95% confidence interval 0.04, 3.02). For non-African Americans, the intervention arm had a faster decline in eGFR over time than the control arm (difference in the annual rate of eGFR decline=-1.7 mL/min/1.73 m; 95% confidence interval -3.3, -0.02).

A multifactorial, pharmacist-delivered telehealth intervention for diabetic kidney disease may be more effective for slowing eGFR decline among African Americans than non-African Americans.

A multifactorial, pharmacist-delivered telehealth intervention for diabetic kidney disease may be more effective for slowing eGFR decline among African Americans than non-African Americans.

This study aimed to describe the characteristics of physician assistant (PA) programs developed in 3 previously defined time periods.

Data were extracted from the websites of 238 PA programs, including admissions, curriculum, faculty, and program characteristics. Institutional characteristics were gathered from the Carnegie Classification website and the US Census Bureau. Program characteristics were analyzed in 3 groups based on when the program was first accredited-early (before 1980), middle (1980-1999), and current (2000-2019).

Early (n = 40), middle (n = 69), and current (n = 129) phase programs are similar regarding the number of admissions, curriculum, faculty, program, and institutional characteristics. Program phase had the greatest effect on undergraduate GPA of matriculating students, the number of PA faculty at the rank of professor, and the size of the admitted cohort. The effect size was medium for outcomes including the number of required biology, chemistry, or physics prerequisites; the probability that the program required a graduate record examination for admission; the number of PA program faculty at the rank of associate professor; the annual tuition and fees; and the probability that the PA program was housed with a medical school.

The data describe some of the similarities and differences among the programs established in the 3 previously described time periods in the history of PA education. With the recent surge in new programs, there is value in deepening our understanding of how newer programs compare with more established programs.

The data describe some of the similarities and differences among the programs established in the 3 previously described time periods in the history of PA education. With the recent surge in new programs, there is value in deepening our understanding of how newer programs compare with more established programs.

Prospective cohort study.

The aim of this study was to identify treatment response trajectories in patients with low back pain (LBP) during and after multidisciplinary care in a tertiary spine center, and to examine baseline patient characteristics that can distinguish trajectories.

Treatment response is often heterogeneous between patients with LBP. Knowledge on key characteristics that are associated with courses of disability could identify patients at risk for less favorable outcome. This knowledge will help improve shared decision-making.

Adult patients with LBP completed questionnaires on disability (Pain Disability Index) and LBP impact (Impact Stratification of the National Institutes of Health minimal dataset) at baseline, 6, 12, 18, and 24 months' follow-up. Latent class analyses were applied to identify trajectories of disability and LBP impact. Baseline sociodemographic and clinical patient characteristics were compared between trajectory subgroups.

Follow-up was available for 996 patients on disability and 707 patients on LBP impact. Six trajectories were identified for both outcome measures. Three disability trajectories remained stable at distinct levels of severity (68% of patients) and three trajectories showed patterns of recovery (32%). For LBP impact there was one stable trajectory (17%), two slightly improving (59%), two recovering (15%), and one with a pattern of recovery and relapse (15%). Significant differences between trajectories were observed for almost all baseline patient characteristics.

On average, patients show moderate improvements in disability and LBP impact 2 years after visiting a multidisciplinary tertiary spine center. selleck screening library However, latent class analyses revealed that most patients belong to subgroups experiencing stable levels of disability and LBP impact. Differences in baseline patient characteristics were mostly associated with baseline levels of functioning, instead of (un)favorable outcome during follow-up.

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A retrospective study.

The aim of this study was to explore the relationship between postoperative neurological disturbance of the upper extremities (NDUE) after cervical laminoplasty and intervertebral foraminal stenosis.

The relationship between foraminal stenosis and neurological disturbance in the C5 segment (C5 palsy) has been reported, but the relationship at other levels has not been examined before. We evaluated foraminal stenosis morphologically using three-dimensional computed tomography (3D-CT), alongside other risk factors for NDUE.

We retrospectively reviewed patients treated by open-door laminoplasty at the authors' institution between January and June 2016. NDUE was defined as postoperative motor deterioration and/or newly emerged sensory disturbance within 2 weeks of surgery. Radiological measurements were performed in bilateral intervertebral foramina from C5 to C8, using 3D-CT. Investigation using magnetic resonance imaging (MRI) was also performed.

Thirty-one patients were reviewed, and 10 (32.