Sustained virologic response from hepatitis C from an emergency department screening & linkage program: A retrospective review.

INTRODUCTION: The role of the Emergency Department (ED) as a vital constituent in Hepatitis C (HCV) screening has become increasingly evident. A key component of the ED's role in HCV screening is the ability to effectively link HCV-RNA positive patients to definitive, HCV-specific care, to include direct-acting antiviral (DAA) medication with resultant sustained virologic response (SVR). We sought to consider the rate of HCV-specific linkage, DAA initiation, and SVR obtained in HCV patients identified from an ED screening program. METHODS: A retrospective chart review was conducted in February of 2022 of all individuals who participated in an opt-out ED-based HCV screening program between January 2018 and December 2019. Data was disaggregated by race, gender, age/birth cohort, insurance status, and achievement of sustained virologic response (SVR). Bivariate analysis using Pearson's chi-square was utilized to compare outcomes based on insurance status, race, sex, and birth cohort. RESULTS: Of 66,634 individuals screened for HCV during the study period, 885 (1.33%) patients were RNA-positive. Of those individuals, 121 (13.67%) were linked to HCV-specific care. Of those linked, the majority (66.9%) were male, white (66.1%; 33.1% Black), baby boomers or older (53.7%) and publicly insured (57.9%; private insurance 23.1%, self-pay 19%). Among linked patients, 88 (72.7%) started DAA medication. Mirroring linked demographics, majority were male (64.8%), white (64.8%), baby boomers or older (52.3%), and publicly insured (57.6%). White patients initiated on DAA were more likely to obtain SVR (64.9% versus 41.9% Black; p = .04) and uninsured patients were more likely to obtain SVR (82.4% versus 50.7% insured; p = .02). Bivariate consideration of SVR-patients specifically demonstrates that Black patients tended to be older, with significant overrepresentation of Baby boomers (77.5%) as compared to whites (37.5%; p < .0001). Black patients were also more likely to be publicly insured (82.5%) while white patients were more likely to have private insurance (28.8%) or be uninsured (26.3%) than their Black counterparts (12.5% and 5% respectively; p < .05). CONCLUSION: An ED-based HCV screening program can result in successful HCV-specific linkage and care, to include DAA initiation and ultimately, SVR. Among linked patients, specific cohort considerations may demonstrate differences in age and insurance status which may have implications on DAA application and adherence, and therefore, individual ability to achieve SVR.

Mineral Trioxide Aggregate May Be the Most Effective Direct Pulp Capping Material.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: The effect of dental pulp capping materials on hard-tissue barrier formation. Didilescu AC, Cristache CM, Andrei M, Voicu G, Perlea P. J Am Dent Assoc 2018; 149 (10):903 - 17. SOURCE OF FUNDING: None. TYPE OF STUDY/DESIGN: Systematic review and meta-analysis of data.

Use of Telepresence Robots in Glaucoma Patient Education.

PRCIS: Telepresence robots (TR) present the versatility to effectively provide remote educational sessions for patients affected by glaucoma to improve disease knowledge. Given COVID-19's effect on clinical practice, TR can maintain social distancing when educating patients. PURPOSE: TR are devices that allow remote users to have a mobile presence anywhere. We compared the effect of an education session given by an in-person educator versus a TR on glaucoma knowledge and identified factors that impact patient education. METHODS: Eighty-five glaucoma patients were split into control, human, and TR groups. We measured glaucoma knowledge scores (KS) using the National Eye Institute's Eye-Q Test. Human and TR groups had the education session with a human or TR followed by the questionnaire. The control group was administered the questionnaire without an education session. Treatment regimen recall (RR) >90% was considered a success. We used linear regression and binary logistic regression to determine variables that affect KS and RR, respectively. RESULTS: Mean age was 58.3±2.8 years. 49% were female. Mean KS were 5.8±0.7 in the control group (n=31), 7.9±0.5 in the TR group (n=26), and 8.4±0.5 in the human group (n=28). Control participants had a lower mean KS than the human or TR groups (P<0.001). Having the education session (2.5, P<0.001), education greater than high school (0.8, P=0.016), and diabetes (-0.7, P=0.037) affected KS. Having diabetes (odds ratio=0.14, P=0.014) negatively affected RR. Having the education session may affect RR (odds ratio=5.47, P=0.07), warranting additional studies. CONCLUSIONS: Education sessions with a human and TR improved patients' glaucoma KS. TRs may serve as an alternative to in-person education sessions and allow educators to safely and effectively educate patients remotely to adhere to COVID-19 social distancing guidelines.