RESUMEN
Sickle cell disease is a prime example of the devastating impact of healthcare inequities. The End Sepsis Initiative developed after a tragic death due to sepsis, provides a powerful model for the sickle cell community. This model recognizes the importance of evidence-based protocols and policy recommendations/mandates to drive transformative systems change. We propose that the sickle cell community mirror this approach. We propose that hospital systems, healthcare organizations, and insurers implement evidence-based protocols, including personalized pain plans, stigma reduction through staff training, vaccinations, preventative screening, disease-modifying therapies, pediatric to adult transition, and connecting unaffiliated SCD patients to a medical home. We recommend state-level interventions, such as using SCD navigator in electronic health records for quality reporting, supporting community health workers' use, and ensuring rural hospitals have access to SCD specialists.
Asunto(s)
Anemia de Células Falciformes , Política de Salud , Accesibilidad a los Servicios de Salud , Disparidades en Atención de Salud , Sepsis , Humanos , Anemia de Células Falciformes/terapia , Estados UnidosRESUMEN
Meeting best-practice guidelines can significantly enhance quality of life and longevity for those with sickle cell disease (SCD). However, many clinical settings lack the necessary resources for optimal care. We present an integrated suite of tools and collaborative actions designed to enhance SCD care.
Asunto(s)
Anemia de Células Falciformes , Anemia de Células Falciformes/terapia , Humanos , Niño , Calidad de la Atención de Salud/organización & administración , Calidad de la Atención de Salud/normas , Guías de Práctica Clínica como AsuntoRESUMEN
Cancer of the colon is the second most common visceral cancer in the United States (lung cancer is the first). It is usually diagnosed in patients older than 40 years, with a peak incidence at 70 years of age. Rarely, are cases seen in the pediatric population. In this study, we report a case of a 13-year-old girl with an 11-month history of intermittent abdominal pain whose diagnosis was delayed due to vague symptoms and a low index of suspicion for this condition.
Asunto(s)
Dolor Abdominal/diagnóstico por imagen , Adenocarcinoma/diagnóstico por imagen , Carcinoma de Células en Anillo de Sello/diagnóstico por imagen , Neoplasias Retroperitoneales/diagnóstico por imagen , Dolor Abdominal/patología , Dolor Abdominal/cirugía , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Adolescente , Carcinoma de Células en Anillo de Sello/patología , Carcinoma de Células en Anillo de Sello/cirugía , Resultado Fatal , Femenino , Humanos , Estadificación de Neoplasias , Neoplasias Retroperitoneales/patología , Neoplasias Retroperitoneales/cirugía , Tomografía Computarizada por Rayos XRESUMEN
Congenital hypofibrinogenemia is a rare coagulation disorder characterized by a deficiency in fibrinogen protein, which is critical to the normal coagulation process. This hematological disorder can go undiagnosed until an event leads to prolonged bleeding. The purposes of this report were to describe an incidental diagnosis of congenital hypofibrinogenemia after a dental procedure, discuss the importance of recognizing coagulopathies on the delivery of dental care, examine the multi-disciplinary clinical management of prolonged bleeding after a dental procedure, and evaluate the challenges health care practitioners may encounter when obtaining a thorough medical history.