RIvER Clinic: Rethinking Incarceration and Empowering Recovery-An Innovative Postincarceration Care Delivery Model Implemented During the COVID-19 Pandemic.

The Rethinking Incarceration and Empowering Recovery (RIvER) Clinic was launched in June 2021 to address the health disparities experienced during and after incarceration. The RIvER Clinic's multidisciplinary, community-centered team engages patients during jail detention and after release via telehealth, collocated in community locations, on a mobile van, and in clinic. The clinic serves as a bridge between incarceration and the establishment of permanent health care and social services in the community. In 2022, a total of 479 visits were completed. The clinic provided multidisciplinary substance use support to all eligible patients, paying for 104 medication for opioid use disorder (MOUD) prescriptions for uninsured patients. Twenty-five percent of patients were transitioned to community-based care, and less than 5% of patients were reincarcerated. Despite some limitations, results demonstrate that the RIvER Clinic is successfully reintegrating a marginalized population into its community. The purpose of this article is to describe the implementation and preliminary outcomes of this postincarceration clinic.

An Incidental Finding of Idiopathic Hypertrophic Pachymeningitis: A Case Report.

In this case report, we discuss and explore the clinical, laboratory, and imaging findings, as well as the treatment options and follow-up measures, in an 83-year-old patient with idiopathic hypertrophic pachymeningitis (IHP), a rare disorder characterized by fibrosing, hypertrophic inflammation that thickens the dura mater. An 83-year-old female with a medical history of hypertension and hyperlipidemia presented with speech arrest and was taken to the emergency department, where she received a stroke code, a CT scan, and an MRI. The MRI results showed a temporal lobe meningioma and a pan-cranial pachymeningitis encasing the entire brain and cerebellum and extending into the upper cervical spine. Multiple unsuccessful attempts at a lumbar puncture were made, so a dural biopsy specimen was obtained, which revealed no malignant process. A cerebral spinal fluid specimen (CSF) from the biopsy showed minimal white blood cells (WBCs) which ruled out infection. Idiopathic hypertrophic pachymeningitis was the given diagnosis based on the apparent MRI findings. The patient was treated in the hospital for four days with IV methylprednisolone and discharged on oral methylprednisolone for four to six weeks.