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North Carolina Medical Journal

Candice J McNeil, Laura H Bachmann
Syphilis continues to be a burden on the public health system. While men who have sex with men and HIV-infected individuals are the most affected populations, syphilis rates have also increased in reproductive-aged women, resulting in concurrent increases in congenital syphilis. Prompt diagnosis and treatment are requisite components of syphilis control.
September 2016: North Carolina Medical Journal
Nada Fadul
No abstract text is available yet for this article.
September 2016: North Carolina Medical Journal
David Alain Wohl
More than 1% of all adults in the United States are currently in a jail or prison. This mass incarceration, particularly of African American men, fosters conditions that facilitate the spread of HIV in communities where both HIV and incarceration are endemic. Recognition of the role of mass incarceration in the perpetuation of the HIV epidemic is essential to development of effective HIV prevention policies.
September 2016: North Carolina Medical Journal
David L Hill
The decision to exclude a child from day care or school leads to widespread educational, social, and economic ramifications for affected families. By understanding and improving how these decisions are made, health care providers and policy makers can promote child well-being throughout the state.
September 2016: North Carolina Medical Journal
Mark M Ash, Charles M Phillips
Parasitic diseases result in a significant global health burden. While often thought to be isolated to returning travelers, parasitic diseases can also be acquired locally in the United States. Therefore, clinicians must be aware of the cutaneous manifestations of parasitic diseases to allow for prompt recognition, effective management, and subsequent mitigation of complications. This commentary also reviews pharmacologic treatment options for several common diseases.
September 2016: North Carolina Medical Journal
Muhammad Salman Ashraf, Paul P Cook
Antibiotic misuse is common in the United States, but the causes of antibiotic misuse may differ from one health care setting to another. In this commentary, we describe the factors associated with inappropriate antibiotic prescriptions in hospital, outpatient, and long-term care settings, along with specific measures that can help prevent antibiotic misuse.
September 2016: North Carolina Medical Journal
Evette Cordoba, Allison E Aiello
Social determinants-such as education, race/ethnicity, socioeconomic status, access to health care services and vaccination, neighborhood-level stressors, and workplace or school policies-can impact influenza illness and outbreaks in the United States. To reduce transmission and disparities in influenza infection, policies should focus on removing existing vaccination barriers and supporting equitable social policies.
September 2016: North Carolina Medical Journal
Dennis Clements
Vaccines stimulate the immune system, mimicking infectious attacks and thereby promoting the development of protective antibodies and/or cellular immunity so that the body is immune to infection when live native infections attack. Some of these infections are associated with cancer-causing changes in the body; thus some vaccines may help prevent cancer.
September 2016: North Carolina Medical Journal
Zack Moore, Corrianne Billings, Chris DeRienzo
With increased federal and state attention to prevention and control of health care-associated infections (HAIs), broad multifacility collaboratives have emerged to guide providers' work at the bedside. This commentary reviews how HAI prevention flows from federal-level guidance through state leadership and into hospitals, connecting governance to its impact on North Carolina's patients.
September 2016: North Carolina Medical Journal
Tom Linden
No abstract text is available yet for this article.
September 2016: North Carolina Medical Journal
Brian D Byrd
Mosquito-borne diseases remain a significant cause of economic, social, and health burdens in North Carolina. Although recently overshadowed by emerging threats such as chikungunya virus and Zika virus, La Crosse virus and other endemic arboviruses remain persistent environmental health hazards. Indeed, La Crosse virus, West Nile virus, and Eastern equine encephalitis virus accounted for more than 98% of the reported human arboviral diseases acquired in North Carolina in the past decade. Arbovirus infection is increasingly prevalent in Western North Carolina, with La Crosse encephalitis being endemic in this area...
September 2016: North Carolina Medical Journal
Philip D Sloane, Kirk Huslage, Christine E Kistler, Sheryl Zimmerman
Antibiotic stewardship is becoming a requirement for nursing homes. Programs should be interdisciplinary and multifaceted; should have support from nursing home administrators; and should aim to promote antibiotics only when needed, not just in case. Recommended components include use of evidence-based guidelines; ongoing monitoring of antibiotic prescriptions, cultures, and study results; monitoring of health outcomes; use of nursing home-specific antibiograms; regular reporting and feedback to medical providers and nurses; and education of residents and families...
September 2016: North Carolina Medical Journal
Paul P Cook
The practice of infectious diseases is an ever-changing discipline. Diseases such as syphilis and tuberculosis have been with mankind for millennia, whereas conditions such as AIDS and Zika virus are relatively new maladies. A working knowledge of clinical presentations associated with Zika virus infection, syphilis, and common parasitic infections will help the primary care provider determine whom to treat and whom to refer to a specialist. Increasing the use of vaccination for influenza and pre-exposure prophylaxis for HIV infection should reduce the burden of these common diseases...
September 2016: North Carolina Medical Journal
Peter J Morris
No abstract text is available yet for this article.
September 2016: North Carolina Medical Journal
Som N Chalise, Haitham T Shaheen, Muhammad Z Rizwan, Kevin O'Brien, Robert Shaw
BACKGROUND: Pulmonary rehabilitation (PR) is an evidence-based measure to benefit chronic obstructive pulmonary disease (COPD) patients. Many patients have benefitted from our robust university hospital-based PR program. We have objectively assessed the benefit of our PR program for COPD patients in Eastern North Carolina. METHODS: We used retrospective chart review to collect data from all the patients who completed PR from January 1, 2012 through December 31, 2013...
September 2016: North Carolina Medical Journal
Mary S Mouw, Jennifer Counts, Corinne Fordham, Molly Merrill Francis, Laura E Bach, Suzanne Maman, Scott K Proescholdbell
BACKGROUND: Injury and violence-related morbidity and mortality present a major public health problem in North Carolina. However, the extent to which local health departments (LHDs) engage in injury and violence prevention (IVP) has not been well described. OBJECTIVES: One objective of the current study is to provide a baseline assessment of IVP in the state's LHDs, describing capacity, priorities, challenges, and the degree to which programs are data-driven and evidence-based...
September 2016: North Carolina Medical Journal
Jonathan Isbit
No abstract text is available yet for this article.
July 2016: North Carolina Medical Journal
C Annette DuBard
No abstract text is available yet for this article.
July 2016: North Carolina Medical Journal
Sabrina Teferi, Ronald Jackson, Richard E Wild
The US Department of Health and Human Services and the Centers for Medicare & Medicaid Services have announced goals and timelines to transition from payments based on volume to payments based on value, quality, and efficient delivery of care. These value-based payments and alternative payment models will impact all health care professionals and provider organizations by encouraging better care, healthier people, and spending health care dollars wisely and efficiently.
July 2016: North Carolina Medical Journal
Joan D Wynn
Patient experience metrics are increasingly the focus of value-based incentive programs by both the federal government and private payers. A clear financial imperative exists to improve experience; at the same time, it is becoming evident that engaging patients in their care also leads to better clinical outcomes.
July 2016: North Carolina Medical Journal
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