Last data update: May 13, 2024. (Total: 46773 publications since 2009)
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Query Trace: Mendoza MD[original query] |
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Best Practices Implementation: Congenital Syphilis Prevention Efforts in Monroe County, New York 2018
Drame F , Urban MA , Inscho RR , Mendoza MD , Hiltunen K , Owens J , Stone C , Hart-Malloy R . Sex Transm Dis 2021 49 (4) 310-312 In 2019, more than half of the United States reported increases of both syphilis among females of reproductive ages and congenital syphilis (CS), with 49 states reporting at least 1 CS case, totaling 1870 cases. From 2013 to 2019, CS cases quadrupled in the United States.1–3 New York State (NYS) syphilis morbidity mirrors a similar trend, with CS cases more than doubling from 2013 to 2019. Although successful prevention of CS requires systemic changes to health and public health infrastructures, one route to identify best practices is to seek areas with a documented high CS aversion rate (the number of pregnancies in which syphilis is diagnosed minus reported CS cases out of the total pregnancies in which syphilis is diagnosed).4 In 2019, the primary and secondary syphilis (PnS) rate in NYS, excluding NY City, was 8.4 per 100,000 residents, an increase of 48.4% from 2013. Monroe County (MC), in western NY, had the highest PnS rate in NYS, excluding NY City in 2019 (28.3 per 100,000 residents).2 Despite the highest PnS rates, MC has documented successive years with a high CS aversion rate. Since 2012, MC has experienced a 1364% increase in PnS diagnoses and reported 1 CS case, averting 94.7% of cases from 2012 to 2019. The CS aversion rate for the rest of the state for the same period was 81.9% (P = 0.15). To better explain and explore successes realized in MC's CS prevention efforts, we summarized activities into 2 practices: (1) increased client-centered syphilis screening among disproportionately impacted communities and (2) enhanced integration of sexual health clinic and public health programming. This article describes activities implemented without evaluating the effectiveness of each policy and practice. To complement the best practices provided hereinafter, we created a visual guide summarizing how community stakeholders can coordinate to implement and use the best practices (Fig. 1). |
HIV disease burden, cost, and length of stay in Portuguese hospitals from 2000 to 2010: a cross-sectional study
Catumbela E , Freitas A , Lopes F , Mendoza MD , Costa C , Sarmento A , da Costa-Pereira A . BMC Health Serv Res 2015 15 (1) 144 BACKGROUND: The number of HIV-related hospitalizations has decreased worldwide in recent years owing to the availability of highly active antiretroviral therapy. However, the change in HIV-related hospitalizations in Portugal has not been studied. Using comprehensive hospital discharge data from mainland Portuguese hospitals, we examined trends in HIV-related inpatient admissions, length of stay (LOS), Elixhauser comorbidity measures, in-hospital mortality, and mean cost from 2000 to 2010. METHODS: The hospital administrative data from inpatient admissions and discharges at 75 public acute care hospitals in the Portuguese National Health Service from 2000 to 2010 were included. HIV-related admissions were identified using the International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes 042.x-044.x. The effect of Elixhauser comorbidity measures on extending the LOS was assessed by comparing admissions in HIV patients with and without comorbidities using the Mann-Whitney U test. Multivariate logistic regression was performed to estimate the odds of having a decreased discharge. RESULTS: A total of 57,027 hospital admissions were analyzed; 73% of patients were male, and the mean age was 39 years. The median LOS was 11 days, and the in-hospital mortality was 14%. The mean cost per hospitalization was 5,148.7euro. A total of 83% of admissions were through the emergency room. During the period, inpatient HIV admissions decreased by 22%, LOS decreased by 9%, and in-hospital mortality dropped by 12%. Elixhauser comorbidities increased the median LOS in nearly all admissions. CONCLUSIONS: Despite small regional variations, a strong, consistent decrease was observed in the hospital admission rate, mean cost, length of stay, and mortality rate for HIV-related admissions in Portugal during 2000-2010. |
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