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1.
American Journal of Gastroenterology ; 117(10 Supplement 2):S1074-S1075, 2022.
Article in English | EMBASE | ID: covidwho-2324086

ABSTRACT

Introduction: As the U.S. population ages, gastroenterologists will provide care for an increasing number of older patients - many of whom use Medicare. In recent years there have been significant policy changes surrounding Medicare reimbursement for physicians. Understanding reimbursement trends can help reveal the financial impact of these policies on gastroenterologists. Our study aims to analyze the trends in Medicare reimbursement of common gastrointestinal (GI) services from 2007 to 2022. Method(s): The top 10 GI procedures and their respective CPT codes were identified through a joint list published by the American College of Gastroenterology, American Society of Gastrointestinal Endoscopy, and American Gastroenterological Association. The top 5 5 CPT codes relating to office/inpatient visits provided by gastroenterologists to Medicare Part B beneficiaries was identified using data from CMS. The Physician Fee Schedule Look-Up Tool from CMS was queried for the selected CPT codes from 2007 to 2022, to determine the facility reimbursement rate by Medicare for each service. The reimbursement data were adjusted to January 2022 U.S. dollars using the U.S. Department of Labor's Bureau of Labor Statistics' consumer price index inflation calculator. Result(s): The unadjusted physician reimbursement for GI procedures exhibited an average decrease of 7.0% (95% CI, 29.9% to 24.1%) from 2007 to 2022. After adjusting for inflation, the mean decrease in physician reimbursement for procedures was 33.0% (95% CI, 235.1% to 230.9%). The mean annual growth rate in reimbursement was 22.6% (95% CI, 22.8% to 22.4%). The unadjusted physician reimbursement for inpatient and outpatient visits exhibited an average increase of 32.1% (95% CI, 4.8% to 59.3%). After adjusting for inflation, physician reimbursement for patient visits exhibited a mean decrease of 4.92% (Figure 1). Conclusion(s): The analysis revealed a steady decline in adjusted and non-adjusted reimbursement between 2007 and 2022. Decreasing Medicare reimbursement may impact health outcomes, healthcare access, and patient satisfaction. Reimbursement policies must be scrutinized particularly in the light of high inflation and increased costs due to additional costs associated with care during the COVID-19 pandemic, staffing shortages, and increased staffing salaries. (Figure Presented).

2.
9th NAFOSTED Conference on Information and Computer Science, NICS 2022 ; : 294-299, 2022.
Article in English | Scopus | ID: covidwho-2233764

ABSTRACT

Corona is one of the most destructive viruses that has ever produced a pandemic in human life, not only in terms of direct victims but also in terms of the socio-economic consequences of the virus' transmission. The 2nd anniversary of the global coronavirus pandemic passed away in 2021. However, it's still impossible to say how long the epidemic will last. After reviewing a study by the World Health Organization on COVID-19, the country's national government urged residents to use facemask in order to reduce the incidence of COVID-19 transmission. As a result of COVID-19, there are presently no facemask detection app that are in great demand for ensuring safety in public area. In the context of the outbreak of COVID-19, A facemask detection model based on deep learning approach of state-of-the-art YOLOv5 may be useful in real-time applications. In this paper, we propose a web app for detecting if the people wears facemask or not in real-time via webcam or public camera. In the app, we deployed and persisted many different YOLOv5-based models that the users can switch between them to guarantee the performance and timing trade-off. Furthermore, our system is able to detect if an individual person captured by surveillance cameras is wearing facemask in acceptable counting time at staging level. In our opinion, this kind of system is extremely efficient for use in airports, train stations, offices, and other public areas, as well as in military. © 2022 IEEE.

3.
Journal of the American Society of Nephrology ; 33:931, 2022.
Article in English | EMBASE | ID: covidwho-2126029

ABSTRACT

Introduction: Alcohol-based hand sanitizer is typically composed of ethanol or 2-propanol, as recommended by the Center for Disease Control and Prevention. However, since the start of the SARS-CoV-2 pandemic, the demand has increased exponentially, leading to the increased circulation of products that do not meet regulatory standards. This case describes a patient who ingested hand sanitizer;however, based on the laboratory findings, it likely contained more toxic alcohols than ethanol. Case Description: A 53-year-old male presented to the emergency department (ED) via emergency medical services (EMS). Patient reportedly had ingested hand sanitizer and become unresponsive. EMS found him pulseless upon arrival, and advanced cardiac life support (ACLS) was initiated, resulting in return of spontaneous circulation (ROSC). He arrested again in the ED and ACLS was initiated, resulting in ROSC again. No family was present, but per chart review, patient had a history of a seizure disorder, polysubstance abuse, and cirrhosis. Patient was admitted to the intensive care unit for further management. Labs indicated an anion gap metabolic acidosis, significant for anion gap of 48 mmol/L, sodium 151 mmol/L, potassium 5.7 mmol/L, bicarbonate 8 mmol/L, creatinine 4.96 mg/dL, blood urea nitrogen (BUN) 74 mg/dL, glucose 196 mg/dL, and lactate 30.48 mmol/L. Serum osmolality was measured at 407 mOsm/kg with a calculated osmolality of 389 mOsm/L (including ethanol level of 216 mg/dL). Venous blood gas showed a pH of 6.86 on admission. Upon discussion with Poison Control, fomepizole or ethanol treatment was not recommended, as hand sanitizers are typically made from ethanol and his level was not severely elevated, so only supportive care was necessary. Continuous renal replacement therapy (CRRT) was initiated. However, he began to demonstrate decorticate posturing. Following discussion of prognosis with family, they decided to pursue comfort care. Discussion(s): Since the beginning of the SARS-CoV-2 pandemic, hand sanitizer production has increased, with some being manufactured outside of typical regulatory standards. As indicated by the osmolar gap and severe anion gap metabolic acidosis, the hand sanitizer ingested in this case may have contained methanol or ethylene glycol. Consequently, it is essential to have a high index of suspicion for alcohols other than ethanol in hand sanitizer ingestion.

4.
J Endocr Soc ; 6(Suppl 1):A345, 2022.
Article in English | PubMed Central | ID: covidwho-2109238

ABSTRACT

Introduction: Diabetes is an independent predictor of poor outcomes in patients with COVID-19. We compared the effects of the preadmission use of antidiabetic medications on the in-hospital mortality of patients with COVID-19 having type 2 diabetes. Methods: A systematic search was performed until November 30, 2021. We used a random-effects meta-analysis to calculate the pooled OR (95% CI). Results: We included 61 studies (3,061,584 individuals). We found some medications protective against COVID-related death, including metformin, GLP-1RA and SGLT-2i. DPP-4i and insulin users were more likely to die during hospitalization. SU, TZD, and AGI were mortality neutral. Metformin use was associated with better outcome in a dose-response manner. Conclusions: Metformin, GLP-1RA, and SGLT-2i were associated with lower mortality rate in patients with COVID-19 having type 2 diabetes. DPP-4i and insulin were linked to increased mortality. SU, TZD and AGI were mortality neutral.Presentation: No date and time listed

5.
J Stomatol Oral Maxillofac Surg ; 123(1): 16-21, 2022 02.
Article in English | MEDLINE | ID: covidwho-1082428

ABSTRACT

During the 2020 coronavirus pandemic, a lockdown was imposed in France during the first wave. An apparent decrease in incidence of cellulitis of odontogenic origin was noticed then. This study aimed to compare the incidence of cellulitis during this extraordinary period with the same period in 2018 and 2019, based on retrospective multicentric data. All maxillofacial surgery departments in French public hospitals were contacted. Responders were asked to include all patients admitted for the surgical drainage of a head and neck abscess of odontogenic origin during the first 2020 lockdown period, and in a similar time frame in 2018 and 2019 (control group), based on screening the French diagnostic and therapeutic classification of medical acts. We report a 44% significant nationwide decrease in the incidence of admissions for cellulitis. There were 187 patients in 2020 for 334 and 333 patients in 2018/2019 respectively. The reasons to explain this finding are hypothetical (organizational reasons leading to earlier management, patients' fear to seek for medical management, usual excess in surgical indications or concomitant decrease of non-steroidal anti-inflammatory drugs delivery). Whatever the explanation, it would be of great interest to find it out in order to improve the prevention of cellulitis.


Subject(s)
COVID-19 , Cellulitis , Cellulitis/diagnosis , Cellulitis/epidemiology , Cellulitis/etiology , Communicable Disease Control , Humans , Retrospective Studies , SARS-CoV-2
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