ABSTRACT
BACKGROUND: The reported disproportionate impact of COVID-19 infections on minority populations may be due to living in disinvested communities with a high level of poverty, pollution, inadequate unsafe employment, and overcrowded housing. OBJECTIVE: To determine the association of county, city, and individual risk factors with COVID-19 infection rates. METHODS: Retrospective chart review on COVID-19 tests performed from March through July 2020 at Arrowhead Regional Medical Center (ARMC), Colton, California. RESULTS: A total of 7104 tests were performed with 69% in the drive-through testing center. The mean duration of test-to-results time was 2.36 (+0.02) days. COVID-19 positive tests occurred in 1095 (15.4%). At least one symptom occurred in 414 (33%) with a sensitivity of 37.8, specificity of 86.02, a positive predictive value of 33.01, and a negative predictive value of 72.76. Individual factors significantly associated with testing positive for COVID-19 were diabetes, Hispanic ethnicity, and male gender. Younger age was significantly associated with testing COVID positive with the highest risk in children <10 years. COVID-19 positive persons significantly resided in cities with higher population density, household members, poverty, non-English speaking homes, disability, lower median household income, lack of health insurance and decreased access to a computer and Wi-Fi services. County health rankings showed a significant positive association between testing positive for COVID-19 with increased smoking, air pollution, violent crimes, physical inactivity, decreased education, and access to exercise. Conclusion: Adverse county health rankings, socially and economically disadvantaged cities are associated with an increased risk of testing positive for COVD-19. This information can be used in strategic planning and invention mitigation.
ABSTRACT
There are several major breast cancer guidelines that have been promoted by various health organizations. Arrowhead Regional Medical Center (ARMC) Family Health Centers adopted the current guideline by the U.S. Preventive Services Task Force (USPSTF), which recommends breast cancer screening with mammograms starting at age 50 for low-risk women. This study evaluates the effectiveness of this screening guideline in the selected Hispanic underserved population in San Bernardino, California (CA). This is a retrospective chart review study. Data were reviewed for any female with the confirmed diagnosis of breast cancer at the Family Health Centers between 2009 and 2018. The current study showed that 25% (40 of 160) of women diagnosed with breast cancer in this selected population were less than 50 years old. This finding suggests that high vigilance in breast cancer screening may be necessary in this population.
ABSTRACT
Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal complication resulting from neuroleptic drug therapy. Presentation of NMS can vary, and diagnosis relies primarily upon medical history and symptomatology. Due to the potential delay in diagnosis, emergency physicians should remain vigilant in recognizing the symptoms of NMS and be prepared to initiate immediate treatment following diagnosis. Dantrolene, which has been used for spasticity and malignant hyperthermia, has been reported as a potential treatment for NMS and led to off-label use for NMS. We report two cases of NMS induced by antipsychotic monotherapy for which dantrolene was administered.
ABSTRACT
BACKGROUND: Crusted Norwegian scabies is a rare hyperkeratotic variant of scabies infestation. We report herein a case of crusted scabies in a woman with underlying Langerhans cell histiocytosis (LCH). OBSERVATIONS: A 49-year-old woman with LCH was hospitalized owing to marked thrombocytopenia. Her hyperkeratotic skin eruption was thought to be secondary to LCH because several years earlier, she had positive biopsy findings and had been diagnosed as having LCH. After a 1-month hospital stay, her laboratory values improved despite worsening of her skin lesions. CONCLUSION: Analysis of skin scrapings confirmed the presence of scabies, and resolution was achieved with a 1-dose ivermectin treatment.
