A Retrospective Evaluation of Time to Obtain an MRI for English- Versus Non-English-Speaking Patients.

PURPOSE: Americans with limited English proficiency (LEP) face significant barriers to health care that result in health disparities in the LEP population. LEP could delay an MRI, potentially increasing morbidity and mortality in the LEP population. This study compares the time to obtain a neurological MRI in English versus non-English language preference patients. METHODS: 24,219 unique patients at a single health system who underwent inpatient neurological MRI were included in the study. Bivariate and multivariate analyses were used to identify characteristics predictive of time to examination (TTE) from the set: patient-preferred language, gender, race, age, performing hospital, and order priority (routine versus stat). RESULTS: Bivariate analysis showed a longer TTE is associated with increasing age category, non-English language preference, and routine priority. A multivariate analysis showed non-English language preference effect on TTE is reduced in magnitude and is no longer significant in a model that includes age group, priority, and hospital (P = .23, effect estimate = 4%, 95% CI: -2.5%, 11.0%). Routine order priority (P < .0001) and increasing age (P < .0001) were associated with increased TTE. In a model that included interactions, the effect of language preference did not depend on order priority (P = .59) or age group (P = .11). CONCLUSION: There is no significant difference in the time to obtain a neurological MRI in English versus non-English language preference patients when age, order priority, and performing hospital are accounted for. This finding supports the effectiveness of the protocols and resources in place to support patients with LEP at the sponsoring health system.

Host environmental signals and effects on biofilm formation.

Biofilm matrix formation is a phenotype linked to the ability to survive a hostile host environment that includes the presence of antimicrobial peptides and serum factors. Multiple hormones and other host derived factors have been shown to function as exogenous quorum signaling compound homologs that inform microbes of their in situ presence, thus triggering a shift from a planktonic to the sessile biofilm phenotype. The focus of this review is to describe the impact various host-derived factors have on the initial steps required for biofilm formation, i.e., adherence to host surfaces and multiplication in the host.

Mediastinal Masses in Nuclear Medicine Studies: A Diagnostic Algorithm.

There are multiple reasons for an anterior mediastinal mass. In this case, we discuss possible etiologies and offer an algorithm to narrow the differential diagnosis. When the mass cannot be diagnosed radiographically, the next step in imaging is a physiologic assessment with radionuclide modalities.