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364563 results in Medicine

Page 75 of 18229

  • Chapter 3 - Whose Coverage Is Denied?

  • Miranda Yaver, University of Pittsburgh
  • Book:
    Coverage Denied
    Published online:
    23 April 2026
    Print publication:
    23 April 2026, pp 91-110

  • Summary

    When Daniel spent years seeking diagnosis for his spinal cyst, he faced denial after denial and only felt compelled to fight his insurer because he had a family to support. Through survey and interview evidence, this chapter explores who is most vulnerable to being denied coverage by health insurers, and what accounts for these vulnerabilities. Highlighting the first patient-level analysis of coverage denials across public and private insurance, this chapter shows that those from marginalized groups – namely, women, LGBTQ patients, and those in worse health – are more vulnerable to experiencing coverage denials. Interestingly, though low health literacy might be expected to lead some patients to pursue care outside their insurance benefits, socioeconomic factors do not consistently correlate with greater vulnerability to coverage denial. This finding offers insights into the scope of defensive medicine amid medical malpractice concerns. Black and Hispanic patients appear to be particularly likely to experience repeated coverage denials, and, given the significant health literacy demands of appealing, patients from marginalized groups may be particularly ill-equipped to weather the storm.

  • The impact of gestational diabetes mellitus on neonatal cardiac development

  • Lina Qi, Lifen Yuan, Junsheng Jiang
  • Journal:
    Cardiology in the Young , First View
    Published online by Cambridge University Press:
    23 April 2026, pp. 1-6
  • Objective:

    To investigate the effect of maternal gestational diabetes mellitus (GDM) on neonatal cardiac development.

    Methods:

    A retrospective analysis of full-term newborns admitted in 2024 was conducted. 100 newborns of mothers with GDM (IADPSG criteria) were the GDM group, and 100 of non-GDM mothers were the control group. We compared their birth parameters,echocardiographic indicators and congenital heart disease (CHD) incidence, and analyzed factors related to neonatal interventricular septal (IVS) hypertrophy.

    Results:

    The GDM group had significantly higher birth weight, length and placental weight (P < 0.05); echocardiography showed larger cardiac chambers, great vessels and thicker IVS (P > 0.05); CHD incidence was 2% (vs. 0% in control, P = 0.047). Maternal glycemic indicators and neonatal birth weight were positively correlated with IVS thickness (P < 0.05).

    Conclusion:

    GDM adversely affects neonatal cardiac development; routine fetal and postnatal cardiac evaluation is necessary for GDM pregnancies. Further research is needed to clarify mechanisms and establish monitoring strategies.

  • Mobile Pharmacy Vehicles as Disaster Response Units: Insights from the 2024 Noto Peninsula Earthquake

  • Satoki Kajimoto, Shota Suzuki, Kunitoshi Okuwa, Hiroshi Okada
  • Journal:
    Disaster Medicine and Public Health Preparedness / Volume 20 / 2026
    Published online by Cambridge University Press:
    23 April 2026, e92

  • Few reports detail the operation of Japan’s unique disaster countermeasures, mobile pharmacy vehicles (MPVs). This case report draws on the authors’ direct operational experience and anonymized, retrospective open-access data to describe the current system and actual operations of MPVs and examine the feasibility of their international implementation. During the Noto Peninsula Earthquake in January 2024, 13 MPVs were deployed to the affected areas following dispatch requests, and 1,834 disaster prescriptions were issued. In accordance with the local medical care delivery system, the deployment of MPVs was coordinated by the disaster pharmacy coordinator, contributing to the rapid and flexible provision of medical services. These results demonstrate the potential international applicability of the MPV system. Further development of information management and operational systems, along with their adaptation for other uses, may enhance the utility of the MPV model as a component of disaster medical support in other countries.

  • Chapter 9 - A Path Forward

  • Miranda Yaver, University of Pittsburgh
  • Book:
    Coverage Denied
    Published online:
    23 April 2026
    Print publication:
    23 April 2026, pp 243-278

  • Summary

    Though coverage denials and delays impose on physicians and patients (especially marginalized patients) substantial administrative burden, the persistence of this practice is inevitable. Drawing on interviews with patients and former health insurance executives, this chapter reflects on harms caused by prior authorization and offers a menu of state and federal solutions to expand access to care, while also reflecting on how the 2024 election results impact their likelihood. A growing complication is major insurers’ increasing reliance on AI tools to process prior authorizations and claims in seconds. Though many states have sought to lessen prior authorization burden in targeted ways, this reach is limited because the Employee Retirement Income Security Act preempts state policies that “relate to” much of employer-sponsored health insurance. Despite some appetite for reform in Congress, legislative efforts have stalled. The 2024 election results signal a likely acceleration of America’s reliance on privatization (especially Medicare Advantage), so it is especially important to understand the impact of these managed care practices and ways to mitigate their burdens.

  • Advance healthcare directives – considerations from an Irish perspective

  • Katherine Reidy, Emma Slattery
  • Journal:
    Irish Journal of Psychological Medicine , First View
    Published online by Cambridge University Press:
    23 April 2026, pp. 1-5
    • Article
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  • This article addresses, in an Irish context, some of the complexities associated with advance planning documents which have been discussed more broadly by Ruck Keene. While the Assisted Decision-Making (Capacity) Act 2015 is an important step forward in Irish law, there remain significant areas of uncertainty. In this regard, the article considers issues around the creation of advance planning documents and difficulties which may arise when they are intended to be activated and compares some of those difficulties with the law in England and Wales.

  • Safety and feasibility of deep sedation and general anaesthesia for cardiovascular MRI studies in paediatric patients from two tertiary European centres

  • Sylvia Krupickova, Mary Lane, Marcel Schmidt, Julieta Rancati, Raad Mohiaddin, Cemil Izgi, Jeeya Shah, Michael Rigby, Piers Daubeney, Anselm Uebing, Dominik Gabbert, Dudley J. Pennell, Inga Voges
  • Journal:
    Cardiology in the Young , First View
    Published online by Cambridge University Press:
    23 April 2026, pp. 1-7
  • Purpose:

    To investigate the safety and feasibility of deep sedation and general anaesthesia for cardiovascular magnetic resonance imaging in paediatric patients with congenital or acquired cardiac diseases.

    Methods:

    This retrospective study included all consecutive patients less than 18 years of age who had deep sedation for cardiovascular magnetic resonance examination at the University Hospital Schleswig-Holstein (Kiel, Germany) between 2010 and 2020 and cardiovascular magnetic resonance examination under general anaesthesia at the Royal Brompton Hospital (London, United Kingdom) between 2013 and 2022.

    Results:

    Five-hundred twenty-two patients were in the deep sedation group and 171 in general anaesthesia group. Most of the patients had CHD (86% in deep sedation and 70% in general anaesthesia group). There were overall 14 adverse events (2%); 8 (1.5%) in the deep sedation group and 6 (3.5%) in the general anaesthesia group. This difference was not statistically significant (p = 0.122). Complications in the deep sedation group included mild anaphylactic reactions in three patients, a severe coughing fit in one patient, increasing cyanosis in three single-ventricle patients, and suspected aspiration in one patient. In the general anaesthesia group, hypotension requiring some intervention was present in three patients (four scans). One patient (0.6%) had inadvertent endobronchial intubation.

    Conclusion:

    Both deep sedation and general anaesthesia can be used for cardiovascular magnetic resonance scans in paediatric patients with a low rate of complications. This, however, requires highly skilled teams who adhere strongly to the safety policies and guidelines set up by each hospital.

Page 75 of 18229