Using 51V NMR spectroscopy, dynamic light scattering and continuous shape analysis to characterize two polyoxometalate-encapsulation in reverse micelles.

Background: Symptomatic pleural effusions create discomfort and are a frequent cause of hospitalization. Ultrasound-guided thoracentesis is a key palliative intervention to assist in the management of this vulnerable population. Our institution has created a multidisciplinary transitional care program to address the needs of those discharged from the hospital with chronic complex conditions, including symptomatic pleural effusions. Methods: This case series was performed in a transitional care clinic between May 8, 2017, and December 11, 2018. Eight unique patients with symptomatic pleural effusions were referred to our clinic posthospital discharge and treated with ultrasound-guided thoracentesis. A retrospective review was performed to assess procedure details, complications, and follow-up emergency department visits or hospital readmissions. Additionally, cost comparison data were obtained from the hospital financial system. Results: Of the 8 unique patients, 15 thoracenteses were performed over the 19-month period in the transitional care clinic. The median age of the cohort was 56 years old (range: 39-92 years). All patients reported an immediate relief of symptoms (dyspnea and/ or pain) and no procedural complications. The total cost of performing an ultrasound-guided thoracentesis in the transitional care clinic was 61.8% that of performing the procedure in the hospital (US$537.61 vs US$869.65). Conclusion: All 8 patients experienced an immediate relief in pleural effusion-related symptoms following thoracentesis. Our experience helps reveal the safety, efficacy, and cost-efficiency of ultrasound-guided thoracentesis in providing symptom management for patients with pleural effusions in a transitional care clinic.

Background: Management of ascites-related symptoms in home hospice and palliative care patients can be challenging. Ultrasound-guided paracentesis is a standard intervention for this indication, but generally requires transfer to a hospital or outpatient interventional-radiology (IR) setting; thus, such interventions are often not practical or attainable for home hospice and palliative care patients. Objective: To describe a mobile, in-home service that provides home-based palliative paracentesis (HBPP) as an interventional palliative option for patients with distressing symptoms related to ascites. Design: Retrospective case series. Setting/Subjects: Thirty patients with ascites, confirmed by portable bedside ultrasound, who underwent HBPP at their residence. Results: Thirty-three patients were referred for HBPP for symptomatic abdominal distention from March 1, 2019 to March 1, 2020. Thirty (91%) patients had ultrasound-confirmed ascites and received HBPP. All 30, verbalized appreciable symptom relief post-intervention. There were no reported post-procedural complications. Conclusion: Home-based palliative paracentesis is a safe, effective, and convenient intervention for hospice and palliative care patients with symptomatic ascites.

INTRODUCTION: Sex-trafficking is one of the world’s fastest growing forms of crime worldwide, and yet less than 2% of victims have been identified. In 2016, there was an estimated 30% increase in reported cases of human trafficking in Arizona. The number of risks and harms endured by sex-trafficked individuals is lengthy, yet strategies and education to identify victims is not universal. The purpose of this study is to further understand the demographics and medical needs of the sex trafficked population of Phoenix. METHODS: Project STARFISH is a biannual drop-in center that provides resources to victims of sex- trafficking. Medical SOAP notes are written on persons who voluntarily seek medical services at these resource centers. Eighty de-identified SOAP notes were reviewed in this IRB-approved observational, qualitative study to determine demographic and medical needs of the sex-trafficked population of Phoenix. RESULTS: The analysis revealed a high incidence of pregnancy, polysubstance use, homelessness, sexually transmitted infections, domestic violence history, chronic pain and mental health needs. Additionally, demographics of this population were extrapolated and include a predominately female population, an average age of 35 years old, with 78% of people having health insurance, and one-third having regular contact with a primary physician. CONCLUSION: The evidence regarding the sex-trafficked population is limited, and this project helps gain valuable insight regarding the demographics and medical needs of this under-researched population. The impact of this project is threefold: identification of victims, education for healthcare professionals, and creation of open communication channels between victims and healthcare providers.