Association between diagnosis code expansion and changes in 30-day risk-adjusted outcomes for cardiovascular diseases

BACKGROUND In January 2011, Centers for Medicare and Medicaid Services expanded the number of inpatient diagnosis codes from 9 to 25, which may influence comorbidity counts and risk-adjusted outcome rates for studies spanning January 2011. This study examines the association between (1) limiting versus not limiting diagnosis codes after 2011, (2) using inpatient-only versus inpatient and outpatient data, and (3) using logistic regression versus the Centers for Medicare and Medicaid Services risk-standardized methodology and changes in risk-adjusted outcomes. METHODS AND RESULTS Using 100% Medicare inpatient and outpatient files between January 2009 and December 2013, we created 2 cohorts of fee-for-service beneficiaries aged ≥65 years. The acute myocardial infarction cohort and the heart failure cohort had 578 728 and 1 595 069 hospitalizations, respectively. We calculate comorbidities using (1) inpatient-only limited diagnoses, (2) inpatient-only unlimited diagnoses, (3) inpatient and outpatient limited diagnoses, and (4) inpatient and outpatient unlimited diagnoses. Across both cohorts

Biased Justice: Ethnicity, Gender, and Justice in Progressive Era Milwaukee

This capstone analyzes the relationships between the Irish, Italian, and German-Americans in Progressive Era Milwaukee in the context of the justice system. A particularly dramatic case, the 1914 trial of the Italian immigrant, Carmello Musso, for the murder of her husband, is analyzed. A closer examination of newspaper accounts, arrest records, trial transcripts, and the Wisconsin Governor’s pardon files reveal the local attitudes, alliances, and prejudices that existed in Progressive Era Milwaukee. Within the courtroom, tensions surfaced between German-American District Attorney, Edward Yockey, the Irish-American elected Sheriff of Milwaukee County, Lawrence McGreal, and the Italian immigrant community that fought to protect Carmello Musso. The Carmello Musso case exposes ethnic, religious, gender, class, and political conflicts which collectively resulted in a biased justice system in Milwaukee during the early twentieth century

Endings are Beautiful, too

https://www.exhibit.xavier.edu/art_of_expression/1020/thumbnail.jp

Opposing forces of cardiogenic shock: left ventricular outflow obstruction, severe mitral regurgitation, and left ventricular dysfunction in Takotsubo cardiomyopathy

Abstract Rates of stress (Takotsubo) cardiomyopathy have increased during the coronavirus pandemic due to social stressors, even in patients who are not infected with the virus. At times, Takotsubo cardiomyopathy (TC) may present as cardiogenic shock. Herein, we present a case during the pandemic of shock from TC secondary to left ventricular outflow tract obstruction (LVOTO), mitral regurgitation (MR), and left ventricular (LV) dysfunction. The contrasting management strategy of LVOTO, MR, and LV failure was cause for clinical challenge, and we highlight the balance of treating these opposing forces