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Introduction: Trapped lung, characterized by atelectatic lung unable to reexpand and fill the thoracic cavity due to a restricting fibrous visceral pleural peel, is occasionally seen in patients with end-stage liver disease complicated by hepatic hydrothorax. Limited data suggest that trapped lung prior to orthotopic liver transplantation may be associated with poor outcomes. Research Question: What is the clinical significance of trapped lung in patients receiving orthotopic liver transplantation? Design: We performed a retrospective analysis of patients who underwent liver transplantation over an 8-year period. Baseline clinical characteristics and postoperative outcomes of adult patients with trapped lung were analyzed and compared to the overall cohort of liver transplant recipients and controls matched 3:1 based on age, sex, Model for End-Stage Liver Disease (MELD) score, and presence of pleural effusion. Results: Of the 1193 patients who underwent liver transplantation, we identified 20 patients (1.68%) with trapped lung. The probability of 1 and 2-year survival were 75.0% and 57.1%, compared to 85.6% and 80.4% (p = 0.02) in all liver transplant recipients and 87.9% and 81.1% (p = 0.03) in matched controls respectively. Patients with trapped lung had a longer hospital length of stay compared to the total liver transplant population (geometric mean 54.9 ± 8.4 vs. 27.2 ± 0.7 days, p ≤ 0.001), when adjusted for age and MELD score. Discussion: Patients with trapped prior to orthotopic liver transplantation have increased probability of mortality as well as increased health care utilization. This is a small retrospective analysis, and further prospective investigation is warranted. [ABSTRACT FROM AUTHOR]

Background: Black individuals with type 2 diabetes suffer disproportionate morbidity and mortality relative to whites with type 2 diabetes, irrespective of health insurance coverage. Objective: Examine the impact of a primary care–embedded clinical pharmacist–led intervention (UCMyRx) on cardiovascular risk factor control among blacks with type 2 diabetes in a large healthcare system. Design: We used data extracted from the electronic health records (EHR) system and a difference-in-differences study design with a propensity-matched comparison group to evaluate the impact of UCMyRx on HbA1c and systolic blood pressure (SBP) among black patients with type 2 diabetes, relative to usual care. Participants: Individuals with type 2 diabetes identified as either black or African American in the EHR that were ≥ 18 years of age that had the following observations during the study window (03/02/2013–12/31/18: (1) HbA1C ≥ 8%, at least once, anywhere between 365 days before and 14 days after the UCMyRx visit and a follow-up HbA1c measure within 120 to 365 days after the visit and/or (2) SBP ≥ 140 mmHg at least once between 365 days before and 14 days after the UCMyRx visit that had a follow-up SBP measure within 120 to 450 days after the visit. Intervention: UCMyRx pharmacists review labs and vital signs, perform medication reconciliation, use a standardized survey to assess barriers to medication adherence, and develop tailored interventions to improve medication adherence. Main Measures: Change in HbA1c and change in SBP from before to after the first UCMyRx visit. Key Results: Having at least one visit with a UCMyRx clinical pharmacist was associated with a significant reduction in HbA1c (− 0.4%, p value =.01); however, there was no significant impact on SBP (−.051 mmHg, p value = 0.74). Conclusions: The UCMyRx intervention is a useful strategy for improving HbA1c control among blacks with type 2 diabetes. [ABSTRACT FROM AUTHOR]

It is now standard practice in the enforcement of anti-discrimination legislation to use statistical analysis, especially in cases where the discriminatory practice is not observed directly but must he inferred. In the classic example, the demographics of a firm's hiring might be compared to that of the county-wide work force. Plaintiffs in these actions would satisfy part of the requirement for a prima facie case by showing that the firm hired fewer protected group members than would be expected using the benchmark availability for that group. Similar calculations are made in promotion or termination investigations, but the benchmark would he the promotion or termination rates of the firm's own employees who are not charging discrimination. The logic of pay comparisons is the same. If the earnings of protected group members are statistically different from earnings of the benchmark group, the defendant is presumed to have failed the statistical test. However, in section I, this article explore the use of regression as an analytical tool and critique the way its results are typically interpreted. In section II, it discusses the use of external availability calculations as benchmarks for the analysis of claims of discriminatory hiring.