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Objectives: To improve rapid detection and response to spikes in suspected nonfatal opioid overdoses in the community, the Rhode Island Department of Health (RIDOH) sought to modify its case definition to align with newly released guidance from the Council of State and Territorial Epidemiologists (CSTE).
Methods: RIDOH used CSTE guidance to create 2 alternative criteria (CSTE-guided and RIDOH-modified CSTE) to replace one of RIDOH's original criteria. We gathered emergency medical services (EMS) records from 4 months in 2022 to determine whether they met any criteria, and we reviewed them to determine the accuracy of identifying an opioid overdose. We calculated the positive predictive value for each criterion individually and as a complete case definition (RIDOH original definition, CSTE-guided definition, and RIDOH-modified CSTE definition).
Results: The RIDOH-modified CSTE case definition was adopted because it had a positive predictive value of 91.5% in identifying nonfatal opioid overdose-related EMS incidents, similar to the original definition (91.3%) and higher than the CSTE-guided definition (82.2%). The RIDOH-modified CSTE case definition identified 624 additional nonfatal opioid overdoses in EMS data from 2018 through 2022, a 7% increase from the original definition.
Conclusions: The RIDOH-modified CSTE case definition increased RIDOH's ability to detect suspected nonfatal opioid overdoses while maintaining the accuracy of the case definition. With the new case definition, RIDOH aims to improve allocation of resources to communities experiencing increased overdose burden.
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http://dx.doi.org/10.1177/00333549241301721 | DOI Listing |
J Epidemiol Glob Health
September 2025
Center for Communicable Diseases Control (CDC), Ministry of Health and Medical Education, Tehran, Iran.
Background: Healthcare-associated infections (HCAIs) pose a serious threat to healthcare systems. Accurately determining the incidence of HCAIs is crucial for planning and implementing efficient interventions, as they are associated with a wide range of challenges. The objective of this study was to assess and update the incidence rates of HCAIs in Iran in 2023, using data from the Iranian Nosocomial Infection Surveillance (INIS) system, a nationwide hospital-based surveillance program.
View Article and Find Full Text PDFActa Neurochir (Wien)
September 2025
Department of Neurosurgery, Istinye University, Istanbul, Turkey.
Background: Recent studies suggest that large language models (LLMs) such as ChatGPT are useful tools for medical students or residents when preparing for examinations. These studies, especially those conducted with multiple-choice questions, emphasize that the level of knowledge and response consistency of the LLMs are generally acceptable; however, further optimization is needed in areas such as case discussion, interpretation, and language proficiency. Therefore, this study aimed to evaluate the performance of six distinct LLMs for Turkish and English neurosurgery multiple-choice questions and assess their accuracy and consistency in a specialized medical context.
View Article and Find Full Text PDFJACC Case Rep
September 2025
Department of Cardiac Surgery, Prince Sultan Cardiac Center, Al-Hassa, Saudi Arabia. Electronic address:
Background: Cardiac tumors are rare, with most being benign. Vascular cardiac tumors, such as hemangiomas, account for 1% to 2% of all cardiac tumors.
Case Summary: We present a case of a 53-year-old woman who presented with palpitations and shortness of breath.
Immunotherapy
September 2025
Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany.
Currently, the first-line treatment of non-metastatic Merkel cell carcinoma (MCC) is complete resection. In case of unresectable or metastatic MCC, immune checkpoint inhibitor (ICI) therapy with avelumab (or in the US also pembrolizumab or retifanlimab) is indicated. We report on a patient with a primary, non-metastatic MCC on the left eyelid and amyotrophic lateral sclerosis (ALS).
View Article and Find Full Text PDF