New insights into immune thrombocytopenia (ITP) epidemiology in adult patients highlight three main outcomes of morbidity and mortality bleeding, infection and thrombosis. This review depicts current evidence about incidence and risk factors of bleeding, infection and thrombosis as well as predictors of chronicity, and shows how this assessment impacts the choice of ITP second-line treatment at the individual-level basis.
  Abortion is a critical reproductive health service that is difficult for many in the United States to afford owing to policies aimed at restricting insurance coverage of this basic health service. This article assesses whether the resulting high out-of-pocket cost for abortion could be considered a catastrophic health expenditure, and explores potential policies that could prevent households from experiencing financial hardship or impoverishment.
 
  We assessed if the average costs of a first and second trimester abortion procedure in 2016 were catastrophic health expenditures by applying a 40% threshold to the monthly nonsubsistence income of households earning their state's median income in all 50 states and Washington, DC.
 
  The out-of-pocket cost for a first trimester abortion procedure would have been catastrophic for households earning their state's median monthly income in 39 states. In nine of these states, the average cost was between 100% and 199% of a household's nonsubsistence income, and in another nine states, this cost was at least double a household's nonsubsistence income. The out-of-pocket cost of a second trimester abortion would have been catastrophic for households earning their state's median monthly income in all 50 states and Washington, DC.
 
  In a majority of states, the out-of-pocket cost of an abortion is financially catastrophic for households earning no more than their state's median monthly income.  https://www.selleckchem.com/products/actinomycin-d.html  The United States should implement policies to create or improve health care safety nets to guarantee abortion care for all individuals, regardless of their income or insurance status.
 In a majority of states, the out-of-pocket cost of an abortion is financially catastrophic for households earning no more than their state's median monthly income. The United States should implement policies to create or improve health care safety nets to guarantee abortion care for all individuals, regardless of their income or insurance status.Lateral lymph node dissection (LLND) is a challenging procedure due to its technical difficulty and higher incidence of surgical morbidity, thus the purpose of this study is to compare the postoperative morbidity and mortality between laparoscopic and conventional open LLND after mesorectal excision (ME) for advanced rectal cancer. A comprehensive search was conducted in August 2019 based on data from PubMed, Embase, Cochrane Library, CNKI and Wanfang Data to identify relevant studies, and studies comparing laparoscopic with conventional open LLND were included. Seven studies with 335 cases in the laparoscopic LLND group and 841 cases in the conventional open LLND group were finally included. Compared with the conventional open LLND group, the laparoscopic LLND group enjoys a lower postoperative morbidity (OR = 0.47,95% CI [0.23, 0.97], P = 0.04), same postoperative mortality (Postoperative mortality in both groups was zero), shorter length of postoperative hospitalization (WMD = -5.30, 95% CI [-8.42, -2.18], P = 0.0009), less wound infection (OR = 0.40,95% CI [0.21, 0.77], P = 0.006), less intestinal obstruction (OR = 0.50,95% CI [0.29, 0.84], P = 0.009), and less urinary retention (OR = 0.61,95% CI [0.38, 0.97], P = 0.04). There were no significant differences in the incidence of anastomotic leakage, abdominal pelvic abscess and urinary tract infection between the two groups (P > 0.05). But in the sensitivity analysis, there was a significant change of urinary tract infection (OR = 0.22, 95%CI [0.06, 0.89], P = 0.03), and the degree of between-study heterogeneity decreased greatly. In conclusion, laparoscopic LLND may be a better alternative to conventional open LLND for advanced rectal cancer with lower postoperative morbidity and shorter postoperative hospital stay.
  Using indicators of campaign effort and relevant news stories, we sought to predict two patterns of patient behavior regarding information about aspirin and heart health patient use of a campaign web tool to determine whether they should talk with a physician about using aspirin and patient searches for information about aspirin and the heart.
 
  We used ARIMA modeling to predict two time series as a function of independent variables.
 
  We found significant prediction of time series in both models, but campaign expenditure only predicted use of a campaign web tool whereas weekly news stories predicted online searches regarding aspirin and the heart originating from Minnesota.
 
  Patient information engagement is a function of information salience at least in part. Campaign advertising expenditure can prompt audience use of campaign tools but news coverage also operates as an important force on patient search behavior.
 
  Health promotion professionals charged with reaching patients with heart health and stroke prevention messages should monitor news coverage as a potential complementary or rival force while at the same time promoting campaign-related information online.
 Health promotion professionals charged with reaching patients with heart health and stroke prevention messages should monitor news coverage as a potential complementary or rival force while at the same time promoting campaign-related information online.
  To review and synthesise definitions of the teach-back method in the literature. The second aim is to synthesise the barriers, facilitators and perceptions of teach-back use in healthcare consultations with patients.
 
  A systematic review and thematic synthesis following Braun and Clarke's method.
 
  The primary search found 1429 citations and the secondary search added 221 citations. Screening identified 66 citations eligible for data extraction. We contrasted and synthesised operational definitions of the teach-back method. The synthesis generated seven themes related to healthcare provider (HCP) and patient perceptions of teach-back (effectiveness, stigma and time-related perceptions), the universal application of teach-back, patient health outcomes and healthcare provider training.
 
  Operational definitions of the teach-back method varied in the literature and contained implied steps. HCPs and patient perceptions of teach-back operated as both enablers and barriers to its use. HCPs training programs for the teach-back method were identified as beneficial for altering HCPs perceptions about the method and increased its use with patients.