Baylor University Medical Center Proceedings最新文献_第2页

History of surgery: Pioneers of esophageal pathology, anatomy, and surgical technique. 外科史：食道病理学、解剖学和外科技术的先驱。

Baylor University Medical Center Proceedings Pub Date : 2025-03-19 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2476328

William J Hlavinka, Marc A Ward, Steven G Leeds

引用次数: 0

Evaluating outcomes in critically ill patients with undiagnosed acute kidney injury: a comparison of the incidence of physician-diagnosed vs KDIGO criteria-diagnosed acute kidney injury. 评估未确诊急性肾损伤危重患者的预后：医师诊断与KDIGO标准诊断急性肾损伤发生率的比较

Baylor University Medical Center Proceedings Pub Date : 2025-03-18 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2475427

William Assante, Shruti Kore, Reza Alavi, Saam Foroshani, Suhaib Andrabi, Asim Kichloo, Savneek Chugh

{"title":"Evaluating outcomes in critically ill patients with undiagnosed acute kidney injury: a comparison of the incidence of physician-diagnosed vs KDIGO criteria-diagnosed acute kidney injury.","authors":"William Assante, Shruti Kore, Reza Alavi, Saam Foroshani, Suhaib Andrabi, Asim Kichloo, Savneek Chugh","doi":"10.1080/08998280.2025.2475427","DOIUrl":"https://doi.org/10.1080/08998280.2025.2475427","url":null,"abstract":"Background: Acute kidney injury (AKI) independently predicts adverse outcomes, including morbidity, mortality, and prolonged hospital stays. Historically, inconsistent diagnostic criteria hindered the assessment of its prevalence. To address this, criteria such as Risk, Injury, Failure, Loss, and End-Stage Kidney Disease (RIFLE), Acute Kidney Injury Network (AKIN), and Kidney Disease: Improving Global Outcomes (KDIGO) were developed. Applying these criteria remains challenging, especially in critical care settings, leading to underdiagnosis and poorer outcomes.Methods: This retrospective cohort study examined AKI incidence in critically ill patients by applying KDIGO criteria to charts of patients in the intensive care unit (ICU), comparing them to physician-diagnosed AKI. We examined the consequences for physician-undiagnosed AKI patients by analyzing variables such as mortality and hospital/ICU length of stay.Results: Of the 1063 patients meeting KDIGO AKI criteria, physicians diagnosed 486 cases, missing 54% of AKI cases identified by KDIGO criteria. AKI was associated with longer hospital and ICU stays and higher mortality. Early stage AKI was particularly prone to underdiagnosis.Discussion: This study reveals the underdiagnosis of AKI by ICU physicians. This significantly impacts patients with cardiovascular disease, complicating recovery from cardiac procedures and affecting both short-term and long-term outcomes. Enhancing early AKI surveillance offers an opportunity to optimize care and improve outcomes.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"266-271"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical utilization and culture concordance of categorical and semiquantitative concentration values on the BioFire^® Pneumonia Panel at a major academic quaternary referral center. 一家主要学术四级转诊中心BioFire®肺炎小组分类和半定量浓度值的临床应用和培养一致性

Baylor University Medical Center Proceedings Pub Date : 2025-03-17 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2474907

Tiana R Endicott-Yazdani, Chris Boseovski, Neelam Dhiman, Yun X Ying, Susan K Mathai, Todd J Grazia, Raul Benavides

{"title":"Clinical utilization and culture concordance of categorical and semiquantitative concentration values on the BioFire® Pneumonia Panel at a major academic quaternary referral center.","authors":"Tiana R Endicott-Yazdani, Chris Boseovski, Neelam Dhiman, Yun X Ying, Susan K Mathai, Todd J Grazia, Raul Benavides","doi":"10.1080/08998280.2025.2474907","DOIUrl":"https://doi.org/10.1080/08998280.2025.2474907","url":null,"abstract":"Background: Pneumonia mortality can be decreased by early antibiotic administration. Pathogen identification aims to minimize inappropriate, nontargeted antibiotic exposure. Molecular assays expedite organism identification through nucleic acid detection and antimicrobial resistance by screening for genetic markers.Methods: We evaluated concordance of organism identification, resistance markers, and semiquantitative results between a Food and Drug Administration-approved molecular diagnostic test and traditional culture methods. We performed a retrospective analysis of BioFire® Pneumonia Panel (PN Panel) orders during a 2-month period.Results: Organism identification was 97% concordant between paired culture and polymerase chain reaction (PCR) detection. Probability of growth in culture varied proportionally with the \"semiquantitative\" PN Panel result, with only 4% of organisms with 104 copies/mL growing in culture, versus 53% of organisms with 107 copies/mL growing in culture. Additionally, in 2.5% of cases, the PN Panel identified an organism that did not grow from culture. In comparison, 0.1% of paired organisms were detected by culture but were not seen by BioFire PCR. Concordance of resistance detection with various culture-based methods was 99%.Conclusion: Combining PN Panel and culture results can maximize early, targeted resistance detection and organism treatment, and the semiquantitative result is a proxy for the probability of growth in culture and the clinical burden of each organism.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"278-284"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bladder angiosarcoma: a systematic literature review and survival analysis. 膀胱血管肉瘤：系统的文献回顾和生存分析。

Baylor University Medical Center Proceedings Pub Date : 2025-03-14 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2476319

Amisha Silwal, Sumie B R, Shafi Rehman, Ananya Daing, Ragini Gopagoni, Muhammad Alyas Akram, Afaq Saeed, Kaiser O'Sahil Sadiq, Ameer Mustafa Farrukh, Arya Harikrishna

{"title":"Bladder angiosarcoma: a systematic literature review and survival analysis.","authors":"Amisha Silwal, Sumie B R, Shafi Rehman, Ananya Daing, Ragini Gopagoni, Muhammad Alyas Akram, Afaq Saeed, Kaiser O'Sahil Sadiq, Ameer Mustafa Farrukh, Arya Harikrishna","doi":"10.1080/08998280.2025.2476319","DOIUrl":"https://doi.org/10.1080/08998280.2025.2476319","url":null,"abstract":"Background: Bladder angiosarcoma is a rare type of cancer with only sporadic cases reported.Methods: We performed a systematic review to describe clinicopathological features and survival outcomes.Results: Thirty-five cases reporting 68 patients were reviewed. Among them, 35 (51.4%) were diagnosed with de novo bladder angiosarcoma and 33 (48.6%) with radiation-induced bladder angiosarcoma. The mean age at presentation was 65.255 years (±14.6), and the median tumor size was 4.6 cm (interquartile range 2.9-6.7). Hematuria was the most common symptom, reported in 52/68 patients (76.4%). Microscopic examination revealed an epithelioid-shaped morphology in 43/47 patients (91.5%), spindle-shaped cells in 13/47 (27.6%), and mixed epithelioid and spindle-shaped cells in 9/47 (19.1%). Immunohistochemical analysis showed that CD31 was positive in 36/36 patients (100%), CD34 in 17/23 (73.9%), and Factor VIII-related antigen in 17/20 (85%). Metastasis was reported in 43/60 patients (71.6%). Chemotherapy was administered to 22/68 patients (32.4%). The median follow-up time was 5 months (interquartile range 3-12). Of the 54 patients with available survival data, 16 (29.6%) survived and 38 (70.4%) died of the disease. Multivariate Cox regression analysis identified female gender (hazard ratio [HR], 2.59; P = 0.01), metastasis (HR, 2.58; P = 0.01), and chemotherapy (HR, 0.28; P = 0.01) as independent prognostic factors. No statistically significant differences in survival were observed between de novo and radiation-induced bladder angiosarcoma.Conclusions: These findings suggest that BA is an aggressive disease regardless of its etiology. Early detection and timely initiation of chemotherapy may improve patient survival.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"305-312"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Avocations. 业余爱好。

Baylor University Medical Center Proceedings Pub Date : 2025-03-14 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2475688

引用次数: 0

The rapid evolution of AI in patient education-promise, peril, and the path forward. 人工智能在患者教育中的快速发展——希望、危险和前进的道路。

Baylor University Medical Center Proceedings Pub Date : 2025-03-10 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2475630

Christian Horazeck, William C Culp, Russell K McAllister

引用次数: 0

Music therapy in addition to music listening for the prevention of delirium in mechanically ventilated patients. 除听音乐外，音乐疗法对预防机械通气患者谵妄的作用。

Baylor University Medical Center Proceedings Pub Date : 2025-02-28 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2466931

Jeannette Crew, Ahmed Abdelmonem, Xuan Wang, Charles Harmon, Ariel Modrykamien

{"title":"Music therapy in addition to music listening for the prevention of delirium in mechanically ventilated patients.","authors":"Jeannette Crew, Ahmed Abdelmonem, Xuan Wang, Charles Harmon, Ariel Modrykamien","doi":"10.1080/08998280.2025.2466931","DOIUrl":"https://doi.org/10.1080/08998280.2025.2466931","url":null,"abstract":"Introduction: Delirium in mechanically ventilated patients has resulted in prolonged intensive care unit (ICU) and ventilator stay and higher mortality. Research has shown that a bundle containing sedation awakening and spontaneous breathing trials, appropriate choice of sedatives, early mobilization, and family engagement was associated with a reduced rate of delirium. Music listening and music therapy have also been studied, showing promising results for anxiety and pain control, but have not been studied in terms of preventing delirium.Methods: As part of a quality improvement project, we implemented a protocol of music listening and music therapy for mechanically ventilated patients. The rate of delirium, ICU and ventilator lengths of stay, and mortality were compared between groups (n = 17 protocol, n = 50 control).Results: There were no statistically significant differences in demographic characteristics, severity of illness, medical comorbidities, or cumulative doses of sedating medications between the groups. The rate of delirium between groups was not statistically significantly different (11.8% vs 16%, P = 0.70). Severity of illness based on APACHE IV score was statistically associated with mortality (estimate coefficient 0.03, P = 0.015), and use of dexmedetomidine was statistically associated with prolonged ICU and ventilator lengths of stay.Conclusion: The music therapy and music listening protocol did not show a reduction of the delirium rate for mechanically ventilated patients.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"285-290"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evolution of patient education materials from large-language artificial intelligence models on complex regional pain syndrome: are patients learning? 复杂局部疼痛综合征患者教育材料的大语言人工智能模型演变：患者在学习吗？

Baylor University Medical Center Proceedings Pub Date : 2025-02-28 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2470033

Anuj Gupta, Adil Basha, Tarun R Sontam, William J Hlavinka, Brett J Croen, Cherry Abdou, Mohammed Abdullah, Rita Hamilton

{"title":"Evolution of patient education materials from large-language artificial intelligence models on complex regional pain syndrome: are patients learning?","authors":"Anuj Gupta, Adil Basha, Tarun R Sontam, William J Hlavinka, Brett J Croen, Cherry Abdou, Mohammed Abdullah, Rita Hamilton","doi":"10.1080/08998280.2025.2470033","DOIUrl":"https://doi.org/10.1080/08998280.2025.2470033","url":null,"abstract":"Objectives: This study assessed the comprehensiveness and readability of medical information about complex regional pain syndrome provided by ChatGPT, an artificial intelligence (AI) chatbot, and Google using standardized scoring systems.Design: A Google search was conducted using the term \"complex regional pain syndrome,\" and the first 10 frequently asked questions (FAQs) and answers generated were recorded. ChatGPT was presented these FAQs generated by Google, and its responses were evaluated alongside Google's answers using multiple metrics. ChatGPT was then asked to generate its own set of 10 FAQs and answers.Results: ChatGPT's answers were significantly longer than Google's in response to both independently generated questions (330.0 ± 51.3 words, P < 0.0001) and Google-generated questions (289.7 ± 40.6 words, P < 0.0001). ChatGPT's answers to Google-generated questions were more difficult to read based on the Flesch-Kincaid Reading Ease Score (13.6 ± 10.8, P = 0.017).Conclusions: Our findings suggest that ChatGPT is a promising tool for patient education regarding complex regional pain syndrome based on its ability to generate a variety of question topics with responses from credible sources. That said, challenges such as readability and ethical considerations must be addressed prior to its widespread use for health information.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"221-226"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A comprehensive evaluation of intramedullary devices in the management of femoral metastasis: 30-day outcomes. 综合评价髓内装置在股骨转移治疗中的作用：30天的结果。

Baylor University Medical Center Proceedings Pub Date : 2025-02-28 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2465058

Halil Bulut, Maria Jose Maestre, Daniel Tomey

{"title":"A comprehensive evaluation of intramedullary devices in the management of femoral metastasis: 30-day outcomes.","authors":"Halil Bulut, Maria Jose Maestre, Daniel Tomey","doi":"10.1080/08998280.2025.2465058","DOIUrl":"https://doi.org/10.1080/08998280.2025.2465058","url":null,"abstract":"Introduction: Bone metastases, affecting 40% to 60% of patients with metastatic disease, are a significant concern, with the femur being one of the most common sites. These metastases significantly impact quality of life and present complex treatment challenges. Intramedullary nailing (IMN) is frequently used for femoral metastases owing to its minimally invasive nature and favorable outcomes.Methods: A retrospective cohort analysis was performed using data from the American College of Surgeons National Surgical Quality Improvement Program database (2016-2021). Patients aged 18 and older who underwent IMN for metastatic femoral disease were included. The primary endpoints were 30-day reoperation and readmission rates. Secondary endpoints assessed 30-day postoperative complications.Results: The cohort primarily comprised female patients (62.7%, n = 482) with notable comorbidities such as hypertension (48.9%) and high smoking rates (71.3%). Low rates of specific reoperations (0.4%, n = 3) and unplanned reoperations (1.7%, n = 13) were observed within 30 days. The incidence of deep vein thrombosis was 1.2%, and the incidence of pulmonary embolism was 0.7%. Surgical site infections were rare (Figure 1).Conclusion: IMN is a safe and effective surgical option for treating metastatic femoral lesions, providing a favorable safety profile. Further research is recommended to explore thromboembolic risks and optimize preventive strategies.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"247-252"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Progress in antiobesity medications. 抗肥胖药物的进展。

Baylor University Medical Center Proceedings Pub Date : 2025-02-26 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2469990

Tonia Yee Vinton

引用次数: 0