Baylor University Medical Center Proceedings最新文献_第3页

Avocations. 职业

Baylor University Medical Center Proceedings Pub Date : 2024-07-31 eCollection Date: 2024-01-01 DOI: 10.1080/08998280.2024.2381416

引用次数: 0

Association of coinfections with differences in outcomes across COVID-19 variants. 合并感染与 COVID-19 变体的结果差异之间的关系。

Baylor University Medical Center Proceedings Pub Date : 2024-07-31 eCollection Date: 2024-01-01 DOI: 10.1080/08998280.2024.2379723

Christian Beltran, Jennifer Hood, Valerie Danesh, Anisha Shrestha, Gerald Ogola, Carl Boethel, Alejandro C Arroliga, Shekhar Ghamande

{"title":"Association of coinfections with differences in outcomes across COVID-19 variants.","authors":"Christian Beltran, Jennifer Hood, Valerie Danesh, Anisha Shrestha, Gerald Ogola, Carl Boethel, Alejandro C Arroliga, Shekhar Ghamande","doi":"10.1080/08998280.2024.2379723","DOIUrl":"10.1080/08998280.2024.2379723","url":null,"abstract":"Background: In previous studies, there was an increase in mortality with secondary coinfections in all COVID-19 variants. However, no prior study has explored the association of coinfection with outcomes of hospitalized patients among the COVID-19 variants (Alpha, Delta, and Omicron).Methods: This observational cohort study involved 21,186 patients hospitalized with COVID-19 in 25 hospitals in Texas. Patients were divided into groups by surges of COVID-19: Alpha (November 1, 2020-February 10, 2021), Delta (July 10, 2021-October 14, 2021), and Omicron (December 21, 2021-March 3, 2022). Data were collected from electronic health records using methodology from the Viral Respiratory Illness Universal Study COVID-19 registry (NCT04323787) of COVID-19 hospitalizations. Multivariable Cox-proportional hazard regression model assessed the adjusted effect of different surge periods on mortality.Results: Bacterial coinfections varied among hospitalization surges associated with Alpha (8.5%), Delta (11.7%), and Omicron (11.9%) variants. Adjusted analyses showed a higher 30-day and 90-day mortality in all variants when coinfections were present compared with isolated COVID-19 infection. In particular, 30-day and 90-day mortality were significantly worse with Delta compared to Alpha and Omicron.Conclusions: All variants were associated with a higher mortality when bacterial coinfections were present. Delta was associated with a higher risk-adjusted mortality at 30 days and thereafter.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"37 5","pages":"750-754"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008124","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

Efficacy, safety, and impact on procedural outcomes of local anesthesia in endoscopic submucosal dissection: a systematic review and meta-analysis. 内镜粘膜下剥离术中局部麻醉的有效性、安全性及其对手术结果的影响：系统综述和荟萃分析。

Baylor University Medical Center Proceedings Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.1080/08998280.2024.2384896

Hazem Abosheaishaa, Abdelmalek Abdelghany, Abdallfatah Abdallfatah, Doha Mohamed, Ammar Ayman Bahbah, Islam Mohamed, Khaled Elfert, Ahmed E Salem, Azizullah Beran, Ahmad Madkour, Mohammad Al-Haddad

{"title":"Efficacy, safety, and impact on procedural outcomes of local anesthesia in endoscopic submucosal dissection: a systematic review and meta-analysis.","authors":"Hazem Abosheaishaa, Abdelmalek Abdelghany, Abdallfatah Abdallfatah, Doha Mohamed, Ammar Ayman Bahbah, Islam Mohamed, Khaled Elfert, Ahmed E Salem, Azizullah Beran, Ahmad Madkour, Mohammad Al-Haddad","doi":"10.1080/08998280.2024.2384896","DOIUrl":"https://doi.org/10.1080/08998280.2024.2384896","url":null,"abstract":"Background: Endoscopic submucosal dissection (ESD) has revolutionized the treatment of early stage gastrointestinal cancers. However, ESD can be associated with increased postprocedural pain and higher complication rates. This systematic review and meta-analysis evaluated the efficacy and safety of local anesthesia.Methods: A comprehensive search was conducted to identify relevant randomized controlled trials investigating the effect of local anesthesia in ESD procedures. The Cochrane risk of bias tool for randomized trials was used to assess study quality. A meta-analysis was performed using Review Manager 5.4, with summary measures expressed as pooled odds ratios (OR) or mean differences with corresponding 95% confidence intervals (CI).Results: Four randomized controlled trials with 296 patients undergoing ESD procedures were included. The use of local anesthesia did not significantly impact procedural time (mean difference = -2.05, 95% CI = -9.29, 5.18, I2 = 30%, P = 0.58). Lastly, the use of local anesthesia did not increase the risk of bleeding or other adverse events (P > 0.05) and decreased the incidence of bradycardia (OR = 0.16, 95% CI = 0.03, 0.95; I2 = 0%; P = 0.04).Conclusion: Our study found that the use of local anesthesia did not significantly affect the procedural time of ESD. However, it effectively reduced postoperative pain in some trials with no risk of increased incidence of adverse events.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"37 6","pages":"963-969"},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493933","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. 职业

Baylor University Medical Center Proceedings Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.1080/08998280.2024.2381985

引用次数: 0

Comparison of mechanical and thermal therapy in upper gastrointestinal bleeding: an analysis of efficacy outcomes. 上消化道出血机械疗法与热疗的比较：疗效分析。

Baylor University Medical Center Proceedings Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.1080/08998280.2024.2381180

Rahul Karna, Bandhul Hans, Thayer Nasereddin, Dhruv Chaudhary, Manish Dhawan

{"title":"Comparison of mechanical and thermal therapy in upper gastrointestinal bleeding: an analysis of efficacy outcomes.","authors":"Rahul Karna, Bandhul Hans, Thayer Nasereddin, Dhruv Chaudhary, Manish Dhawan","doi":"10.1080/08998280.2024.2381180","DOIUrl":"10.1080/08998280.2024.2381180","url":null,"abstract":"Background: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a complication of dual antiplatelet therapy (DAPT) and direct oral anticoagulant therapy (DOAC). There is a lack of data comparing mechanical therapy (clips) with thermal therapy in this population.Methods: We conducted a retrospective chart review of patients undergoing urgent/emergent endoscopy for NVUGIB while being on DAPT or DOAC. Patients who had DAPT/DOAC held as per American Society of Gastrointestinal Endoscopy guidelines were excluded from the study.Results: A total of 122 patients were included in the study. There was no difference in primary hemostasis, rebleeding rate, rescue hemostatic procedure, and 30-day mortality between the mechanical and thermal therapy groups. The mechanical therapy group had a significantly higher rate of prolonged length of stay (61.2% vs 38.9%, P = 0.02), serious clinical outcomes (56% vs 37.5%, P = 0.04), and intensive care unit admissions (50% vs 20.8%, P = 0.001) than the thermal therapy group.Conclusion: Patients on DAPT/DOAC presenting with NVUGIB can undergo mechanical or thermal endoscopic intervention without a significant difference in achieving primary hemostasis, rebleeding, requiring a secondary procedure, or mortality outcomes.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"37 5","pages":"734-741"},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008127","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

Engaging the services of remote clinical pharmacists in the management of type 2 diabetes. 让远程临床药剂师参与 2 型糖尿病的管理。

Baylor University Medical Center Proceedings Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.1080/08998280.2024.2381177

Michael McNeal

引用次数: 0

The changing landscape of geriatric care in acute myeloid leukemia: a 5-year analysis of inpatient mortality predictors, trends in mortality, and chemotherapy use. 急性髓性白血病老年病护理的变化情况：住院病人死亡率预测因素、死亡率趋势和化疗使用情况的 5 年期分析。

Baylor University Medical Center Proceedings Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.1080/08998280.2024.2381174

Zubair Hassan Bodla, Mariam Hashmi, Fatima Niaz, Muhammad Jahanzeb Khalil, Farhan Khalid, Zahra Niaz, Mohammad Abdullah Hashmi, Umer Farooq, Rajashree Chaudhury, Christopher L Bray

{"title":"The changing landscape of geriatric care in acute myeloid leukemia: a 5-year analysis of inpatient mortality predictors, trends in mortality, and chemotherapy use.","authors":"Zubair Hassan Bodla, Mariam Hashmi, Fatima Niaz, Muhammad Jahanzeb Khalil, Farhan Khalid, Zahra Niaz, Mohammad Abdullah Hashmi, Umer Farooq, Rajashree Chaudhury, Christopher L Bray","doi":"10.1080/08998280.2024.2381174","DOIUrl":"10.1080/08998280.2024.2381174","url":null,"abstract":"Background: This study examined inpatient mortality factors in geriatric patients with acute myeloid leukemia (AML) using data from the 2016 to 2020 National Inpatient Sample.Methods: Identifying patients through ICD-10 codes, a total of 127,985 individuals with AML were classified into age categories as follows: 50.58% were 65 to 74 years, 37.74% were 75 to 84 years, and 11.68% were 85 years or older. Statistical analysis, conducted with STATA, involved Fisher's exact and Student's t tests for variable comparisons. Mortality predictors were identified through multivariate logistic regression.Results: Various hospital and patient-level factors, including an increase in age, race, a higher Charlson Comorbidity Index score, insurance status, and specific comorbidities such as atrial fibrillation and protein-calorie malnutrition, independently elevated the risk of inpatient mortality. Asthma, hyperlipidemia, and inpatient chemotherapy were linked to lower mortality. Although there was no statistically significant mortality rate change from 2016 to 2020, a decline in chemotherapy use in the eldest age group was noted.Conclusion: This study highlights the complexity of factors influencing inpatient mortality among geriatric patients with AML, emphasizing the need for personalized clinical approaches in this vulnerable population.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"37 5","pages":"813-821"},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008215","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

Hepatic hyperechoic lesion in a young, healthy man. 一名年轻健康男子的肝脏高回声病变。

Baylor University Medical Center Proceedings Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.1080/08998280.2024.2379152

Tyler Tepfenhart, Callie Fort, Jyoti Jha, Eric Smith

引用次数: 0

Utility of ¹⁸F-fluoroestradiol over ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography in the initial diagnosis of over 90 metastatic lesions in a patient with metastatic estrogen receptor-positive breast cancer. 在初步诊断一名雌激素受体阳性转移性乳腺癌患者的 90 多个转移病灶时，18F-氟雌二醇比 18F- 氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描更有用。

Baylor University Medical Center Proceedings Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.1080/08998280.2024.2376972

Caroline Breit, Valerie Gorman

{"title":"Utility of 18F-fluoroestradiol over 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the initial diagnosis of over 90 metastatic lesions in a patient with metastatic estrogen receptor-positive breast cancer.","authors":"Caroline Breit, Valerie Gorman","doi":"10.1080/08998280.2024.2376972","DOIUrl":"https://doi.org/10.1080/08998280.2024.2376972","url":null,"abstract":"Approximately 6% of women with newly diagnosed breast cancer will present with metastatic disease. Proper staging workup and diagnosis of metastatic lesions is crucial prior to surgical treatment.18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is often included in the staging workup of locally advanced breast cancer. Recently, PET/CT with 18F-fluoroestradiol (18F-FES), a radiolabeled form of estradiol that binds to the estrogen receptor, has been approved as an additional imaging technique for the detection of estrogen receptor-positive lesions in patients with metastatic breast cancer. Though the two have been shown to have comparable sensitivity for diagnosis of metastatic lesions, there is still much debate regarding when to use 18F-FES PET/CT over 18F-FDG PET/CT imaging. We present the case of a 68-year-old patient diagnosed with estrogen and progesterone receptor-positive invasive ductal carcinoma of the left breast. Her staging workup included an 18F-FDG PET/CT that did not demonstrate any evidence of metastatic lesions. Due to discordant imaging findings, the patient then underwent 18F-FES PET/CT, which demonstrated over 90 metastatic osseous lesions. This study highlights the utility of 18F-FES PET/CT over 18F-FDG PET/CT in diagnosis of metastatic osseous lesions in a patient with metastatic estrogen receptor-positive breast cancer.","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"37 6","pages":"984-986"},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493942","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. 职业

Baylor University Medical Center Proceedings Pub Date : 2024-07-23 eCollection Date: 2024-01-01 DOI: 10.1080/08998280.2024.2381400

Rolando M Solis

引用次数: 0