Baylor University Medical Center Proceedings最新文献

{"title":"Enhancing ad hoc team performance with emotional intelligence.","authors":"Bobbie Ann Adair White, Michael G Healy, Britlyn D Orgill, Alejandro C Arroliga","doi":"10.1080/08998280.2025.2463274","DOIUrl":"https://doi.org/10.1080/08998280.2025.2463274","url":null,"abstract":"<p><p>Ad hoc teams in healthcare systems are beneficial from an organizational lens. Despite the benefits of ad hoc teams, clinical faculty have reported concerns due to a short time to coalesce prior to taking care of complex patients in areas such as the intensive care unit, trauma bay, or operating room. Evidence around ad hoc teams is scarce, so we extrapolated key findings from adjacent literature to establish a foundation for ad hoc team members' individual readiness. We propose that it is critical for team members to be individually prepared, and we borrow from literature focused on building emotionally intelligent (EI) teams. Thus, all team members should develop their EI to ensure that they will demonstrate self-awareness, empathy, transparency, adaptability, and collaboration. If each team member shows up with a high level of EI, the team should be able to read the situation, anticipate the needs of other team members, and adapt as needed, ensuring a positive outcome for the patient and team.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"354-357"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969468","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}

{"title":"Future practice plans of internal medicine fellowship graduates: a focus on pulmonary and critical care medicine.","authors":"Hamza Alzghoul, Akram Khan, Sherie Gause, Osama Alzoubi, Raju Reddy","doi":"10.1080/08998280.2025.2466372","DOIUrl":"https://doi.org/10.1080/08998280.2025.2466372","url":null,"abstract":"<p><strong>Background: </strong>The practice patterns of pulmonary and critical care medicine (PCCM) graduates are not well described. We aimed to describe the career paths sought by PCCM fellowship graduates entering the workforce.</p><p><strong>Methods: </strong>Using the Fellowship and Residency Electronic Interactive Database, we examined data on the career paths of trainees graduating from internal medicine fellowship programs for 2022.</p><p><strong>Results: </strong>Our study found that 712 trainees completed PCCM fellowship during 2022. Approximately 17% of PCCM graduates opted to pursue additional subspecialty training. Among those opting to enter practice, approximately 40% and 39% of PCCM graduates preferred academic practice and private practice, respectively. Among those opting for private practice, 48% chose group practice. Among all internal medicine subspecialties, there was a trend toward more graduates entering academia compared to historical averages. Notably, only 2.5% of PCCM graduates entering private practice opted to work in a rural setting. A similar trend was noted in other subspecialties. All specialties showed low percentages for practicing in underserved areas.</p><p><strong>Conclusion: </strong>PCCM fellowship graduates exhibited a preference for academic practice and a reduced likelihood of pursuing further subspecialty training. The percentage of internal medicine subspecialists practicing in underserved areas remains low.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"235-240"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966835","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}

{"title":"Gender disparities, prognostic indicators, and survival differences in pulmonary typical carcinoid: a SEER database analysis.","authors":"Asim Ahmed, Abdul Qahar Khan Yasinzai, Bisma Tareen, Agha Wali, Marjan Khan, Lukman Tijani, Asad Ullah","doi":"10.1080/08998280.2025.2464454","DOIUrl":"https://doi.org/10.1080/08998280.2025.2464454","url":null,"abstract":"<p><strong>Background: </strong>Typical carcinoid is a subtype of neuroendocrine neoplasia of the lung making up <1% of all lung cancers and 2% of resected lung tumors. This study assessed the impact of demographic features, racial and gender disparities, and tumor characteristics on survival in patients with typical carcinoid tumors.</p><p><strong>Methods: </strong>Data were extracted from the SEER database from 2000 to 2018. Multivariate Cox regression analyses were used to analyze the survival based on demographic and clinical factors.</p><p><strong>Results: </strong>We identified 11,713 cases of typical carcinoid tumors of the lungs. The mean age was 61.8 years (standard deviation, 14.7), and the tumors affected predominantly women (70.1%) and White (89.4%) individuals. The overall 5-year survival rate was 84.3% (95% confidence interval [CI] 83.5-85.2). The 5-year survival rate for those treated with systemic therapy was 49.8% (95% CI 43.5-55.9). Those treated with surgery had a 5-year survival rate of 97.2% (95% CI 96.7-97.6), and those treated with radiation had a 5-year survival rate of 71.9% (95% CI 60.3-80.6). Combination therapy provided a survival rate of 86.9% (95% CI 64.6-95.6).</p><p><strong>Conclusion: </strong>Surgery was the most common treatment modality and offered the best prognosis. On multivariate analysis, age >60, male gender, distant spread, and liver metastases were associated with worse prognosis.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"241-245"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966843","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}

{"title":"Digital clinical decision support to improve care and to save costs: a pilot survey of the views of frontline healthcare professionals.","authors":"George West, Jonathan Foo, Dragan Ilic, Kieran Walsh","doi":"10.1080/08998280.2025.2465055","DOIUrl":"https://doi.org/10.1080/08998280.2025.2465055","url":null,"abstract":"<p><strong>Introduction: </strong>There has been much discourse about the features and impact of clinical decision support. However, until recently, there has been less evidence on <i>how</i> healthcare professionals use decision support to provide evidence-based care or on the potential cost savings that could emerge from its use. This study attempted to fill this gap by asking healthcare professionals to what extent they value digital clinical decision support as a means to apply evidence-based care and to save costs.</p><p><strong>Methods: </strong>Frontline resident doctors were invited to complete an online semistructured questionnaire on if, and how, they used a clinical decision support resource to obtain and apply information to provide evidence-based care and/or to save costs.</p><p><strong>Results: </strong>Among the respondents, 93% agreed or strongly agreed that the clinical decision support helped them obtain information to provide evidence-based care, and 93% agreed or strongly agreed that they could apply the information obtained from the resource to provide evidence-based care. Half of the respondents agreed or strongly agreed that using the resource helped them save healthcare costs.</p><p><strong>Discussion: </strong>The results strongly support the idea that the doctors used the resource to provide evidence-based care; the results related to cost savings were not as strong.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"229-232"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972835","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}

{"title":"Preoperative blood pressure in Mohs micrographic surgery.","authors":"Howard K Steinman","doi":"10.1080/08998280.2025.2464468","DOIUrl":"https://doi.org/10.1080/08998280.2025.2464468","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"277"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956043","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}

{"title":"There's more fun than work: Neurologist Walter Shelden's atypical work-life balance in early 20th century medicine.","authors":"Nathaniel P Rogers, Christopher J Boes","doi":"10.1080/08998280.2025.2466393","DOIUrl":"https://doi.org/10.1080/08998280.2025.2466393","url":null,"abstract":"<p><p>Walter DeWitt Shelden (1870-1946), Mayo Clinic's first neurologist, set himself apart from his early 20th century peers. Despite his professional achievements, Shelden modeled a remarkable work-life balance, an uncommon trait among physicians of his time. His diverse interests outside of neurology included tree cultivation, woodworking, and golf. Shelden worked with famed golf course architect Albert Warren Tillinghast on the development of the golf course at Rochester Golf and Country Club, where he personally planted thousands of trees, exemplifying his dedication to his passions outside of medicine. His life serves as an early example of successfully integrating work with personal interests.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"358-361"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956046","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}

{"title":"Characteristics and outcomes of observed versus resected pancreatic neuroendocrine tumors.","authors":"Caroline Breit, Bobby Dow, Masen Ragsdale, Rachel Jefferies, Pallavi Patil, Catherine H Davis","doi":"10.1080/08998280.2025.2463289","DOIUrl":"https://doi.org/10.1080/08998280.2025.2463289","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic neuroendocrine tumors (pNETs) are a rare group of tumors with a wide range of clinical presentations. pNETs may present as incidentally discovered slow-growing tumors or as more aggressive tumors with metastatic potential. The mainstay of treatment is surgical resection; however, some have argued that observation can be considered for small, nonfunctional tumors. The objective of this study was to compare patients with pNETs who underwent initial resection versus observation to better understand tumor characteristics that favor either treatment approach.</p><p><strong>Methods: </strong>A retrospective review was performed of patients diagnosed with pNETs at a tertiary referral center from 2018 to 2023. Information on the patient and tumor, disease and treatment course, and outcomes was collected.</p><p><strong>Results: </strong>Forty-three patients were included in the study; 33% underwent initial resection, 37% underwent observation, and 30% underwent surgical resection following a period of observation (delayed resection). Patients who underwent initial resection were more likely to be younger with fewer comorbidities and have symptomatic or functional tumors. Patients with tumors >2 cm were more likely to have a postoperative complication. In a subgroup of patients with incidentally discovered tumors ≤2 cm, 33% underwent delayed resection and did not experience any postoperative complications; 66% underwent observation, and none had progression of their disease over the follow-up period of 17 months.</p><p><strong>Conclusion: </strong>While surgical resection remains the mainstay of treatment for pNETs, a period of observation in select individuals with small, incidentally discovered pNETs may also be considered safe. Management with surgical resection or initial observation must be an individualized decision and may be optimally supported with formal multidisciplinary tumor board discussion.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"213-219"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956913","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}

{"title":"Efficacy and safety of retatrutide, a novel GLP-1, GIP, and glucagon receptor agonist for obesity treatment: a systematic review and meta-analysis of randomized controlled trials.","authors":"Alaa Abdrabou Abouelmagd, Amro Mamdouh Abdelrehim, Mohamed Nabih Bashir, Fares Abdelsalam, Ahmed Marey, Yousef Tanas, Duha Milad Abuklish, Mohamed Mohamed Belal","doi":"10.1080/08998280.2025.2456441","DOIUrl":"https://doi.org/10.1080/08998280.2025.2456441","url":null,"abstract":"<p><strong>Background: </strong>Retatrutide is a novel triple agonist targeting the receptors of glucagon-like peptide 1 (GLP-1), gastric inhibitory polypeptide (GIP), and glucagon. We sought to assess the efficacy and safety of retatrutide in obese patients with or without diabetes.</p><p><strong>Methods: </strong>PubMed, Scopus, Web of Science, and Cochrane databases were searched from inception until May 2024. Eligible studies comprised randomized controlled trials that compared retatrutide with placebo in obese patients. We excluded studies on healthy populations, non-English texts, single-arm studies, animal studies, and abstracts. RevMan software (version 5.4) was used for analysis, with subgroup evaluation by dose (4 mg, 8 mg, 12 mg).</p><p><strong>Results: </strong>Three randomized controlled trials, encompassing 878 patients, satisfied our inclusion criteria. Retatrutide significantly reduced body weight (mean difference [MD]: -14.33%), body mass index (MD: -5.38), waist circumference (MD: -10.51 cm), fasting plasma glucose (MD: -23.51 mg/dL), hemoglobin A1c (MD: -0.91%), and systolic and diastolic blood pressure (MD: -9.88 mm Hg and -3.88 mm Hg, respectively), all with <i>P</i> values < 0.00001. No significant difference in adverse events was observed between the groups (relative risk: 1.11, <i>P</i> = 0.24).</p><p><strong>Conclusion: </strong>Retatrutide demonstrated significant improvements in body weight and metabolic outcomes among adults with obesity and had an appropriate safety profile. However, additional large and long-term trials are required to establish these results.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"291-303"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952682","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}

{"title":"Liver transplant program utilization of donation after circulatory death liver grafts by procurement technique and storage modality: a survey of US liver transplant surgical directors.","authors":"Nazokat Otajonova, Eric J Martinez, Amar Gupta, Johanna Bayer, Giuliano Testa, Anji E Wall","doi":"10.1080/08998280.2025.2457899","DOIUrl":"https://doi.org/10.1080/08998280.2025.2457899","url":null,"abstract":"<p><strong>Introduction: </strong>Donation after circulatory death (DCD) increased in the US over the past decade. However, 30% of DCD liver grafts procured for transplantation are not utilized. Barriers to DCD liver utilization include quality concerns, particularly the risk of ischemic cholangiopathy and retransplantation, and costs associated with DCD organ acquisition. This study investigated the attitudes of the liver transplantation community in the US toward DCD and identified barriers to DCD liver utilization.</p><p><strong>Methods: </strong>RedCap survey of liver transplantation surgical directors in the US.</p><p><strong>Results: </strong>Of 101 liver transplantation surgical directors, 24 responded to the survey, and 96% of respondents accepted DCD donors. Most programs accepted livers from thoracoabdominal normothermic regional perfusion with cold storage (96%), while substantially fewer accepted liver grafts from rapid recovery DCD donors with cold storage (67%). Sixty-five percent of transplant centers' functional warm ischemic time started when oxygen saturation or systolic blood pressure was <80%/mm Hg; 13% started at extubation, 17.4% started at systolic blood pressure <80 mm Hg, and 4.3% used a systolic blood pressure <50 mm Hg.</p><p><strong>Conclusion: </strong>We found variability among transplant programs in DCD liver graft acceptance based on procuring surgeon, procurement technique, and storage modality. Quality and cost are two main barriers to DCD liver utilization, with the main tradeoffs being between rapid recovery with static cold storage (lower cost, lower quality) and machine perfusion/normothermic regional perfusion (higher cost, better quality).</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"253-258"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966546","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}

{"title":"Sex differences after PCI are not explained by comorbidities.","authors":"Cara East","doi":"10.1080/08998280.2025.2454183","DOIUrl":"https://doi.org/10.1080/08998280.2025.2454183","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 2","pages":"170"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482170","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}