Baylor University Medical Center Proceedings最新文献

{"title":"Airway management-being prepared for the difficult case.","authors":"Michael A Ramsay","doi":"10.1080/08998280.2024.2448614","DOIUrl":"10.1080/08998280.2024.2448614","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 2","pages":"140-141"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482144","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":"Carrel, Abraham Flexner, and Osler: selected World War I correspondence.","authors":"Mathieu Ginier-Gillet","doi":"10.1080/08998280.2024.2441615","DOIUrl":"10.1080/08998280.2024.2441615","url":null,"abstract":"<p><p>The relationship between Alexis Carrel, who received the Nobel Prize in Physiology or Medicine in 1912, and Simon Flexner, director of the Rockefeller Institute for Medical Research, is well documented. However, Carrel's collaboration with Abraham Flexner, a key figure in US medical reform, is less widely recognized, and it seems there are no previous mentions of a connection with William Osler. This historical vignette offers insights into the interactions among these three figures during World War I. Five letters, preserved in the library of the National Academy of Medicine in Paris, are presented in full.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 2","pages":"202-204"},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482204","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":"Transient oculomotor nerve palsy associated with spontaneous intracranial hypotension in a pediatric patient.","authors":"Yi Fang, Stephanie Blasick, Ehab Dayyat","doi":"10.1080/08998280.2024.2439232","DOIUrl":"https://doi.org/10.1080/08998280.2024.2439232","url":null,"abstract":"<p><p>Spontaneous intracranial hypotension (SIH) is a condition where cerebrospinal fluid (CSF) levels decrease and is primarily caused by spontaneous CSF leaks, most commonly occurring at the level of the thoracic spine. We report the first case of a transient and isolated oculomotor nerve (cranial nerve III) palsy associated with SIH and elevated CSF protein in a pediatric patient. Unlike typical SIH cases that often present with decreased CSF protein, this patient's findings emphasize the variability in SIH manifestations and emphasize the necessity for clinical suspicion and accurate diagnosis to avoid serious complications.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"343-345"},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961500","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":"Implementation of an oxytocin bolus protocol for cesarean delivery at a Texas level IV maternal center: a single-center retrospective study.","authors":"Brittany Hood, Emily E Sharpe, Carmen Gomez Fitzpatrick, Annarose Dement, Claudia Serrano, Jessica C Ehrig, Chandni Raiyani, Michael P Hokfamp","doi":"10.1080/08998280.2024.2446021","DOIUrl":"10.1080/08998280.2024.2446021","url":null,"abstract":"<p><strong>Objective: </strong>We hypothesized that patients who underwent cesarean delivery and received oxytocin boluses followed by an infusion would have a lower incidence of secondary uterotonic administration compared to patients who had an oxytocin infusion without boluses.</p><p><strong>Methods: </strong>Patients who had cesarean deliveries at our hospital from September 1, 2021 through December 31, 2021 and from September 1, 2022 through December 31, 2022, corresponding to the oxytocin bolus and oxytocin infusion cohorts, respectively, were included. Patient demographic, physical, and clinical characteristic data were collected by a study investigator. Intramyometrial oxytocin, intramuscular methylergonovine, intramuscular carboprost tromethamine, and sublingual misoprostol were defined as secondary uterotonics.</p><p><strong>Results: </strong>There were 266 and 283 patients in the oxytocin bolus and oxytocin infusion cohorts, respectively. The odds ratio for patients in the oxytocin bolus cohort receiving a secondary uterotonic was 0.25 (95% confidence interval 0.16, 0.41; <i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>Patients in the oxytocin bolus cohort were approximately 75% less likely to receive a secondary uterotonic agent compared to patients in the oxytocin infusion cohort. A limitation of this study was that we defined intramyometrial administration of oxytocin as a secondary uterotonic, and our results may not be generalizable to hospitals that do not use intramyometrial oxytocin.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 2","pages":"149-154"},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482236","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":"Exploring current practices and perspectives on gastric varices management in the US.","authors":"Ahmad Moussawi, Ranjeeta Bahirwani","doi":"10.1080/08998280.2024.2446019","DOIUrl":"10.1080/08998280.2024.2446019","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 2","pages":"135-136"},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482225","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":"Airway management for patients who underwent appendectomy for the indication of acute appendicitis at a Texas tertiary care center: a single center retrospective study.","authors":"Dylan Noble, Val Lumani, Macy Meyer, Lindsay Howe, Michael P Hofkamp","doi":"10.1080/08998280.2024.2443878","DOIUrl":"10.1080/08998280.2024.2443878","url":null,"abstract":"<p><strong>Background: </strong>The primary aim of our study was to determine the frequency of video laryngoscopy (VL) use on the first intubation attempt for patients who underwent appendectomy for acute appendicitis at our hospital.</p><p><strong>Methods: </strong>Patients who had an appendectomy for the indication of acute appendicitis at Baylor Scott & White Medical Center - Temple between January 1, 2021, and December 31, 2023, were included in our study. Study investigators extracted demographic, physical, and clinical data from our electronic medical record.</p><p><strong>Results: </strong>A total of 533 and 70 patients had direct laryngoscopy (DL) and VL for their first intubation attempts, respectively. Among these, 518 (97.2%) and 53 (75.7%) performed with DL and VL, respectively, were successful on the first attempt (<i>P</i> < 0.001). Patients who had VL for the first intubation attempt were more likely to be male, older, have a higher body mass index, and have a higher incidence of previous airway management with VL, appendiceal perforation, nasopharyngeal tube placement, and SARS-CoV-2 infection compared to patients who had DL.</p><p><strong>Conclusion: </strong>Approximately 12% of our patients who underwent appendectomy for acute appendicitis had VL on the first intubation attempt, and these patients were more complex than those who had DL.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 2","pages":"137-139"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482199","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":"The effect of tobacco use on clinical outcomes in total knee arthroplasty patients.","authors":"Dylan Parry, Jack Allen, Brennon Henderson, Jordan Kassab, Evan Hernandez, George Brindley","doi":"10.1080/08998280.2024.2441633","DOIUrl":"10.1080/08998280.2024.2441633","url":null,"abstract":"<p><strong>Introduction: </strong>Previous research has established that smoking significantly increases the complication rate of total knee arthroplasty (TKA). Risk of infection, prosthetic loosening, fractures, wound healing issues, and revisions are increased in smokers, but research is limited on the long-term clinical outcomes of pain, range of motion, stability, and functionality between smokers, nonsmokers, and former smokers, specifically utilizing Knee Society Scores (KSS).</p><p><strong>Methods: </strong>This was a retrospective chart review of primary TKA patients (n = 203) at a single university hospital. The patients were divided by smoking status: nonsmoker, current smoker, or former smoker. One-way analysis of variance with associated f ratios was performed to assess variance in KSS by smoking status over time. Relative risk ratio analyses were employed to assess patients' predictive risk of acquiring postoperative infection and requiring additional surgery following TKA based on smoking status.</p><p><strong>Results: </strong>Postoperative KSS were significantly lower in the smoker group compared to nonsmokers and former smokers at 6 weeks and 1 year. For every 20 months a former smoker used tobacco, an approximate 1-point decrease in KSS was expected. The relative risk ratios for postoperative infection rates and patients requiring additional surgery were 2.13 and 1.44, respectively, when current smokers were compared to nonsmokers.</p><p><strong>Conclusions: </strong>This analysis found that current smokers had lower KSS and higher infection rates following TKA when compared to nonsmoking controls. In addition, increased duration of smoking was correlated with poorer outcomes within the former smoker group.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 2","pages":"171-174"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481825","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":"Differences in Medicare payment and practice characteristics for orthopedic surgery subspecialties.","authors":"Jack Allen, Colton Shepherd, Tanner Heaton, Nate Behrens, Alexander Dorius, Jerry Grimes","doi":"10.1080/08998280.2024.2440282","DOIUrl":"10.1080/08998280.2024.2440282","url":null,"abstract":"<p><strong>Background: </strong>Medicare payment, practice, and patient characteristics give perspective on the lifestyle, challenges, and attractiveness unique to each orthopedic surgery subspecialty. Changes to Medicare reimbursement may also affect health care delivery, warranting policy change. We analyzed differences in orthopedic surgery subspecialty characteristics and Medicare payments.</p><p><strong>Methods: </strong>The Centers for Medicare and Medicaid Services data set was filtered by Current Procedural Terminology (CPT) codes unique to each orthopedic surgery subspecialty in 2019. After filtering by unique CPT codes, 100 randomized physicians were validated for each subspecialty: adult reconstruction and arthroplasty, trauma, sports medicine, hand surgery, shoulder and elbow surgery, foot and ankle surgery, and spine surgery. Data gathered included unique procedural codes, number of beneficiaries, services provided, and the total Medicare allowed amount. Differences were assessed with post hoc tests. Subspecialty changes in Medicare payment were assessed using the Physician Fee Schedule and compared using a single-factor analysis of variance.</p><p><strong>Results: </strong>On average, hand surgery recorded the most unique CPT codes (106) and the highest volume of beneficiaries (571). Adult reconstruction and arthroplasty had the fewest unique codes (60) and the greatest total Medicare payment ($328,000). Spine surgery had the lowest number of beneficiaries (387) and lowest number of services provided (1752). Lastly, sports medicine provided the largest volume of services (4221). Mean total codes, unique codes, and total patients differed between subspecialties. Varying differences in average Medicare payment, total billed codes, total unique codes, total patients, patient race, patient age, patient sex, and patient health were found for all orthopedic surgery subspecialties in 2019.</p><p><strong>Conclusions: </strong>These data may illustrate financial incentives for orthopedic surgery residents to pursue certain subspecialties.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 2","pages":"175-178"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482213","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":"Recombinant von Willebrand factor: a new tool to manage von Willebrand disease in obstetric patients.","authors":"Angie J He, Michael P Hofkamp","doi":"10.1080/08998280.2024.2443877","DOIUrl":"10.1080/08998280.2024.2443877","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 2","pages":"148"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482168","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":"Portal vein thrombosis in patients with cirrhosis.","authors":"Michael L Volk, Gerald O Ogola, Patrick G Northup","doi":"10.1080/08998280.2024.2444145","DOIUrl":"10.1080/08998280.2024.2444145","url":null,"abstract":"<p><strong>Background and aims: </strong>Portal vein thrombosis (PVT) is common among patients with cirrhosis, but the independent impact on outcomes and management is uncertain. We aimed to determine whether the development of PVT is independently associated with mortality, bleeding, and hospitalization and whether anticoagulation improves these outcomes.</p><p><strong>Methods: </strong>Patients with cirrhosis and PVT were identified using billing codes from a large health system between 2016 and 2023 and compared to matched control cirrhosis patients without PVT. Among the cohort with PVT, those who received anticoagulation were compared to those who did not. Outcomes included mortality, gastrointestinal bleeding, and hospitalization. Adjustment for confounding was performed using propensity score analysis.</p><p><strong>Results: </strong>Among 48,596 patients with cirrhosis, 1332 formed the PVT cohort and 3440 formed the non-PVT matched cohort. On adjusted analysis, patients with PVT had higher mortality (hazard ratio [HR] 1.33, <i>P</i> < 0.001), bleeding (HR 1.41, <i>P</i> < 0.001), and hospitalization (incidence rate ratio [IRR] 1.25, <i>P</i> < 0.001). Among the 1161 PVT patients meeting inclusion criteria, 768 received no anticoagulation, 309 received anticoagulation for ≤90 days, and 84 received anticoagulation for >90 days. In the unadjusted analysis, anticoagulation was associated with lower mortality (log-rank <i>P</i> = 0.004), with a dose-response relationship. After propensity score adjustment, the association between anticoagulation and lower mortality persisted but no longer reached statistical significance (HR 0.8, <i>P</i> = 0.075). However, anticoagulation remained associated with higher bleeding (HR 1.67, <i>P</i> = 0.004) and hospitalization (IRR 1.43, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Among patients with cirrhosis, PVT is independently associated with a higher risk of mortality, bleeding, and hospitalization. Anticoagulation may improve overall survival but is associated with a higher risk of bleeding and hospitalization.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 2","pages":"121-125"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482163","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}