{"title":"Surveillance strategies for renal cell carcinoma in the renal allograft: balancing early detection and resource utilization.","authors":"Arthi Rajagopal","doi":"10.1080/08998280.2024.2384343","DOIUrl":"10.1080/08998280.2024.2384343","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"37 5","pages":"839-840"},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008214","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}
Tarun Sontam, William Hlavinka, Eitan Podgaetz, Richard Naftalis, Gary S Schwartz
{"title":"Esophageal perforation following anterior cervical discectomy and fusion.","authors":"Tarun Sontam, William Hlavinka, Eitan Podgaetz, Richard Naftalis, Gary S Schwartz","doi":"10.1080/08998280.2024.2384011","DOIUrl":"10.1080/08998280.2024.2384011","url":null,"abstract":"<p><p>Anterior cervical discectomy and fusion (ACDF) is one of the most common spinal surgeries performed in the US but is associated with various morbidities. Esophageal perforation is one of the rarest complications of ACDF, but it is potentially fatal, therefore requiring timely detection and treatment. We present three cases of esophageal perforation after ACDF.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 1","pages":"76-79"},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876160","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":"Avocations.","authors":"","doi":"10.1080/08998280.2024.2381416","DOIUrl":"https://doi.org/10.1080/08998280.2024.2381416","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"37 5","pages":"762"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071923","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}
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":"<p><strong>Background: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","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}
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":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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, I<sup>2</sup> = 30%, <i>P</i> = 0.58). Lastly, the use of local anesthesia did not increase the risk of bleeding or other adverse events (<i>P</i> > 0.05) and decreased the incidence of bradycardia (OR = 0.16, 95% CI = 0.03, 0.95; I<sup>2</sup> = 0%; <i>P</i> = 0.04).</p><p><strong>Conclusion: </strong>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.</p>","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}
{"title":"Avocations.","authors":"","doi":"10.1080/08998280.2024.2381985","DOIUrl":"https://doi.org/10.1080/08998280.2024.2381985","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"37 5","pages":"812"},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071922","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}
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":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%, <i>P</i> = 0.02), serious clinical outcomes (56% vs 37.5%, <i>P</i> = 0.04), and intensive care unit admissions (50% vs 20.8%, <i>P</i> = 0.001) than the thermal therapy group.</p><p><strong>Conclusion: </strong>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.</p>","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}
{"title":"Engaging the services of remote clinical pharmacists in the management of type 2 diabetes.","authors":"Michael McNeal","doi":"10.1080/08998280.2024.2381177","DOIUrl":"10.1080/08998280.2024.2381177","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"37 5","pages":"781"},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008128","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}
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":"<p><strong>Background: </strong>This study examined inpatient mortality factors in geriatric patients with acute myeloid leukemia (AML) using data from the 2016 to 2020 National Inpatient Sample.</p><p><strong>Methods: </strong>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 <i>t</i> tests for variable comparisons. Mortality predictors were identified through multivariate logistic regression.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","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}
Tomas Escobar Gil, Angelica Ruby Garcia, Kimberly Nguyen, Malik Alqawasmi, Oscar Felipe Borja Montes, Leonard Noronha, Daniel Babu
{"title":"Breaking the storm: ruxolitinib as a lifeline in refractory hemophagocytic lymphohistiocytosis with macrophage activation syndrome.","authors":"Tomas Escobar Gil, Angelica Ruby Garcia, Kimberly Nguyen, Malik Alqawasmi, Oscar Felipe Borja Montes, Leonard Noronha, Daniel Babu","doi":"10.1080/08998280.2024.2384042","DOIUrl":"10.1080/08998280.2024.2384042","url":null,"abstract":"<p><p>This case report presents the management of a 25-year-old woman with refractory hemophagocytic lymphohistiocytosis (HLH) secondary to adult-onset Still's disease. Despite initial treatment with corticosteroids and biologic therapies, including anakinra and tocilizumab, her condition continued to deteriorate, necessitating intensive care unit admission. Following multidisciplinary consultation, ruxolitinib therapy, a Janus kinase (JAK) inhibitor targeting hyperinflammation, was initiated. Remarkably, the patient exhibited significant clinical improvement with resolution of fever, normalization of inflammatory markers, and organ function recovery. This case underscores the potential of ruxolitinib as a therapeutic option in refractory cases of HLH or macrophage activation syndrome, highlighting the importance of exploring novel therapies in refractory and challenging clinical scenarios.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 1","pages":"94-97"},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876155","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}