Baylor University Medical Center Proceedings最新文献

{"title":"Macrophage activation syndrome-associated adult onset Still disease treatment: a scoping review of case reports and case series.","authors":"Nattanicha Chaisrimaneepan, Pitchaporn Yingchoncharoen, Watsachon Pangkanon, Chanakarn Kanitthamniyom","doi":"10.1080/08998280.2025.2482315","DOIUrl":"10.1080/08998280.2025.2482315","url":null,"abstract":"<p><strong>Objective: </strong>One of the most lethal complications of adult-onset Still disease (AOSD) is macrophage activation syndrome, which can be present later in the case of uncontrolled AOSD or concurrently with the first diagnosis of AOSD. Up to the present, there has not been a standard guideline of treatment for AOSD associated with macrophage activation syndrome (MAS). Therefore, this systematic scoping review aimed to examine the available literature and provide an overview of treatment based on the available literature, mostly case reports and case series.</p><p><strong>Methods: </strong>A search strategy combined terms for AOSD, MAS, hemophagocytic lymphohistiocytosis, and treatment from PubMed, Web of Science, Embase, and Scopus databases from inception to June 2024. Studies were included and excluded by two independent authors. The quality of the studies was assessed. A qualitative and quantitative narrative synthesis of the results was conducted based on the study design.</p><p><strong>Results: </strong>Among 611 articles identified, 204 duplicates were removed, and 171 studies were included for full-text screening. A total of 83 articles met the inclusion criteria, with 69 case reports and 14 case series. Overall, mortality was 12.07%. There were more females (72.41%) than males (27.59%). Most required more than one medical treatment or treatment modality (80.17%), and 18.97% of all cases utilized monotherapy, mainly systemic corticosteroids. Others required combined therapy, ranging from two to five therapies.</p><p><strong>Conclusion: </strong>Systemic glucocorticoids should be administered as first-line treatment concomitantly with either a conventional or biologic agent to suppress cytokine storms. The findings from this systematic review can be effectively applied to patients who are cared for and provide alternatives in circumstances where patients are resistant to general treatment.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 4","pages":"499-511"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483009","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 disparity in clinical and management outcomes in patients with pulmonary embolism: a systematic review and meta-analysis.","authors":"Ubaid Khan, Mohamed Abuelazm, Abdallah Saeed, Ahmed Abdelhalem, Ahmed Badawy, Majd M AlBarakat, Zaid Hatamleh, Mohamed R Abdelraouf, Muhammad Moiz Nasir, Hazem Rezq, Basel Abdelazeem","doi":"10.1080/08998280.2025.2475429","DOIUrl":"https://doi.org/10.1080/08998280.2025.2475429","url":null,"abstract":"<p><strong>Background: </strong>Gender may contribute significantly to the variation in prognostic aspects and outcomes in various clinical conditions. We reviewed original studies to determine the impact of gender on the clinical outcomes in patients with pulmonary embolism.</p><p><strong>Methods: </strong>A systematic review and meta-analysis synthesizing observational studies was conducted by systematically searching PubMed, Web of Science, SCOPUS, and Cochrane through April 12, 2023. We reported dichotomous outcomes using risk ratio (RR) and the corresponding 95% confidence interval (CI).</p><p><strong>Results: </strong>We included 18 studies with a total of 1,339,937 patients. There was no difference between men and women for all-cause mortality (RR: 0.99; 95% CI [0.89, 1.10]; <i>P</i> = 0.81), in-hospital mortality (RR: 0.94; 95% CI [0.88, 1.02]; <i>P</i> = 0.13), PE-related mortality (RR: 0.86; 95% CI [0.68, 1.09]; <i>P</i> = 0.21), and recurrence (RR: 1.00; 95% CI [0.82, 1.22]; <i>P</i> = 0.99). However, the major bleeding rate was significantly higher among women (RR: 0.69; 95% CI [0.48, 0.98]; <i>P</i> = 0.04), as was hospital length of stay (mean difference: -0.29; 95% CI: [-0.36, -0.22], <i>P</i> < 0.00001; I²= 96%). Also, there was no difference between men and women regarding catheter-directed thrombolysis (RR: 0.96; 95% CI [0.81, 1.14]; <i>P</i> = 0.66) and risk of heparin infusion (RR: 1.00; 95% CI [0.95, 1.04]; <i>P</i> = 0.90).</p><p><strong>Conclusion: </strong>There was no difference between men and women for the clinical outcomes and management of PE. However, women undergoing treatment for pulmonary thromboembolic disease had a significantly higher risk of major bleeding and longer length of stay compared to men. Further research is required to investigate the reasons behind these differences and assess their potential impact on patient management and prognosis.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"313-324"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960678","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":"Questions and answers following SEER database analysis of pulmonary typical carcinoids.","authors":"Catherine H Davis","doi":"10.1080/08998280.2025.2478761","DOIUrl":"https://doi.org/10.1080/08998280.2025.2478761","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"246"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952881","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":"Factors associated with hypothermia risk among patients undergoing cesarean delivery: a retrospective cohort study.","authors":"Ryan J Keneally, Andrew B Canonico, Laura M Roland, Jonathan M Wainblat, Thomas B Ebanja, Eric R Heinz, Bhiken I Naik, Michael A Mazzeffi","doi":"10.1080/08998280.2025.2477956","DOIUrl":"10.1080/08998280.2025.2477956","url":null,"abstract":"<p><strong>Introduction: </strong>Hypothermia can be detrimental in the perioperative period. Previous studies of hypothermia among patients after cesarean delivery (CD) have not adequately addressed a difference in hypothermia risk between general anesthesia (GA) and neuraxial anesthesia (NA).</p><p><strong>Methods: </strong>Inclusion criteria were patients in the National Anesthesia Clinical Outcomes Registry undergoing CD. Unadjusted rates of hypothermia and odds ratios for hypothermia were determined. Continuous variables were compared using Student's <i>t</i> test or Mann-Whitney rank sum, as appropriate. A mixed-effects multiple logistic regression analysis was performed.</p><p><strong>Results: </strong>There was a higher rate of hypothermia among patients undergoing CD with NA compared to GA (3.6% vs 2.4%, <i>P</i> = 0.001). There was a significant difference in hypothermia rates between patients from areas of different socioeconomic status (7.1% in areas of median income <$50,000 vs 2.3%, <i>P</i> < 0.001). A higher odds for hypothermia was associated with NA (odds ratio = 1.48; 95% confidence interval, 1.1-2), longer duration of anesthesia, and lower socioeconomic status.</p><p><strong>Conclusion: </strong>NA was associated with a higher rate and risk for hypothermia. Patients in areas of lower socioeconomic status and those undergoing longer anesthetics were also at higher risk for hypothermia. Anesthesia providers must work to prevent and treat hypothermia in patients with these identified risk factors.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 4","pages":"436-440"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482989","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":"<i>\"I wished I had caught that earlier\":</i> the timely diagnosis of AKI.","authors":"Samiya Yasin, Michael Wiederkehr","doi":"10.1080/08998280.2025.2478791","DOIUrl":"https://doi.org/10.1080/08998280.2025.2478791","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"272-273"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960560","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":"A closer look at gender disparities in patients with pulmonary embolism.","authors":"Claire Chen, Randall Rosenblatt","doi":"10.1080/08998280.2025.2475634","DOIUrl":"https://doi.org/10.1080/08998280.2025.2475634","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"325-326"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972922","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":"A balancing act: the promise and pitfalls of clinical decision support.","authors":"Jacob Minor, Kenneth Youens","doi":"10.1080/08998280.2025.2478758","DOIUrl":"https://doi.org/10.1080/08998280.2025.2478758","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"233-234"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968581","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":"Inpatient outcomes of rheumatoid arthritis in hospitalized patients using cannabis: data from the National Inpatient Sample.","authors":"Karun Shrestha, Prakriti Subedi, Anil Regmi, Manoj Ghimire, Sajana Poudel, Mahmoud Hashim, Mohammed Hasan, Clement Tagoe","doi":"10.1080/08998280.2025.2473863","DOIUrl":"https://doi.org/10.1080/08998280.2025.2473863","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in rheumatoid arthritis (RA) treatment, effective pain management remains challenging, with many patients also experiencing insomnia, anxiety, and depression. Cannabis, with its analgesic properties, offers a promising nonopioid alternative. This study evaluated outcomes in hospitalized RA patients using cannabis through the National Inpatient Sample (NIS) database.</p><p><strong>Methods: </strong>This retrospective study analyzed NIS data (2016-2021) using ICD-10 codes to identify RA patients. Demographic and clinical characteristics and inpatient outcomes were compared between cannabis users and nonusers.</p><p><strong>Results: </strong>RA patients using cannabis (n = 42,415) were younger (mean age 51.8 vs 67.8 years), less likely to be female (60.65% vs 73.71%), and more likely to be African American (24.02% vs 12.86%) and Native American (2.25% vs 0.86%). Cannabis use was associated with lower mortality (0.98% vs 2.71%) and hospital charges ($57,773 vs $63,681). After adjusting for age, gender, race, and comorbidities, cannabis use was linked to decreased mortality (odds ratio [OR]: 0.50), depression (OR: 0.47), chronic pain (OR: 0.45), and anxiety (OR: 0.55). Conversely, cannabis use increased the risk of opioid use (OR: 1.10), nicotine dependence (OR: 1.35), and alcohol use (OR: 1.35).</p><p><strong>Conclusion: </strong>RA patients using cannabis had lower mortality, depression, chronic pain, and anxiety, but higher risks of opioid, nicotine, and alcohol use. Further research is needed on the long-term effects of cannabis in RA management.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"259-264"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961485","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":"Pancreatic neuroendocrine tumors: studying real-world outcomes.","authors":"Lucas Wong","doi":"10.1080/08998280.2025.2478756","DOIUrl":"https://doi.org/10.1080/08998280.2025.2478756","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 3","pages":"220"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953291","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":"Cost analysis of urine testing for hospitalized patients in the emergency department.","authors":"A Corey Yeates, Jennifer A Zimmerman, Christopher J Destache, David S Quimby","doi":"10.1080/08998280.2025.2479375","DOIUrl":"10.1080/08998280.2025.2479375","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary tract infections (UTIs) are commonly diagnosed in the emergency department (ED). However, an accurate diagnosis requires an appropriate clinical presentation. The objective of this retrospective review of patients admitted to the hospital via the ED was to determine the extent of urinary testing for infection despite no appropriate medical criteria and the associated economic costs.</p><p><strong>Methods: </strong>Adult patients admitted to an academic medical center via the ED in two 1-week periods were reviewed. The medical records were manually reviewed to determine whether the urine was tested for infection and whether this was medically necessary based on generally accepted clinical criteria. The economic cost of the unnecessary testing was determined based on direct laboratory processing costs, staffing costs associated with sample acquisition and processing, and antimicrobials prescribed.</p><p><strong>Results: </strong>There were 401 admissions to the hospital via the ED in the two 1-week timeframes, and 212 (52.87%) had urinalyses on admission. Among them, 133 (62.74%) had no medical necessity for the testing. The total annual cost was extrapolated to a direct cost of $8,490.68 and a total cost of $49,701.01.</p><p><strong>Conclusions: </strong>These results demonstrate the projected annual cost of inappropriate urine testing in patients admitted through the ED. Data such as these may be of value to hospital systems in the design or creation of order sets to focus on appropriate testing. These data would also be helpful for diagnostic stewardship programs to help rein in the ever-increasing cost of healthcare.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 4","pages":"449-452"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482956","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}