Baylor University Medical Center Proceedings最新文献

{"title":"Periprocedural rescue antiemetic administration during radiologic procedures performed under conscious sedation.","authors":"Toby N Weingarten, Courtney E Ubl, Chris J Reisenauer, Juraj Sprung, Arnoley S Abcejo","doi":"10.1080/08998280.2026.2732447","DOIUrl":"https://doi.org/10.1080/08998280.2026.2732447","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the incidence and clinical predictors of periprocedural rescue antiemetic administration during radiologic procedures performed under conscious sedation.</p><p><strong>Methods: </strong>We performed a retrospective review of adult patients who underwent radiologic procedures under conscious sedation with midazolam and/or fentanyl between May 6, 2018, and December 31, 2024. Rescue antiemetics was defined as the use of an antiemetic during the procedure or recovery period. A modified Apfel score (excluding need for postprocedural opioids) was calculated. Logistic regression was used to assess the association of clinical characteristics with the need for rescue antiemetics.</p><p><strong>Results: </strong>Among 21,343 unique patients, 990 (4.64%; 95% confidence interval [CI] 4.34-4.93) were administered a rescue antiemetic. Clinical factors associated with the need for rescue antiemetics included female sex (adjusted odds ratio [OR], 2.31; 95% CI, 1.99-2.67), history of postprocedural nausea and vomiting (OR, 1.99; 95% CI, 1.59-2.48), younger age (OR, 0.84 per decade of life; 95% CI, 0.81-0.88), procedural duration (OR, 1.78 per hour; 95% CI, 1.60-1.99), and fentanyl dose (OR, 1.12 per 25 mcg; 95% CI, 1.07-1.16). Risk increased with higher modified Apfel scores. Duration of recovery was longer among patients who were administered vs not administered a rescue antiemetic (median duration 116 [73, 165] vs 47 [27, 100] minutes, <i>P</i> < 0.001).</p><p><strong>Discussion: </strong>Rescue antiemetic administration during radiologic procedures with conscious sedation complicates <5% of cases. Risk factors for rescue antiemetics are similar to those for postprocedural nausea and vomiting following general anesthesia.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical considerations in post-programmed cell death-1 therapy for cutaneous squamous cell carcinoma.","authors":"Seo Won Cho, Mojahed Mohammad K Shalabi, Marcus Zaayman, Chad D Housewright","doi":"10.1080/08998280.2026.2718726","DOIUrl":"https://doi.org/10.1080/08998280.2026.2718726","url":null,"abstract":"<p><p>Cutaneous squamous cell carcinoma (cSCC) can present as advanced disease requiring systemic therapy. Programmed cell death-1 (PD-1) inhibitors such as cemiplimab enable significant tumor regression. We report a patient with advanced cSCC who achieved near-complete remission after cemiplimab, followed by Mohs surgery revealing unexpected frontal sinus communication. This case underscores the importance of considering underlying structural changes when operating in previously treated areas.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of patient and clinical characteristics with failed conversion of neuraxial anesthesia for intrapartum cesarean delivery among patients who had top-up of indwelling labor epidural catheters: a retrospective single center study.","authors":"Ritesh Dontula, Rohan Nagabhirava, Celeste Wang, Diana Villazana-Kretzer, Michael Hofkamp","doi":"10.1080/08998280.2026.2732442","DOIUrl":"https://doi.org/10.1080/08998280.2026.2732442","url":null,"abstract":"<p><strong>Background: </strong>The primary aim of our study was to determine which patient and clinical characteristics were associated with failed conversion from neuraxial labor analgesia to neuraxial anesthesia for intrapartum cesarean delivery (CD) at our hospital.</p><p><strong>Methods: </strong>The study included patients who had a CD between July 1, 2019, and December 31, 2023, and had attempted conversion from neuraxial labor analgesia to neuraxial anesthesia for intrapartum CD by top-up of an indwelling labor epidural catheter. We performed a bivariate analysis comparing patients who did and did not have neuraxial anesthesia conversion failure along with a multivariate logistic regression to determine which variables were associated with neuraxial anesthesia conversion failure.</p><p><strong>Results: </strong>Among the 455 patients in the final analysis, 70 (15%) had neuraxial anesthesia conversion failure. A multivariate logistic regression found that replacement of the epidural catheter during labor (adjusted odds ratio [aOR] 3.03, 95% confidence interval [CI] 1.13-8.12; <i>P</i> = 0.03) and emergency obstetric indication for CD (aOR 5.14, 95% CI 2.25-11.72; <i>P</i> < 0.01) were associated with neuraxial anesthesia conversion failure.</p><p><strong>Discussion: </strong>Replacement of an epidural catheter during labor and emergency indication for CD were both independently associated with neuraxial anesthesia conversion failure among patients who had top-up of their indwelling labor epidural catheter.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serial cardiac MRI in LCHADD: one adult patient, many unanswered questions.","authors":"Haojie Wang","doi":"10.1080/08998280.2026.2724229","DOIUrl":"https://doi.org/10.1080/08998280.2026.2724229","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148928990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid growth of a giant inflammatory polyp mimicking rectal malignancy in well-controlled Crohn's colitis: a diagnostic and therapeutic challenge.","authors":"Saad Nadeem, Muhammad Zain, Michael Deavers, Rachel L Schiesser","doi":"10.1080/08998280.2026.2724706","DOIUrl":"https://doi.org/10.1080/08998280.2026.2724706","url":null,"abstract":"<p><p>Inflammatory pseudopolyps are a recognized complication of inflammatory bowel disease (IBD). However, their development in the context of well-controlled IBD is poorly understood. A 73-year-old woman with longstanding ileocolonic Crohn's disease that had been in endoscopic and histologic remission on sulfasalazine for 8 years developed a rapidly growing, fungating, ulcerated pedunculated rectal lesion, endoscopically indistinguishable from rectal carcinoma, within 1 year of a completely normal surveillance colonoscopy. An en bloc hot snare polypectomy confirmed an inflammatory pseudopolyp on histology, with no dysplasia or malignancy. She was subsequently escalated to vedolizumab after individualized consideration of her advanced liver disease and the agent's gut-selective mechanism, with sustained clinical improvement. This case highlights that quiescent IBD does not preclude alarming endoscopic findings, that inflammatory polyps can develop rapidly and mimic malignancy, and that even patients with apparent remission may have residual histologic disease activity. Pathologic evaluation remains indispensable, and such lesions should prompt reassessment of therapeutic adequacy.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin-derived nodular amyloidosis at sites of injection.","authors":"Saad Nadeem, Muhammad Zain, Sreeram Pasupuleti, Heleb Chen, John Griffin","doi":"10.1080/08998280.2026.2724657","DOIUrl":"https://doi.org/10.1080/08998280.2026.2724657","url":null,"abstract":"<p><p>We present the case of a 52-year-old man with insulin-dependent type 2 diabetes mellitus with multiple 2 to 3 cm firm subcutaneous masses on the abdomen, where biopsy confirmed nodular amyloidosis via apple green birefringence when stained with Congo red. Insulin, along with enfuvirtide, is one of two known medications capable of causing iatrogenic nodular amyloidosis, and patients should avoid repeat insulin injections into sites of amyloidosis, as absorption of insulin may be altered in these areas. Accurate amyloid typing may obviate the need for systemic evaluation and prevent accompanying costs and morbidity.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Itchy, blistering rash in pregnancy: pemphigoid gestationis.","authors":"Bryanda Woods, Madeline Folke, Julia Griffin, Lauren Madigan","doi":"10.1080/08998280.2026.2644102","DOIUrl":"10.1080/08998280.2026.2644102","url":null,"abstract":"<p><p>Pemphigoid gestationis is a rare autoimmune blistering disorder associated with pregnancy that may present diagnostic challenges, particularly when onset occurs postpartum. We describe a woman in her 30s who developed an intensely pruritic blistering eruption 1 day after delivery. Histopathology was nondiscriminatory, but direct immunofluorescence demonstrated specific findings-including linear complement deposition along the basement membrane-confirming the diagnosis. This case highlights a practical diagnostic approach to postpartum blistering eruptions and underscores the importance of immunofluorescence studies and neonatal monitoring.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"39 5","pages":"886-888"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148824419","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":"Trends and racial-geographic disparities in mortality among US older adults with peripheral artery disease, 1999 to 2020.","authors":"Muhammad Salman Mustafa, Muhammad Yousuf Saleem, Deep Birjani, Muhammad Bilal Fahmi, Manahil Salman, Hania Faisal, Aliza Fatima, Maryam Tehreem Khatura, Maryam Waqar, Unaisa Ishaque, Hasibullah Aminpoor","doi":"10.1080/08998280.2026.2694928","DOIUrl":"10.1080/08998280.2026.2694928","url":null,"abstract":"<p><strong>Background: </strong>Peripheral arterial disease (PAD) is a progressive vascular disorder among older adults that is associated with significant disability and elevated cardiovascular mortality. However, national mortality trends and disparities among US adults aged ≥65 years with PAD listed on death certificates have not been fully characterized.</p><p><strong>Methods: </strong>This study evaluated national mortality trends and demographic disparities among US adults aged ≥65 years with PAD or selected peripheral vascular/arterial conditions. Using the CDC WONDER Multiple Cause of Death database (1999-2020), we conducted a retrospective population-based analysis. ICD-10 codes for peripheral vascular and arterial diseases were used to identify deaths in which PAD or associated peripheral arterial/vascular conditions were listed as an underlying or contributing cause of death. Age-adjusted mortality rates (AAMR) per 100,000 population were calculated using the 2000 US standard population. We used joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC), with <i>P</i> values < 0.05 considered statistically significant.</p><p><strong>Results: </strong>A total of 1,738,432 PAD-related deaths occurred among adults aged ≥65 years. The overall AAMR declined from 245.14 in 1999 to 145.82 in 2020. Mortality was higher among males than females (282.70 vs 215.26 in 1999; 173.84 vs 117.10 in 2020). Non-Hispanic Black individuals had the highest mortality burden (319.28; 179.12), whereas non-Hispanic Asian or Pacific Islander individuals had the lowest (116.56; 77.52). Adults aged ≥85 years exhibited the highest mortality (836.30; 473.61). Nonmetropolitan areas demonstrated higher mortality than metropolitan areas (268.35 vs 239.55 in 1999; 160.15 vs 142.88 in 2020). Regionally, the Midwest had the highest AAMR (265.61; 148.99), while the Northeast had the lowest (203.99; 127.07). State-level variation ranged from 281.89 in Ohio to 114.82 in Hawaii. Most deaths occurred in medical facilities (39.1%).</p><p><strong>Conclusions: </strong>Mortality among older adults with PAD or selected peripheral vascular/arterial conditions listed on death certificates declined overall. However, demographic and geographic disparities persisted, with recent increases observed after 2018. Targeted prevention, early detection, and modification of risk factors are needed for high-risk older populations.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"797-808"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418387","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":"Endoscopic ultrasound-guided liver biopsy: refining a new approach.","authors":"Theresa A Reno, Stevan A Gonzalez","doi":"10.1080/08998280.2026.2701610","DOIUrl":"10.1080/08998280.2026.2701610","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"884-885"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148443939","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":"Rolando M Solis","doi":"10.1080/08998280.2026.2691672","DOIUrl":"10.1080/08998280.2026.2691672","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"844"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547567","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}