Medical Specialties Commons^™

Association Between Longer Hospitalization And Development Of De Novo Donor Specific Antibodies In Simultaneous Liver–Kidney Transplant Recipients, M. Yazawa, O. Cseprekal, R. A. Helmick, M. Talwar, V. Balaraman, P. S. Podila, S. Fossey, S. K. Satapathy, J. D. Eason, M. Z. Molnar

Journal Articles

© 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background:De novo Donor Specific Antibodies (DSA) are considered as a risk factor for the kidney allograft outcomes in recipients after simultaneous liver–kidney transplantation (SLKT). We hypothesized that length of hospital stay (LOS) might be associated with de novo DSA development of due to the increased likelihood of receiving blood transfusions with reduced immunosuppressive regimens. Methods: This study is a single-center, retrospective cohort study consisting of 85 recipients who underwent SLKT from 2009 to 2018 in our hospital. We divided the patients into two …

Effect Of Depression Screening After Acute Coronary Syndromes On Quality Of Life The Codiacs-Qol Randomized Clinical Trial, I. M. Kronish, N. Moise, Y. K. Cheung, G. N. Clarke, R. J. Dolor, J. Duer-Hefele, K. L. Margolis, T. St Onge, F. Parsons, K. W. Davidson, +2 Additional Authors

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No abstract provided.

Risk Models For Vte And Bleeding In Medical Inpatients: Systematic Identification And Expert Assessment, A. J. Darzi, S. G. Karam, F. A. Spencer, A. C. Spyropoulos, L. Mbuagbaw, S. C. Woller, N. A. Zakai, M. B. Streiff, M. K. Gould, H. J. Schunemann, +9 Additional Authors

Journal Articles

No abstract provided.

Treatment Of Parvovirus B19 Viremia To Facilitate Kidney Transplantation In A Patient With Collapsing Glomerulopathy., V. Nair, N. Jandovitz, K. D. Jhaveri, D. Hirschwerk, E. Grodstein, V. Bijol, E. Molmenti, L. Teperman

Journal Articles

Collapsing glomerulopathy (CG) is a severe form of glomerulopathy which results in nephrotic syndrome and often ensues in rapid progression to end-stage kidney disease (ESKD). Although most commonly a result of HIV infection, other conditions such as parvovirus B19 (PB19) infection have been associated with CG. We present a case of an 18-year-old male with CG associated with PB19 infection who was heterozygous for APOL1 G1 and G2 genetic variants. In an attempt to treat, he was started on intravenous immunoglobulin (IVIg), however rapidly progressed to ESKD. During workup for a living donor kidney transplant he was found to have …

Prevalence And Profile Of Nonalcoholic Fatty Liver Disease In Lean Adults: Systematic Review And Meta-Analysis., S. Young, R. Tariq, J. Provenza, S. K. Satapathy, K. Faisal, A. Choudhry, S. L. Friedman, A. K. Singal

Journal Articles

Data on prevalence and profile of nonalcoholic fatty liver disease (NAFLD) among individuals who are lean (normal body mass index) is unclear. Published data from studies comparing lean with obese NAFLD or with healthy subjects on prevalence, comorbidities, liver chemistry and histology, and metabolic/inflammatory markers were analyzed. Data were reported as odds ratio and 95% confidence interval for categorical variables and difference of means for continuous variables. Analysis of 53 studies on 65,029 subjects with NAFLD (38,084 lean) and 249,544 healthy subjects showed a prevalence of lean NAFLD at 11.2% in the general population. Among individuals with NAFLD, the prevalence …

Acute Appendicitis Review: Background, Epidemiology, Diagnosis, And Treatment., M. Krzyzak, S. M. Mulrooney

Journal Articles

Appendicitis is a common occurrence in both the adult and pediatric populations. The condition most commonly occurs between the ages of 10 and 20 years with a lifetime risk of 8.6% and 6.7% for males and females respectively. Its diagnosis focuses on clinical presentation and imaging modalities classified according to scoring systems such as the Alvarado scoring system. A number of imaging modalities can be used, with CT being the most common one. For acute appendicitis, surgical intervention is considered to be the gold standard of treatment. However, recent research has focused on other modalities of treatment including antibiotics and …

Outcomes Of Liver Transplant Recipients With Acute-On-Chronic Liver Failure Based On Easl-Clif Consortium Definition: A Single-Center Study, U. Agbim, A. Sharma, B. Maliakkal, S. Karri, M. Yazawa, W. Goldkamp, P. S. Podila, J. M. Vanatta, H. Gonzalez, S. K. Satapathy, +3 Additional Authors

Journal Articles

© 2020 Cambridge University Press. All rights reserved. Background. The impact of acute-on-chronic liver failure (ACLF) defined by European Association for the Study of the Liver-Chronic Liver Failure in liver transplant (LT) recipients has not been well characterized. The aim of the study was to assess early posttransplant morbidity and survival of ACLF patients. Methods. Eight hundred twenty-five consecutive LT patients (04/2006-03/2013) were included in a retrospective analysis. Of the 690 evaluable patients, 589 had no ACLF, and the remaining 101 were grouped into ACLF Grades 1-3 (ACLF Grade 1: 50 [49.5%], ACLF Grade 2: 32 [31.7%], and ACLF Grade …

Predictors Of Preprocedural Direct Oral Anticoagulant Levels In Patients Having An Elective Surgery Or Procedure, J. R. Shaw, N. Li, T. Vanassche, M. Coppens, A. C. Spyropoulos, S. Syed, M. Radwi, J. Duncan, S. Schulman, J. D. Douketis

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No abstract provided.

Nafld Epidemiology, Emerging Pharmacotherapy, Liver Transplantation Implications And The Trends In The United States, C. Gadiparthi, M. Spatz, S. Greenberg, U. Iqbal, S. Kanna, S. K. Satapathy, A. Broder, A. Ahmed

Journal Articles

© 2020 Authors. Nonalcoholic fatty liver disease (NAFLD) is a hepatic mani-festation of metabolic syndrome. The spread of obesity worldwide in pandemic proportions has led to a rapid rise of NAFLD in developed and developing countries alike. There are no approved pharmacological agents to treat steatohepatitis or advanced fibrosis but obeticholic acid recently has shown some promise in phase III trial. Currently, NAFLD is the number one etiology for simultaneous liver and kidney transplantation in the USA, second most common indication for liver transplantation (LT) and projected to become number one very soon. LT for NAFLD poses unique challenges, as …

Racial Disparities In Diagnosis And Prognosis Of Nonalcoholic Fatty Liver Disease, N. S. Samji, P. D. Snell, A. K. Singal, S. K. Satapathy

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No abstract provided.

Impact Of Idelalisib On Health-Related Quality Of Life In Patients With Relapsed Chronic Lymphocytic Leukemia In A Phase Iii Randomized Trial, P. Ghia, S. E. Coutre, B. D. Cheson, J. C. Barrientos, P. Hillmen, A. R. Pettitt, A. D. Zelenetz, S. Shreay, M. Hallek, R. R. Furman

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No abstract provided.

Case And Commentary: How Should Clinicians' Performance Be Assessed When Health Care Organizations Implement Behavioral Architecture That Generates Negative Consequences?, S. Richardson

Journal Articles

© 2020 American Medical Association. All rights reserved. Behavioral interventions have been shown to have powerful effects on human behavior both outside of and within the context of health care. As organizations increasingly adopt behavioral architecture, care must be taken to consider its potential negative consequences. An evidencedbased approach is best, whereby interventions that might have a significant deleterious effect on patients' health outcomes are first tested and rigorously evaluated before being systematically rolled out. In the case of clinical decision support, brief and thorough instructions should be provided for use. Physician performance when using these systems is best measured …

Polycystic Ovary Syndrome And Gender Identity, M. Liu, S. Murthi, L. Poretsky

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No abstract provided.

Anticoagulant Reversal Strategies In The Emergency Department Setting: Recommendations Of A Multidisciplinary Expert Panel, C. W. Baugh, M. Levine, D. Cornutt, J. W. Wilson, R. Kwun, C. E. Mahan, C. V. Pollack, E. G. Marcolini, A. C. Spyropoulos, J. Williams

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No abstract provided.

Utility Of D-Dimer In Predicting Venous Thromboembolism In Non-Mechanically Ventilated Covid-19 Survivors., P. C. Nauka, S. W. Baron, A. Assa, L. Mohrmann, S. Jindal, E. Oran, G. Glazman-Kuczaj, W. N. Southern, S. Chekuri

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No abstract provided.

Dedicated Area Within The Emergency Department Versus An Outside Dedicated Area For Evaluation And Management Of Suspected Coronavirus Disease 2019., G. Garra, S. Gupta, S. Ferrante, W. Apterbach

Journal Articles

Background

The circumstances of the coronavirus disease 2019 pandemic necessitated an alternate operations strategy for efficient patient management. Alternate care sites were a viable option for managing emergency department (ED) surge in previous epidemics and disasters.

Objective

This study describes the development of an alternate care site and evaluates efficiency by comparing key performance indicators between an ad hoc nested respiratory evaluation unit (NRU) within the ED and an alternate care site outside the ED.

Methods

This was a cohort study of 2 care models in the same ED during 2 different time periods. As coronavirus disease 2019 surged in …

Liver Injury In Covid-19: The Hepatic Aspect Of The Respiratory Syndrome — What We Know So Far, P. Anirvan, P. Bharali, M. Gogoi, P. J. Thuluvath, S. P. Singh, S. K. Satapathy

Journal Articles

© 2020. All Rights Reserved. The 2019 novel coronavirus disease (COVID-19) pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a serious threat to global public health. Although primarily, the infection causes lung injury, liver enzyme abnormalities have also been reported to occur during the course of the disease. We conducted an extensive literature review using the PubMed database on articles covering a broad range of issues related to COVID-19 and hepatic injury. The present review summarizes available information on the spectrum of liver involvement, the possible mechanisms and risk factors of liver injury due to SARS-CoV-2 …

Clinical Characteristics And Outcomes Of Critically Ill Patients With Covid-19 Admitted To An Intensive Care Unit In London: A Prospective Observational Cohort Study, R. J. Thomson, J. Hunter, J. Dutton, J. Schneider, M. Khosravi, A. Casement, K. Dhadwal, D. Martin

Journal Articles

© 2020 Thomson et al. Background Cohorts of severely ill patients with COVID-19 have been described in several countries around the globe, but to date there have been few published reports from the United Kingdom (UK). Understanding the characteristics of the affected population admitted to intensive care units (ICUs) in the UK is crucial to inform clinical decision making, research and planning for future waves of infection. Methods We conducted a prospective observational cohort study of all patients with COVID-19 admitted to a large UK ICU from March to May 2020 with follow-up to June 2020. Data were collected from …

An Approach To Predicting Patient Experience Through Machine Learning And Social Network Analysis., V. Bari, J. S. Hirsch, J. Narvaez, R. Sardinia, K. R. Bock, M. I. Oppenheim, M. Meytlis

Journal Articles

OBJECTIVE:Improving the patient experience has become an essential component of any healthcare system's performance metrics portfolio. In this study, we developed a machine learning model to predict a patient's response to the Hospital Consumer Assessment of Healthcare Providers and Systems survey's "Doctor Communications" domain questions while simultaneously identifying most impactful providers in a network. MATERIALS AND METHODS:This is an observational study of patients admitted to a single tertiary care hospital between 2016 and 2020. Using machine learning algorithms, electronic health record data were used to predict patient responses to Hospital Consumer Assessment of Healthcare Providers and Systems survey questions in …

Comparative Safety And Effectiveness Of Vedolizumab To Tumour Necrosis Factor Antagonist Therapy For Crohn's Disease, M. Bohm, R. Xu, Y. Zhang, S. Varma, M. Fischer, G. Kochhar, B. Boland, S. Singh, A. Swaminath, S. Chablaney, +26 Additional Authors

Journal Articles

© 2020 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd Background: Direct comparisons are lacking between vedolizumab and tumour necrosis factor (TNF)-antagonist therapy in Crohn's disease (CD). Aim: To compare safety and effectiveness of vedolizumab and TNF-antagonist therapy in adult CD patients. Methods: Retrospective observational cohort (May 2014–December 2017) propensity score-weighted comparison of vedolizumab vs TNF-antagonist therapy (infliximab, adalimumab, certolizumab) in CD. Propensity scores were weighted for age, prior treatments, disease complications, extent and severity, steroid dependence, and concomitant immunosuppressive drug use. The primary outcome was comparative risk for infections or non-infectious serious adverse events …

Pro: Portal Vein Thrombosis Impacts Liver Transplantation Outcomes, U. Agbim, S. K. Satapathy

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No abstract provided.

Clinical Management Of Hyperkalemia, B. F. Palmer, J. J. Carrero, D. J. Clegg, G. B. Colbert, M. Emmett, S. Fishbane, D. J. Hain, E. Lerma, M. Onuigbo, M. R. Weir, +3 Additional Authors

Journal Articles

© 2020 Mayo Foundation for Medical Education and Research Hyperkalemia is an electrolyte abnormality with potentially life-threatening consequences. Despite various guidelines, no universally accepted consensus exists on best practices for hyperkalemia monitoring, with variations in precise potassium (K+) concentration thresholds or for the management of acute or chronic hyperkalemia. Based on the available evidence, this review identifies several critical issues and unmet needs with regard to the management of hyperkalemia. Real-world studies are needed for a better understanding of the prevalence of hyperkalemia outside the clinical trial setting. There is a need to improve effective management of hyperkalemia, including classification …

Cortical Encoding Of Melodic Expectations In Human Temporal Cortex, G. M. Di Liberto, C. Pelofi, R. Bianco, P. Patel, A. D. Mehta, J. L. Herrero, A. De Cheveigne, S. Shamma, N. Mesgarani

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No abstract provided.

Recommendations For Core Critical Care Ultrasound Competencies As A Part Of Specialist Training In Multidisciplinary Intensive Care: A Framework Proposed By The European Society Of Intensive Care Medicine (Esicm), A. Wong, L. Galarza, L. Forni, D. De Backer, M. Slama, B. Cholley, P. Mayo, A. Mclean, F. Duška, +17 Additional Authors

Journal Articles

© 2020 The Author(s). Critical care ultrasound (CCUS) is an essential component of intensive care practice. Although existing international guidelines have focused on training principles and determining competency in CCUS, few countries have managed to operationalize this guidance into an accessible, well-structured programme for clinicians training in multidisciplinary intensive care. We seek to update and reaffirm appropriate CCUS scope so that it may be integrated into the international Competency-based Training in Intensive Care Medicine. The resulting recommendations offer the most contemporary and evolved set of core CCUS competencies for an intensive care clinician yet described. Importantly, we discuss the rationale …

Submaximal Angioplasty For Symptomatic Intracranial Atherosclerotic Disease: A Meta-Analysis Of Peri-Procedural And Long-Term Risk, C. J. Stapleton, Y. F. Chen, H. Shallwani, K. Vakharia, T. N. Turan, H. H. Woo, C. P. Derdeyn, F. T. Charbel, A. H. Siddiqui, S. Amin-Hanjani

Journal Articles

© 2019 by the Congress of Neurological Surgeons. BACKGROUND: Symptomatic intracranial atherosclerotic disease (ICAD) is an important cause of stroke. Although the high periprocedural risk of intracranial stenting from recent randomized studies has dampened enthusiasm for such interventions, submaximal angioplasty without stenting may represent a safer endovascular treatment option. OBJECTIVE: To examine the periprocedural and long-term risks associated with submaximal angioplasty for ICAD based on the available literature. METHODS: All English language studies of intracranial angioplasty for ICAD were screened. Inclusion criteria were as follows: ≥ 5 patients, intervention with submaximal angioplasty alone, and identifiable periprocedural (30-d) outcomes. Analysis was …

Role Of Sulfonylurea Receptor 1 And Glibenclamide In Traumatic Brain Injury: A Review Of The Evidence, R. M. Jha, J. Bell, G. Citerio, J. C. Hemphill, W. T. Kimberly, R. K. Narayan, J. Sahuquillo, K. N. Sheth, J. M. Simard

Journal Articles

No abstract provided.

A Model For Focal Seizure Onset, Propagation, Evolution, And Progression, J. Liou, E. H. Smith, L. M. Bateman, S. L. Bruce, G. M. Mckhann, R. R. Goodman, R. G. Emerson, C. A. Schevon, L. F. Abbott

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No abstract provided.

Identification Of A Brainstem Locus That Inhibits Tumor Necrosis Factor., A. M. Kressel, T. Tsaava, Y. A. Levine, E. H. Chang, M. E. Addorisio, Q. Chang, B. J. Burbach, V. A. Pavlov, S. S. Chavan, K. J. Tracey, +4 Additional Authors

Journal Articles

In the brain, compact clusters of neuron cell bodies, termed nuclei, are essential for maintaining parameters of host physiology within a narrow range optimal for health. Neurons residing in the brainstem dorsal motor nucleus (DMN) project in the vagus nerve to communicate with the lungs, liver, gastrointestinal tract, and other organs. Vagus nerve-mediated reflexes also control immune system responses to infection and injury by inhibiting the production of tumor necrosis factor (TNF) and other cytokines in the spleen, although the function of DMN neurons in regulating TNF release is not known. Here, optogenetics and functional mapping reveal cholinergic neurons in …

The Hydrogel Endovascular Aneurysm Treatment Trial (Heat): A Randomized Controlled Trial Of The Second-Generation Hydrogel Coil, B. R. Bendok, K. R. Abi-Aad, J. D. Ward, J. F. Kniss, M. J. Kwasny, R. J. Rahme, S. G. Aoun, T. Y. El Ahmadieh, H. H. Woo, J. Hartman, +57 Additional Authors

Journal Articles

© 2020 Congress of Neurological Surgeons 2020. BACKGROUND: Aneurysm recurrence after coiling has been associated with aneurysm growth, (re)hemorrhage, and a greater need for follow-up. The second-generation HydroCoil Embolic System (HES; MicroVention, Inc) consists of a platinum core with integrated hydrogel and was developed to reduce recurrence through enhancing packing density and healing within the aneurysm. OBJECTIVE: To compare recurrence between the second-generation HES and bare platinum coil (BPC) in the new-generation Hydrogel Endovascular Aneurysm Treatment Trial (HEAT). METHODS: HEAT is a randomized, controlled trial that enrolled subjects with ruptured or unruptured 3- to 14-mm intracranial aneurysms amenable to coiling. …

A Management Algorithm For Adult Patients With Both Brain Oxygen And Intracranial Pressure Monitoring: The Seattle International Severe Traumatic Brain Injury Consensus Conference (Sibicc), R. Chesnut, S. Aguilera, A. Buki, E. Bulger, G. Citerio, D. J. Cooper, R. D. Arrastia, M. Diringer, J. S. Ullman, G. W. Hawryluk, +32 Additional Authors

Journal Articles

No abstract provided.