Medical Specialties Commons^™

Inform, Providence - Special Pathogens Program

Additional Resources

No abstract provided.

Ppe, Providence - Special Pathogens Program

Additional Resources

No abstract provided.

Getting Started, Providence - Special Pathogens Program

Additional Resources

No abstract provided.

Waste Management, Providence - Special Pathogens Program

Additional Resources

No abstract provided.

Isolate, Providence - Special Pathogens Program

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No abstract provided.

Treatment And Care, Providence - Special Pathogens Program

Additional Resources

No abstract provided.

Association Between Multimorbidity And Postoperative Mortality In Patients Undergoing Major Surgery: A Prospective Study In 29 Countries Across Europe, Starsurg Collaborative, Eurosurg Collaborative

Department of Surgery Faculty Publications

Background Multimorbidity poses a global challenge to healthcare delivery. This study aimed to describe the prevalence of multimorbidity, common disease combinations and outcomes in a contemporary cohort of patients undergoing major abdominal surgery. Methods This was a pre-planned analysis of a prospective, multicentre, international study investigating cardiovascular complications after major abdominal surgery conducted in 446 hospitals in 29 countries across Europe. The primary outcome was 30-day postoperative mortality. The secondary outcome measure was the incidence of complications within 30 days of surgery. Results Of 24,227 patients, 7006 (28.9%) had one long-term condition and 10,486 (43.9%) had multimorbidity (two or more …

World Allergy Organization (Wao) Diagnosis And Rationale For Action Against Cow's Milk Allergy (Dracma) Guideline Update – Xi – Milk Supplement/Replacement Formulas For Infants And Toddlers With Cma – Systematic Review, Antonio Bognanni, Ramon Firmino, Stefania Arasi, Derek Chu, Alexandro Chu, Siw Waffenschmidt, Arnav Agarwal, Piotr Dziechciarz, Andrea Horvath, Rose Kamenwa

Paediatrics and Child Health, East Africa

Background: Cow's milk allergy (CMA) is the most complex and common food allergy in infants. Elimination of cow's milk from the diet and replacement with a specialized formula for infants with cow's milk allergy who cannot be breastfed is an established approach to minimize the risk of severe allergic reactions while avoiding nutritional deficiencies. Given the availability of multiple options, such as extensively hydrolyzed cow's milk-based formula (eHF-CM), aminoacid formula (AAF), hydrolyzed rice formula (HRF), and soy formula (SF), there is some uncertainty regarding which formula might represent the most suitable choice with respect to health outcomes. The addition of …

Axonal Injury, Sleep Disturbances, And Memory Following Traumatic Brain Injury, Emma M. Tinney, Goretti España-Irla, Aaron E. L. Warren, Lauren N. Whitehurst, Alexandra N. Stillman, Charles H. Hillman, Timothy P. Morris, Alzheimer’S Disease Neuroimaging Initiative

Neurology Faculty Publications

Objectives: Traumatic brain injury (TBI) is associated with sleep deficits, but it is not clear why some report sleep disturbances and others do not. The objective of this study was to assess the associations between axonal injury, sleep, and memory in chronic and acute TBI. Methods: Data were acquired from two independent datasets which included 156 older adult veterans (69.8 years) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) with prior moderate- to-severe TBIs and 90 (69.2 years) controls and 374 (39.6 years) from Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) with a recent mild TBI (mTBI) and 87 controls …

The Internist's Post V.1 N.7, The University Of Texas Rio Grande Valley. School Of Medicine, Diana Othon Martinez, Edgar Dorsey Trevino, Barbara Malaga-Espinoza, Ramon Elizondo Romo, Carlos Alejos Aguero, Roque Mifuji Lira, Martha Solis, Cesar Gutierrez

School of Medicine Publications

No abstract provided.

Low-Acuity Pediatric Emergency Department Utilization, Lisa Ziemnik, Noah Parker, Kyra Bufi, Kristen Waters, Jacob Almeda, Adrienne Stolfi

Medical Education Faculty Publications

Objectives: Proper emergency department (ED) utilization is a hallmark of population health. Emergency department overcrowding due to nonurgent visits causes increased stress to healthcare staff, higher costs, and longer wait times for more urgent cases. This study sought to better understand post pandemic reasons caregivers have when bringing in their children for nonurgent visits and devise effective interventions to improve caregiver choice for non-ED care for nonurgent conditions.

Methods: Surveys were conducted at an urban pediatric hospital for Emergency Severity Index (ESI) level 3 to 5 visits. A total of 602 surveys were completed with 8 being excluded from analysis. …

Competency-Based Medical Education And The Education Continuum: Establishing A Framework For Lifelong Learning, Ann E. Burke, Daniel J. Sklansky, Hilary M. Haftel, Andrew Mitchell, Keith J. Mann

Pediatrics Faculty Publications

Competency Based Medical Education (CBME) is built on the concept that the competencies of learners, both graduates and practicing physicians, should ensure they are ready to meet the ever-changing healthcare needs of patients.1, 2, 3 Education outcomes in a CBME system are defined based on the needs of patients, and in healthy CBME systems, there is a paradigm shift from a focus on process and teachers to outcomes and learners.2,4 CBME should occur across the continuum of one's career, from undergraduate medical education through retirement. Furthermore, learners must be accustomed to driving their own educational processes.4,5 This learner-centered perspective requires …

The Psychometric Properties Of The Swahili Version Of The Primary Care Post Traumatic Stress Disorder Screen For Dsm-5 Among Adults In Kenya, Patrick Nzivo Mwangala, Joseph Newton Guni, Paul Mwangi, Millicent Makandi, Anita Kerubo, Rachel Odhiambo, Amina Abubakar

Institute for Educational Development, East Africa

Background: The psychometric properties of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) are undocumented in Kenya and sub-Saharan Africa (SSA) at large. This study aimed to evaluate the psychometric properties of the Swahili version of the tool, S-PC-PTSD-5, in a community sample of adults 18 years and older drawn from Nairobi, Mombasa and Kwale counties in Kenya.

Methods: Analysis of cross-sectional data from 1431 adults from the community was conducted, examining the reliability, factorial structure, measurement invariance, and convergent and divergent validity of the interviewer-administered S-PC-PTSD-5.

Results: Out of 1431 adults who completed the S-PC-PTSD-5, 666 (46.5%) reported experiencing …

Decreasing Utilization Of Indwelling Urinary Catheters, Stacie Lomibao Fujimoto

Articles, Abstracts, and Reports

Increased utilization and prolonged dwell times of indwelling urinary catheters (IUCs) are directly related to the risk of catheter-associated urinary tract infections (CAUTIs)- the fifth most common type of healthcare associated infection (HAI). The National Health and Safety Network (NHSN) uses the Standardized Utilization Ratio (SUR) metric to measure and compare device utilization in acute care hospitals across the nation. The national target SUR benchmark is 1.0, and a SUR under 1.0 indicates less device usage than NHSN predicts on an inpatient unit. In 2022 a Neuro Med-Surg unit experienced an overall SUR of 1.047 with 2 CAUTIs observed. A …

Hla-A01 And Hla-B27 Supertypes, But Not Hla Homozygocity, Correlate With Clinical Outcome Among Patients With Non-Small Cell Lung Cancer Treated With Pembrolizumab In Combination With Chemotherapy, Afaf Abed, Anna Reid, Ngie Law, Michael Millward, Elin S. Gray

Research outputs 2022 to 2026

Introduction: Maximal heterozygosity on the human leukocyte antigen (HLA) loci has been found to be associated with improved survival and development of immune-related adverse events (irAEs) among NSCLC patients treated with immunotherapy. Here, we investigated the effect of germline HLA-I/-II on clinical outcomes among NSCLC patients treated with first-line pembrolizumab in combination with chemotherapy. Method: We prospectively recruited patients with NSCLC who were commencing first-line pembrolizumab in combination with chemotherapy. DNA from white blood cells was used for high-resolution HLA-I/II typing. Results: Of the 65 patients recruited, 53 complied with the inclusion criteria. We did not find an association between …

Concordance Of Her2 Expression In Paired Primary And Metastatic Sites Of Endometrial Serous Carcinoma And The Effect Of Intratumoral Heterogeneity, Francis Hong Xin Yap, Yancey Wilson, Joanne Peverall, Benhur Amanuel, Ben Allanson, Sukeerat Ruba

Research outputs 2022 to 2026

Primary endometrial serous carcinoma, known for its aggressive nature and poor prognosis, shares similarities with breast and gastric cancers in terms of potential HER2 overexpression as a therapeutic target. Assessing HER expression is complicated by tumor heterogeneity and discrepancies between primary and metastatic sites. In this study, we retrospectively analyzed HER amplification and expression in 16 pairs of primary endometrial serous carcinoma resections and corresponding metastases. HER2 status was determined using immunohistochemistry (IHC), with criteria based on the percentage and intensity of tumor cell staining. Confirmatory techniques, such as dual in situ hybridization (DISH) and fluorescence in situ hybridization (FISH), …

Evaluating Efficacy Of Vedolizumab, Ustekinumab, And Golimumab In The Management Of Inflammatory Bowel Disease And The Combined Role Of Nutritional Therapy With Biologics: A Review, Shahed Kamal, Karan Varshney, Danielle Josefa F. Uayan, Fides Myles C. Caliwag

Ateneo School of Medicine and Public Health Publications

Inflammatory bowel disease (IBD), which encompasses both ulcerative colitis (UC) and Crohn’s disease (CD), is a major health burden worldwide. There are increasing concerns surrounding the impacts of this disease due to significant rises in the prevalence rates of IBD across the world. In consideration of the complexities of managing IBD along with this marked rise in prevalence and incidence, developing new forms of treatment for this condition has become a major priority. In recent years, a potential new form of treatment for IBD has emerged in the form of biologic therapies. While there is a high level of optimism …

Neurological Symptoms And Cause Of Death Among Young Children In Low- And Middle-Income Countries, Sara Ajanovic, Zachary Madewell, Shams El Arifeen, Emily Gurley, Mohammad Zahid Hossain, Kazi Munisul Islam, Afruna Rahman, Nega Assefa, Lola Madrid, R Gunturu

Pathology, East Africa

Importance: The emergence of acute neurological symptoms in children necessitates immediate intervention. Although low- and middle-income countries (LMICs) bear the highest burden of neurological diseases, there is a scarcity of diagnostic and therapeutic resources. Therefore, current understanding of the etiology of neurological emergencies in LMICs relies mainly on clinical diagnoses and verbal autopsies.

Objective: To characterize the association of premortem neurological symptoms and their management with postmortem-confirmed cause of death among children aged younger than 5 years in LMICs and to identify current gaps and improve strategies to enhance child survival.

Design, Setting, and Participants: This cross-sectional …

Can Written Prompts Help Medical Residents To Accurately Monitor Their Own Communication Skills And Those Of Others?, F. O. De Meijer, N. Nyamu, A. H. De Bruin

Family Medicine, East Africa

In healthcare, effective communication in complex situations such as end of life conversations is critical for delivering high quality care. Whether residents learn from communication training with actors depends on whether they are able to select appropriate information or ‘predictive cues’ from that learning situation that accurately reflect their or their peers’ performance and whether they use those cues for ensuing judgement. This study aimed to explore whether prompts can help medical residents improving use of predictive cues and judgement of communication skills. First and third year Kenyan residents (N = 41) from 8 different specialties were randomly assigned to …

Leptomeningeal Carcinomatosis In A Young Patient With Colorectal Cancer: A Case Report, Zamanali Khakhar, Soraiya Manji, Rajiv Patel, Karishma Sharma, Sheila Waa, Sayed Karar

Internal Medicine, East Africa

Leptomeningeal carcinomatosis (LMC) is a rare and fatal complication associated with various solid tumors and hematological malignancies. It presents significant diagnostic challenges due to its nonspecific symptoms and complex clinical course. This case report details the presentation, diagnosis, and implications of LMC in a 33-year-old male with a history of colorectal cancer (CRC) and hemicolectomy. The patient presented with nonspecific symptoms of headache and dizziness. Cerebrospinal fluid cytology revealed the presence of malignant cells, leading to the diagnosis of LMC secondary to CRC. The elusive and multifaceted nature of this condition highlights the necessity for increased clinical awareness and extensive …

Can Written Prompts Help Medical Residents To Accurately Monitor Their Own Communication Skills And Those Of Others?, Fleur Demeijer, Nelson Nyamu, A. B. H. De Bruin

Family Medicine, East Africa

In healthcare, effective communication in complex situations such as end of life conversa- tions is critical for delivering high quality care. Whether residents learn from communica- tion training with actors depends on whether they are able to select appropriate informa- tion or ‘predictive cues’ from that learning situation that accurately reflect their or their peers’ performance and whether they use those cues for ensuing judgement. This study aimed to explore whether prompts can help medical residents improving use of predic- tive cues and judgement of communication skills. First and third year Kenyan residents (N = 41) from 8 different specialties …

Predictors Of Outcome And Symptomatic Intracranial Hemorrhage In Acute Basilar Artery Occlusions: Analysis Of The Pc-Search Thrombectomy Registry., Adam T Mierzwa, Ashley Nelson, Sami Al Kasab, Santiago Ortega Gutierrez, Juan Vivanco-Suarez, Mudassir Farooqui, Ashutosh P Jadhav, Shashvat Desai, Gabor Toth, Anas Alrohimi, Thanh N Nguyen, Piers Klein, Mohamad Abdalkader, Hisham Salahuddin, Aditya Pandey, Zachary Wilseck, Sravanthi Koduri, Niraj Vora, Nameer Aladamat, Khaled Gharaibeh, Ehad Afreen, Hisham Al-Hajala, Julie Shawver, Syed Zaidi, Mouhammad Jumaa

Neuroscience Articles

INTRODUCTION: Recent randomized controlled trials demonstrated superiority of mechanical thrombectomy compared to medical therapy in acute basilar artery occlusions, however, little data is available to guide clinicians in functional prognosis and risk stratification.

PATIENTS AND METHODS: Data from the retrospectively established PC-SEARCH Thrombectomy registry, which included patients with basilar artery occlusion from eight sites from January 2015 to December 2021, was interrogated. Outcomes were dichotomized into 90-day favorable (mRS ⩽ 3) and unfavorable (mRS > 3). Multivariate logistic regression analysis was performed with respect to the outcome groups and were adjusted for potential confounding baseline characteristics.

RESULTS: Four-hundred-forty-four patients were included …

Simple And Epididymal-Sparing Orchiectomy For Surgical Castration In Stage Iv Prostate Cancer, Harrison Travis, Michael Dubic, Joseph Bardot, Blane Edwards, Jessie R. Gills, Scott E. Delacroix, Stephen Lacour, Matthew Mutter, Donald Bell, Mary E. Westerman

School of Medicine Faculty Publications

Background: Androgen deprivation therapy, the mainstay of treatment for patients with advanced prostate cancer, can be either medical or surgical. Surgery has cost benefits compared to medical treatment. In this study, we evaluated the use of simple and epididymal-sparing orchiectomy in 2 different practice settings for the treatment of metastatic prostate cancer. Methods: We reviewed patients who underwent surgical castration for metastatic prostate cancer between 2011 and 2022. The primary outcome was achieving castration-level total testosterone of /dL. We also compared the characteristics of patients who were seen at a public academic teaching hospital vs those who were seen at …

Child Physical Abuse, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Congenital Diaphragmatic Hernia, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Transvenous Tissue Sampling In The Diagnosis Of Intravascular Neoplasm., Christopher J Neely, Christopher M Huff, Andrew C Gordon, Raghu Kolluri, Kush R Desai

Heart and Vascular Articles

No abstract provided.

Annual Adherence Of Asian American Individuals In A Lung Cancer Screening Program Compared With Other Racial Groups, Benjamin Tasevac, Christine S. Shusted, Brooke Ruane, Emily Muse, Olugbenga Okusanya, Tyler Grenda, Nathaniel R. Evans, Gregory C. Kane, Kuang-Yi Wen, Hee-Soon Juon, Julie Barta

Department of Medicine Faculty Papers

Racial differences in lung cancer screening (LCS) eligibility and outcomes persist despite recent expansion of the US Preventive Services Task Force criteria and greater recognition of screening disparities. Research Question: What is the annual screening adherence rate for US Preventive Services Task Force-eligible Asian American individuals receiving LCS through a centralized screening program? Study Design and Methods: Individuals screened through a centralized LCS program were identified retrospectively using the Jefferson LCS Program Registry. Sociodemographic and clinical data were extracted from the prospectively maintained registry. Frequency statistics were compared by race including among Asian American subgroups, and multivariate logistic regression was …

Complications And Healthcare Cost Of Total Hip Arthroplasty In Patients With Depressive Disorder, Antoinette R Portnoy, Shirley Chen, Ameer Tabbaa, Matthew L Magruder, Kevin Kang, Afshin E Razi

SKMC Student Presentations and Publications

PURPOSE: The purpose of this study was to determine whether the rates of (1) in-hospital lengths of stay (LOS), (2) readmissions, (3) medical complications, and (4) costs of care are higher for patients with depressive disorder (DD) undergoing primary total hip arthroplasty (THA) for treatment of femoral neck fractures (FNFs).

MATERIALS AND METHODS: A retrospective query of a national administrative claims database for patients undergoing primary THA from 2006 to 2014 was conducted. Patients with DD undergoing THA for treatment of FNF were 1:5 ratio propensity score matched to a cohort (DD=6,758, controls=33,708). Primary endpoints included LOS, 90-day medical complications, …

Evidence-Based Approach For Prevention Of Surgical Site Infection, Mehmet Kursat Yilmaz, Nursanem Celik, Saad Tarabichi, Ahmad Abbaszadeh, Javad Parvizi

Rothman Institute Papers

Periprosthetic joint infection (PJI) is regarded as a critical factor contributing to the failure of primary and revision total joint arthroplasty (TJA). With the increasing prevalence of TJA, a significant increase in the incidence of PJI is expected. The escalating number of cases, along with the significant economic strain imposed on healthcare systems, place emphasis on the pressing need for development of effective strategies for prevention. PJI not only affects patient outcomes but also increases mortality rates, thus its prevention is a matter of vital importance. The longer-term survival rates for PJI after total hip and knee arthroplasty correspond with …

Predicting The Association Of Metabolites With Both Pathway Categories And Individual Pathways, Erik D. Huckvale, Hunter Moseley

Markey Cancer Center Faculty Publications

Metabolism is a network of chemical reactions that sustain cellular life. Parts of this metabolic network are defined as metabolic pathways containing specific biochemical reactions. Products and reactants of these reactions are called metabolites, which are associated with certain human-defined metabolic pathways. Metabolic knowledgebases, such as the Kyoto Encyclopedia of Gene and Genomes (KEGG) contain metabolites, reactions, and pathway annotations; however, such resources are incomplete due to current limits of metabolic knowledge. To fill in missing metabolite pathway annotations, past machine learning models showed some success at predicting the KEGG Level 2 pathway category involvement of metabolites based on their …