Successful modeling of long term outcomes in end-stage renal disease patients undergoing percutaneous coronary intervention with drug-eluting stents.

Objectives: The objective of this study is to identify and model risk factors for major adverse cardiac events (MACE) and all-cause mortality among patients with ESRD treated with PCI using DES.

Background: Patients with end-stage renal disease (ESRD) have poor long-term outcomes after percutaneous coronary intervention (PCI) compared with non-ESRD patients. However, there is a paucity of literature regarding risk factors associated with outcomes of ESRD patients after PCI with drug-eluding stents (DES).

Social Behaviors Associated With a Positive COVID-19 Test Result.

Objective To compare the social behaviors of individuals who were tested positive for COVID-19 relative to non-infected individuals.   Methods We sent COVID positive cases and age/gender-matched controls a survey regarding their social behaviors via MyChart (online patient portal). We called cases if they did not complete the electronic survey within two days.

Real-time polymerase chain reaction (PCR) cycle threshold and infection outcomes.

Objective: Clostridioides difficile infection (CDI) causes significant morbidity and mortality; however, the diagnosis of CDI remains controversial. The primary aim of our study was to evaluate the association of polymerase chain reaction (PCR) cycle threshold (Ct) values with CDI disease severity, recurrence, and mortality among adult patients with CDI.

Design: Retrospective cohort study.

Can an Academic RVU Model Balance the Clinical and Research Challenges in Surgery?

Objective: The purpose of this study is to identify perceptions of academic surgeons regarding academic productivity and assess its relationship to clinical productivity. We hypothesized that these perceptions would vary based on respondent characteristics including clinical activity and leadership roles.

Design: This retrospective, survey-based study was performed from August 26, 2019 to September 26, 2019.

End-stage renal disease as an independent risk factor for in-hospital mortality after coronary drug-eluting stenting: Understanding and modeling the risk.

Objectives: We sought to compare in-hospital outcomes between patients with and without end-stage renal disease (ESRD) undergoing coronary drug-eluting stent (DES) placement and to model risk of in-hospital adverse postpercutaneous coronary intervention (PCI) events in ESRD patients.

Background: The effect of ESRD on the risk of in-hospital complications after DES PCI is relatively unclear, as is the ability to prospectively stratify risk in this population.

Methods: Consecutive patients undergoing first-time DES between April 1, 2003 and June 30, 2018 at a single tertiary care hospital were included in a prospective registry.

The Impact of Clinical Decision Support Alerts on Clostridioides difficile Testing: A Systematic Review.

Background: Several studies have investigated the utility of electronic decision support alerts in diagnostic stewardship for Clostridioides difficile infection (CDI). However, it is unclear if alerts are effective in reducing inappropriate CDI testing and/or CDI rates. The aim of this systematic review was to determine if alerts related to CDI diagnostic stewardship are effective at reducing inappropriate CDI testing volume and CDI rates among hospitalized adult patients.

Monitoring the effectiveness of daily cleaning practices in an intensive care unit (ICU) setting using an adenosine triphosphate (ATP) bioluminescence assay.

Background: The degree to which daily intensive care unit (ICU) cleaning practices impacts bacterial burden is controversial. The study aimed to assess the utility of using adenosine triphosphate (ATP) bioluminescence assays for monitoring effectiveness of daily cleaning in ICU environments.

Methods: We sampled 364 total samples from 57 patient rooms and 18 common areas in 3 medical ICUs over 12 weeks, before and after routine daily cleaning.

Perceptions of Patients, Health Care Workers, and Environmental Services Staff Regarding Ultraviolet Light Room Decontamination Devices.

Background: Mobile ultraviolet C (UV-C) room decontamination devices are widely used in health care facilities; however, there is limited information on the perceptions of patients, health care workers (HCWs), and environmental services staff (EVS-staff) regarding their use for environmental decontamination.

Methods: An anonymous questionnaire was administered to participants in 4 medical/surgical units of a tertiary care hospital where UV-C devices were deployed for a 6-month period. Survey questions assessed perceptions regarding the importance of environmental disinfection, effectiveness of UV-C decontamination, willingness to delay hospital admission in order to use UV-C, and safety of UV-C devices.

Effectiveness of daily chlorhexidine bathing for reducing gram-negative infections: A meta-analysis.

Objective: Multiple studies have demonstrated that daily chlorhexidine gluconate (CHG) bathing is associated with a significant reduction in infections caused by gram-positive pathogens. However, there are limited data on the effectiveness of daily CHG bathing on gram-negative infections. The aim of this study was to determine whether daily CHG bathing is effective in reducing the rate of gram-negative infections in adult intensive care unit (ICU) patients.

Changes in Influenza Vaccination Rates After Withdrawal of Live Vaccine.

Background: Before the start of the 2016-2017 influenza season, the Advisory Committee on Immunization Practices withdrew its recommendation promoting the use of live attenuated influenza vaccines (LAIVs). There was concern that this might lessen the likelihood that those with a previous LAIV would return for an injectable influenza vaccine (IIV) and that child influenza immunization rates would decrease overall.

Methods: Using Oregon's statewide immunization registry, the ALERT Immunization Information System, child influenza immunization rates were compared across the 2012-2013 through 2016-2017 seasons.

The Generation in Between: A Perspective from the Keystone IV Conference.

Keystone IV affirmed the value of relationships in family medicine, but each generation of family physicians took away different impressions and lessons. "Generation III," between the Baby Boomers and Millennials, reported conflict between their professional ideal of family medicine and the realities of current practice. But the Keystone conference also helped them appreciate core values of family medicine, their shared experience, and new opportunities for leadership.

Percutaneous Venoarterial Extracorporeal Membrane Oxygenation for Refractory Cardiogenic Shock Is Associated with Improved Short- and Long-Term Survival.

Mortality due to refractory cardiogenic shock (RCS) exceeds 50%. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has become an accepted therapy for RCS. The aim of our study was to evaluate outcomes of patients with RCS treated with percutaneous VA-ECMO (pVA-ECMO).

Prediction of antidepressant response in both 2.25xthreshold RUL and fixed high dose RUL ECT.

Unlabelled: Some forms of electroconvulsive therapy (ECT) can result in generalized seizures that lack efficacy, therefore physiological markers of treatment adequacy would be helpful. EEG measures of seizure quality, such as EEG regularity and post-ictal suppression, have largely supplanted seizure duration as a marker for seizure adequacy, yet no predictive algorithm has gained wide clinical acceptance. Electrographic seizure durations of less than 25 s still prompt re-stimulation in many settings.

What predicts patients' expressed likelihood of choosing electroconvulsive therapy as a future treatment option?

Objective: To examine the relationship between stated intention to choose electroconvulsive therapy (ECT) as a future treatment option and measures of function and quality of life, mood, and cognition in the month after this therapy. Understanding the factors influencing patient choice of ECT is a source of insight into the interplay between measures of response and perceived value of this treatment to patients, lending perspective to patient-centered quality improvement efforts.

Method: In a prospective sample of 77 depressed patients given ECT, we surveyed recipients at 1 month about their expressed likelihood of choosing ECT given a future episode and examined predictors of their responses.

Quality of life and function after electroconvulsive therapy.

Background: The National Institute for Clinical Excellence in the UK has recommended limiting the use of electroconvulsive therapy (ECT), partly because of the inadequacy of research into the effects of ECT on quality of life and function.

Aims: To examine the effects of ECT on function and quality of life, particularly as they relate to changes in mood and cognition in the month following this therapy.

Method: We measured changes in quality of life, function, mood and cognition in a prospective sample of 77 depressed patients given ECT.

Cognitive deficits are associated with functional impairment in severely depressed patients.

Cognitive deficits have been associated with poorer function and quality of life (QOL) in schizophrenia, but no similar findings have been confirmed in persons with major depressive episode (MDE). We investigated whether cognitive deficits were associated with detrimental effects on the QOL of persons with primary MDE. Seventy-seven non-demented adults with MDE underwent evaluations of mood, cognition and QOL.

A meta-analysis of sleep changes associated with placebo in hypnotic clinical trials.

Objectives: The effects associated with placebo (EAP) have been incompletely described in clinical trials of insomnia treatment. We conducted a meta-analysis of insomnia medication trials for the purpose of estimating the magnitude of sleep EAP.

Method: We reviewed Medline for 1966 through 2000 for the meta-analysis.

Stability over time of patients' attitudes toward ECT.

This study examined the stability of patients' attitudes toward electroconvulsive therapy (ECT). Surveys were administered to 64 study participants at 2 and 4 weeks post treatment. The survey responses were highly significantly correlated and not significantly different, which suggests that attitudes toward ECT are stable during this time.

Markedly suprathreshold right unilateral ECT versus minimally suprathreshold bilateral ECT: antidepressant and memory effects.

Right unilateral (RUL) ECT is reported to have fewer memory side effects than bilateral (BL) ECT. We compared RUL ECT at eight times the seizure threshold (ST) against BL ECT at 1.5 times the ST.

Proxy validation of patient self-reports of ADL and IADL function before and after electroconvulsive therapy.

Objective: To determine whether electroconvulsive therapy (ECT) patients' self-reported functional status is similar to that reported by a proxy.

Background: Increasing levels of depression are associated with deteriorating functional status as reflected in the Instrumental Activities of Daily Living (IADL) scale. Depressed patients referred for ECT have poorer IADL status compared with depressed patients receiving medications, suggesting that IADL status may shape physicians' decision to recommend ECT ( 1).