CT guided versus non-image guided bone marrow aspiration and biopsy: Comparison of indications, specimen quality and cost.

Purpose: To compare the indications, specimen quality, and cost of CT versus non-image guided bone marrow aspirate and biopsy (BMAB).

Methods: All CT and non-image guided BMAB performed from January 2013-July 2022 were studied. Body-mass-index (BMI), skin-to-bone distance, aspirate, and core specimen quality, and core sample length were documented.

Recombinant ADAMTS13 for Immune Thrombotic Thrombocytopenic Purpura.

In patients with immune thrombotic thrombocytopenic purpura (iTTP), autoantibodies against the metalloprotease ADAMTS13 lead to catastrophic microvascular thrombosis. However, the potential benefits of recombinant human ADAMTS13 (rADAMTS13) in patients with iTTP remain unknown. Here, we report the clinical use of rADAMTS13, which resulted in the rapid suppression of disease activity and complete recovery in a critically ill patient whose condition had proved to be refractory to all available treatments.

Rethinking the consultation paradigm: Validity evidence for a new framework, a multimethods study.

Background: In-hospital consultation is essential for patient care. We previously proposed a framework of seven specific consultation types to classify consult requests to improve communication, workflow, and provider satisfaction.

Methods: This multimethods study's aim was to evaluate the applicability of the consult classification framework to real internal medicine (IM) consults.

Comparison of direct oral anticoagulants versus low-molecular-weight heparin in primary and metastatic brain cancers: a meta-analysis and systematic review.

Background: The safety and efficacy of direct-acting oral anticoagulants (DOACs) for therapeutic anticoagulation in the setting of primary or metastatic brain cancer is not known.

Objectives: To conduct a meta-analysis and systematic review of studies that compare the risk of intracranial hemorrhage (ICH) in patients with brain cancer treated with DOACs vs low-molecular-weight heparin (LMWH).

Methods: A literature search was conducted using PubMed, EMBASE, and Cochrane databases.

Anticoagulation management and related outcomes in patients with cancer-associated thrombosis and thrombocytopenia: A systematic review and meta-analysis.

Background: Patients with cancer have an increased risk of both venous thromboembolism (VTE) requiring anticoagulation and thrombocytopenia. The optimal management is unclear. We performed a systematic review and meta-analysis to evaluate the outcomes in these patients.

Anticoagulation in cancer-associated thromboembolism with thrombocytopenia: a prospective, multicenter cohort study.

Venous thromboembolism (VTE) with concurrent thrombocytopenia is frequently encountered in patients with cancer. Therapeutic anticoagulation in the setting of thrombocytopenia is associated with a high risk of hemorrhage. Retrospective analyses suggest the utility of modified-dose anticoagulation in this population.

Intracranial hemorrhage with direct oral anticoagulants in patients with brain metastases.

Direct oral anticoagulants (DOACs) are increasingly prescribed in treatment of cancer-associated thrombosis, but limited data exist regarding safety of DOACs in patients with brain metastases. We aimed to determine the incidence of intracranial hemorrhage (ICH) in patients with brain metastases receiving DOACs or low-molecular-weight heparin (LMWH) for venous thromboembolism or atrial fibrillation. An international 2-center retrospective cohort study was designed.

Anticoagulation after intracranial hemorrhage in brain tumors: Risk of recurrent hemorrhage and venous thromboembolism.

Background: Intracranial hemorrhage (ICH) is a common and often devastating outcome in patients with brain tumors. Despite this, there is little evidence to guide anticoagulation management following an initial ICH event.

Objectives: To analyze the risk of recurrent hemorrhagic and thrombotic outcomes after an initial ICH event in patients with brain tumors and prior venous thromboembolism (VTE).

Lipopeptide biosurfactants from Paenibacillus polymyxa inhibit single and mixed species biofilms.

Although biofilms are recognised as important in microbial colonisation, solutions to their inhibition are predominantly based on planktonic assays. These solutions have limited efficacy against biofilms. Here, a series of biofilm-orientated tests were used to identify anti-biofilm compounds from marine micro-flora.

Association between implementation of a medical team training program and surgical morbidity.

Objective: To determine whether there is an association between the Veterans Health Administration Medical Team Training (MTT) program and surgical morbidity.

Design, Setting, And Participants: A retrospective health services study was conducted with a contemporaneous control group. Outcome data were obtained from the Veterans Health Administration Surgical Quality Improvement Program.

Angiotensin-I-converting enzyme and prolyl endopeptidase inhibitory peptides from natural sources with a focus on marine processing by-products.

Like many natural resource-based processing industries, the seafood processing sector gives rise to a significant volume of organic waste. Environmental issues, economic concerns and legal restrictions regarding the disposal of processing wastes have led to increased research in the discovery of alternative value-added products, such as bioactive peptides from these waste streams. Bioactive peptides have various physiological functionalities in the human body following consumption and these include antihypertensive, antiamnesiac, mineral-binding, immunodulatory, antioxidative and antithrombotic activities.

Improving perceptions of teamwork climate with the Veterans Health Administration medical team training program.

There are differences between nurse and physician perceptions of teamwork. The purpose of this study was to determine whether these differences would be reduced with medical team training (MTT). The Safety Attitudes Questionnaire was administered to nurses and physicians working in the operating rooms of 101 consecutive hospitals before and at the completion of an MTT program.

Incorrect surgical procedures within and outside of the operating room: a follow-up report.

Objective: To describe incorrect surgical procedures reported from mid-2006 to 2009 from Veterans Health Administration medical centers and build on previously reported events from 2001 to mid-2006.

Design: Retrospective database review.

Setting: Veterans Health Administration medical centers.

Changing perceptions of safety climate in the operating room with the Veterans Health Administration medical team training program.

Perceptions of organizational commitment to safety differ between the operating rooms in high- and medium-complexity facilities of the Veterans Health Administration (VHA). The purpose of this study was to see whether medical team training (MTT) reduced this difference. The Safety Attitudes Questionnaire was administered before and at the completion of a MTT program.

Briefing guide study: preoperative briefing and postoperative debriefing checklists in the Veterans Health Administration medical team training program.

Background: The purpose of this study was to examine the outcomes of checklist-driven preoperative briefings and postoperative debriefings during the Veterans Health Administration (VHA) medical team training program.

Methods: A briefing score (1, never started; 2, started then discontinued; 3, maintained on original targeted cases; 4, expanded to other services; 5, briefing all cases, all services) was established at 10.1 ± .

Association between implementation of a medical team training program and surgical mortality.

Context: There is insufficient information about the effectiveness of medical team training on surgical outcomes. The Veterans Health Administration (VHA) implemented a formalized medical team training program for operating room personnel on a national level.

Objective: To determine whether an association existed between the VHA Medical Team Training program and surgical outcomes.

The role of the operating room nurse manager in the successful implementation of preoperative briefings and postoperative debriefings in the VHA Medical Team Training Program.

To improve communication within surgical teams, Veterans Health Administration (VHA) implemented a Medical Team Training Program (MTT) based on the principles of crew resource management. One hundred two VHA facilities were analyzed. Nursing leadership participation in the planning stages of the program was compared with outcomes at follow-up.

Medical team training and coaching in the Veterans Health Administration; assessment and impact on the first 32 facilities in the programme.

Background: Communication is problematic in healthcare. The Veterans Health Administration is implementing Medical Team Training. The authors describe results of the first 32 of 130 sites to undergo the programme.

Differences in nurse and surgeon perceptions of teamwork: implications for use of a briefing checklist in the OR.

The quality of teamwork among health care professionals is known to affect patient outcomes. In the OR, surgeons report more favorable perceptions of communication during procedures and of teamwork effectiveness than do nurses. We undertook a quality improvement project in the Veterans Health Administration to confirm reported teamwork differences between perioperative nurses and surgeons and to examine the implications of these differences for improving practice patterns in the OR.

The effect of facility complexity on perceptions of safety climate in the operating room: size matters.

This study explores the effect of facility complexity on operating room (OR) caregiver perceptions of safety climate in the Veterans Health Administration (VHA). Facility complexity is a standardized score based on volume, risk, teaching, research, and intensive care unit capability. The Safety Attitudes Questionnaire was administered at 34 VHA hospitals.

Early prediction of posttraumatic in-hospital mortality in pediatric patients.

Background: The purpose of this study was to develop a triaging tool to predict pediatric in-hospital mortality from data available soon after emergency department (ED) presentation.

Methods: The study group consisted of patients of less than 18 years of age from the National Trauma Data Bank with a reported in-hospital mortality status. Variables analyzed were (1) patient demographics, (2) Glasgow Coma Scale (GCS) values, (3) ED vital signs, (4) injury mechanism, and (5) number of days from trauma until admission.