Publications by authors named "Brian W Locke"

Article Synopsis
  • Hickam's dictum suggests patients can have multiple diseases, challenging Ockham's razor which favors a single diagnosis; however, multiple diagnoses haven't been studied in depth before.* -
  • Researchers analyzed multiple diagnoses through case reports, New England Journal of Medicine entries, and an online survey, identifying common categories of additional diagnoses associated with primary conditions.* -
  • Findings indicate that while multiple diagnoses are common, most cases involve causally linked conditions or pre-existing diseases, which clinicians generally find unsurprising, leading to a framework that examines time, probability, and causation in these diagnoses.*
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Background: Immersive virtual reality (VR) is a promising therapy to improve the experience of patients with critical illness and may help avoid postdischarge functional impairments. However, the determinants of interest and usability may vary locally and reports of uptake in the literature are variable.

Objective: The aim of this mixed methods feasibility study was to assess the acceptability and potential utility of immersive VR in critically ill patients at a single institution.

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An emerging body of literature describes the prevalence and consequences of hypercapnic respiratory failure. While device qualifications, documentation practices, and previously performed clinical studies often encourage conceptualizing patients as having a single "cause" of hypercapnia, many patients encountered in practice have several contributing conditions. Physiologic and epidemiologic data suggest that sleep-disordered breathing-particularly obstructive sleep apnea (OSA)-often contributes to the development of hypercapnia.

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Introduction: Weight loss is recommended for individuals with obstructive sleep apnea (OSA) and overweight or obesity, but there is limited evidence to guide the selection of weight management strategies for patients who do not lose sufficient weight with diet and lifestyle changes. We evaluated the relationship between weight loss caused by pharmacologic or surgical interventions and subsequent improvement in OSA by the apnea-hypopnea index (AHI).

Methods: PubMed, Cochrane CENTRAL, and EMBASE were searched for randomized trials comparing pharmacologic or surgical obesity interventions to usual care, placebo, or no treatment in adults with OSA.

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Purpose: Guidelines recommend considering an initial trial of continuous positive airway pressure (CPAP) to treat central sleep apnea (CSA). However, practice patterns vary widely. This study investigated predictors for an initial trial of CPAP in patients with central apneas and whether those factors predict adequate treatment response in patients receiving an initial CPAP trial.

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Purpose: Guidelines recommend considering an initial trial of continuous positive airway pressure (CPAP) to treat central sleep apnea (CSA). However, practice patterns vary widely. This study investigated predictors for an initial trial of CPAP in patients with central apneas and whether those factors predict adequate treatment response in patients receiving an initial CPAP trial.

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Article Synopsis
  • Findings show that enlarged pulmonary artery diameter (PAd) and increased pulmonary artery to ascending aorta ratio (PA:AA) on CT scans can indicate higher mortality in certain cardiopulmonary disease patients.
  • In a study of 990 emergency department patients, 27.9% had enlarged PAd, particularly among older individuals and those with obesity or heart failure, while 34.2% had an increased PA:AA, more common in younger patients with peripheral vascular disease or obesity.
  • Both enlarged PAd and increased PA:AA were independently linked to increased mortality risk, highlighting their significance as prognostic indicators in the emergency setting.
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Study Objectives: Considerable disparities in the prevalence, diagnosis, and management of obstructive sleep apnea (OSA) exist for minority groups in the United States. However, the impact of OSA on Native Hawaiian/Pacific Islanders (NHPIs) has not been evaluated.

Methods: We performed a retrospective review of patient records of NHPIs who underwent sleep apnea testing between 2014 and 2021 at a single center in Utah to characterize the distribution of comorbidities, disease severity, and treatment adherence.

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Obstructive sleep apnea (OSA) is a highly prevalent disorder that has profound implications on the outcomes of patients with chronic lung disease. The hallmark of OSA is a collapse of the oropharynx resulting in a transient reduction in airflow, large intrathoracic pressure swings, and intermittent hypoxia and hypercapnia. The subsequent cytokine-mediated inflammatory cascade, coupled with tractional lung injury, damages the lungs and may worsen several conditions, including chronic obstructive pulmonary disease, asthma, interstitial lung disease, and pulmonary hypertension.

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Study Objectives: To assess the effectiveness of continuous positive airway pressure (CPAP) management guided by CPAP machine downloads in newly diagnosed patients with obstructive sleep apnea (OSA) using electronic health record-derived health care utilization, biometric variables, and laboratory data.

Methods: Electronic health record data of patients seen at the University of Utah Sleep Program from 2012-2015 were reviewed to identify patients with new diagnosis of OSA in whom CPAP adherence and residual apnea-hypopnea index as measured by a positive airway pressure adherence tracking device data for ≥ 1 year were available. Biometric data, laboratory data, and system-wide charges were compared in the 1 year before and after CPAP therapy.

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Objective: : To provide medical kit recommendations for short mountain wilderness recreation trips (hiking, trekking, backpacking, mountaineering etc.) based on the epidemiology of injury and illness sustained and best treatment guidelines. Additionally, to compare these recommendations to the medical kit contents of mountain climbers in Colorado.

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