A Narrative Review on the Efficacy and Safety of Loop Diuretics in Patients With Heart Failure With Reduced Ejection Fraction and Preserved Ejection Fraction.

To date, loop diuretics are the mainstay treatment for decongestion in patients with acute decompensated heart failure (HF). In clinical practice, loop diuretics have also been utilized for patients with chronic HF with reduced and preserved ejection fractions. There is a paucity of quality evidence of the effect of loop diuretics use and dosing on clinical outcomes in HF patients beyond symptomatic relief.

Complications, length of stay, and cost of cholecystectomy in kidney transplant recipients.

We hypothesized that cholecystectomy may be riskier for kidney transplant recipients (KTR) given their lifelong immunosuppression, physiologic impact of renal failure, and increased risk of gallstone and biliary disease. Using NIS, we compared mortality, morbidity, length of stay and cost in KTR vs non-KTR following cholecystectomy in the US from 2000 to 2011, adjusting for patient and hospital level factors, including transplant center status. Mortality was higher (OR 2.

Outcomes Following Colorectal Resection in Kidney Transplant Recipients.

Background: Kidney transplant recipients (KTR) are at increased risk of requiring colorectal resection compared to the general population. Given the need for lifelong immunosuppression and the physiologic impact of years of renal replacement, we hypothesized that colorectal resection may be riskier for this unique population.

Methods: We investigated the differences in mortality, morbidity, length of stay (LOS), and cost between 2410 KTR and 1,433,437 non-KTR undergoing colorectal resection at both transplant and non-transplant centers using the National Inpatient Sample between 2000 and 2013, adjusting for patient and hospital level factors.

Surgical approach, cost, and complications of appendectomy in kidney transplant recipients.

Kidney transplant recipients (KTRs) have greater morbidity and length of stay (LOS) following certain surgical procedures than non-KTR. Given that appendectomy is one of the most common surgical procedures, we investigated differences in outcomes between 1336 KTR and 2 640 247 non-KTR postappendectomy at transplant and nontransplant centers in the United States from 2000 to 2011, using NIS data and adjusting for patient-level and hospital-level factors. Postoperative complications were identified using ICD-9 codes.

Provider Perceptions of the Organization's Cultural Competence Climate and Their Skills and Behaviors Targeting Patient-Centered Care for Socially At-Risk Populations.

As part of a cultural competence needs assessment study at a large academic health care system, we conducted a survey among 1,220 practicing physicians to assess their perceptions of the organization's cultural competence climate and their skills and behaviors targeting patient-centered care for culturally and socially diverse patients. Less than half of providers reported engaging in behaviors to address cultural and social barriers more than 75% of the time. In multivariable logistic regression models, providers who reported moderate or major structural problems were more likely to report low skillfulness in identifying patient mistrust (aOR: 2.

Frailty and Postkidney Transplant Health-Related Quality of Life.

Background: Health-related quality of life (HRQOL) reflects a patient's disease burden, treatment effectiveness, and health status and is summarized by physical, mental, and kidney disease-specific scales among end-stage renal disease patients. Although on average HRQOL improves postkidney transplant (KT), the degree of change depends on the ability of the patient to withstand the stressor of dialysis versus the ability to tolerate the intense physiologic changes of KT. Frail KT recipients may be extra vulnerable to either of these stressors, thus affecting change in HRQOL after KT.

Individual Frailty Components and Mortality in Kidney Transplant Recipients.

Background: Frailty increases early hospital readmission and mortality risk among kidney transplantation (KT) recipients. Although frailty represents a high-risk state for this population, the correlates of frailty, the patterns of the 5 frailty components, and the risk associated with these patterns are unclear.

Methods: Six hundred sixty-three KT recipients were enrolled in a cohort study of frailty in transplantation (12/2008-8/2015).

Thirty day postoperative outcomes following anterior lumbar interbody fusion using the National Surgical Quality Improvement Program database.

Objective: Anterior lumbar interbody fusion (ALIF) is a common procedure used to treat various lumbar degenerative pathologies. The purpose of this study is to describe 30-day postoperative outcomes following ALIF on a national scale.

Methods: The American College of Surgeons National Surgery Quality Improvement Program (ACS NSQIP) was searched for ALIF patients between 2005 and 2011.

Impact of Age on Short-term Outcomes After Lumbar Fusion: An Analysis of 1395 Patients Stratified by Decade Cohorts.

Background: The safety and efficacy of spinal fusion in the elderly population remains uncertain with conflicting data.

Objective: To determine if elderly patients undergoing instrumented lumbar fusion have increased 30-day complication rates compared to younger patients.

Methods: The American College of Surgeons National Surgical Quality Improvement Program was used to identify all patients undergoing instrumented posterolateral lumbar fusion between 2005 and 2011.

Novel wound management system reduction of surgical site morbidity after ventral hernia repairs: a critical analysis.

Background: Prophylactic incisional negative-pressure wound therapy use after ventral hernia repairs (VHRs) remains controversial. We assessed the impact of a modified negative-pressure wound therapy system (hybrid-VAC or HVAC) on outcomes of open VHR.

Methods: A 5-year retrospective analysis of all VHRs performed by a single surgeon at a single institution compared outcomes after HVAC versus standard wound dressings.