Publications by authors named "REARDON L"
Purpose: Patient experiences of brachytherapy for locally advanced cervical cancer (LACC) are widely variable, with reports of difficult and traumatic experiences and aspects of care requiring improvement. The aim of this study was to develop patient care recommendations and consult with key stakeholders to review, refine and prioritise recommendations.
Methods: Phase 1: Patient care recommendations were developed from qualitative exploratory study data.
Background: The Doctor of Nursing Practice (DNP) degree culminates in the DNP project, a scholarly project aimed at enhancing health care systems aligned with national standards. While DNP projects are valued, they pose challenges due to resource-intensive demands including faculty time and effort.
Problem: Faculty workload models related to DNP projects have not kept pace with increasing enrollment and program expectations.
Article Synopsis
- - The study aimed to analyze trends in head and neck injuries from barbell weightlifting using data from the National Electronic Injury Surveillance System (NEISS) covering 2014 to 2023.
- - Researchers identified 3,105 cases of injuries, mostly affecting males (71.7%) with an average age of 27.7 years, and found that the majority were treated and released, with the head being the most commonly injured body part (44.1%).
- - The findings suggest that significant injuries occur primarily above the shoulder, indicating a need for enhanced safety measures and protective equipment in barbell weightlifting settings.
Importance: In the US, there are more than 1.5 million adults living with congenital heart disease (CHD). The Congenital Heart Initiative (CHI) is a digital, online, patient-empowered registry that was created to advance multicenter research and improve clinical care by gathering patient-reported outcomes (PROs) in adults with CHD.
View Article and Find Full Text PDFBackground: Lack of sexual orientation and gender identity (SOGI) data creates barriers for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people in health care. Barriers to SOGI data collection include physician misperception that patients do not want to answer these questions and discomfort asking SOGI questions. This study aimed to assess patient comfort towards SOGI questions across five quaternary care adult congenital heart disease (ACHD) centres.
View Article and Find Full Text PDFPurpose Of Review: The number of adult congenital heart disease (ACHD) patients presenting for consideration of heart transplantation continues to grow. Comprehensive pretransplant assessment and thoughtful patient selection are of critical importance to mitigate perioperative and posttransplant morbidity and mortality in this population.
Recent Findings: There is increasing evidence that patient outcomes after the onset of heart failure in the ACHD population are poor while overall transplant outcomes for ACHD patients have improved over time.
As health care outcomes improve the priority for those living with adult congenital heart disease have changed to a more holistic focus on quality of life and well-being. Although health care has embraced this, there are still areas where there is a deficit in advice, allyship, and advocacy. One of these deficits is in the area of sexual health and well-being.
View Article and Find Full Text PDFArticle Synopsis
- Rett syndrome is a rare neurodevelopmental disorder that primarily affects females, and trofinetide is the first FDA-approved treatment based on positive results from the phase 3 LAVENDER trial.
- Despite its benefits in managing core RTT symptoms, trofinetide has side effects, notably gastrointestinal issues like diarrhea and vomiting.
- The article explores insights from caregivers of girls undergoing trofinetide trials and nurse coordinators, emphasizing strategies for managing these GI symptoms during treatment.
Article Synopsis
- This study explored the molecular mechanisms of Fontan-associated liver disease (FALD) by examining gene expression differences in liver fibrosis among patients.
- Researchers analyzed data from 106 adults with the Fontan circulation, identifying upregulated genes in those with advanced fibrosis and assessing clinical outcomes.
- Findings revealed that patients with advanced fibrosis had increased inflammation and vascular development gene activity, but these did not predict clinical outcomes like serious complications.
Article Synopsis
- - The study aims to create new pulse oximetry screening (POS) algorithms for critical congenital heart disease (CCHD) suitable for high-altitude conditions, where existing algorithms are ineffective.
- - Conducted in Peru, the research involved 502 healthy newborns and 15 with CCHD, incorporating oximetry tests and follow-ups to assess the effectiveness of the algorithms.
- - Two new algorithms were developed, showing one with high sensitivity (92%) but lower specificity (73%), while the other maintained a balance with lower sensitivity (80%) and higher specificity (88%), although both faced challenges with false positives.
Importance: The rising self-identifying lesbian, gay, bisexual, transgender, and queer (LGBTQ+) population makes understanding the unique health care needs of sexual and gender minoritized patients an urgent one. The interaction between minority stress and cardiovascular disease has been well described among underrepresented minoritized populations. The underrepresentation of minoritized populations in clinical research is partly responsible for worse cardiovascular outcomes in these populations.
View Article and Find Full Text PDFIntroduction: Fontan patients have variable exercise capacity. Contemporary understanding as to which factors predict high tolerance is limited.
Methods: Records from the Ahmanson/University of California, Los Angeles Adult Congenital Heart Disease Center were reviewed for adult Fontan patients who underwent CPET.
Background: The molecular mechanisms underlying Fontan associated liver disease (FALD) remain largely unknown. We aimed to assess intrahepatic transcriptomic differences among patients with FALD according to the degree of liver fibrosis and clinical outcomes.
Methods: This retrospective cohort study included adults with the Fontan circulation at the Ahmanson/UCLA Adult Congenital Heart Disease Center.
Article Synopsis
- An increasing number of adult Fontan patients are needing heart or combined heart-liver transplants, but there is limited data on their outcomes and ideal referral timing.
- This study analyzed 131 adult Fontan patients who underwent transplantation between 1995 and 2021, finding a 79% survival rate at one year and 66% at five years post-transplant, with improved outcomes noted in patients transplanted after 2010.
- Late referrals and certain health indicators like poor functional status and specific vascular issues were linked to lower survival rates, highlighting the importance of timely evaluations.
Article Synopsis
- - The study investigates the effects of Fontan-associated liver disease (FALD) on post-transplant outcomes, specifically looking at heart transplant (HT) versus combined heart-liver transplant (CHLT) in adult Fontan patients.
- - Results showed that CHLT patients were generally older and had higher FALD scores, but they exhibited better survival rates compared to HT, particularly in those with higher FALD scores.
- - The research indicates a correlation between higher FALD scores and increased mortality post-transplant, suggesting that CHLT may offer improved survival outcomes for patients with significant liver disease.
Background: Cardiac allograft vasculopathy (CAV) remains a leading cause of graft loss in pediatric heart transplant (HTx) recipients. Adult literature suggests that aspirin (ASA) use in the early post-HTx period may reduce the risk of CAV. This study aimed to determine the impact of early ASA use on the development of CAV in pediatric HTx recipients.
View Article and Find Full Text PDFBackground Current recommendations for delivery timing of pregnant persons with congenital heart disease (CHD) are based on expert opinion. Justification for early-term birth is based on the theoretical concern of increased cardiovascular stress. The objective was to evaluate whether early-term birth with maternal CHD is associated with lower adverse maternal or neonatal outcomes.
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- Persons with adult congenital heart disease (ACHD) face challenges in being selected for orthotopic heart transplant (OHT) due to a lack of defined eligibility criteria and risk assessment methods.
- A study analyzed 49 ACHD patients who underwent OHT, revealing impressive survival rates of 94% at one month and 83% at ten years.
- The findings emphasize the complexity of ACHD patients, the need for specialized multispecialty care, and the importance of ongoing discussions to ensure fair treatment access for this population.
Each year, 1.35 million people are killed on the world's roads and another 20-50 million are seriously injured. Morbidity or serious injury from road traffic collisions is estimated to increase to 265 million people between 2015 and 2030.
View Article and Find Full Text PDFBackground: COVID-19 and Fontan physiology have each been associated with an elevated risk of venous thromboembolism (VTE), however little is known about the risks and potential consequences of having both.
Case Presentation: A 51 year old male with tricuspid atresia status post Fontan and extracardiac Glenn shunt, atrial flutter, and sinus sick syndrome presented with phlegmasia cerulea dolens (PCD) of the left lower extremity in spite of supratherapeutic INR in the context of symptomatic COVID-10 pneumonia. He was treated with single session, catheter directed mechanical thrombectomy that was well-tolerated.
Objective: The main objective of this study was to evaluate the accuracy of point-of-care ultrasound (POCUS) for the diagnosis of appendicitis in a general emergency department (ED) population as performed by emergency physicians with variable ultrasound experience.
Methods: We performed a prospective, multicenter, observational study examining a convenience sample of adult patients with potential appendicitis presenting to the ED between July 2014 and February 2020. Each emergency physician-performed POCUS was interpreted at the bedside and retrospectively by an expert reviewer.