Alterations in Plasma Lipid Profile before and after Surgical Removal of Soft Tissue Sarcoma.

Soft tissue sarcoma (STS) is a relatively rare malignancy, accounting for about 1% of all adult cancers. It is known to have more than 70 subtypes. Its rarity, coupled with its various subtypes, makes early diagnosis challenging.

Workplace Productivity Loss and Indirect Costs Associated With Preterm Birth in the United States.

Objective: To estimate workplace productivity loss and indirect costs in the year after birth among individuals who deliver preterm in the United States.

Methods: This retrospective, observational cohort study estimated workplace productivity loss and indirect costs for individuals aged 18-55 years with an inpatient delivery between January 1, 2016, and September 30, 2021, using data from the Merative MarketScan Commercial Claims and Encounters database and the Health and Productivity Management database. Workdays lost and costs attributable to medical-related absenteeism, workplace absenteeism (defined as sick leave, leave, recreational leave, Family Medical Leave Act); disability (defined as short-term and long-term disability), and aggregate workplace productivity loss, a combined outcome measure, were compared between propensity-score-matched birth cohorts: preterm birth (before 37 weeks of gestation) and full-term birth (at or after 37 weeks of gestation).

Intraoperative hypotension is associated with persistent acute kidney disease after noncardiac surgery: a multicentre cohort study.

Background: Whilst intraoperative hypotension is associated with postoperative acute kidney injury (AKI), the link between intraoperative hypotension and acute kidney disease (AKD), defined as continuing renal dysfunction for up to 3 months after exposure, has not yet been studied.

Methods: We conducted a retrospective multicentre cohort study using data from noncardiac, non-obstetric surgery extracted from a US electronic health records database. Primary outcome was the association between intraoperative hypotension, at three MAP thresholds (≤75, ≤65, and ≤55 mm Hg), and the following two AKD subtypes: (i) persistent (initial AKI incidence within 7 days of surgery, with continuation between 8 and 90 days post-surgery) and (ii) delayed (renal impairment without AKI within 7 days, with AKI occurring between 8 and 90 days post-surgery).

Association of perioperative hypotension with subsequent greater healthcare resource utilization.

Study Objective: Determine if perioperative hypotension, a modifiable risk factor, is associated with increased postoperative healthcare resource utilization (HRU).

Design: Retrospective cohort study.

Setting: Multicenter using the Optum® electronic health record database.

An Ecological Study of a Universal Employee Depression Awareness and Stigma Reduction Intervention: "Right Direction".

Right Direction (RD) was a component of a universal employee wellness program implemented in 2014 at Kent State University (KSU) to increase employees' awareness of depression, reduce mental health stigma, and encourage help-seeking behaviors to promote mental health. We explored changes in mental health care utilization before and after implementation of RD. KSU Human Resources census and service use data were used to identify the study cohort and examine the study objectives.

Association between perioperative fluid management and patient outcomes: a multicentre retrospective study.

Background: Postoperative complications increase hospital length of stay and patient mortality. Optimal perioperative fluid management should decrease patient complications. This study examined associations between fluid volume and noncardiac surgery patient outcomes within a large multicentre US surgical cohort.

Well-Being, Burnout, and Depression Among North American Psychiatrists: The State of Our Profession.

Objective: The authors examined the prevalence of burnout and depressive symptoms among North American psychiatrists, determined demographic and practice characteristics that increase the risk for these symptoms, and assessed the correlation between burnout and depression.

Methods: A total of 2,084 North American psychiatrists participated in an online survey, completed the Oldenburg Burnout Inventory (OLBI) and the Patient Health Questionnaire-9 (PHQ-9), and provided demographic data and practice information. Linear regression analysis was used to determine factors associated with higher burnout and depression scores.

Prevalence and Persistence of Uremic Symptoms in Incident Dialysis Patients.

Background: Uremic symptoms are major contributors to the poor quality of life among patients on dialysis, but whether their prevalence or intensity has changed over time is unknown.

Methods: We examined responses to validated questionnaires in two incident dialysis cohort studies, the Choices for Health Outcomes in Caring for ESRD (CHOICE) study (=926, 1995-1998) and the Longitudinal United States/Canada Incident Dialysis (LUCID) study (=428, 2011-2017). We determined the prevalence and severity of uremic symptoms-anorexia, nausea/vomiting, pruritus, sleepiness, difficulty concentrating, fatigue, and pain-in both cohorts.

Abnormal shock index exposure and clinical outcomes among critically ill patients: A retrospective cohort analysis.

Purpose: To assess the predictive value of a single abnormal shock index reading (SI ≥0.9; heart rate/systolic blood pressure [SBP]) for mortality, and association between cumulative abnormal SI exposure and mortality/morbidity.

Materials And Methods: Cohort comprised of adult patients with an intensive care unit (ICU) stay ≥24-h (years 2010-2018).

Contribution of 'clinically negligible' residual kidney function to clearance of uremic solutes.

Background: Residual kidney function (RKF) is thought to exert beneficial effects through clearance of uremic toxins. However, the level of native kidney function where clearance becomes negligible is not known.

Methods: We aimed to assess whether levels of nonurea solutes differed among patients with 'clinically negligible' RKF compared with those with no RKF.

Advance Directives, Medical Conditions, and Preferences for End-of-Life Care Among Physicians: 12-year Follow-Up of the Johns Hopkins Precursors Study.

Context: Stability of preferences for life-sustaining treatment may vary depending on personal characteristics.

Objective: We estimated the stability of preferences for end-of-life treatment over 12 years and whether advance directives and medical conditions were associated with change in preferences for end-of-life treatment.

Design: Mailed survey of older physicians.

The effect of community socioeconomic status on sepsis-attributable mortality.

Purpose: Community factors may play a role in determining individual risk for sepsis, as well as sepsis-related morbidity and mortality. We sought to define the relationship between community socioeconomic status and mortality due to sepsis in an urban locale.

Methods: Using community statistical areas of Baltimore City, we dichotomized neighborhoods at median household income, and compared distribution of outcomes of interest within the two income categories.

Impact of Alcohol Tax Increase on Maryland College Students' Alcohol-Related Outcomes.

Objective: This study A) assessed whether levels of alcohol-related disciplinary actions on college campuses changed among MD college students after the 2011 Maryland (MD) state alcohol tax increase from 6% to 9%, and B) determined which school-level factors impacted the magnitude of changes detected.

Method: A quasi-experimental interrupted time series (ITS) analysis of panel data containing alcohol-related disciplinary actions on 33 MD college campuses in years 2006-2013. Negative binomial regression models were used to examine whether there was a statistically significant difference in counts of alcohol-related disciplinary actions comparing time before and after the tax increase.

The impact of peer mentor communication with older adults on depressive symptoms and working alliance: A pilot study.

Objective: The objective of this pilot study was to describe peer communication in meetings with depressed elders, associate their relationship with working alliance and depression and assess congruence of communication with training.

Methods: Three peers with a history of depression, in recovery, received 20h of training in peer mentoring for depression as part of an 8-week pilot program for 23 depressed older adults. Each peer-client meeting was recorded; a sample of 69 recorded meetings were chosen across the program period and coded with the Roter Interaction Analysis System, a validated medical interaction analysis system.

Impact of Physical Activity on Reporting of Childhood Asthma Symptoms.

This study aims to determine the impact of physical activity on asthma symptom reporting among children living in an inner city. Among 147 children aged 5-12 years with physician-diagnosed asthma, we assessed asthma symptoms using twice-daily diaries and physical activity using the physical activity questionnaire for children during three 8-day periods (baseline, 3 and 6 months). Linear, logistic, and quasi-poisson regression models were used to determine the association between physical activity and asthma symptoms; adjusting for age, sex, race, BMI, caregiver's education, asthma severity, medication use, and season.

Physician Preferences for Aggressive Treatment at the End of Life and Area-Level Health Care Spending: The Johns Hopkins Precursors Study.

To determine whether physician preferences for end-of-life care were associated with variation in health care spending. We studied 737 physicians who completed the life-sustaining treatment questionnaire in 1999 and were linked to end-of-life care data for the years 1999 to 2009 from Medicare-eligible beneficiaries from the Dartmouth Atlas of Health Care (in hospital-related regions [HRRs]). Using latent class analysis to group physician preferences for end-of-life treatment into most, intermediate, and least aggressive categories, we examined how physician preferences were associated with health care spending over a 7-year period.

Results of the HEMO Study suggest that p-cresol sulfate and indoxyl sulfate are not associated with cardiovascular outcomes.

Cardiovascular disease, the leading cause of mortality in hemodialysis patients, is not fully explained by traditional risk factors. To help define non-traditional risk factors, we determined the association of predialysis total p-cresol sulfate, indoxyl sulfate, phenylacetylglutamine, and hippurate with cardiac death, sudden cardiac death, and first cardiovascular event in the 1,273 participants of the HEMO Study. The results were adjusted for potential demographic, clinical, and laboratory confounders.

Incremental short daily home hemodialysis: a case series.

Background: Patients starting dialysis often have substantial residual kidney function. Incremental hemodialysis provides a hemodialysis prescription that supplements patients' residual kidney function while maintaining total (residual + dialysis) urea clearance (standard Kt/Vurea) targets. We describe our experience with incremental hemodialysis in patients using NxStage System One for home hemodialysis.

Residual Kidney Function: Implications in the Era of Personalized Medicine.

The association of residual kidney function (RKF) with improved outcomes in peritoneal dialysis and hemodialysis patients is now widely recognized. RKF provides substantial volume and solute clearance even after dialysis initiation. In particular, RKF provides clearance of nonurea solutes, many of which are potential uremic toxins and not effectively removed by conventional hemodialysis.

Costs of substance use disorders from claims data for Medicare recipients from a population-based sample.

Medicare spending is projected to increase over the next decade, including for substance use disorders (SUD). Our objective was to determine whether SUDs are associated with higher six-year Medicare costs (1999-2004) among participants in the Baltimore Epidemiologic Catchment Area (ECA) Study. Medicare claims data for the years 1999-2004 from the Centers for Medicare and Medicaid Services were linked to four waves of data from the Baltimore ECA cohort collected between 1981 and 2005 (n=566).

Serum Asymmetric and Symmetric Dimethylarginine and Morbidity and Mortality in Hemodialysis Patients.

Background: Asymmetric (ADMA) and symmetric dimethylarginine (SDMA) are putative uremic toxins that may exert toxicity by a number of mechanisms, including impaired nitric oxide synthesis and generation of reactive oxygen species. The study goal was to determine the association between these metabolites and cardiovascular outcomes in hemodialysis patients.

Study Design: Post hoc analysis of the Hemodialysis (HEMO) Study.