Publications by authors named "Thomas I"

Introduction: Atrial fibrillation (AF) in end-stage kidney disease (ESKD) and kidney transplant (KTx) recipients presents challenges in stroke risk management. This study aimed to compare hospitalization rates for ischemic and hemorrhagic cerebrovascular events in ESKD and KTx patients with and without AF.

Methods: Using the National Inpatient Sample (2005-2019), retrospective analysis was conducted on hospitalizations for ESKD and KTx patients with and without AF.

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Options for the continuous and non-invasive monitoring of blood pressure are limited. Cuff-based sphygmomanometers are widely available, yet provide only discrete measurements. The clinical gold-standard approach for the continuous monitoring of blood pressure requires an arterial line, which is too invasive for routine use.

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Background: Prevention is a cornerstone for management of recurrent urinary stone disease. Current guidelines recommend metabolic evaluation, lifestyle modification, and medical treatment for patients with urinary stone disease. Nephrologists are uniquely qualified to evaluate stone risk and formulate treatment strategies to reduce that risk.

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Purpose: To evaluate the survival benefit of chemotherapy intensification in older patients with AML who have not achieved a measurable residual disease (MRD)-negative remission.

Methods: Five hundred twenty-three patients with AML (median age, 67 years; range, 51-79) without a flow cytometric MRD-negative remission response after a first course of daunorubicin and AraC (DA; including 165 not in remission) were randomly assigned between up to two further courses of DA or intensified chemotherapy-either fludarabine, cytarabine, granulocyte colony-stimulating factor and idarubicin (FLAG-Ida) or DA with cladribine (DAC).

Results: Overall survival (OS) was not improved in the intensification arms (DAC DA: hazard ratio [HR], 0.

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The diagnosis of death by neurological criteria (DNC) requires the exclusion of any clinical effect attributable to xenobiotics. We undertook a retrospective analysis of enquiries to the National Poisons Information Service (NPIS) relating to DNC over a 10-year period. Enquiries were categorised as toxicological, where exposure to a non-therapeutically administered xenobiotic was implicated in the clinical presentation and non-toxicological where exposure to the xenobiotic was not the primary cause of the clinical state.

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Importance: Men with limited life expectancy (LE) have historically been overtreated for prostate cancer despite clear guideline recommendations. With increasing use of active surveillance, it is unclear if overtreatment of men with limited LE has persisted and how overtreatment varies by tumor risk and treatment type.

Objective: To determine if rates of overtreatment of men with limited LE have persisted in the active surveillance era and whether overtreatment varies by tumor risk or treatment type.

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Article Synopsis
  • Treatment outcomes for acute promyelocytic leukemia (APL) have significantly improved through targeted therapies like ATRA and arsenic trioxide, as confirmed by a study analyzing 1,438 newly diagnosed patients from 1999 to 2022.
  • Among those treated, patients receiving the ATRA-ATO regimen demonstrated a higher 7-year overall survival rate (91%) compared to those on AIDA-like chemotherapy (81%), along with better event-free survival and lower relapse rates.
  • The study highlights the ongoing issue of early death, particularly in older patients and those with high Sanz risk scores, suggesting a need for further examination and targeted interventions in these vulnerable groups.
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Objective: To determine rates of urology follow-up and implementation of stone prevention measures after stone surgery and to assess variation in care delivery within a large, integrated healthcare system.

Materials And Methods: We used nationwide data from the United States Veterans Health Administration to identify patients who had stone surgery between 2016 and 2018 and who were at higher risk for recurrence. Our cohort included 13,444 Veterans across 90 facilities.

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  • The European Union includes 30 outermost and overseas countries and territories (OCTs), where renal transplantation is growing, but many patients still seek treatment in continental Europe, necessitating collaborative care.
  • Each OCT has its own infectious disease patterns, which are crucial for ensuring effective post-transplant care for kidney transplant recipients (KTRs).
  • The paper suggests a practical approach to enhance pre-transplant evaluations and provides region-specific epidemiological data, advocating for more collaborative research among the OCTs to improve care for infected KTRs.
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Purpose: Patients treated with radical cystectomy experience a high rate of postoperative complications and frequent hospital readmissions. We sought to explore the utility of the Care Assessment Need (CAN) score, derived from electronic health data, to estimate the risk of these adverse clinical outcomes, thereby aiding patient counseling and informed treatment decision-making.

Materials And Methods: We retrospectively examined data from 982 patients with bladder cancer who underwent radical cystectomy between 2013 and 2018 within the national Veterans Health Administration system.

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Background: Seafood allergy (SA), including allergy to shellfish (crustacean and mollusks) and fish, is among the 4 most common food allergies causing anaphylaxis, but there are limited data showing SA clinical management in different countries.

Objective: We sought to characterize a large cohort of patients with fish and shellfish allergy and to facilitate standardization of future care for this increasingly common allergic disease.

Methods: We performed a retrospective, observational, noninterventional study from 945 patients from 2015 to 2019 in 7 hospitals in the United States and the United Kingdom to evaluate SA.

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Acute traumatic brain injury (TBI) is associated with substantial abnormalities in lipid biology, including changes in the structural lipids that are present in the myelin in the brain. We investigated the relationship between traumatic microstructural changes in white matter from magnetic resonance imaging (MRI) and quantitative lipidomic changes from blood serum. The study cohort included 103 patients from the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study.

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Article Synopsis
  • - The study focuses on older patients (over 60 years) with acute myeloid leukemia (AML) and aims to create a prognostic model to identify those who would benefit from intensive chemotherapy and stem cell transplantation.
  • - Researchers analyzed data from 1,910 patients, using a random survival forest to evaluate clinical and genetic factors associated with overall survival, resulting in the identification of four distinct survival groups based on nine variables.
  • - The newly developed AML60+ classification shows improved prognostic accuracy and indicates that intermediate- and very poor-risk patients may benefit from allogeneic hematopoietic cell transplantation, potentially guiding treatment decisions for older adults with AML.
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Article Synopsis
  • Older adults with kidney failure not referred for transplant have two options: starting dialysis or continuing medical management, which may prolong home time and survival.
  • An observational study compared survival and time spent at home between groups starting dialysis and those opting for medical management, revealing only slight differences in survival (9.3 days) with the dialysis group having 13.6 fewer days at home.
  • Limitations of the study include potential unmeasured confounding and limited applicability to women and non-veterans, suggesting cautious interpretation of the results for broader populations.
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Type 2 diabetes (T2D) is a growing concern among the pediatric population. During the coronavirus disease 2019 (COVID-19) pandemic, the incidence of pediatric T2D increased. This was more notable among males and Black people.

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Article Synopsis
  • Accurate data extraction is crucial for valid evidence synthesis, and recent interest in large language models (LLMs) like Claude 2 and GPT-4 has raised questions about their effectiveness for this purpose.
  • In a comparison of these two LLMs on extracting data from PDFs of systematic review articles, Claude 2 achieved high accuracy (96.3%), while GPT-4 had a lower accuracy (68.8%) mainly due to the challenges of using a third-party PDF parsing plugin.
  • Although both models performed well in identifying missing data and generating correct information, the study emphasizes the need for human verification of LLM extractions and highlights limitations such as the study’s narrow focus and potential biases in the training data.
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Background: Hepatitis C virus (HCV) infection is a significant global health burden, particularly among people who inject drugs. Rapid point-of-care HCV testing has emerged as a promising approach to improve HCV detection and linkage to care in harm reduction organizations such as needle and syringe programs. The objective of this study was to use an intersectionality lens to explore the barriers and enablers to point-of-care HCV testing in a needle and syringe program.

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Article Synopsis
  • There are limited treatment options for people with HIV-1 who have already tried many medicines and have drug-resistant HIV-1.
  • Since 2018, three new medications have been approved to help these patients: ibalizumab, fostemsavir, and lenacapavir.
  • Experts created guidelines to help doctors use these new medicines better and suggested more areas to study for future research.
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Background: Dementia is a general term for several progressive neurodegenerative disorders including Alzheimer's disease. Timely and accurate detection is crucial for early intervention. Advancements in artificial intelligence present significant potential for using machine learning to aid in early detection.

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Background: Methamphetamine-associated cardiomyopathy (MACM) is a known complication of methamphetamine use; however, risk factors and outcomes of patients with MACM are not well understood.

Study Objectives: This study aims to identify risk factors, emergency department (ED) interventions, and outcomes for MACM.

Methods: This case-control study was conducted between 2012 and 2020 at two academic EDs.

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Our study aimed to assess the severity of severe acute respiratory syndrome coronavirus 2 infection in hospitalized infants under 40 days old, across 21 Belgian hospitals between 2020 and 2022. Of the 365 infants studied, 14.2% needed respiratory support.

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Article Synopsis
  • NPM1-mutated acute myeloid leukemia (AML) has a generally good prognosis, but many patients still relapse, and traditional risk factors only include FLT3-ITD mutations and adverse karyotypes due to inconsistent findings from other factors.* -
  • A study involving 1,357 patients revealed that specific mutations (FLT3-ITD, DNMT3A, WT1, and certain NPM1 mutations) correlate with poorer overall survival and are linked to measurable residual disease (MRD) status.* -
  • Intensified chemotherapy using the FLAG-Ida regimen showed better outcomes across all patient subgroups, with particularly notable improvements for those in high-risk molecular categories.*
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Objective: The purpose of this study is to examine diabetes distress as a potential mediator of the relationship between depression symptoms and diabetes outcomes, including hemoglobin A1c (hemoglobin A1c [HbA1c]) and diabetes management behaviors in a clinical sample of adolescents and young adults.

Methods: In a pediatric diabetes clinic, 716 youth (ages 12-21 years) completed measures of diabetes distress (Problem Areas in Diabetes-Teen [PAID-T]), a single-item of diabetes distress, and depression (Patient Health Questionnaire [PHQ-9]) as part of standard care. Electronic health records were extracted for the "Six Habits" and glycemic management (HbA1c).

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