Allogeneic stem cell transplantation (ASCT) is a complex medical procedure for some patients with hematologic malignancies. Most ASCTs occur at academic centers where either medical residents (house staff [HS]) or advanced practice providers (APPs) provide daily care. As a result of increasing work-hour regulations, APPs have assumed greater responsibilities, including those traditionally held by HS. In this study we evaluate ASCT patient outcomes by inpatient provider service. A retrospective, single-center chart review of ASCT patients was performed. ASCT patients admitted to an HS service from May 2011 to May 2012 (N = 86) were compared with ASCT patients admitted to a newly formed APP service from October 2012 to October 2013 (N = 81). As part of a secondary sensitivity analysis, we compared ASCT patients on the APP service to a subset of ASCT patients admitted to the HS service also from October 2012 to October 2013 (n = 27). Our primary outcomes were 100-day survival and relapse-free survival rates. Additional outcomes included length of stay (LOS), inpatient complications, and ordering behavior. Our primary pre- and post-analyses found no differences in 100-day overall survival and 100-day relapse-free survival rate between the services. The rate of pneumonia was lower on the APP service (15% versus 28%, P = .04), with no significant differences in other infectious complications. HS ordered more blood cultures (6.7 versus 4.2, P = .03) per patient than the APP service. There was no difference in LOS, readmission rates, or inpatient mortality. With regards to our secondary sensitivity analysis, no differences were found in 100-day overall survival and 100-day relapse-free survival rates between the services. There was a decreased LOS on the APP service (29.4 versus 37.2 days, P = .01). HS ordered more blood cultures (9.3 versus 4.2, P < .01) and more radiological films (8.1 versus 5.2, P = .05) per patient than the APP service. This increased ordering and LOS was associated with an increase in mean hospital charges on the HS service (P = .04). ASCT patients on an APP service had similar 100-day outcomes as those on the HS service. In the setting of limited resources, APPs are potential alternative providers for complex transplant inpatients.
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http://dx.doi.org/10.1016/j.bbmt.2015.05.021 | DOI Listing |
Spinal Cord
January 2025
McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
Study Design: Experimental Animal Study.
Objective: To continue validating an antibody which targets an epitope of neurofilament light chain (NF-L) only available during neurodegeneration and to utilize the antibody to describe the pattern of axonal degeneration 10 days post-unilateral C4 contusion in the rat.
Setting: University of Florida laboratory in Gainesville, USA.
J Racial Ethn Health Disparities
January 2025
School of Nursing, University of California, 700 Tiverton Ave, Los Angeles, CA, 90095, USA.
Objective: The purpose of this review was to identify relationships between social determinants of mental health service utilization and outcomes among Asian American cancer survivors in the United States (U.S.).
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Background: Clinicopathological studies of Alzheimer's disease (AD) have demonstrated that synaptic or neuronal loss and clinical cognitive decline do not reliably correlate with fibrillar amyloid burden. We created a transgenic mouse model overexpressing Dutch (E693Q) mutant human amyloid precursor protein (APP) driven by the pan-neuronal Thy1 promoter. Accumulation of APP carboxyl-terminal fragments was observed in the brains of these mice, which develop an impaired learning phenotype directly proportional to brain oAβ levels.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Department of Neurology, University Medical Center Medical Faculty Mannheim, Heidelberg, Baden-Württemberg, Germany.
Background: Timely diagnosis of mild cognitive impairment (MCI) in Alzheimer's disease (AD) is crucial for early interventions, but its implementation is often challenging due to the complexity and time burden of required cognitive assessments. Remote unsupervised self-testing of cognition can potentially addres this health care challenge. We conducted the to date largest evaluation of feasibility and experienced added value of unsupervised digital remote assessment in primary and specialized health care in Germany.
View Article and Find Full Text PDFCureus
December 2024
Clinical Microbiology, Prathima Institute of Medical Sciences, Karimnagar, IND.
Introduction Intestinal carriage of multidrug-resistant organisms (MDROs) in healthy populations could amplify resistant bacteria, which may increase the risk of infections by these bacteria in the community and in the hospital. This study investigated the prevalence of colonization of multidrug-resistant (MDR) bacteria in the intestines of healthy individuals in South India. Methods A prospective study was conducted for six months at a tertiary care teaching hospital.
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