Exploring Nurses' Personal and Professional Values and Care Quality: A Convergent Mixed-Methods Analysis.

Background: Professional standards and the Codes of Ethics from the International Council of Nurses and American Nurses Association are frameworks driving professional practice and are linked to positive patient and nursing outcomes.

Objective: To describe qualitative themes extracted from narrative responses on how nurses' personal values influence nursing care and converge with quantitative results assessing personal values, professional values, and the practice environment, a key component of nurse satisfaction and subsequent care quality.

Methods: A convenience sample of nurses across 19 sites within a large nonprofit healthcare system was surveyed.

Standardized Clinical Infectious Diseases Pharmacy Care Delivery and Antimicrobial Stewardship Program Management Within a Large, Integrated Healthcare System.

Purpose: Infectious Diseases (ID) pharmacy expertise is crucial for the success of antimicrobial stewardship (AMS) efforts. As health systems expand due to mergers and acquisitions, ID pharmacy teams strive to deliver consistent care across the enterprise. This report describes the fusion of multiple AMS practice models during the integration of health systems to optimize and standardize care delivery.

Characteristics and Outcomes of Patients With a Moderate History, ECG, Age, Risk Factors, and Troponin (HEART) Score.

Introduction Chest pain is a common, expensive cause of admission to the hospital from the Emergency Department (ED). The History, ECG, Age, Risk Factors, and Troponin (HEART) score is a risk stratification tool often used to determine the disposition of chest pain patients. This study evaluates the association of age, gender, HEART score, diabetes mellitus (DM), hypertension (HTN), hypercholesterolemia, family history (Fam Hx), and tobacco use with major adverse cardiovascular events (MACE) and hospital readmission.

International cross-sectional survey on current and updated definitions of intra-abdominal hypertension and abdominal compartment syndrome.

Background: The Abdominal Compartment Society (WSACS) established consensus definitions and recommendations for the management of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in 2006, and they were last updated in 2013. The WSACS conducted an international survey between 2022 and 2023 to seek the agreement of healthcare practitioners (HCPs) worldwide on current and new candidate statements that may be used for future guidelines.

Methods: A self-administered, online cross-sectional survey was conducted under the auspices of the WSACS to assess the level of agreement among HCPs over current and new candidate statements.

Impact of Remote Dielectric Sensing on Predicting Worsening Heart Failure During Hospitalization for Heart Failure.

A remote dielectric sensing (ReDS) system quickly quantifies pulmonary congestion. Nonetheless, its efficacy in predicting an in-hospital increase in plasma B-type natriuretic peptide levels, the potential surrogate of worsening heart failure, remains undetermined. Patients who underwent ReDS measurement on admission during their hospitalization in the general wards for heart failure between 2021 and 2022 were eligible.

Congenital Arteriovenous Fistula in a Nine-Year-Old Child: A Case Report.

Congenital external carotid-jugular fistula is a rare condition caused by altered embryologic development of the vasculature. It is usually treated with surgery or endovascular embolization; controversy exists on the best therapeutic approach and the specific endovascular technique. We report a case of a complex congenital fistula between the external carotid and jugular veins treated with a combined trans-arterial dual microcatheter coiling technique followed by n-BCA (n-butyl cyanoacrylate) glue embolization.

Validation of artificial intelligence-based application to estimate nutrients in daily meals.

Background: Diet modification is a mainstay for the successful management of metabolic syndrome and potentially may reduce the risk of cardiovascular disease. Accurate estimation of essential nutrients in daily meals is currently challenging to quantify. HAKARIUM (AstraZeneca Co.

Delays in Cardiopulmonary Resuscitation, Defibrillation, and Epinephrine Administration in Out-of-Hospital Cardiac Arrest - Composite Time-Dependent Effects of Prehospital Interventions on 30-Day Favorable Neurological Outcomes and Social Implications From a Prospective Nationwide Population-Based Cohort Study.

Background: Our study investigated the prognostic impacts of the interval between collapse and the initiation of cardiopulmonary resuscitation (CPR), and subsequent intervals to defibrillation or epinephrine administration, on 30-day favorable neurological outcomes following out-of-hospital cardiac arrest (OHCA).

Methods And Results: This nationwide population-based cohort study used the All Japan Utstein Registry, encompassing OHCA patients in Japan between January 2006 and December 2021. The primary outcome was 30-day favorable neurological outcomes, defined as Cerebral Performance Category 1 or 2.

Development and Implementation of a Multicenter Registry for Resuscitation-Focused Transesophageal Echocardiography.

Study Objective: To evaluate the clinical effect, safety, and clinical outcomes of focused transesophageal echocardiography (TEE) in the evaluation of critically ill patients in the emergency department (ED) and ICUs.

Methods: We established a prospective, multicenter, observational registry involving adult critically ill patients in whom focused TEE was performed for evaluation of out-of-hospital cardiac arrest (OHCA), inhospital cardiac arrest, evaluation of undifferentiated shock, hemodynamic monitoring, and/or procedural guidance in the ED, ICU, or operating room setting. The primary objective of the current investigation was to evaluate the clinical influence and safety of focused, point-of-care TEE in critically ill patients.

Second-Trimester Ultrasound Receipt Mediates the Relationship Between Public Insurance and Prenatal Diagnosis of a Congenital Heart Defect.

Objective: To delineate the mechanism behind insurance-related disparities in the prenatal diagnosis of a congenital heart defect (CHD).

Methods: This was a retrospective analysis of electronic health records of pregnant individuals whose infants received CHD surgery between 2019 and 2020 in the third-largest United States metropolitan area. The outcome was whether a prenatal diagnosis was received.

Outflow Graft Tamponade: An Underrecognized Cause of Obstruction.

Background: Left ventricular assist device (LVAD) outflow graft obstruction can result in severe clinical deterioration. Underlying mechanisms may vary depending on the location. Outflow graft tamponade due to external compression can be under recognized.

Impaired Gastrointestinal Motility and Worsening Heart Failure in Patients Receiving Trans-Catheter Aortic Valve Replacement.

Impaired gastric motility in the form of constipation may often occur in elderly patients with chronic heart failure. Candidates for trans-catheter aortic replacement (TAVR) are of old age and have multiple comorbidities, probably including constipation. However, the clinical implication of a history of constipation in patients receiving TAVR remains unknown.

Chronic Kidney Disease Stage and Cardiovascular and Mortality Events Among Older Adults: The SPRINT Trial.

Rationale & Objective: The risk implications of the Kidney Disease: Improving Global Outcomes (KDIGO) chronic kidney disease classification in older adults are controversial. We evaluated the risk of adverse outcomes in this population across categories of estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR).

Study Design: Prospective cohort.

Lupus nephritis: management challenges during pregnancy.

Lupus nephritis (LN), a severe complication of systemic lupus erythematosus (SLE), leads to significant kidney inflammation and damage and drastically increases mortality risk. Predominantly impacting women in their reproductive years, LN poses specific risks during pregnancy, including pre-eclampsia, growth restrictions, stillbirth, and preterm delivery, exacerbated by lupus activity, specific antibodies, and pre-existing conditions like hypertension. Effective management of LN during pregnancy is crucial and involves carefully balancing disease control with the safety of the fetus.

A Lower Remote Dielectric Sensing Value Was Associated with Hypovolemia and Worse Clinical Outcomes.

Remote dielectric sensing (ReDS) systems can estimate the amount of lung fluid non-invasively and easily without expert techniques. The correlation between the elevated ReDS value and other modalities that estimate pulmonary congestion has been validated. The clinical implications of lower ReDS values, which may indicate hypovolemia, remain unknown.

T-Cell Lymphoproliferative Disorders Following Allogeneic Bone Marrow Transplant: A Report of Two Cases and a Literature Review.

Post-transplantation lymphoproliferative disorders (PTLD) are a commonly occurring condition following solid organ transplantation (SOT) and, rarely, hematopoietic stem cell transplantation (HSCT). As the name suggests, a PTLD is a condition where there is a clonal proliferation of lymphoid cells that occurs as a complication after transplantation. Though the clonal origin cell is primarily associated with the B-cell lineage, there are existing cases in the literature describing PTLD from the T-cell lineage.

Clinical Implications of Remote Dielectric Sensing-Guided Management.

Remote dielectric sensing (ReDS) systems can quantify the degree of pulmonary congestion rapidly and non-invasively. However, the clinical implications of ReDS-guided medication adjustment remain uncertain. Patients hospitalized to treat cardiovascular diseases, including heart failure, valvular disease, and coronary artery disease, and underwent ReDS measurement before index discharge between 2021 and 2022 were included.

Pancreaticoduodenectomy for trauma in an adolescent female with complex pancreatic and duodenal injuries: Case report and review of the literature.

Background: We present a successful staged surgical repair of an adolescent who sustained a high grade combined pancreaticoduodenal injury following a high-speed motor vehicle collision.

Methods: We discuss our case as well as provide a thorough literature review made on databases such as PubMed, Google Scholar, and Embase.

Summary: A fifteen-year-old female presented after a motor vehicle collision with abdominal pain and imaging suggestive of pancreatic and duodenal injuries.

A Review of Focal Segmental Glomerulosclerosis Classification With a Focus on Genetic Associations.

Focal segmental glomerulosclerosis (FSGS) defines a distinct histologic pattern observed in kidney tissue that is linked to several distinct underlying causes, all converging on the common factor of podocyte injury. It presents a considerable challenge in terms of classification because of its varied underlying causes and the limited correlation between histopathology and clinical outcomes. Critically, precise nomenclature is key to describe and delineate the pathogenesis, subsequently guiding the selection of suitable and precision therapies.

Cardiovascular, Kidney Failure, and All-Cause Mortality Events in Patients with FSGS in a US Real-World Database.

Key Points: In our patients with FSGS, elevated proteinuria and progression to kidney failure (KF) were associated with a higher risk of cardiovascular disease/all-cause mortality events. In addition, elevated pre-KF proteinuria was associated with KF/all-cause mortality events. CKD stage, nephrotic syndrome, and cardiovascular disease event rates, as well as the incremental costs of these events, were high.