16,991 results match your criteria: "Birmingham Women & Children's Hospital[Affiliation]"

Perioperative Fluid Management.

Clin Geriatr Med

February 2025

Department of Anesthesia and Perioperative Care, University of California, VA Medical Center-San Francisco, 4150 Clement Street, San Francisco CA 94121, USA. Electronic address:

Article Synopsis
  • The medical complexities of geriatric patients are increasing, but surgical outcomes for older adults are improving as medical centers expand their approaches.
  • Effective perioperative fluid management is recognized as crucial for better postoperative results in older patients.
  • Managing fluids in older adults is difficult due to age-related organ changes, more existing health issues, and significant fluid shifts during complex surgeries.
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Background: Abaloparatide and teriparatide are osteoanabolic treatments indicated for postmenopausal women and men with osteoporosis at high risk of fracture. In the Abaloparatide Comparator Trial In Vertebral Endpoints study, bone mineral density improvements were significantly greater with abaloparatide compared to teriparatide at the total hip and femoral neck. We conducted a retrospective claims study to examine the incidences of hip and nonvertebral fractures and cardiovascular events in women aged ≥50 years initiating abaloparatide or teriparatide therapy, expanding on a previous retrospective claims study.

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Background: Management of patients with locoregionally advanced head and neck squamous cell carcinoma (HNSCC) when cisplatin is contraindicated is controversial. We aimed to assess whether radiotherapy with concurrent and adjuvant durvalumab would improve outcomes compared with radiotherapy with cetuximab.

Methods: NRG-HN004 was designed as an open-label, multicentre, parallel-group, randomised, phase 2/3 trial with safety lead-in conducted at 89 academic and community medical centres in North America.

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Kidney Outcomes in Transthyretin Amyloid Cardiomyopathy.

JAMA Cardiol

January 2025

National Amyloidosis Centre, Royal Free Hospital, University College London, London, United Kingdom.

Importance: Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive cardiomyopathy that commonly presents with concomitant chronic kidney disease. Chronic kidney dysfunction is associated with worse outcomes, but the prognostic value of changes in kidney function over time has yet to be defined.

Objective: To assess the prognostic importance of a decline in estimated glomerular filtration rate (eGFR) in a large cohort of patients with ATTR-CM.

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Interventions to Improve COVID-19 Vaccine Hesitancy.

Rheum Dis Clin North Am

February 2025

Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women's Hospital, 60 Fenwood Road, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA. Electronic address:

Coronavirus disease 2019 (COVID-19) vaccine uptake among individuals with rheumatic conditions remains low despite heightened risk for related adverse outcomes. This is especially pronounced among historically marginalized populations who suffered disproportionately from the COVID-19 pandemic. Among the myriad of reasons for low vaccine uptake, mistrust in the healthcare system, misinformation related to the vaccine development process, fear of rheumatic disease flares, and inconsistent physician recommendations, are highlighted.

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Objectives: The purpose of this study was to investigate head kinematic variables in elite men's and women's rugby union and their ability to predict player removal for an off-field (HIA1) head injury assessment.

Methods: Instrumented mouthguard (iMG) data were collected for 250 men and 132 women from 1865 and 807 player-matches, respectively, and synchronised to video-coded match footage. Head peak resultant linear acceleration (PLA), peak resultant angular acceleration (PAA) and peak change in angular velocity (dPAV) were extracted from each head acceleration event (HAE).

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Background: Adults who maintain ideal cardiovascular health (CVH) profiles up to midlife have lower risk of several chronic diseases and better quality of life. Some evidence suggests that individual-level exposures earlier in life shape midlife CVH, but the impact of neighborhood-level exposures over the life course remains understudied.

Methods And Results: Participants were 3017 Black and White men and women aged 18 to 30 years at baseline (1985-1986), recruited from Birmingham, Alabama; Minneapolis, Minnesota; Chicago, Illinois; and Oakland, California, as part of the CARDIA (Coronary Artery Risk Development in Young Adults) study.

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Article Synopsis
  • Percutaneous coronary intervention (PCI) for stable angina in the left main coronary artery has increased, with a study examining outcomes between men and women based on data from the UK's national PCI registry (2006-2022).
  • The study found that while women undergoing LMCA PCI were older and had fewer comorbid conditions, they experienced higher mortality rates and major bleeding events compared to men, with significant statistical differences in these outcomes.
  • The authors suggest that a sex-specific approach to treatment, taking into account factors like age and imaging techniques, could help improve the health outcomes for female patients undergoing this procedure.
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PCSK9 in metabolism and diseases.

Metabolism

February 2025

Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China; National Clinical Research Center for Interventional Medicine, Shanghai 200032, China. Electronic address:

PCSK9 is a serine protease that regulates plasma levels of low-density lipoprotein (LDL) and cholesterol by mediating the endolysosomal degradation of LDL receptor (LDLR) in the liver. When PCSK9 functions unchecked, it leads to increased degradation of LDLR, resulting in elevated circulatory levels of LDL and cholesterol. This dysregulation contributes to lipid and cholesterol metabolism abnormalities, foam cell formation, and the development of various diseases, including cardiovascular disease (CVD), viral infections, cancer, and sepsis.

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Functional and imaging outcomes of the Fontan circulation following pregnancy.

Int J Cardiol

January 2025

Department of Adult Congenital Heart Disease, Queen Elizabeth Hospital, University Hospital, Birmingham, UK.

Introduction: The Fontan circulation palliates single-ventricle congenital heart disease by separating the systemic and pulmonary circulations. An increasing number of women with a Fontan circulation are wishing to become pregnant, however the ability to increase cardiac output during pregnancy is limited in many due to the chronic low output state. We describe pregnancy outcomes in these women at a large tertiary centre, including functional and imaging outcomes.

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The study aimed to develop structured, expert-based clinical guidance on the prenatal and postnatal management of hemolytic disease of the fetus and newborn. A Delphi procedure was conducted among an international panel of experts in fetal medicine, neonatology, and hematology. Experts were selected based on their expertise, relevant publications, and affiliations.

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Objective: Sexually transmitted infections (STIs), including HIV, are a key contributor to psychological and physical morbidity across the United States (US). African American (AA) women are disproportionately impacted by STIs, particularly in the Deep South of the US. Strong patient-provider communication can help to increase client understanding of STI prevention and treatment options.

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Article Synopsis
  • Hippocampal sclerosis (HS) is a major cause of temporal lobe epilepsy (TLE) but can be hard to detect on MRI, leading to surgical delays, so researchers created open-source software to improve diagnosis.
  • The study involved 365 participants, using the software HippUnfold to analyze MRI scans and develop a logistic regression model that accurately identifies and localizes HS.
  • The classifier showed high accuracy in detecting HS in both initial and independent patient cohorts, proving effective for individual assessments by comparing patient data with normative growth patterns.
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Importance: Children born very preterm (<32 weeks) are at risk of ongoing morbidity and admission to pediatric intensive care units (PICUs) in childhood. However, the influence of the timing of neonatal discharge on unplanned PICU admission has not been established.

Objective: To examine whether the timing of neonatal discharge (postmenstrual age and season) is associated with subsequent unplanned PICU admission.

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Metrics derived from continuous glucose monitoring (CGM) systems are often discordant between systems. A major cause is that CGM systems are not standardized; they use various algorithms and calibration methods, leading to discordant CGM readings across systems. This discordance can be addressed by standardizing CGM performance assessments: If manufacturers aim their CGM systems at the same target, then CGM readings will align across systems.

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To highlight the use of multimodal imaging for detecting and monitoring macular neovascularization (MNV) in the presence of focal choroidal excavation. A case and its findings were analyzed. Spectral-domain optical coherence tomography (OCT) and OCT angiography (OCTA) were performed in a 30-year-old Asian woman with metamorphopsia in the left eye.

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Hyperoxaluria is a condition in which there is a pathologic abundance of oxalate in the urine through either hepatic overproduction (primary hyperoxaluria [PH]) or excessive enteric absorption of dietary oxalate (enteric hyperoxaluria [EH]). Severity can vary with the most severe forms causing kidney failure and extrarenal manifestations. To address the current challenges and innovations in hyperoxaluria, the 14th International Hyperoxaluria Workshop convened in Perugia, Italy, bringing together international experts for focused presentation and discussion.

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Cervical Precancer Treatment Outcomes in Cameroon.

Int J MCH AIDS

September 2024

Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of Buea, Cameroon.

Background And Objective: The ablative and excision treatment procedures are effective, accessible, and affordable in resource-constrained settings, but the rollout and posttreatment follow-up are not remarkable. The outcomes of treatment procedures among women treated for precancerous lesions of the cervix have not been adequately studied in Cameroon. This study assessed the outcome of ablative and excisional treatment procedures.

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Pediatric and congenital cardiac surgery, characterized by its complexity and high-stakes nature, demands superior technical expertise and multidisciplinary teamwork. With limited surgeons worldwide, the role of continuous skill refinement and collaborative practice is crucial for patient safety and successful outcomes. A literature search was performed using the PubMed, Cochrane, SCOPUS and Web of Science databases for studies published until September 2024.

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Background: Adolescent mental health problems have increased in prevalence. Teachers' Mental Health Literacy (MHL) may play an important role in public mental health prevention approaches. This systematic review and narrative synthesis aimed to identify what is known globally about the extent of secondary school teachers' MHL and the types and effectiveness of MHL interventions for secondary school teachers.

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Article Synopsis
  • Intestinal parasitic infections (IPIs) are significant public health concerns, particularly in low and middle-income countries, where they can severely affect vulnerable populations through contaminated food and water.
  • A study analyzing 9 years of stool examination data found an overall prevalence of 21.20% of IPIs, with the highest rates among patients aged 70-79 and in the year 2020.
  • The most common parasites identified were intestinal flagellates, which accounted for 98.31% of the infections diagnosed in the study.
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Objectives: Due to prognostic uncertainty and limited decision-making capacity, the choice to perform transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis (AS) and comorbid dementia is challenging. This study explores older adults' perspectives on complex decision-making preceding TAVI in the hypothetical setting of comorbid dementia.

Design: Qualitative study entailing semistructured interviews.

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Long-acting injectable cabotegravir plus rilpivirine (LA CAB/RPV) is currently US Food and Drug Administration (FDA)-approved and HIV treatment guideline-endorsed as a switch strategy for patients with HIV (PWH) who are virologically suppressed on oral ART without a history of treatment failure. Recent changes to the International Antiviral Society-USA (IAS-USA) and U.S.

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Background: Advances in haemolytic disease of the fetus and newborn have led to numerous treatment options. We report practice variations in the management and outcomes of haemolytic disease of the fetus and newborn in at-risk pregnancies.

Methods: In this international, retrospective, observational cohort study, data from cases with moderate or severe haemolytic disease of the fetus and newborn were retrieved from 31 centres in 22 countries.

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The Journal of Hospital Medicine turns 20.

J Hosp Med

January 2025

Divisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

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