697 results match your criteria: "Chronic Disease Hospital "St. Luke"[Affiliation]"

Background: Stroke patients often face disabilities that significantly interfere with their daily lives. Poor nutritional status is a common issue amongst these patients, and malnutrition can severely impact their functional recovery post-stroke. Therefore, nutritional therapy is crucial in managing stroke outcomes.

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Cytomegalovirus (CMV) infection is widespread in immunocompromised people, and several cases of CMV infections of the gastrointestinal (GI) tract have been reported in these individuals. We present a case of an immunocompetent patient on hemodialysis (HD) who developed CMV colitis. We also conducted a review of the literature on CMV GI tract infections among patients with chronic kidney disease undergoing dialysis.

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Article Synopsis
  • Despite improved treatments, colorectal cancer (CRC) still has high mortality rates, but some evidence points to aspirin (ASA) potentially lowering CRC incidence and metastasis.
  • A study of over 814,000 CRC patients revealed that those using ASA had significantly lower rates of total and gastrointestinal metastasis compared to non-users.
  • Results showed that ASA users had better outcomes even after adjusting for factors like age and other health conditions, although more research is needed to understand how it works and how long treatment should last to be effective.
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Metformin is a widely prescribed medication for the management of type 2 diabetes. It is known to have a high safety index; however, it can cause serious adverse effects such as lactic acidosis, particularly in patients with chronic kidney disease. Elderly patients are at higher risk of developing metformin-associated lactic acidosis (MALA) due to aging kidneys.

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A duodenal-cecal fistula is characterized as an unnatural connection between the duodenum and cecum. Here, we present the case of a 40-year-old male with unintentional weight loss and a history of foreign body ingestion a few years prior. Computerized tomography (CT) small bowel enterography showed a linear soft tissue tract extending from the inferior aspect of the distal duodenum to the cecum.

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  • A systematic review examined the impact of interdisciplinary home healthcare services, involving at least two providers (like nurses and physiotherapists), on the quality of life and health outcomes in older adults with chronic conditions.
  • The review included 13 randomized controlled trials (RCTs) with 4,709 participants, finding that these services significantly reduced hospital admissions in the first 6 months of care, though certainty around quality of life and mortality outcomes was low.
  • The study concluded that while interdisciplinary home care may lower hospital admissions, more thorough research is needed to assess its overall effectiveness on other health outcomes.
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Background: While numerous studies have reported associations between low dietary potassium intake and adverse clinical outcomes, methods to estimate potassium intake, mainly self-reported dietary measures and urinary potassium excretion, entail certain limitations. Self-reported measures are subject to underreporting and overreporting. Urinary potassium excretion is affected by multiple factors including renal function.

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Optimal Timing of Delivery for Pregnant Individuals With Mild Chronic Hypertension.

Obstet Gynecol

September 2024

Departments of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, University of Texas at Houston, Houston, and University of Texas Medical Branch, Galveston, Texas, University of Pennsylvania and Drexel University College of Medicine, Philadelphia, and Magee Women's Hospital and University of Pittsburgh, Pittsburgh, Pennsylvania, University of North Carolina at Chapel Hill, Chapel Hill, and Duke University, Durham, North Carolina, Columbia University and Weill Cornell University, New York, and NYU Langone Hospital-Long Island, Long Island, and NewYork-Presbyterian Queens Hospital, Flushing, New York, University of Oklahoma Health Sciences, Oklahoma City, Oklahoma, Indiana University, Indianapolis, Indiana, University of Alabama at Birmingham, Birmingham, and University of South Alabama at Mobile, Mobile, Alabama, UnityPoint Health-Meriter Hospital/Marshfield Clinic, Madison, and Medical College of Wisconsin, Milwaukee, Wisconsin, Washington University, St. Louis, Missouri, University of Mississippi Medical Center, Jackson, Mississippi, The Ohio State University, Columbus, and Wright State University and Miami Valley Hospital, Dayton, Ohio, Rutgers University-Robert Wood Johnson Medical School, New Brunswick, New Jersey, Yale University, New Haven, Connecticut, University of Colorado, Aurora, and Denver Health, Denver, Colorado, Emory University, Atlanta, Georgia, University of California, San Francisco, San Francisco, Stanford University, Stanford, and Arrowhead Regional Medical Center, Colton, California, Beaumont Hospital, Michigan, Grosse Pointe, Michigan, Oregon Health & Science University, Portland, Oregon, Tulane University, New Orleans, Louisiana, and University of Kansas Medical Center, Kansas City, Kansas; the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, and the Department of Women's Health, University of Texas at Austin, Austin, Texas; the Department of Biostatistics, the Division of Neonatology, Department of Pediatrics, and the Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama; Ochsner Baptist Medical Center, New Orleans, Louisiana; St. Luke's University Health Network, Fountain Hill, and the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Lehigh Valley Health Network, Allentown, Pennsylvania; MetroHealth System, Cleveland, and the Fetal Care Center of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Intermountain Healthcare, Ogden, Utah; Christiana Care Health Services, Newark, Delaware; St. Peters University Hospital, New Brunswick, Virtua Health, Marlton, and the Department of Obstetrics, Gynecology and Women's Health, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, New Jersey; Zuckerberg San Francisco General Hospital, San Francisco, California; the Department of Obstetrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Obstetrics and Gynecology/Maternal-Fetal Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; Medical University of South Carolina, Charleston, South Carolina; and the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland.

Objective: To investigate the optimal gestational age to deliver pregnant people with chronic hypertension to improve perinatal outcomes.

Methods: We conducted a planned secondary analysis of a randomized controlled trial of chronic hypertension treatment to different blood pressure goals. Participants with term, singleton gestations were included.

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Pregnancy Outcomes of Nifedipine Compared With Labetalol for Oral Treatment of Mild Chronic Hypertension.

Obstet Gynecol

July 2024

Departments of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, and University of South Alabama at Mobile, Mobile, Alabama, University of North Carolina at Chapel Hill, Chapel Hill, and Duke University, Durham, North Carolina, University of Pennsylvania and Drexel University College of Medicine, Philadelphia, and Magee Women's Hospital and University of Pittsburgh, Pittsburgh, Pennsylvania, University of Texas at Houston and the Division of Maternal-Fetal Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, and University of Texas Medical Branch, Galveston, Texas, Columbia University and Weill Cornell University, New York, and New York Presbyterian Queens Hospital, Flushing, New York, University of Oklahoma Health Sciences, Oklahoma City, Oklahoma, Indiana University, Indianapolis, Indiana, University of Utah and Intermountain Healthcare, Salt Lake City, Utah, UnityPoint Health-Meriter Hospital/Marshfield Clinic, Madison, Wisconsin, Washington University in St. Louis, St. Louis, Missouri, University of Mississippi Medical Center, Jackson, Mississippi, The Ohio State University, Columbus, Ohio, Rutgers University-Robert Wood Johnson Medical School, New Brunswick, New Jersey, Medical College of Wisconsin, Milwaukee, Wisconsin, Yale University, New Haven, Connecticut, University of Colorado, Aurora, and Denver Health, Denver, Colorado, Emory University, Atlanta, Georgia.

Objective: To evaluate maternal and neonatal outcomes by type of antihypertensive used in participants of the CHAP (Chronic Hypertension in Pregnancy) trial.

Methods: We conducted a planned secondary analysis of CHAP, an open-label, multicenter, randomized trial of antihypertensive treatment compared with standard care (no treatment unless severe hypertension developed) in pregnant patients with mild chronic hypertension (blood pressure 140-159/90-104 mm Hg before 20 weeks of gestation) and singleton pregnancies. We performed three comparisons based on medications prescribed at enrollment: labetalol compared with standard care, nifedipine compared with standard care, and labetalol compared with nifedipine.

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Article Synopsis
  • * Interviews with 11 experts identified eight categories of barriers, leading to a questionnaire that surveyed 112 medical professionals involved in ESKD care, with a response rate of 47.3%.
  • * The analysis revealed five main barriers to CKM, with "lack of palliative care experience" and "lack of support system" being the most significant, while most respondents viewed CKM as a viable treatment option for ESKD.
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Background: Prenatal folate supplementation has been consistently associated with a reduced risk of childhood acute lymphoblastic leukemia (ALL). Previous germline genetic studies examining the one carbon (folate) metabolism pathway were limited in sample size, scope, and population diversity and led to inconclusive results.

Methods: We evaluated whether ∼2,900 single-nucleotide polymorphisms (SNP) within 46 candidate genes involved in the folate metabolism pathway influence the risk of childhood ALL, using genome-wide data from nine case-control studies in the Childhood Cancer and Leukemia International Consortium (n = 9,058 cases including 4,510 children of European ancestry, 3,018 Latinx, and 1,406 Asians, and 92,364 controls).

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Background: Autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD) are major genetic polycystic kidney diseases that can progress to end-stage kidney disease (ESKD). Longitudinal data on the clinical characteristics associated with clinical outcomes in polycystic kidney disease (PKD), including the development of ESKD and cardiovascular disease (CVD) are lacking in Japan. To address this unmet need the authors are establishing a novel, web-based, Nationwide Cohort Registry Study-the Japanese Registry of PKD (JRP).

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Article Synopsis
  • Bronchiectasis is a chronic lung disease affecting many, especially Indigenous populations in wealthy countries, and currently has no approved treatments.
  • A randomized controlled trial (RCT) aims to test the mucoactive agent erdosteine over 12 months to see if it reduces acute respiratory exacerbations in children and adults aged 2-49 with bronchiectasis.
  • The study will also evaluate the impact of erdosteine on quality of life, exacerbation duration, hospitalizations, lung function, and its overall cost-effectiveness.
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Superficial Venous Disease-An Updated Review.

Ann Vasc Surg

August 2024

Interventional and Endovascular Cardiologist, Stern Cardiovascular Foundation, UT Health Science Center, Memphis, TN.

Article Synopsis
  • Superficial venous diseases (SVDs) primarily affect the lower extremities and can lead to serious issues like varicose veins, chronic venous insufficiency, and venous ulcers.
  • The review discusses the anatomy, risk factors (like age, race, and lifestyle), and the clinical classification of SVDs, emphasizing the Clinical-Etiology-Anatomy-Pathophysiology system.
  • Various imaging techniques (mainly duplex ultrasound), along with a range of treatment options from conservative methods like compression stockings to advanced interventional therapies, are presented for managing SVD effectively.
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Introduction: Mitral valve stenosis (MS) can be concomitantly present in patients undergoing Transcatheter Aortic Valve Implantation (TAVI). Some studies have reported up to one-fifth of patients who underwent TAVI also have MS. The relationship between mitral stenosis and TAVI has led to concerns regarding increased adverse cardiac outcomes during and after the procedure.

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Background: Agonal bacteremia, diagnosed with postmortem positive blood culture results, is considered a possible contributing factor to death. We hypothesized that some premortem organ damage, such as kidney damage, can enhance agonal bacteremia.

Methods: We performed a postmortem blood and alveolar fluid culture study in 30 cadavers and evaluated the relationship between blood culture results and clinical parameters, including organ damage (brain, heart, lung, kidney, liver and gastrointestinal tract).

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Article Synopsis
  • * Existing research primarily focuses on observational studies, revealing heterogeneity in study designs and outcomes, which complicates evidence synthesis and comparison.
  • * The Neurocritical Care Society's Curing Coma Campaign is working to improve future research through coordinated observational studies and clinical trials to better understand and treat these disorders.
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Purpose: The OlympiA randomized phase III trial compared 1 year of olaparib (OL) or placebo (PL) as adjuvant therapy in patients with germline , high-risk human epidermal growth factor receptor 2-negative early breast cancer after completing (neo)adjuvant chemotherapy ([N]ACT), surgery, and radiotherapy. The patient-reported outcome primary hypothesis was that OL-treated patients may experience greater fatigue during treatment.

Methods: Data were collected before random assignment, and at 6, 12, 18, and 24 months.

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  • - The study evaluated a gamification program that uses non-monetary points to encourage exercise among cardiovascular disease patients, analyzing its impact on daily step counts over a 4-week period.
  • - A total of 29 CVD patients participated, with significant increases in average daily step counts observed during intervention weeks (ranging from 1,165 to 1,508 steps).
  • - Results indicated that women were more likely to achieve step goals, while higher body mass index correlated with smaller increases in step counts, demonstrating the program’s potential effectiveness for promoting physical activity in this patient group.
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  • The study investigates the geographical differences in coronary artery disease (CAD) characteristics among patients from Japan and Brazil, focusing on those undergoing percutaneous coronary intervention (PCI).
  • Results show that Japanese patients had more significant functional stenoses and lower post-PCI flow ratios compared to Brazilian patients, indicating a disparity in CAD patterns between the two regions.
  • The findings suggest that assessing both pre-procedural physiological indices and the diffuseness of CAD can help identify patients who may benefit most from PCI, highlighting the importance of tailored treatment approaches.
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Chronic kidney disease (CKD), which is globally on the rise, has become an urgent challenge from the perspective of public health, given its risk factors such as end-stage renal failure, cardiovascular diseases, and infections. The pathophysiology of CKD, including dialysis patients, is deeply associated with enhanced oxidative stress in both the kidneys and the entire body. Therefore, the introduction of a safe and widely applicable antioxidant therapy is expected as a measure against CKD.

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This case describes a 72-year-old Japanese woman with hypertrophic cardiomyopathy and non-sustained ventricular tachycardia who had received a total of 215 g of amiodarone over six years and presented with hepatic encephalopathy. The abdominal non-contrast computed tomography showed diffusely increased attenuation of the liver parenchyma. The liver biopsy revealed drug-induced steatohepatitis.

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Global Burden of Cardiovascular Diseases and Risks, 1990-2022.

J Am Coll Cardiol

December 2023

Department of Health Metrics Sciences, Institute for Health Metrics and Evaluation, School of Medicine, University of Washington, Seattle, Washington, USA; Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA. Electronic address:

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  • - The study examined the safety and effectiveness of tolvaptan for preserving kidney function in children (ages 5-17) with autosomal dominant polycystic kidney disease (ADPKD), where assessing disease progression risk was initially not included due to unvalidated criteria.
  • - Four pediatric nephrologists reviewed baseline data from 90 participants and rated the risk of rapid disease progression, finding 77% of ratings were concordant, with a mean rating of 3.5 indicating significant risk in older age groups (15-17 years).
  • - The reviewers identified key characteristics for assessing risk—such as age, kidney imaging, kidney function, blood pressure, urine protein levels, and genetics—highlighting the feasibility
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Objectives: We investigated the association between patient severity or mortality and time to positivity in bacteremia caused by various pathogens.

Patients And Methods: This single-center retrospective study included patients with positive blood culture results.

Results: Longer time to positivity was associated with 30-day mortality for Staphylococcus aureus (221 cases, time to positivity: 17.

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