57,360 results match your criteria: "Duke University Medical Center[Affiliation]"

Dietary guidance is based on a robust evidence base that includes high-quality clinical trials, of which some have been designed to establish causal relationships between dietary interventions and ASCVD risk reduction. However, the complexity associated with conducting these trials has resulted in criticism of nutrition and dietary recommendations because the strength and quality of evidence falls short of that for some pharmaceutical interventions. In this paper, we aim to promote greater awareness of the nutrition-related clinical trials that have been conducted showing ASCVD benefits and how this evidence has contributed to dietary recommendations.

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  • Sexual concerns are prevalent among breast cancer survivors, impacting their sexual adjustment significantly, which suggests that involving partners in the therapeutic process could be beneficial.
  • The study tested the Intimacy Enhancement (IE) intervention, a telephone-based program for couples, to tackle these sexual issues, comparing its effectiveness to a control group intervention.
  • Results indicated that the IE intervention led to notable short-term improvements in the sexual function and satisfaction of survivors, although sustaining these benefits over time may require additional strategies.
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There is a growing trend in performing outpatient total shoulder arthroplasty (TSA). The purpose of this study was to analyze the public perception of outpatient TSA by querying a validated online market research platform regarding the public's knowledge, expectations, and beliefs on outpatient TSA. One thousand eighty respondents completed the survey in 2021.

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Approaches to management of HIT in complex scenarios, including cardiac surgery.

Hematology Am Soc Hematol Educ Program

December 2024

Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, NC.

Although heparin-induced thrombocytopenia (HIT) presents management challenges for any population, it adds complexity to the management of certain patient populations, including those undergoing cardiac surgery and those with refractory HIT and/or acute bleeding. For each of these scenarios, we review alternative management strategies when standard therapies-heparin cessation and the initiation of a nonheparin anticoagulant-are either insufficient or not practicable. In patients with HIT undergoing cardiac surgery, we review the clinical experience for heparin reexposure using therapeutic plasma exchange (TPE) or antiplatelet therapy.

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Basiliximab induction immunosuppression and lung transplant outcomes: Propensity analysis in a multicenter cohort.

J Heart Lung Transplant

December 2024

Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Duke University Medical Center, Durham, NC; Duke Clinical Research Institute, Duke University Medical Center, Durham, NC. Electronic address:

Background: Basiliximab induction immunosuppression is increasingly employed in lung transplant recipients despite limited prospective evidence to support its use in this population. We sought to determine the relationship between basiliximab induction and development of acute rejection, chronic lung allograft dysfunction, and other clinically relevant outcomes in a multicenter lung transplant cohort with variable induction practice patterns.

Methods: We applied propensity-based statistical methods to rigorous, prospectively collected longitudinal data from 768 newly transplanted adult lung recipients at 5 North American centers (368 who received basiliximab induction immunosuppression and 400 who received no induction immunosuppression).

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Objective: The Endoscopic Third Ventriculostomy Success Score (ETVSS) is a useful decision-making heuristic when considering the probability of surgical success, defined traditionally as no repeat cerebrospinal fluid diversion surgery needed within 6 months. Nonetheless, the performance of the logistic regression (LR) model in the original 2009 study was modest, with an area under the receiver operating characteristic curve (AUROC) of 0.68.

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Selecting an appropriate sanitizer (i.e., "rub") for application to hands and gloves before and, if necessary, during sterile compounding is as important as is its consistent and judicious use.

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Background: Randomized controlled trials (RCTs) of complete revascularization (CR) versus culprit-only revascularization (COR) in patients with ST-elevation myocardial infarction (STEMI) have shifted the recommendation for CR from class III to class I in the AHA/ACC/SCAI guidelines, but it remains unclear if the benefit of CR over COR extends to older adults, who have greater bleeding risk, comorbidity burden, and complexity of lesions. We performed a meta-analysis to place the results of the previous RCTs in the context of the recently published FIRE trial and the subgroup analysis of the COMPLETE trial in adults ≥75 years old.

Methods: We searched the literature from inception to October 21, 2023.

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  • This study compares the image quality and methods for measuring infarct size between a new technique called MT-FIDDLE and the standard bright-blood LGE cardiac MRI in patients who had a heart attack (STEMI).
  • The results indicate that MT-FIDDLE provides significantly better subjective image quality, particularly in terms of confidence for infarct segmentation and blood-pool contrast, with a high concordance in infarct volume measurements compared to bright-blood LGE.
  • Ultimately, MT-FIDDLE proved to enhance the ability to differentiate between heart injury (myocardial infarction) and surrounding blood, suggesting it could be a superior imaging method for assessing heart damage after a STEMI.
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Unveiling the fate and potential neuroprotective role of neural stem/progenitor cells in multiple sclerosis.

Front Neurol

November 2024

Department of Experimental Pathology, Immunology, and Microbiology, American University of Beirut, Beirut, Lebanon.

Article Synopsis
  • Chronic pathological conditions can lead to systemic inflammation, which plays a significant role in the development of neuroinflammatory diseases like Multiple Sclerosis (MS), characterized by damage to myelin and cognitive impairments.
  • The review emphasizes the importance of neural stem cells (NSCs) and neural progenitor cells (NPCs) in the regeneration process through mechanisms called adult neurogenesis (ANG) and gliogenesis, highlighting how these processes can help in recovery from MS.
  • Additionally, the text examines how MS alters the fate of NSCs and NPCs, discussing potential therapeutic interventions that could mitigate cognitive decline and disease progression in MS patients.
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  • Second look flexible nephroscopy (SLFN) is performed after percutaneous nephrolithotomy (PCNL) in patients with residual fragments (RFs) to assess and potentially remove any remaining stones.
  • In a study involving 201 patients, the final stone-free rate after SLFN was found to be 60.7%, despite many still having RFs post-procedure, with factors like bilateral stones and larger stone burdens linked to persistent fragments.
  • The study highlights that even with aggressive removal efforts during both PCNL and SLFN, some patients may still retain stone fragments, though the risk of complications from these fragments is currently unclear.
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Analysis of real world FRα testing in ovarian, fallopian tube, and primary peritoneal cancers.

Gynecol Oncol

December 2024

Labcorp, Durham, NC, USA; Wake Forest Comprehensive Cancer Center and Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA.

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Background: Brazil is a country with different biomes and social disparities. There are limited data available on regional differences and prognosis of heart failure (HF) in the country.

Objective: The Rosa dos Ventos study aims to investigate regional differences and the current prognosis of HF outpatients with reduced or mildly reduced ejection fraction in Brazil.

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Boys With Duchenne Muscular Dystrophy Have Diastolic Dysfunction Based on CMR.

Circ Cardiovasc Imaging

December 2024

Division of Pediatric Cardiology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN (J.R.S., J.G.W., K.G.-D., K.C., C.C.H., J.H.S.).

Article Synopsis
  • Cardiomyopathy is a major cause of death in boys with Duchenne muscular dystrophy (DMD), and this study investigates cardiac function using cardiac magnetic resonance (CMR) imaging to compare DMD patients with healthy controls.
  • The study involved 179 DMD patients and 96 healthy controls, focusing on measuring left ventricular (LV) function, with findings demonstrating significant differences in ventricular volumes and ejection rates, indicating compromised cardiac function in DMD patients.
  • Results suggest that certain CMR filling and ejection indices correlate with increased mortality in DMD patients, highlighting the potential for these measures to serve as important prognostic tools.
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Myocardial blood flow mechanism of mental stress-induced myocardial ischemia in women with ANOCA.

iScience

December 2024

The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China.

Article Synopsis
  • Mental stress-induced myocardial ischemia (MSIMI) significantly increases cardiovascular events, yet its precise mechanisms related to myocardial blood flow (MBF) are not fully understood.
  • A study using cardiac positron emission tomography (PET-CT) revealed that women with angina but no obstructive coronary artery disease (ANOCA) had a much higher prevalence of MSIMI compared to healthy controls.
  • Results showed that these participants had lower MBF and coronary flow reserves, indicating that impaired coronary microvascular function plays a crucial role in the development of MSIMI in individuals with ANOCA.
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Purpose: Psychological distress, including anxiety and depression, is common among adults with CF, associating with poor quality of life, lung function, and healthcare utilization. This 3-year, multi-site, telehealth-delivered randomized trial sought to determine whether Acceptance and Commitment Therapy (ACT with CF) is superior to supportive psychotherapy (SP), in improving psychological functioning for adults with CF.

Methods: One hundred twenty-four adults with CF and elevated anxiety and/or depressive symptoms were recruited coincident with the first COVID lockdown, from Thomas Jefferson University Hospitals, University of Virginia, Augusta University, Duke University Medical Center, and social media.

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