Nurse Scientists.

These nurses bridge the gap between research and clinical practice.

Iron Deficiency Related to Obesity.

There is a direct correlation between being overweight and iron deficiency. Physiological changes occur in obese adipose cells that contribute to the development of iron deficiency (ID) and iron deficiency anemia (IDA). These changes disrupt the normal iron metabolic checks and balances.

Evaluating the utility of procalcitonin and a clinical decision support tool to determine duration of antimicrobial therapy for respiratory tract infections.

Purpose: Procalcitonin (PCT) levels may play a role in decreasing the duration of antimicrobial therapy in institutions that have long durations of therapy for management of community-acquired pneumonia. We assessed the impact of the combination of pharmacist stewardship interventions assisted by a clinical decision support (CDS) tool and PCT assessment on the antimicrobial days of therapy (DOT) prescribed for respiratory tract infections (RTIs).

Methods: We conducted a quasi-experimental study in which patients in the preintervention group were admitted between April and June 2021 and patients in the intervention group were admitted between April and June 2022.

Investigating patient engagement associations between a postdischarge texting programme and patient experience, readmission and revisit rates outcomes.

Objectives: This study aimed (1) to examine the association between patient engagement with a bidirectional, semiautomated postdischarge texting programme and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey outcomes, readmissions and revisit rates in a large health system and (2) to describe operational and clinical flow considerations for implementing a postdischarge texting programme.

Setting: The study involved 1 main academic hospital (beds: 2500+) and 6 community hospitals (beds: 190-400, averaging 300 beds per hospital) in Houston, Texas.

Methods: Retrospective, observational cohort study between non-engaged patients (responded with 0-2 incoming text messages) and engaged patients (responded with 3+ incoming, patient-initiated text messages) between December 2022 and May 2023.

Evaluation of computerized clinical decision support system to reduce unnecessary nasal methicillin-resistant (MRSA) polymerase chain reaction (PCR) testing.

Our health system implemented a novel clinical decision-support system to reduce unnecessary duplicate nasal methicillin-resistant (MRSA) polymerase chain reaction (PCR) orders. In an 8-month period, the rate of duplicate MRSA PCR orders within 7 days declined from 4.7% (370 of 7,861) to 1.

Left ventricular pseudoaneurysm without antecedent myocardial infarction.

Unlabelled: A left ventricle pseudoaneurysm (LVPA) occurs when the left ventricle free wall rupture becomes contained by pericardium or adhesions. It is rare and has a poor prognosis. LVPA is strongly associated with myocardial infarction.

Delayed Hemolysis With Parenteral Artesunate.

Artesunate is an effective and first-line therapy option in patients with severe malaria caused by species. Among adverse effects of the drug is a phenomenon of delayed hemolysis. This usually occurs at least 7 days after initiation of therapy, and is characterized by reductions in hemoglobin and haptoglobin and an increase in lactate dehydrogenase.

Design and Integration of a Texting Tool to Keep Patients' Family Members Updated During Hospitalization: Clinicians' Perspectives.

An important gap in the literature is how clinicians feel about patient-centered technologies and how clinicians experience patient-centered technologies in their workflows. Our goal was to identify clinician users' perspectives on facilitators (pros) and barriers (cons) to using 1 digital texting innovation to promote family centered care during patients' hospitalizations. This qualitative study was conducted at a tertiary care center in Houston, consisting of 7 hospitals (1 academic hospital and 6 community hospitals), involving analyzation of 3 focus groups of 18 physicians, 5 advanced practice providers, and 10 nurse directors and managers, as well as a content analysis of 156 real-time alerts signaling family dissatisfaction on the nursing unit/floor.

Design and Integration of a Texting Tool to Keep Patients' Family Members Updated During Hospitalization: Family Members' Perspectives.

While there is an evolving literature on the benefits of texting and patient-centered technologies, texting initiatives have not focused on family members. We sought to identify patients' family members' perspectives on facilitators and barriers to using 1 digital texting innovation to promote family-centered care during patients' hospitalizations. This qualitative study was conducted at a tertiary care center in Houston, consisting of 7 hospitals (1 academic hospital and 6 community hospitals), involving analyzation of 3137 comments from family members who used the digital texting technology.

A Single-Center, Retrospective Cohort Study Evaluating the Use of Probiotics for the Prevention of Hospital-Onset Infection in Hospitalized Patients Receiving Intravenous Antibiotics.

Background: Exposure to antimicrobials is a known risk factor for infection (CDI). Antimicrobials cause collateral damage by disrupting the natural intestinal microbiota allowing for to thrive and production of toxins. Probiotics could modulate the onset and course of CDI.

Scleroderma Renal Crisis With Thrombotic Microangiopathy Treated With Eculizumab.

We herein report the unusual case of a 52-year-old female with systemic scleroderma who was admitted to the emergency department (ED) with renal dysfunction and hypertension. Following a decline in hemoglobin (Hb) and platelet (Plt) count, the diagnosis of scleroderma renal crisis (SRC) with associated microangiopathic hemolytic anemia was made. Renal replacement therapy using hemodialysis was required.

Melanoma metastasis to the femoral nerve: a novel case of melanoma masquerading as mononeuropathy. Illustrative case.

Background: Metastatic cancer may involve the central and peripheral nervous system, usually in the late stages of disease. At this point, most patients have been diagnosed and treated for widespread systemic disease. Rarely is the involvement of the peripheral nervous system the presenting manifestation of malignancy.

Comparison of antimicrobial utilization metrics: Food for thought for an antimicrobial stewardship programme.

Given the overuse of antimicrobials and increasing antimicrobial resistance, the World Health Organization and Centers for Disease Control and Prevention recommend antimicrobial stewardship programmes to measure and assess the use of antimicrobials. Several antimicrobial use metrics have been described, including days of therapy, defined daily doses and standardized antimicrobial administration ratio. Understanding these metrics, including the advantages and disadvantages, can help antimicrobial stewardship programmes to monitor antimicrobial use at their institution, and assess the impact of antimicrobial stewardship efforts.

Impact of Antimicrobial Stewardship Interventions on Antimicrobial Utilization in Asymptomatic Bacteriuria.

Antimicrobial therapy for asymptomatic bacteriuria (ASB) is often unnecessary and is a common reason for inappropriate antimicrobial use in hospitalized patients. Unnecessary ASB treatment leads to collateral damage such as resistance, and infections. This study evaluated the impact of interdisciplinary antimicrobial stewardship interventions on antimicrobial utilization in ASB.

Assessing the Impact of Patient-Facing Mobile Health Technology on Patient Outcomes: Retrospective Observational Cohort Study.

Background: Despite the growth of and media hype about mobile health (mHealth), there is a paucity of literature supporting the effectiveness of widespread implementation of mHealth technologies.

Objective: This study aimed to assess whether an innovative mHealth technology system with several overlapping purposes can impact (1) clinical outcomes (ie, readmission rates, revisit rates, and length of stay) and (2) patient-centered care outcomes (ie, patient engagement, patient experience, and patient satisfaction).

Methods: We compared all patients (2059 patients) of participating orthopedic surgeons using mHealth technology with all patients of nonparticipating orthopedic surgeons (2554 patients).

The role of magnetic resonance imaging in patients with palpable breast abnormalities and negative mammographic and sonographic findings.

Objective Or Purpose Of Study: The objective of this retrospective study was to determine the frequency of positive findings on breast magnetic resonance imaging (MRI) in patients with palpable breast abnormalities in the setting of negative mammographic and sonographic evaluations.

Materials, Methods, And Procedures: Consecutive patients undergoing breast MRI for palpable abnormalities from January 1, 2005 to December 31, 2015 were identified for this retrospective study. Those with preceding imaging (mammograms or ultrasounds) demonstrating positive findings related to the palpable abnormalities were excluded.

Which criteria are used to clear patients to return to sport after primary ACL reconstruction? A scoping review.

Objective: To describe the criteria used to clear athletes to return to sport (RTS) following primary ACL reconstruction.

Design: Scoping review.

Data Sources: MEDLINE, Embase, CINAHL and SPORTDiscus electronic databases were searched using keywords related to ACL and RTS.

A Novel Use of Aortic Stent Graft Components in Massive Venous Retroperitoneal Hematoma.

Venous retroperitoneal hematoma (VRH) can present as a sudden-onset life-threatening condition. Unlike arterial hematoma, VRH is difficult to treat because of anatomic and structural considerations. Moreover, because VRH is rare and iatrogenic, there are no commercially available devices to treat this problem.

Severe Malaria Treated With Investigational Artesunate in the United States.

Purpose: We describe here the case of a 40-year-old Nigerian male with severe malaria successfully treated with investigational intravenous (IV) artesunate.

Summary: A 40-year-old Nigerian male was admitted to the medical intensive care unit for the treatment of severe malaria. The patient presented with the classic malaria paroxysm and altered mental status and was in acute renal failure.

Predictors of Weeks to Opioid Cessation after Lumbar Fusion: A Prospective Cohort Study.

Background: Although the use of prescription opioid analgesics to treat acute, postoperative pain is a well-established practice, the role of opioids in the management of persistent, postoperative pain remains ill-defined. Nevertheless, high rates of long-term opioid use following lumbar fusion have been reported.

Aim: The goal of this prospective, longitudinal study was to identify predictors of weeks to opioid cessation in a cohort of patients undergoing elective lumbar fusion.

The Biopsychosocial Model of Low Back Pain and Patient-Centered Outcomes Following Lumbar Fusion.

Lumbar fusion is a surgical procedure performed to eliminate painful motion in a spinal segment by joining, or fusing, two or more vertebrae. Although the surgery has a high rate of producing radiographic fusion, many patients report pain, functional disability, an inability to return to work, and prolonged opioid pain reliever use following the procedure. Using the biopsychosocial model of low back pain as a framework, this review of the literature describes the biological, psychological, and social factors that have been associated with these negative outcomes.