3,864 results match your criteria: "Luke's Hospital[Affiliation]"

Introduction: Peritoneal dialysis (PD)-related peritonitis (PDRP) is a common cause of transfer to hemodialysis, patient morbidity, and is a risk factor for mortality. Associated patient anxiety can deter selection of PD for renal replacement therapy. Diagnosis relies on hospital laboratory tests; however, this might be achieved earlier if such information was available at the point-of-care (POC), thereby significantly improving outcomes.

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  • The study aimed to assess how the prostate-specific antigen (PSA) levels six months after radiotherapy affect the prognosis of patients treated with radiotherapy alone or along with short- or long-term androgen-deprivation therapy (ADT).
  • Data were collected from 16 clinical trials involving localized prostate cancer patients, analyzing their PSA levels and their association with metastasis-free survival (MFS), prostate cancer-specific mortality (PCSM), and overall survival (OS) twelve months post-treatment.
  • Results showed higher PSA levels (≥0.1 ng/mL) after treatment were linked to poorer MFS, OS, and higher PCSM rates across all treatment groups, indicating that PSA levels can help in making treatment decisions and designing future clinical trials
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  • Gastrointestinal bleeding (GIB) is frequent in patients with left ventricular assist devices (LVADs), but the best screening method before implantation is not well defined.
  • A study at Saint Luke's Hospital analyzed data from 167 LVAD patients, revealing that pre-implantation endoscopic evaluations showed a high occurrence of angiodysplasia but did not reduce overall GIB rates.
  • The findings support avoiding routine pre-LVAD endoscopic screening, advocating for individualized assessments based on each patient’s circumstances instead.
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  • Drug-coated balloons, specifically paclitaxel-coated balloons, show promise for treating coronary in-stent restenosis but previously lacked approval for U.S. use.
  • A clinical trial, involving 600 participants across 40 centers, compared the effectiveness of paclitaxel-coated balloons to uncoated ones in preventing target lesion failure one year post-treatment.
  • Results indicated that patients receiving the paclitaxel-coated balloon had significantly lower rates of target lesion revascularization and myocardial infarction compared to those with uncoated balloons, demonstrating the coated balloon's superiority (17.9% vs 28.6% failure rate).
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Purpose: The present study aims to report the arthroscopic, radiological and clinical appearance of a rare anatomical variation of a hypertrophied medial parapatellar plica with its response to arthroscopic treatment.

Case Presentation: A 14-year-old female handball athlete presented with a history of left knee injury during her participation in a handball training session and subsequent locked knee at 20º flexion. Tenderness was located at the medial joint line.

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Patellofemoral instability is a complex pathology with multiple risk factors, which affects mostly young females and may avert them from both activities of daily living and sports participation. Risk factors for instability include patella alta, trochlea dysplasia, abnormal lateral patellar tilt, and increased tibial tuberosity-trochlea groove distance. The knowledge of these anatomical abnormalities is the key to identifying the problem and succeeding in treating the patients.

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A blueprint for health technology assessment capacity building: lessons learned from Malta.

Int J Technol Assess Health Care

February 2024

Institute for Medical Technology Assessment, Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.

Objectives: The development and strengthening of health technology assessment (HTA) capacity on the individual and organizational level and the wider environment is relevant for cooperation on HTAs. Based on the Maltese case, we provide a blueprint for building HTA capacity.

Methods: A set of activities were developed based on Pichler et al.

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Left Main Coronary Artery Calcium and Diabetes Confer Very-High-Risk Equivalence in Coronary Artery Calcium >1,000.

JACC Cardiovasc Imaging

July 2024

Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Electronic address:

Background: Although a coronary artery calcium (CAC) of ≥1,000 is a subclinical atherosclerosis threshold to consider combination lipid-lowering therapy, differentiating very high from high atherosclerotic cardiovascular disease (ASCVD) risk in this patient population is not well-defined.

Objectives: Among persons with a CAC of ≥1,000, the authors sought to identify risk factors equating with very high-risk ASCVD mortality rates.

Methods: The authors studied 2,246 asymptomatic patients with a CAC of ≥1,000 from the CAC Consortium without a prior ASCVD event.

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Background: Dysbiosis of the gut microbiome is frequent in the intensive care unit (ICU), potentially leading to a heightened risk of nosocomial infections. Enhancing the gut microbiome has been proposed as a strategic approach to mitigate potential adverse outcomes. While prior research on select probiotic supplements has not successfully shown to improve gut microbial diversity, fermented foods offer a promising alternative.

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Objective: The necessity of postmastectomy radiotherapy(PMRT) for patients with HR+/HER2 T1-2 N1M0 breast cancer remains controversial. We want to use explainable machine learning to learn the feature importance of the patients and identify the subgroup of the patients who may benefit from the PMRT. Additionally, develop tools to provide guidance to the doctors.

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Isolated primary cardiac angiosarcoma.

Curr Probl Cardiol

May 2024

St. Luke's Hospital, 232 S Woods Mill Rd, Suite 400 South, Chesterfield, MO 63017, USA.

Cardiac angiosarcoma (CAS) is the most prevalent malignant primary cardiac tumor in adults, often affecting young males. We present a case of this rare entity in a young female, highlighting the multidisciplinary team's role and multimodality imaging in the diagnosis and management.

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The 4 S's of Disaster Management Framework: A Case Study of the 2022 Pediatric Tripledemic Response in a Community Hospital.

Ann Emerg Med

June 2024

Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Harvard University, Boston, MA.

Most children in the United States present to community hospitals for emergency department (ED) care. Those who are acutely ill and require critical care are stabilized and transferred to a tertiary pediatric hospital with intensive care capabilities. During the fall of 2022 "tripledemic," with a marked increase in viral burden, there was a nationwide surge in pediatric ED patient volume.

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  • The study compares outcomes of conservative vs. surgical treatments for distal hamstring tendon injuries, focusing on patient-reported results and return to sports.
  • Researchers reviewed 18 clinical studies involving 67 patients to evaluate the effectiveness of each treatment method based on return-to-sports rates and times.
  • Results show that 92.3% of patients who had surgery returned to sports in about 4.2 months, while only 46.4% of those initially treated conservatively succeeded in returning, averaging 3.6 months, with a significant percentage of those needing surgery later on.
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Aim: To investigate whether linear measurements or ratios on the Graf's "standard plane" ultrasound images of the neonatal/infantile hip, can support the clinically important differentiation between type I and type II hips.

Material And Methods: A total of 60 Graf type II hips and 124 randomly selected Graf type I hips, matched to the gestational age at delivery, birth weight, delivery mode, and age at the time of the examination, were identified through our hip screening service, during a period of two years. The images were diagnostically suitable, following anatomical identification and usability check, according to Graf.

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Validation of a noninvasive cardiac output monitor in maternal cardiac disease: comparison of NICOM and transthoracic echocardiogram.

Am J Obstet Gynecol MFM

March 2024

Mid-America Heart Institute, Saint Luke's Hospital of Kansas City, Kansas City, MO (Drs Schmidt, Grodzinsky, Lee, Rader, and Magalski, Ms Gosch, Mr Jones, and Drs Fu and Spertus); Department of Cardiology, University of Missouri-Kansas City, Kansas City, MO (Drs Schmidt, Grodzinsky, Lee, Rader, Magalski, and Spertus).

Article Synopsis
  • The study looked at how well two different methods measure heart output in pregnant people, especially those with heart problems.
  • One method used was NICOM, a noninvasive monitor, while the other was a 2D echocardiogram, which is more traditional.
  • Results showed that NICOM often gave higher readings than echocardiograms, making it less accurate for measuring heart output, especially in healthy pregnant women.
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  • - Missouri has high maternal mortality rates, but there are no existing studies on birthing peoples' knowledge regarding this issue, highlighting the need for targeted interventions based on specific population insights.
  • - A survey study involving 1,738 respondents found that a majority (78.2%) were aware of pregnancy-related death risks, with many identifying higher rates of maternal mortality among certain groups such as Black and uninsured birthing people.
  • - The leading causes of maternal death were perceived to be severe bleeding (56.9%), with specific beliefs about the timing of mortality varying by age, suggesting a need for tailored educational efforts to improve understanding of maternal health.
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Hyperglycemia and rash are expected but challenging adverse events of phosphatidylinositol-3-kinase inhibition (such as with alpelisib). Two modified Delphi panels were conducted to provide consensus recommendations for managing hyperglycemia and rash in patients taking alpelisib. Experts rated the appropriateness of interventions on a 1-to-9 scale; median scores and dispersion were used to classify the levels of agreement.

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Background: Patients who experience in-hospital ST-segment elevation myocardial infarction (iSTEMI) represent a uniquely high-risk cohort owing to delays in diagnosis, prolonged time to reperfusion and increased mortality. Quality initiatives aimed at improving the care of this vulnerable, yet understudied population are needed.

Methods: This study included consecutive patients with iSTEMI treated with percutaneous coronary intervention (PCI) between 1 January 2011 and 15 July 2019 at a single, tertiary referral centre.

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Background: Aspiration thrombectomy has gained popularity in patients with massive and sub-massive pulmonary embolism (PE) and having contraindications to thrombolysis.

Methods: A meta-analysis was conducted including studies on aspiration thrombectomy in patients with high-risk and intermediate-risk PE. The pooled odds ratio for efficacy parameters, including change in heart rate, blood pressure and right ventricle/left ventricle (RV/LV) ratio, and safety parameters including major bleeding and stroke, was calculated using a random effects model.

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Background: Hepatitis C virus infection is often asymptomatic, and many patients may be unaware they are infected. Community-based, birth cohort screening has been advocated to identify these patients. It has been estimated that 0.

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  • - Mast cell tumors, such as mastocytoma (MCT) and systemic mastocytosis (SM), are diseases found in various species, including dogs, cats, and humans, with specific genetic mutations commonly identified.
  • - In humans, 80% of mastocytosis cases exhibit the p.D816H gene mutation, while about 25% of MCT cases can metastasize, with overexpression of certain genes promoting this process.
  • - Research indicates that a specific gene panel can effectively differentiate between healthy dogs and those affected by MCT, highlighting the potential for advancements in diagnosis and treatment based on understanding mast cell biology.
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Blunt cardiac injury in the hemodynamically stable patient.

JAAPA

February 2024

At St. Luke's Hospital/Southcoast Health in New Bedford, Mass., Mollie R. Calzone practices in trauma surgery and acute care surgery and Michael D. Grossman is the chief of acute care surgery and trauma medical director. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Blunt cardiac injury (BCI) describes a spectrum of problems including severe, potentially life-threatening injuries from trauma. Pericardial effusion is an example of a BCI that has generally been assumed to imply serious underlying injury to the heart and should be considered hemopericardium until proven otherwise. A standard of care has been established to screen for BCI and treat hemodynamically unstable patients with an acute pericardial effusion presumably related to BCI.

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The aggravating fury rituximab obliterated.

Haematologica

June 2024

Department of Hematology/Oncology, Saint Luke's Cancer Institute, Saint Luke's Hospital of Kansas City, 4401 Wornall Rd, Kansas City, MO - 64111.

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