479 results match your criteria: "ProMedica Toledo Hospital; Toledo[Affiliation]"

Introduction: Liver cirrhosis, a complex and progressive disease, imposes a significant global health burden, characterized by irreversible liver tissue scarring and various life-threatening complications. Traditionally linked to factors like chronic alcohol consumption and viral hepatitis infections, the rising prevalence of obesity introduces a new dimension to its etiology. As obesity rates continue to climb worldwide, the confluence of liver cirrhosis and bariatric surgery has become an increasingly pertinent and clinically relevant topic of inquiry.

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Background: Colorectal cancer most commonly metastasizes to the liver. While various treatment strategies have been developed, surgical management of these patients has vital implications on the prognosis and survival of this group of patients. There remains a need for a consensus guideline regarding the surgical evaluation and management of patients with colorectal liver metastases (CRLM).

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Introduction: Mechanical thrombectomy (MT) for medium vessel occlusions (MeVO) is emerging as a promising treatment in acute stroke. We aim to evaluate the utility of additional imaging (CTP) in patients with MeVOs who received thrombolysis at a spoke hospital and were transferred to the hub.

Methods: This was a retrospective review of prospectively collected data from April 2018 to June 2023.

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The clinical presentation and epidemiology of infective endocarditis (IE) have evolved over time. While the cornerstones of IE treatment remain antimicrobial therapy and surgery, percutaneous mechanical aspiration (PMA) has emerged as an option for carefully selected patients as a complementary modality, based on retrospective data, case series, and expert experience. In this comprehensive review, we summarize the proceedings from an inaugural summit dedicated to the discussion of PMA in the global management of IE, consisting of experts across multiple disciplines from diverse geographic regions and care environments.

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Background: Recent studies suggest that the use of adjunctive intraarterial alteplase after mechanical thrombectomy (MT) may improve outcomes; however, there are limited data on the use of intraarterial tenecteplase, a newer-generation lytic, in this acute ischemic stroke patient population. Here, we evaluate the use of intraarterial tenecteplase in the ALLY pilot study (Adjunctive Intraarterial Tenecteplase Following Mechanical Thrombectomy).

Methods: ALLY was a prospective, single-center, nonrandomized pilot study assessing the feasibility and safety of intraarterial tenecteplase up to 4.

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A carotid cavernous fistula (CCF) is a disruption in the carotid arteries within the cavernous sinus. The pooling of blood in the sinus causes a myriad of neurological deficits. When correctly diagnosed, this condition can be easily managed through surgical intervention.

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Background: Outpatient parenteral antibiotic therapy (OPAT) enhances patient safety, improves outcomes, and reduces healthcare costs by decreasing 30-day readmissions and adverse events. However, the optimal structure and follow-up protocols for OPAT programs remain undefined. Identifying high-risk patients for readmission and managing adverse drug events (ADEs) are critical components of OPAT care.

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Background: This review aims to analyze sex-related differences in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS).

Methods: 10 studies were retrieved from PubMed and Embase comparing outcomes between men and women admitted with AMI complicated by CS. Pooled log odds ratios (OR) were calculated for binary outcomes using the Mantel-Haenszel method, and Hedges' g with the inverse-variance method was used for continuous outcomes.

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Article Synopsis
  • The study examined differences in echocardiographic assessments of native and bioprosthetic aortic valves between core laboratories and clinical centers, finding clinically relevant discrepancies.
  • Data was collected from the PERIGON trial, which involved patients undergoing surgical aortic valve replacement, and involved comparing echocardiographic results from centers to independent analysis by a core lab.
  • Results showed that while some continuous measurements had high agreement (around 0.90), there were notable variances, particularly in left ventricular outflow tract area and stroke volume, indicating the need for standardized evaluation practices.
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Pulmonary Emboli Mimicking ST-Elevation Myocardial Infarction Patterns.

Cureus

October 2024

Emergency Medicine, Emergency Physicians of Northwest Ohio (EPNO), Toledo, USA.

A pulmonary embolism (PE) is a serious condition characterized by obstruction of the pulmonary arteries, often presenting with symptoms such as sudden shortness of breath and chest pain. While pulmonary emboli and ST-segment elevation myocardial infarctions (STEMI) are distinct clinical entities, they can present with similar electrocardiogram (ECG) findings, complicating diagnosis and management. This study presents two case reports of patients who exhibited ECG changes resembling STEMI but were ultimately diagnosed with PE via CT angiography (CTA).

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Adjunctive Middle Meningeal Artery Embolization for Subdural Hematoma.

N Engl J Med

November 2024

From the Departments of Neurosurgery (J.M.D., A.H.S.), Biomedical Informatics (J.M.D.), and Radiology (A.H.S.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, the Department of Neurological Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center (J.K.), and the Department of Neurosurgery, Icahn School of Medicine at Mount Sinai (C.P.K.), New York, the Department of Neurosurgery, North Shore University Hospital at Northwell Health, Great Neck (T.W.L.), the Department of Neurosurgery, Albany Medical Center, Albany (A.R.P.), and the Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla (J. Santarelli) - all in New York; the Department of Neurosurgery and Brain Repair, University of South Florida, and Tampa General Hospital, Tampa (M.M.), Lyerly Neurosurgery, Baptist Medical Center Jacksonville, Jacksonville (R.A.H.), the Orlando Health Neuroscience Institute, Division of Neurosurgery, Orlando Health, Orlando Regional Medical Center, Orlando (M.C.C.), and the Department of Neurosurgery, University of Florida, Gainesville (M.J.K.) - all in Florida; the Department of Neuroscience, Valley Baptist Medical Center, and the Department of Neurology, University of Texas Rio Grande Valley, Harlingen (A.E.H.), the Department of Neurosurgery, Memorial Hermann-Texas Medical Center, Houston (P.R.C.), and the Department of Neurosurgery, Baylor Scott and White Health, Temple (W.S.L.) - all in Texas; the Departments of Neurosurgery and Engineering Science and Mechanics, Penn State University, Hershey (R.E.H.), the Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh (B.A.G.), and the Department of Neurosurgery, Geisinger and Geisinger Commonwealth School of Medicine, Wilkes-Barre (C.M.S.) - all in Pennsylvania; the Departments of Neurological Surgery, Surgery, Radiology, and Neurosciences, University of California, San Diego, La Jolla (A.K.), the Departments of Radiology (J.T.) and Neurosurgery (W.S.), Providence Little Company of Mary Medical Center, Torrance, Pacific Neuroscience Institute, Santa Monica (J.T., W.S.), and the Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles (W.J.M.) - all in California; the Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (J.F.); the Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City (R.G.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B.), the Department of Neurology, ProMedica Toledo Hospital-University of Toledo College of Medicine and Life Sciences, Toledo (M.J.), and Wexner Medical Center, Ohio State University, Columbus (P.Y.) - all in Ohio; the Department of Neurosurgery, Rush University, Chicago (R.W.C.), and the Department of Neurosciences, Advocate Lutheran General Hospital, Park Ridge (J.B.) - both in Illinois; the Departments of Neurological Surgery, Neurology, Radiology, Otolaryngology, and Neuroscience, University of Kentucky, Lexington (J.F.F.); the Departments of Neurological Surgery, Radiology, Neurology, and Mechanical Engineering and the Stroke and Applied Neuroscience Center, University of Washington, Seattle (M.R.L.); the Department of Neurosurgery, Atrium Health Carolinas Medical Center, and Carolina Neurosurgery and Spine Associates - both in Charlotte, NC (J.D.B.); the Department of Diagnostic Radiology and Neuroradiology, Prisma Health Southeastern Neurosurgical and Spine Institute, Greenville, SC (M.I.C.); the Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City (H.J.S.); the Departments of Neurosurgery and Radiology, University of Alabama School of Medicine, Birmingham (J.J.); the Departments of Neurosurgery, Radiology, and Neurology, Washington University in St. Louis, St. Louis (J.W.O.); the Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City (K.D.); the Department of Neurosurgery, Emory University School of Medicine, Atlanta (J.A.G.); the Department of Neurointerventional Radiology, Goodman Campbell Brain and Spine, Indianapolis (D.H.S.); the Department of Neurosurgery, Michigan State University College of Human Medicine, Grand Rapids (J.S.), the Department of Neurology, McLaren Flint Hospital, Flint (A.Q.M.), and McLaren Macomb Hospital, Mount Clemens (A.Q.M.) - all in Michigan; the Department of Neurological Surgery, Oregon Health and Science University, Portland (J.J.L.); Aurora Neuroscience Innovation Institute, Milwaukee (T.W.); the Division of Neurointerventional Radiology, Department of Radiology, Beth Israel Lahey Health, Lahey Hospital and Medical Center, Burlington, MA (N.V.P.); and the Department of Neurosurgery, University of Colorado, Denver (C.R.).

Background: Subacute and chronic subdural hematomas are common and frequently recur after surgical evacuation. The effect of adjunctive middle meningeal artery embolization on the risk of reoperation remains unclear.

Methods: In a prospective, multicenter, interventional, adaptive-design trial, we randomly assigned patients with symptomatic subacute or chronic subdural hematoma with an indication for surgical evacuation to undergo middle meningeal artery embolization plus surgery (treatment group) or surgery alone (control group).

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Objectives: Safety, efficacy and durability are important considerations when selecting a bioprosthesis for aortic valve replacement (AVR). This study assessed 7-year clinical outcomes and haemodynamic performance of the Avalus bioprosthesis.

Methods: Patients indicated for surgical AVR were enrolled in this prospective, nonrandomized trial, conducted across 39 sites globally.

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Article Synopsis
  • A study evaluated the safety and efficacy of endovascular thrombectomy in patients with acute large-vessel occlusion and tandem lesions, focusing on those with low (0-5) and high (6-10) Alberta Stroke Program Early Computed Tomography Scores (ASPECTS).
  • The analysis included 691 patients, revealing that those with low ASPECTS had significantly lower odds of achieving a favorable functional outcome (mRS 0-2) and higher odds of suffering symptomatic intracranial hemorrhage compared to those with high ASPECTS.
  • The researchers concluded that endovascular thrombectomy may lead to poorer functional recovery in patients with tandem lesions and low ASPECTS, particularly in the
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Protein kinases are critical components of a myriad biological processes and strongly associated with various diseases. While kinase research has been a point of focus in biomedical research for several decades, a large portion of the kinome is still considered understudied or "dark," because prior research is targeted towards a subset of kinases with well-established roles in cellular processes. We present an empirical and in-silico hybrid workflow to extend the functional knowledge of understudied kinases.

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Article Synopsis
  • The study looked at whether a medical procedure called thrombectomy helps patients who have a large stroke as seen on a specific type of scan called a noncontrast CT within 24 hours of having the stroke.
  • It involved 300 patients from different hospitals who were split into two groups; one group received the thrombectomy treatment, while the other only received regular care.
  • The main goal was to see if those who had thrombectomy had better recovery after 90 days compared to those who didn’t, along with checking if there were any serious side effects.
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  • - This study focused on community-acquired pneumonia (CAP) in children, aiming to identify mucosal biomarkers that can aid in determining the severity and cause of the illness.
  • - Researchers analyzed cytokine levels in nasopharyngeal samples from 182 children with CAP and 26 healthy controls, finding that those with atypical bacteria and influenza virus had significantly elevated cytokine concentrations compared to those with typical bacteria.
  • - The findings suggest that differences in inflammatory and antiviral cytokine levels correlate with disease severity in CAP, indicating that mucosal biomarkers might be helpful for better assessing and classifying the condition in pediatric patients.
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Omics studies use large-scale high-throughput data to explain changes underlying different traits or conditions. However, omics analysis often results in long lists of pathways that are difficult to interpret. Therefore, it is of interest to describe a tool named PAVER (Pathway Analysis Visualization with Embedding Representations) for large scale genomic analysis.

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  • The incidence of pressure injuries (PIs) is rising due to an aging population, leading to longer hospital stays and increased healthcare costs.
  • While many PIs can be prevented with proper interventions, some conditions result in unavoidable PIs, particularly in critically ill patients.
  • Factors such as prolonged immobility, severe diseases, and treatments like mechanical ventilation contribute to decreased tissue tolerance, making these patients more susceptible to skin breakdown.
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  • Catastrophic Antiphospholipid Syndrome (CAPS) is a serious illness that can cause many organs to fail quickly.
  • Unlike regular Antiphospholipid Syndrome (APS), which affects larger blood vessels, CAPS usually affects many small blood vessels in places like the kidneys, heart, skin, and brain.
  • A 21-year-old woman with a history of blood problems developed multiple severe issues from CAPS and sadly passed away despite receiving medical care.
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In recent years, there has been a shift in the epidemiology of patients with infective endocarditis (IE). This has been characterized by an alarming increase in IE in patients who inject drugs, cardiac implantable electronic device-related IE, and those with comorbid conditions and high surgical risk. This unmet need has mandated a reevaluation of complex management strategies in these patients and introduction of unconventional approaches in treatment.

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Introduction: Bacteria can enter the bloodstream through simple actions such as brushing teeth, flossing, and even chewing food, increasing the chance of hematogenous seeding of prosthetic joints. Antibiotics before dental work in patients with orthopedic hardware is a topic of debate because of concerns for antibiotic resistance. Patients with dentures theoretically avoid this risk due to the lack of teeth and their maintenance.

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Introduction: Thrombectomy for medium vessel occlusion is a topic of great interest. We describe a single-center experience with the Penumbra 3-MAX aspiration catheter in stroke thrombectomy of medium vessel occlusion(MeVO). We investigated the use of 3-MAX as a de-novo first pass catheter and as a rescue aspiration device following attempted thrombectomy with other devices.

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  • Age is often a factor in predicting outcomes for patients with large vessel occlusions treated with mechanical thrombectomy, but there’s limited research on outcomes for octo/nonagenarians compared to younger patients, specifically for acute basilar artery occlusions.
  • A study using data from the PC-SEARCH Thrombectomy Registry analyzed 444 cases, dividing patients into two age groups: those over 80 and those 80 or younger.
  • Results showed that while fewer older patients achieved favorable outcomes at 90 days post-treatment, the differences were not statistically significant after adjusting for other health factors, suggesting that octo/nonagenarians can have comparable functional recovery to younger patients when treated with thrombectomy.
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