264 results match your criteria: "Promedica-Toledo Hospital[Affiliation]"

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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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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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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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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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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Objective: New echocardiographic definitions have been proposed for hemodynamic structural valve deterioration. We aimed to study their consistency in classifying structural valve deterioration after surgical aortic valve replacement.

Methods: Data were used of patients undergoing surgical aortic valve replacement in a multicenter, prospective cohort study with a 5-year follow-up.

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Mediation Analysis of Acute Carotid Stenting in Tandem Lesions: Effect on Functional Outcome in a Multicenter Registry.

Neurology

August 2024

From the Departments of Neurology (A.R.C., M.G.-C., M.F., D.Q.-O., Y.L., J.V.-S., M.D., S.O.-G.), Neurosurgery (S.O.-G.), and Radiology (S.O.-G.), University of Iowa Hospitals and Clinics, Iowa City; Neuroscience, Clinical Effectiveness, and Public Health Research Group (A.R.C.), Universidad Cientifica del Sur, Lima, Peru; Department of Neurology (N.H.P.), Yale University School of Medicine, New Haven, CT; Department of Neurology (M.R.), Hospital Vall d'Hebron, Barcelona, Spain; Department of Neurology (A.E.H.), Valley Baptist Medical Center/University of Texas Rio Grande Valley, Harlingen, TX; Department of Neurology (M.A.J.), ProMedica Toledo Hospital, OH; Department of Neurology (A.A.D.), University of New Mexico Health Science Center, Albuquerque; Department of Neurology (M.G.A.), University of Kansas Medical Center, Kansas City; Department of Neurosurgery (J.T.F.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology and Brain Repair (W.R.G., M.M.), University of South Florida, Tampa; Department of Neurology (A.M.M., D.R.Y.), University of Miami Miller School of Medicine, FL; Cooper Neurological Institute (J.E.S., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Neurology (T.N.N.), Boston Medical Center, MA; Department of Neurology (S.S.), UT Health McGovern Medical School, Houston; Texas Stroke Institute (A.J.Y.), Dallas-Fort Worth, TX; Department of Neurology (G.L.), Saint Louis University, MO; Asia Pacific Comprehensive Stroke Institute (N.J.), Pomona Valley Hospital Medical Center, CA.

Article Synopsis
  • - The study investigates the effects of acute carotid artery stenting (CAS) on functional outcomes in patients with acute stroke and tandem lesions (TLs) undergoing endovascular therapy (EVT), suggesting that CAS leads to better outcomes.
  • - Conducted across 16 stroke centers, the research included 570 patients and found that those who underwent CAS had higher rates of successful reperfusion and favorable functional outcomes compared to those who did not.
  • - The analysis indicates that successful reperfusion significantly predicts better functional outcomes, while also showing that it partially mediates the relationship between acute CAS and improved outcomes in stroke patients.
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Background: Mechanical thrombectomy (MT) is the standard of care for acute ischemic stroke (AIS) patients with large vessel occlusion (LVO). The SOFAST study collected clinical evidence on the safety and efficacy of the 6 French SOFIA Flow Plus aspiration catheter (SOFIA 6F) when used as first-line treatment.

Methods: This was a prospective, multicenter investigation to assess the safety and efficacy of SOFIA 6F used for first-line aspiration.

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Article Synopsis
  • Tandem lesions involve stenosis or occlusion of the cervical internal carotid artery, often due to atherosclerosis or dissection, combined with a large vessel occlusion; this study compares patient outcomes based on the cause of ICA lesions.
  • The study analyzed data from 526 patients treated endovascularly between 2015 and 2020, focusing on 90-day functional independence and various secondary outcomes, using matching methods for analysis.
  • Results showed no differences in 90-day independence, but patients with dissection had lower successful recanalization rates and higher distal emboli incidents compared to those with atherosclerosis.
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Article Synopsis
  • Cryptococcus neoformans is a fungus that primarily affects individuals with weakened immune systems, often leading to meningoencephalitis, but cases of muscle infections are rare.
  • A 45-year-old man with extensive cryptococcal infection developed multiple muscle abscesses and osteomyelitis, which led to surgery, an amputation, and ultimately death.
  • Increased awareness and rapid diagnosis of orthopedic complications from cryptococcal infections may enhance patient outcomes.
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Rationale: Clinical outcomes in acute ischemic stroke due to medium vessel occlusion (MeVO) are often poor when treated with best medical management. Data from non-randomized studies suggest that endovascular treatment (EVT) may improve outcomes in MeVO stroke, but randomized data on potential benefits and risks are hitherto lacking. Thus, there is insufficient evidence to guide EVT decision-making in MeVO stroke.

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Background: Neuroblastomas are rare tumors activated by the gene commonly found in pediatric patients. Due to the novelty of these tumors, there is no standard diagnostic profile. However, they have been found to express , and synaptophysin, and they can be identified with magnetic resonance imaging (MRI).

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Background: P2Y12 inhibitors have differing associations of bradyarrhythmias. Ticagrelor has been shown to increase adenosine plasma concentrations leading to increases in bradyarrhythmias. While clopidogrel and prasugrel have not been shown to have any association with bradyarrhythmias.

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Article Synopsis
  • This study aimed to compare the effectiveness of rescue therapy (RT) versus medical management (MM) in improving functional outcomes for patients who experienced a failed mechanical thrombectomy (MT).
  • Analyzing data from 2011 to 2021, the research focused on patients with large vessel occlusions (LVOs) and assessed disability at 90 days using the modified Rankin Scale (mRS).
  • Results showed that RT led to better functional independence, lower rates of symptomatic intracranial hemorrhage, and decreased 90-day mortality compared to MM, suggesting that RT might be a more effective treatment strategy for these patients.
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Objectives: The objective of this analysis was to assess the normal haemodynamic performance of contemporary surgical aortic valves at 1 year postimplant in patients undergoing surgical aortic valve replacement for significant valvular dysfunction. By pooling data from 4 multicentre studies, this study will contribute to a better understanding of the effectiveness of surgical aortic valve replacement procedures, aiding clinicians and researchers in making informed decisions regarding valve selection and patient management.

Methods: Echocardiograms were assessed by a single core laboratory.

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The Angiovac aspiration system has been used successfully for the removal of intravascular material or thrombus in the right-sided heart structures, vena cava, implantable cardiac defibrillator, or other devices. For infective endocarditis, it is reserved for the patients who warrant but are not good candidates for the surgery. The evidence regarding Angiovac aspiration of the infective endocarditis of the left-sided heart valves is scarce.

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Aims: The management of pelvic organ prolapse (POP) involves both nonsurgical and surgical management. Views on best surgical approach for apical prolapse is an evolving field based on recent evidence and events related to transvaginal mesh.

Methods: At the 97th Annual Meeting of the North Central Section of the American Urological Association (Scottsdale, AZ, USA), this topic was discussed and debated.

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Background: In patients with severe traumatic brain injury (TBI), clinicians must balance preventing venous thromboembolism (VTE) with the risk of intracranial hemorrhagic expansion (ICHE). We hypothesized that low molecular weight heparin (LMWH) would not increase risk of ICHE or VTE as compared to unfractionated heparin (UH) in patients with severe TBI.

Methods: Patients ≥ 18 years of age with isolated severe TBI (AIS ≥ 3), admitted to 24 level I and II trauma centers between January 1, 2014 to December 31, 2020 and who received subcutaneous UH and LMWH injections for chemical venous thromboembolism prophylaxis (VTEP) were included.

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Purpose: Intracranial hemorrhage (ICH) is associated with high morbidity and mortality, with mortality rates up to 65%. Oral anticoagulants (OAC) are a major risk factor for ICH. Since these patients are usually diagnosed in the emergency department (ED), emergency medicine (EM) pharmacists can help ensure appropriate selection and delivery of medications in urgent situations including reversal agents for OAC-associated bleeding.

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