34,832 results match your criteria: "Providence Hospital & Medical Centers[Affiliation]"

Background: Epidemiological studies have been inconsistent regarding an association between proton pump inhibitor (PPI) use and risk of primary cardiovascular disease (CVD) events.

Methods: We studied 85,189 postmenopausal women (mean age 63 years at baseline) without known CVD at enrollment into the Women's Health Initiative Observational Study (1993-1998). PPI use was determined from medication inventories at baseline and Year-3.

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Do Medicare Beneficiaries Under Accountable Care or Medicare Advantage Use Lower Quality Nursing Homes?

J Am Geriatr Soc

December 2024

Center for Gerontology and Healthcare Research, Brown University, Providence, Rhode Island, USA.

Background: With the growing number of Medicare beneficiaries attributed to Accountable Care Organizations (ACO) or enrolled in Medicare Advantage (MA) and their financial incentives to lower the cost of the cared patients, it is essential to understand how these alternative payment models affect post-acute outcomes among beneficiaries, with or without dementia diagnoses. In this study, we examined the quality of skilled nursing facilities (SNFs) that beneficiaries entered after hospital discharge under different payment models.

Study Participants: Medicare beneficiaries who were discharged from hospitals and admitted to SNFs between 2013 and 2018.

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Identifying county-level factors that influence pre-exposure prophylaxis (PrEP) adherence is critical for ending the HIV epidemic in the United States (US). PrEP primary reversal is a term used to describe patients who do not obtain their prescribed medication from the pharmacy. This study sought to identify factors associated with PrEP reversal at the county level in 2018.

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Lichen sclerosus (LS) is a chronic, inflammatory dermatosis most commonly characterized by changes in skin pigmentation and pruritus, with associated dyspareunia and genital architectural changes. There are a variety of complications associated with LS, which further worsen a patient's health-related quality of life. A systematic review was conducted to summarize the literature regarding clinical features of LS, as well as LS-associated complications.

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Purpose: Borderline personality disorder (BPD) is a severe form of psychopathology associated with a host of negative outcomes. Some literature suggests elevated prevalence among transgender and gender diverse (TGD) samples. Elevated BPD prevalence among TGD populations could be due to factors other than BPD-specific psychopathology.

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Purpose: Transgender and nonbinary adults (TNB) are disproportionately burdened by sexually transmitted infections (STI) and the human immunodeficiency virus (HIV). This study investigated whether gender-affirming hormone therapy was associated with TNB adults' odds of screening for STI and HIV.

Methods: Longitudinal data came from the electronic medical records of TNB primary care patients receiving care at two community health centers located in Boston, Massachusetts, and New York City, New York, between January 2013 and December 2019.

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Background: Glioblastoma (GBM) has a median survival of <2 years. Pexidartinib (PLX3397) is a small-molecule inhibitor of CSF1R, KIT, and oncogenic FTL3, which are implicated in GBM treatment resistance. Results from glioma models indicate that combining radiation therapy (RT) and pexidartinib reduces radiation resistance.

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Background/objective: Iodine deficiency hypothyroidism is an important cause of neurocognitive and motor impairment in children globally. In the United States, universal salt iodization, which began in the 1920s, led to a dramatic decline in iodine deficiency hypothyroidism. However, iodine deficiency may be reemerging due to increased consumption of noniodized salts, decreased dairy iodine concentrations, and decreased intake of iodine containing foods due to food allergies, dietary preferences such as vegan diets, or restrictive food intake disorders.

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Major Perioperative Bleeding in Patients on Dialysis Undergoing Nonelective Abdominal Surgeries.

J Surg Res

December 2024

The Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Surgery, Cambridge Health Alliance, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address:

Introduction: Patients with end-stage renal disease (ESRD) are at increased risk for bleeding complications following surgery. However, the approach to the preoperative risk assessment and risk reduction, if feasible, in ESRD patients undergoing nonelective abdominal surgery has not been comprehensively studied. We aim to determine the prevalence and risk factors for perioperative bleeding in patients on dialysis undergoing nonelective abdominal surgery.

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Background: Although total hip and total knee arthroplasty are highly successful operations, the decision of whether and when to undergo surgery is highly subjective and discretionary, and specific guidelines regarding readiness for surgery remain elusive. The nature of these decisions underscores the importance of shared decision-making, which is founded on the concept that patients substantially contribute to determining their own readiness for surgery. The OPTION survey was developed as a conversation aid to facilitate shared decision-making in the context of total joint arthroplasty.

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Introduction: Medication regimen complexity may be an important risk factor for adverse outcomes in older adults with heart failure. However, increasing complexity is often necessary when prescribing guideline-directed medical therapy at the time of a heart failure hospitalization. We sought to determine whether increased medication regimen complexity following a heart failure hospitalization was associated with worse post-hospitalization outcomes.

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The COVID-19 pandemic has triggered the adoption of new technologies to reduce the need for in-person physical therapy (PT). This study evaluated the impact of the COVID-19 pandemic on PT utilization and outcomes of patients prescribed a smartphone-based care management platform (sbCMP) for self-directed rehabilitation (SDR). A secondary analysis of data collected in a multicenter, prospective cohort trial investigating a mobile platform to deliver SDR after arthroplasty was performed.

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Retroperitoneal fibrosis (RPF) is a rare disease with a nonspecific presentation. RPF can be classified into Idiopathic, the most common, or secondary due to malignancy and various medications resulting in chronic inflammation and fibrosis in the retroperitoneum. The complications arise due to the compression of structures in the retroperitoneum.

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Background: Universal, classroom-based mental health literacy (MHL) curricula are associated with improved mental health knowledge, attitudes, and help-seeking behaviors. Young adolescents are an ideal target given their need for and receptivity toward MHL education.

Methods: We conducted a scoping review to identify universal, school-based MHL programs primarily for students aged 10-14 years, with adequate descriptions of curriculum implementation and content, and measured outcomes.

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Introduction: Maternal undernutrition and inflammation in utero may significantly impact the neurodevelopmental potential of offspring. However, few studies have investigated the effects of pregnancy interventions on long-term child growth and development. This study will examine the effects of prenatal nutrition and infection management interventions on long-term growth and neurodevelopmental outcomes of offspring.

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Background: We sought to identify predictors of acute renal failure (ARF) following acute type A aortic dissection (ATAAD) and its implications on postoperative outcomes.

Methods: ATAAD cases were identified from The Society of Thoracic Surgeons - Adult Cardiac Surgery Database (2017-2022). Cases with chronic dissection, prior aortic repair, primary endovascular repair, preoperative extracorporeal membrane oxygenation, preoperative renal failure, and operative room deaths were excluded.

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Background And Objectives: The use of rapid response EEG (rr-EEG) has recently expanded in limited-resource settings and as a supplement to conventional EEG to rapidly detect and treat nonconvulsive status epilepticus. The study objective was to test the accuracy of an rr-EEG's automated seizure burden estimator (ASBE).

Methods: This is a retrospective observational study using multiple blinded reviewers.

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Study Design: Retrospective analysis of prospectively-collected data.

Objective: This study aims to define clinically relevant blood loss in adult spinal deformity (ASD) surgery.

Background: Current definitions of excessive blood loss following spine surgery are highly variable and may be suboptimal in predicting adverse events (AE).

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Modeling the role of temperature-dependent microbiome composition in black band disease transmission among coral reefs.

Math Biosci

December 2024

Disease Modeling Lab (DiMoLab), Department of Mathematics and Statistics, San Diego State University, San Diego, 92182, CA, USA; Computational Science Research Center, San Diego State University, San Diego, 92182, CA, USA; Viral Information Institute, San Diego State University, San Diego, 92182, CA, USA. Electronic address:

Black band disease (BBD) is one of the most prevalent diseases causing significant destruction of coral reefs. Coral reefs acquire this deadly disease from bacteria in the microbiome community, the composition of which is highly affected by the environmental temperature. While previous studies have provided valuable insights into various aspects of BBD, the temperature-dependent microbiome composition has not been considered in existing BBD models.

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Objectives: Urothelial carcinoma in situ (CIS) with early papillary formation is terminology sometimes used to suggest incipient high-grade papillary urothelial carcinoma (PUC) but may lead to confusion between true CIS and lateral flat spread of PUC.

Methods: It remains unclear how pathologists and urologists interpret this scenario, so a survey was circulated to 68 pathologists (group 1 = 28 academic genitourinary pathologists; group 2 = 17 pathologists with a self-reported genitourinary focus; group 3 = 23 pathologists self-reported as not genitourinary specialists) and 32 urologists.

Results: Regarding atypical urothelial lesions that appear mainly flat but contain possible papillae, group 3 was more likely to label this as CIS compared with groups 1 and 2 (35% for group 3 vs 13% for groups 1 and 2), while groups 1 and 2 more often adopted another descriptive diagnosis, such as "CIS with early papillary features" (38% for groups 1 and 2 vs 13% for group 3).

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Mixed Cardiogenic-Vasodilatory Shock: Current Insights and Future Directions.

JACC Adv

January 2025

Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, and Lifespan Cardiovascular Institute, Providence, Rhode Island, USA.

This state-of-the-art review describes the potential etiologies, pathophysiology, and management of mixed shock in the context of a proposed novel classification system. Cardiogenic-vasodilatory shock occurs when cardiogenic shock is complicated by inappropriate vasodilation, impairing compensatory mechanisms, and contributing to worsening shock. Vasodilatory-cardiogenic shock occurs when vasodilatory shock is complicated by myocardial dysfunction, resulting in low cardiac output.

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Background: The clinical significance of natural and treatment-emergent antibodies specific for amustaline/glutathione pathogen-reduced red blood cells (PRRBCs) is not known.

Study Design And Methods: A Phase 3, randomized clinical trial of PRRBCs (ReCePI) compared PRRBCs with conventional RBCs in cardiac or thoracic-aorta surgery. Subjects transfused during and for 7 days after surgery were screened for PRRBC-specific antibodies at baseline, 28 and 75 days post-surgery.

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