19 results match your criteria: "Providence St. Joseph Hospital[Affiliation]"

is a rapidly emerging fungal pathogen associated with high resistance rates, particularly in healthcare settings. It most commonly affects patients with severe underlying medical conditions and requiring complex medical care. Patients with invasive medical devices tend to be at increased risk for getting and developing infection.

View Article and Find Full Text PDF

Background Opioids, commonly used to control pain associated with surgery, are known to prolong the duration of mechanical ventilation and length of hospital stay. A wide range of adjunctive strategies are currently utilized to reduce postoperative pain, such as local and regional nerve blocks, nerve cryoablation, and adjunctive medications. We hypothesized that dronabinol (a synthetic cannabinoid) in conjunction with standard opioid pain management will reduce opioid requirements to manage postoperative pain.

View Article and Find Full Text PDF

Objective: To compare the comparative effects of treatment with contemporary mechanical thrombectomy (MT) or anticoagulation (AC) on Villalta scores and post-thrombotic syndrome (PTS) incidence through 12 months in iliofemoral deep vein thrombosis (DVT).

Methods: Patients with DVT in the Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis (ATTRACT) randomized trial and the ClotTriever Outcomes (CLOUT) registry were included in this analysis. Both studies evaluated the effects of thrombus removal on the incidence of PTS.

View Article and Find Full Text PDF

Background: Sex-related differences in clinical manifestations and disease outcomes exist in psoriatic arthritis, however, there is limited information on sex-related differences in randomised controlled trials of psoriatic arthritis. We aimed to compare patient characteristics and efficacy and safety of advanced therapies (including biological and targeted synthetic therapies) between male and female patients with psoriatic arthritis participating in randomised controlled trials.

Methods: In this systematic review and meta-analysis, we searched Medline, Embase, and Central databases, and conference abstract archives, from their inception to June 10, 2022, for randomised controlled trials that assessed the efficacy of advanced therapies in psoriatic arthritis.

View Article and Find Full Text PDF

Purpose: Chordomas are ultrarare tumors of the axial spine and skull-base without approved systemic therapy. Most chordomas have negative expression of thymidylate synthase (TS), suggesting a potential for responding to the antifolate agent pemetrexed, which inhibits TS and other enzymes involved in nucleotide biosynthesis. We evaluated the therapeutic activity and safety of high-dose pemetrexed in progressive chordoma.

View Article and Find Full Text PDF

Purpose: Mechanical thrombectomy for the treatment of deep vein thrombosis (DVT) is being increasingly utilized to reduce symptoms and prevent postthrombotic syndrome (PTS), but more data on clinical outcomes are needed. Mechanical thrombectomy was studied in the ClotTriever Outcomes (CLOUT) registry with 6-month full analysis outcomes reported herein.

Materials And Methods: The CLOUT registry is a prospective, all-comer study that enrolled 500 lower extremity DVT patients across 43 US sites treated with mechanical thrombectomy using the ClotTriever System.

View Article and Find Full Text PDF

Transcatheter Aortic Valve Replacement Outcomes in End-Stage Renal Disease Patients on Hemodialysis Requiring Midodrine.

Struct Heart

May 2023

Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence Heart Institute, Providence St. Joseph Health, Portland, Oregon, USA.

Background: Patients with dialysis-dependent end-stage renal disease (ESRD) taking midodrine may be at high risk for poor outcomes following transcatheter aortic valve replacement (TAVR). We evaluated dialysis-dependent ESRD patients taking midodrine.

Methods: We conducted a retrospective analysis of non-clinical trial TAVR patients from February 2012 to December 2020 from 11 facilities in a Western US health system.

View Article and Find Full Text PDF

The HIV epidemic continues to pose a significant burden on the healthcare system. Although the incidence of annual new infections is decreasing, health disparities persist and most new infections remain concentrated into different racial, ethnic, and minority groups. Pre-exposure prophylaxis (PrEP), which involves those at high risk of acquiring HIV to take chronic medications to prevent acquisition of the virus, is key to preventing new HIV infections.

View Article and Find Full Text PDF

Introduction: Granulocyte-macrophage colony-stimulating factor (GM-CSF), a protein produced in the lung, is essential for pulmonary host defense and alveolar integrity. Prior studies suggest potential benefits in several pulmonary conditions, including acute respiratory distress syndrome and viral infections. This trial evaluated the effect of the addition of inhaled sargramostim (yeast-derived, glycosylated recombinant human GM-CSF) to standard of care (SOC) on oxygenation and clinical outcomes in patients with COVID-19-associated acute hypoxemia.

View Article and Find Full Text PDF

The Effects of Magnesium Coadminstration During Treatment of Hypokalemia in the Emergency Department.

J Emerg Med

September 2022

Department of Pharmacy Practice, College of Pharmacy, Marshall B. Ketchum University, Fullerton, California; Clinical Education, Providence St. Joseph Hospital Orange, Orange, California.

Background: Hypokalemia is a common disorder that can negatively affect organ function. Magnesium supplementation is frequently recommended despite limited evidence to support its use.

Objectives: The purpose of this study was to evaluate the clinical effects of magnesium coadministration in patients treated for hypokalemia in the emergency department (ED).

View Article and Find Full Text PDF

Objectives: Here we investigate the safety and efficacy of a continuous mechanical aspiration system when used before percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS).

Background: Historically, trials of routine manual aspiration thrombectomy in ACS patients have reported mixed results. This may be due to the technical limitations of manual aspiration, which suffers from decreasing vacuum power as aspiration is performed.

View Article and Find Full Text PDF

Background: Fluoroquinolones are one of the most prescribed antimicrobials in the United States and have been increasingly used in inpatient and outpatient settings to treat various infectious diseases syndromes. Due to the unwanted collateral effects on antibiotic resistance, poor susceptibility rates among Gram-negative pathogens, and adverse effects, fluoroquinolones are often targeted by hospital antimicrobial stewardship programs to prevent overutilization. This study describes the association of nonrestrictive antimicrobial stewardship interventions at 2 nonacademic community hospitals on levofloxacin utilization, prescribing patterns on alternative antibiotics, and nonsusceptibility rates to levofloxacin.

View Article and Find Full Text PDF

Prehospital triage tools across the world: a scoping review of the published literature.

Scand J Trauma Resusc Emerg Med

April 2022

Department of Emergency Medicine, School of Medicine, University of Colorado, 12631 E. 17th Ave, Room 2612, MS C326, Aurora, CO, 80045, USA.

Background: Accurate triage of the undifferentiated patient is a critical task in prehospital emergency care. However, there is a paucity of literature synthesizing currently available prehospital triage tools. This scoping review aims to identify published tools used for prehospital triage globally and describe their performance characteristics.

View Article and Find Full Text PDF

Bilateral Acute Angle-Closure Glaucoma: A Case Report of an Unusual Cause of Acute Headache in a Child.

Clin Pract Cases Emerg Med

November 2021

CHOC Children's Hospital, Department of Pediatric Emergency Medicine, Orange, California.

Introduction: Acute angle-closure glaucoma (AACG) is typically considered a disease of adulthood. However, AACG may occasionally be seen in children. The clinical presentation is similar to adults, including headache, vomiting, and eye pain.

View Article and Find Full Text PDF

Students' perceptions of a new transitions of care elective course in the pharmacy curriculum.

Curr Pharm Teach Learn

September 2021

Department of Pharmacy Practice, Marshall B. Ketchum University College of Pharmacy, 2575 Yorba Linda Blvd, Fullerton, CA 92831, United States. Electronic address:

Background And Purpose: The purpose of the new transitions of care (TOC) elective to the pharmacy curriculum is to train pharmacy students to address TOC medication-related problems, assess students' knowledge and perceptions of the TOC pharmacist's role, and explore the impact on interest in post-graduate career planning.

Educational Activity And Setting: Third-year pharmacy students were enrolled in the two-credit TOC elective course. The course was designed to include relevant TOC concepts and application of the Pharmacists' Patient Care Process.

View Article and Find Full Text PDF

The antibiogram is an essential resource for institutions to track changes in antimicrobial resistance and to guide empirical antimicrobial therapy. In this Viewpoint, data and examples from literature are presented that suggest institutions have not completely adopted the standardized approach in developing antibiograms, as variations in the development methodologies of antibiograms exist despite consensus guidelines (M39) published by CLSI. We emphasize developing antibiograms in line with the M39 recommendations will help ensure that they are accurate, reliable and valid, and highlight that understanding the limitations of antibiogram data is critical to ensuring appropriate interpretation and application to clinical decision-making.

View Article and Find Full Text PDF

Background: Outpatient parenteral antimicrobial therapy (OPAT) can be managed by specialists in infectious diseases (ID) or by other physicians. Better management of OPAT can reduce the likelihood of readmission or emergency department (ED) use. The relative success of ID specialists and other physicians in managing OPAT has received little study.

View Article and Find Full Text PDF