193 results match your criteria: "San Diego Veterans Affairs Medical Center[Affiliation]"

Atrial Fibrillation after RSV Vaccination Among Older Adults.

Clin Infect Dis

December 2024

Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, California, USA.

RSV vaccine clinical trials reported higher frequencies of atrial fibrillation in intervention groups compared to control. In this large, population-based, propensity-matched study, we found RSV vaccine was not associated with increased risk of new-onset or recurrent atrial fibrillation within 1-42 days compared to influenza or Tdap vaccines.

View Article and Find Full Text PDF

Factors Associated With PrEP Utilization and Access in the United States.

AIDS Educ Prev

December 2024

Division of Infectious Diseases & Global Public Health, University of California San Diego, La Jolla, California.

HIV pre-exposure prophylaxis (PrEP) is a cornerstone of the Ending the HIV Epidemic plan. We evaluated sociodemographic factors associated with PrEP use in jurisdictions with high HIV diagnosis rates between the initial years of PrEP rollout in the U.S.

View Article and Find Full Text PDF

Phylodynamics for HIV Prevention: A Miami-Dade Case Study.

J Infect Dis

December 2024

Division of Infectious Diseases & Global Public Health, University of California San Diego, La Jolla CA, USA.

Background: To date, HIV molecular epidemiology (HIV ME) has been primarily used to identify clusters of related infections (cluster detection and response [CDR]) and then address interventions to these clusters. Community groups have raised concern regarding CDR regarding privacy and ethical concerns. Here we demonstrate how an alternative approach to HIV ME can provide public health benefit.

View Article and Find Full Text PDF
Article Synopsis
  • Proenkephalin (PENK) is a potential biomarker indicating kidney function and cardiovascular risk, particularly in patients with cardiovascular disease.
  • An observational study of 199 ambulatory Veterans found that higher levels of PENK were linked to an increased risk of major adverse cardiac events (MACE), although this association was less significant after adjusting for other factors.
  • PENK did not show a clear relationship with all-cause mortality, heart failure, or left ventricular measurements, but it did reveal an interesting non-linear connection with left ventricular ejection fraction (LVEF). Further research is needed to confirm these findings.
View Article and Find Full Text PDF

Background: Worsening renal function (WRF) is common in hospitalized patients being treated for acute heart failure. However, discriminating clinically significant WRF remains challenging. In patients hospitalized with acute heart failure, we evaluated if blood and urine biomarkers of cardiac and kidney dysfunction were associated with adverse outcomes.

View Article and Find Full Text PDF

Background: The effectiveness of glucagon-like peptide-1 receptor agonists (GLP1Ras) for prevention of heart failure (HF) in patients with type 2 diabetes (T2DM) without HF and for risk of death in patients with T2DM with HF has not been fully elucidated in routine clinical practice.

Methods: Using the real-world global electronic medical record TriNetX database, individuals with T2DM and with or without HF who initiated either GLP1Ras or sitagliptin from 2017 to 2020 were retrospectively analyzed. In individuals with T2DM without HF, the primary outcome was a composite of all-cause mortality and a new diagnosis of HF within three years.

View Article and Find Full Text PDF

Background: Higher cardiac troponin is associated with worse outcomes in patients with acute heart failure. The significance of repeat measurements over hours remains unclear. We assessed whether a repeat measurement and the Δ between measurements of high-sensitivity cardiac troponin I (hs-cTnI) were associated with outcomes in hypervolemic patients with acute heart failure without acute coronary syndrome.

View Article and Find Full Text PDF

Analysis of Requirements within Neuroradiology Job Advertisements in a Specific Timeframe.

AJNR Am J Neuroradiol

September 2024

From the Department of Radiology (V.D.T., J.Y.C.), University of California, San Diego Health System, San Diego, California

Background And Purpose: The neuroradiology job market is constantly changing along with the skill sets needed by fellowship graduates to participate successfully in the job market. This study aimed to establish a baseline of employer requirements in the neuroradiology job market within the study timeframe.

Materials And Methods: The American Society of Neuroradiology and American College of Radiology job boards were queried for neuroradiology positions between August 12, 2022, and December 31, 2022.

View Article and Find Full Text PDF

Treatment strategies for diuretic resistance in patients with heart failure.

J Cardiol

June 2024

Division of Cardiovascular Medicine, San Diego Veterans Affairs Medical Center, San Diego, CA, USA; Division of Cardiovascular Medicine, University of California, San Diego, La Jolla, CA, USA.

Improving congestion with diuretic therapy is crucial in the treatment of heart failure (HF). However, despite the use of loop diuretics, diuresis may be inadequate and congestion persists, which is known as diuretic resistance. Diuretic resistance and residual congestion are associated with a higher risk of rehospitalization and mortality.

View Article and Find Full Text PDF

News event memory in amnestic and non-amnestic MCI, heritable risk for dementia, and subjective memory complaints.

Neuropsychologia

July 2024

San Diego Veterans Affairs Medical Center, San Diego, CA, USA; Department of Psychiatry, University of California San Diego, CA, USA; Center for the Neurobiology of Learning and Memory, University of California Irvine, CA, USA. Electronic address:

Robust and sensitive clinical measures are needed for more accurate and earlier detection of Alzheimer's disease (AD), for staging preclinical AD, and for gauging the efficacy of treatments. Mild impairment on episodic memory tests is thought to indicate a cognitive risk of developing AD and mild cognitive impairment (MCI), considered to be a transitional stage between normal aging and AD. Novel tests of semantic memory, such as memory for news events, are also impaired early on but have received little clinical attention even though they may provide a novel way to assess cognitive risk for AD.

View Article and Find Full Text PDF

Aim: Schizophrenia is a leading cause of disability worldwide; early detection and intervention are critical. Early in their illness, individuals at clinical high-risk (CHR) for psychosis have subthreshold psychotic symptoms that are often derogatory and self-directed. We hypothesized that CHR participants with negative self-reference (NSR) as a component of subthreshold psychosis would also have higher levels of social anxiety and depression, lower self-esteem and lower social/role/global functioning as compared with CHR participants without NSR.

View Article and Find Full Text PDF

Sex workers have been demonstrated to have increased vulnerabilities to HIV and a high population prevalence of the disease. Despite their increased risk, sex workers have been underrepresented in molecular epidemiology studies assessing HIV in Mesoamerica. This study aims to describe the sociodemographic characteristics and phylogenetic profile of HIV-1 within a cohort of HIV-positive female sex workers (FSW) situated at the Guatemala-Mexico border.

View Article and Find Full Text PDF

Nasopharyngeal SARS-CoV-2 viral load kinetics using digital PCR.

Heliyon

October 2023

Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Drive, CA, 92093, USA.

Background: The relationship between the viral kinetics of SARS-CoV-2 and clinical outcomes remains unclear.

Methods: A convenience sample of 955 remnant nasopharyngeal swabs collected during routine care between 11/18/20 and 9/26/21 were analyzed using digital PCR and associated clinical data extracted from the medical record. 18 individuals had >1 sample within 30 days of onset of symptoms.

View Article and Find Full Text PDF

Background: The rarity and heterogeneity of mucormycosis make treatment variable, and no prospective or randomized clinical trials exist in plastic surgery literature. The use of wound vacuum-assisted closure in combination with the instillation of amphotericin B to treat cutaneous mucormycosis is not well documented.

Case Presentation: A 53-year-old man underwent left Achilles tendon reconstruction with allograft after a complete tear during exercise.

View Article and Find Full Text PDF
Article Synopsis
  • Body mass index (BMI) affects the relationship between certain biomarkers and prognosis in patients with acute heart failure (AHF), with a specific focus on B-type natriuretic peptide (BNP) and high-sensitivity cardiac troponin I (hs-cTnI).
  • A study of 866 AHF patients revealed that while BNP and hs-cTnI levels decreased with higher BMI, biomarkers like galectin-3 and sNGAL showed an increase.
  • The analysis indicated that BNP's association with adverse outcomes weakened as BMI rose, particularly in obese individuals, whereas hs-cTnI remained a reliable prognostic factor across all BMI categories.
View Article and Find Full Text PDF

The association between nasopharyngeal (NP) SARS-CoV-2 viral loads and clinical outcomes remains debated. Here, we examined the factors that might predict the NP viral load and the role of the viral load as a predictor of clinical outcomes. A convenience sample of 955 positive remnant NP swab eluent samples collected during routine care between 18 November 2020 and 26 September 2021 was cataloged and a chart review was performed.

View Article and Find Full Text PDF

Osteomyelitis due to in an adult renal transplant recipient.

IDCases

January 2023

Division of Infectious Diseases and Global Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA.

is an increasingly recognized pathogen of the non-tuberculous mycobacteria family that largely infects immunocompromised adults and immunocompetent children. is a fastidious and slow-growing organism that exhibits preferential growth at lower temperature with iron supplemented media, and therefore most clinical manifestations involve cutaneous infection or musculoskeletal infection of the distal extremities. It is believed that opportunistic infection occurs in immunocompromised hosts when the organism is acquired through environmental exposure.

View Article and Find Full Text PDF

Background: Galectin-3, a biomarker of inflammation and fibrosis, can be associated with renal and myocardial damage and dysfunction in patients with acute heart failure (AHF).

Methods And Results: We retrospectively analyzed 790 patients with AHF who were enrolled in the AKINESIS study. During hospitalization, patients with galectin-3 elevation (> 25.

View Article and Find Full Text PDF

Aims: Kidney function changes dynamically during AHF treatment, but risk factors for and consequences of worsening renal function (WRF) at hospital admission are uncertain. We aimed to determine the significance of WRF at admission for acute heart failure (AHF).

Methods And Results: We evaluated a subgroup of 406 patients from The Acute Kidney Injury Neutrophil gelatinase-associated lipocalin Evaluation of Symptomatic heart failure Study (AKINESIS) who had serum creatinine measurements available within 3 months before and at the time of admission.

View Article and Find Full Text PDF

Objective: The health and economic burden of type 2 diabetes is of global significance. Many people with type 2 diabetes eventually need insulin to help reduce their risk of serious associated complications. However, barriers to the initiation and/or optimization of insulin expose people with diabetes to sustained hyperglycemia.

View Article and Find Full Text PDF

Background: In patients with acute heart failure (AHF), the development of worsening renal function with appropriate decongestion is thought to be a benign functional change and not associated with poor prognosis. We investigated whether the benefit of decongestion outweighs the risk of concurrent kidney tubular damage and leads to better outcomes.

Methods: We retrospectively analyzed data from the AKINESIS study, which enrolled AHF patients requiring intravenous diuretic therapy.

View Article and Find Full Text PDF

Impacts of an Opioid Safety Initiative on US Veterans Undergoing Cancer Treatment.

J Natl Cancer Inst

May 2022

Office of Research and Development, Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.

Background: There is limited research on how the opioid epidemic and consequent risk reduction policies have affected pain management among cancer patients. The purpose of this study was to analyze how the Opioid Safety Initiative (OSI) implemented at the Veterans Health Administration affected opioid prescribing patterns and opioid-related toxicity.

Methods: We performed an interrupted time series analysis of 42 064 opioid-naïve patients treated at the Veterans Health Administration for prostate, lung, breast, and colorectal cancer from 2011 to 2016.

View Article and Find Full Text PDF