113 results match your criteria: "St John Medical Center[Affiliation]"

Background: Surrogates often provide substituted judgement for neurologically critically ill patients. Resilience and spirituality are understudied constructs in this patient population. In this study we examine how accurately surrogates estimate measures of resilience and spirituality for neurologically critically ill patients.

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Background: There is limited data on gender differences among patients with spontaneous coronary artery dissection (SCAD) who present as ST-elevation myocardial infarction (STEMI) and develop cardiogenic shock (CS).

Objectives: To describe outcomes of SCAD patients presenting with STEMI and CS and outline the differences between men and women.

Methods: We queried the US Nationwide Readmissions Database (NRD) from January 2016 to December 2020 to identify patients with SCAD presenting with STEMI who developed CS.

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Background: Plan of Care of Visits (POCV), including the patient, nurse, and hospital provider were implemented across an integrated health system to improve provider-patient communication during hospitalization and patient outcomes.

Objectives: To assess POCV adoption after implementation, patient characteristics assosites were classified as teachsites were classified as teachsites were classified as teachsites were classified as ciated with POCV completion, and association of POCV with 30-day readmissions.

Methods: This retrospective cohort study utilized electronic medical record (EMR) data of 237,430 adult patients discharged to home from 11 hospitals from January 2020 to December 2022.

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Management of Elbow Terrible Triad Injuries: A Comprehensive Review and Update.

J Am Acad Orthop Surg

August 2024

From the Ascension St. John Medical Center, Detroit, MI (Fahs, Waldron, Afsari, and Best), Ascension Macomb-Oakland Hospital, Warren, MI (Fahs, Waldron, Afsari, and Best).

The "terrible triad" of the elbow, encompassing elbow dislocation, radial head fracture, and coronoid process fracture, remains a formidable challenge in orthopaedic practice. Typically, stabilizing structures in the elbow fail from lateral to medial through a posterolateral rotatory force after a fall onto an outstretched upper extremity. Surgery is often needed to repair the lateral ligamentous complex, replace or fix the radial head, possibly repair the anterior capsule or fix the coronoid, and consider medial repair or application of an internal versus external fixator.

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Article Synopsis
  • Corticosteroids have been widely used in critical care for various conditions like respiratory distress, septic shock, and COVID-19, showing both benefits and risks.
  • Key advantages include improved treatment outcomes, shorter hospital stays, and lower mortality rates, while significant adverse effects include hyperglycemia, hypertension, and increased infection risk.
  • There is currently no thorough report on corticosteroid use in critical care, highlighting the need for better understanding and management of their use in therapy.
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  • Cryptococcus infection is a serious fungal infection mainly affecting immunocompromised individuals, such as organ transplant recipients and HIV patients, with symptoms ranging from skin lesions to severe systemic issues.
  • The case study discusses a 50-year-old woman with diabetes and kidney transplant history who exhibited symptoms like fever and cough, along with findings of a lung lesion and a cystic mass on her foot.
  • Diagnosis of disseminated cryptococcus infection was confirmed through imaging and lab tests, and the patient successfully responded to antifungal treatment, highlighting the need for awareness of this rare presentation in transplant patients.
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Importance: Multiple continuous intravenous anesthetic drugs (CIVADs) are available for the treatment of refractory status epilepticus (RSE). There is a paucity of data comparing the different types of CIVADs used for RSE.

Objective: To systematically review and compare outcome measures associated with the initial CIVAD choice in RSE in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

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Article Synopsis
  • Spinal cord ischemia (SCI) is a rare but serious complication that can occur after thoracic endovascular aortic repair (TEVAR), mainly due to reduced blood supply to the spinal cord.
  • A case study of a 67-year-old patient showed that delayed SCI occurred nearly two years post-TEVAR, presenting as acute paraplegia triggered by pre-syncope and a thrombosed endoleak, along with the patient's existing vascular issues.
  • Treatment strategies, including CSF drainage and MAP augmentation, led to moderate recovery, emphasizing the importance of quick diagnosis and intervention to prevent worsening of spinal cord injury after TEVAR.
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The current study aims to evaluate the effect of bariatric metabolic surgery (BMS) on the New York Heart Association (NYHA) class and left ventricular ejection fraction (LVEF) in patients with diagnosed heart failure (HF). Fourteen related articles with 217 patients were included in the final analysis. LVEF significantly improved after BMS in patients with HF with a mean difference of 7.

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Characteristics of Population-Based Practice in Physical Therapy.

Phys Ther

February 2023

Physical Therapy Department, Central Ohio Primary Care, Columbus, Ohio, USA.

Objective: Physical therapy is placing new emphasis on how the profession might contribute to improving population health. However, little is known about the nature of population-based practice (PBP) of physical therapists. Therefore, the purpose of this study was to develop a view of PBP from the perspective of physical therapists engaged in it.

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Lenvatinib is a tyrosine kinase inhibitor that is being used to treat neuroendocrine tumors based on the success shown in the TALENT trial. There are two documented cases of lenvatinib-induced pancreatitis in patients being treated for thyroid cancer. This report describes the first case of pancreatitis seen in a patient with a metastatic neuroendocrine tumor being treated with lenvatinib.

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A Comprehensive Management Approach in Pediatric and Adolescent Patients With Hereditary Angioedema.

Clin Pediatr (Phila)

October 2023

Department of Medicine, Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology, Medical University of South Carolina, Charleston, SC, USA.

Hereditary angioedema (HAE) is a rare autosomal-dominant disorder; most cases are characterized by low plasma levels of C1 esterase inhibitor (C1-INH). Clinical manifestations of HAE due to C1-INH deficiency include unpredictable, acute, recurrent episodes of nonpruritic swelling that can affect the face, trunk, limbs, and the respiratory, gastrointestinal, and genitourinary tracts. Attacks can be disfiguring, disabling, painful, and even life-threatening if laryngeal swelling occurs.

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Highest resolution microCT scan of the human brainstem reveals putative anatomical basis for infrequency of medial medullary syndrome.

Neuroimage Clin

December 2022

Oklahoma State University Center for Health Sciences, Department of Anatomy and Cell Biology, 1111 W 17th Street, Tulsa, OK 74107, USA; University of Arizona, Department of Cellular and Molecular Medicine, 1501 N. Campbell Avenue, PO Box 245044, Tucson, AZ 85724, USA. Electronic address:

Ischemic strokes affecting the medial medulla are exceedingly rare. The anatomical basis for the relative infrequency of this stroke syndrome has been largely uninvestigated due to historically coarse MRI and CT scan resolution. We capture and digitally dissect the highest-ever-resolution diffusible iodine-based contrast-enhanced CT (diceCT) scanned images of a cadaveric brainstem to map arterial territories implicated in medial medullary infarctions.

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What the American Journal of Critical Care Junior Peer Reviewers Were Reading During Year 2 of the Program.

Am J Crit Care

September 2022

Aluko A. Hope is an associate professor in the Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Oregon Health & Science University, Portland.

The American Journal of Critical Care's Junior Peer Reviewer program aims to mentor novice reviewers in the peer review process. To grow their critical appraisal skills, the participants take part in discussion sessions in which they review articles published in other journals. Here we summarize the articles reviewed during the second year of the program, which again focused on the care of critically ill patients with COVID-19.

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Purpose: The pathophysiology of nocturia and nocturnal polyuria (NP), conditions that become more prevalent with aging, may in part be explained by changes in hormones involved in water homeostasis. The purpose of this study was to analyze the impact of aging on urinary natriuretic peptides in nocturia and NP.

Methods: Patients aged ≥18 years completed 24-hour bladder diaries for assessment of nocturia and NP.

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The Junior Peer Reviewer program of the American Journal of Critical Care provides mentorship in the peer review process to novice reviewers. The program includes discussion sessions in which participants review articles published in other journals to practice and improve their critical appraisal skills. The articles reviewed during the first year of the program focused on caring for patients with COVID-19.

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One promising goal for utilizing the molecular information circulating in biofluids is the discovery of clinically useful biomarkers. Extracellular RNAs (exRNAs) are one of the most diverse classes of molecular cargo, easily assayed by sequencing and with expressions that rapidly change in response to subject status. Despite diverse exRNA cargo, most evaluations from biofluids have focused on small RNA sequencing and analysis, specifically on microRNAs (miRNAs).

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Use of the Sphenopalatine Ganglion Block to Treat Migraine Headaches in the Emergency Department.

Cureus

January 2022

Emergency Medicine, University Hospitals Community Consortium, St. John Medical Center, Westlake, USA.

Headaches are a common presenting complaint to the emergency department. Amongst the common non-life-threatening headaches, migraine headaches tend to be one of the more severe. Commonly, migraines are treated with the so-called "migraine cocktail.

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