6,027 results match your criteria: "St. Louis University.[Affiliation]"

Mode of Delivery and Subsequent Motor Function in Children With Myelomeningocele Without In Utero Repair.

Obstet Gynecol

January 2025

Departments of Obstetrics and Gynecology and Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin; University of Pittsburgh Medical Center, Magee-Women's Hospital, and the Children's Hospital of Pittsburgh, Pittsburgh, and the Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; the Department of Neurosurgery, Duke University Medical Center, Duke Children's Hospital, Durham, North Carolina; the University of Michigan, Ann Arbor, Michigan; the Department of Surgery (and Maternal Fetal Care Center), Boston Children's Hospital, Boston, Massachusetts; Children's Minnesota, St. Paul and Minneapolis, Minnesota; the Johns Hopkins Center for Fetal Therapy, Baltimore, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee; Wexner Medical Center, The Ohio State University, Columbus, Ohio; Stanford University School of Medicine, Stanford, and UC Davis Fetal Care and Treatment Center, Sacramento, California; St. Louis University, St. Louis, Missouri; University of Rochester Medical Center, Rochester, New York; and UTHealth Houston Fetal Center, University of Texas McGovern Medical School at Houston, Houston, Texas.

Objective: To assess the association between mode of delivery and 2-year motor function in children with prenatal diagnosis of myelomeningocele.

Methods: A multisite retrospective cohort study of children with myelomeningocele across 14 NAFTNet (North American Fetal Therapy Network) centers born between 2007 and 2020 who had a physical examination available at 2 years of life. Exclusion criteria were in utero myelomeningocele repair, postnatal myelomeningocele diagnosis, missing data on fetal presentation at delivery, and contraindications to labor.

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Objectives: To explore practice variations in the rate and timing of tracheostomy and gastrostomy for adolescent with severe traumatic brain injury (TBI) across trauma center types.

Design: Retrospective cohort study.

Setting: Trauma centers participating in the American College of Surgeons Trauma Quality Improvement Program (2017-2021) included adult (ATC), mixed (MTC), and pediatric trauma centers (PTC).

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Introduction: Intermittent fasting (IF) has emerged as a potential lifestyle intervention for mitigating cognitive decline and enhancing brain health in individuals with mild to major neurocognitive disorders. Unlike preventive strategies, this review evaluates IF as a therapeutic approach, focusing on its effects on neuroplasticity, inflammation, and cognitive function.

Methods: A narrative review was conducted using a comprehensive PubMed search with the terms "intermittent fasting AND neurocognition" and "intermittent fasting AND neuroplasticity".

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Background: Chronic kidney disease (CKD) is associated with higher risk of myocardial infarction and anemia. Among patients with anemia and CKD who experience myocardial infarction, it remains uncertain if a liberal red blood cell transfusion threshold strategy (hemoglobin cutoff [Hgb] < 10 g/dL) is superior to a restrictive transfusion threshold (Hgb 7-8 g/dL) strategy.

Methods: Among the 3,504 patients enrolled in the Myocardial Ischemia and Transfusion (MINT) trial with non-missing creatinine, we compared baseline characteristics and 30-day and 6-month outcomes of patients without CKD (N = 1279), CKD with eGFR 30-60 mL/min/1.

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Youth living with HIV (YLWH) have high rates of virologic failure due to medication non-adherence. is a novel, gamified mobile health (mHealth) application designed with user-centered principles to improve medication adherence by integrating medication reminders with social and financial incentives, virtual peer social support and early clinic outreach for non-adherent YLWH in Nigeria. Focus Group Discussions (FGDs) were conducted to identify reactions to key prototype features (user interface, medication reminders, incentives, and peer support), facilitators and barriers to app use, and how well the app would meet adherence needs.

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Article Synopsis
  • A study in Jordan found a 2.4% prevalence of vaccine administration errors (VAEs) during the COVID-19 vaccination campaign, with various types of errors identified, including timing and dosing mistakes.
  • Most errors were minor or moderate, and significant contributing factors included healthcare provider issues and higher error rates during peak vaccination times and in the Southern region.
  • The findings highlight the need for more research and strategies to address VAEs to ensure effective immunization and patient safety.
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Forecasting Pediatric Trauma Volumes: Insights From a Retrospective Study Using Machine Learning.

J Surg Res

December 2024

Department of Pediatric Surgery, SSM Health Cardinal Glennon Children's Hospital, St. Louis, Missouri; Department of Pediatric Surgery, St. Louis University, St. Louis, Missouri.

Introduction: Rising pediatric firearm-related fatalities in the United States strain Trauma Centers. Predicting trauma volume could improve resource management and preparedness, particularly if daily forecasts are achievable. The aim of the study is to evaluate various machine learning models' accuracy on monthly, weekly, and daily data.

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Background And Aims: Interest in cold endoscopic mucosal resection (EMR) for colorectal polyps has been growing lately. We conducted a meta-analysis of RCTs to compare cold and hot EMR for colorectal polyps.

Methods: We reviewed several databases from inception to October 06, 2024.

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Background And Aims: Fully covered self-expandable metallic stents (FCSEMS) are often used in the management of post-sphincterotomy bleeding which is refractory to conventional endoscopic treatments. In this meta-analysis, we have evaluated the efficacy and safety of FCSEMS in the management of post-sphincterotomy bleeding.

Methods: We reviewed several databases from inception to November 6, 2024 to identify studies that evaluated the efficacy, and/or safety of FCSEMS in the management of post sphincterotomy bleeding.

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Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease with a significant risk of developing hepatocellular carcinoma (HCC). Recent clinical evidence indicates the potential benefits of statins in cancer chemoprevention and therapeutics. However, it is still unclear if these drugs can lower the specific risk of HCC among patients with MASLD.

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Background: The relationship between the extent and severity of stress-induced ischemia and the extent and severity of anatomic coronary artery disease (CAD) in patients with obstructive CAD is multifactorial and includes the intensity of stress achieved, type of testing used, presence and extent of prior infarction, collateral blood flow, plaque characteristics, microvascular disease, coronary vasomotor tone, and genetic factors. Among chronic coronary disease participants with site-determined moderate or severe ischemia, we investigated associations between ischemia severity on stress testing and the extent of CAD on coronary computed tomography angiography.

Methods: Clinically indicated stress testing included nuclear imaging, echocardiography, cardiac magnetic resonance imaging, or nonimaging exercise tolerance test.

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Use of a large language model (LLM) for ambulance dispatch and triage.

Am J Emerg Med

December 2024

Icahn School of Medicine at Mount Sinai, New York City, NY, United States of America; Department of Emergency Medicine, Mount Sinai Hospital, New York City, NY, United States of America.

Introduction: Large language models (LLMs) have grown in popularity in recent months and have demonstrated advanced clinical reasoning ability. Given the need to prioritize the sickest patients requesting emergency medical services (EMS), we attempted to identify if an LLM could accurately triage ambulance requests using real-world data from a major metropolitan area.

Methods: An LLM (ChatGPT 4o Mini, Open AI, San Francisco, CA, USA) with no prior task-specific training was given real ambulance requests from a major metropolitan city in the United States.

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Article Synopsis
  • The study aims to predict the likelihood of death or severe neurodevelopmental impairment (NDI) in neonates with hypoxic-ischemic encephalopathy (HIE) who undergo hypothermia treatment.
  • The research involved 424 neonates from U.S. neonatal intensive care units, tracking their outcomes up to the age of 2 years, with a focus on clinical indicators taken 24 hours after birth.
  • Findings revealed that specific clinical characteristics, including severely abnormal EEG, low pH, and a poor Apgar score, can effectively signal high risk for severe outcomes, offering a high level of specificity and predictive value for clinicians.
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  • Dual antiplatelet therapy (DAPT) combined with proton pump inhibitors (PPI) can significantly reduce the risk of upper gastrointestinal bleeding (UGIB) in patients with acute coronary syndrome (ACS) compared to DAPT alone.
  • A meta-analysis of seven randomized controlled trials involving 6708 patients showed a marked decrease in UGIB rates and all-cause mortality when PPI was added, with no negative impact on major cardiovascular events.
  • Specifically, the PPI + DAPT group had a risk ratio of 0.39 for UGIB and 0.46 for mortality, indicating substantial benefits from this combination treatment.
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Article Synopsis
  • * A study involving nearly 50,000 AVF and 12,688 AVG patients assessed the impact of different anti-thrombotic therapies, showing SAPT yielded better outcomes compared to no antiplatelet treatment.
  • * Dual antiplatelet therapy (DAPT) also improved primary patency for AVG patients, while the combination of aspirin and anticoagulation showed no significant benefits and had worse survival outcomes for both AVF and AVG patients.
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We previously reported -hydroxypyridinedione (HPD) compounds with mid-nanomolar efficacy and selectivity indexes around 300 against hepatitis B virus (HBV) replication. However, they lack pharmacological evaluation. Here, we report anti-HBV efficacy, cytotoxicity, and pharmacological characterization of 29 novel HPDs within seven subgroups.

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Glioblastomas (GBMs) are dreadful brain tumors with abysmal survival outcomes. GBM extracellular vesicles (EVs) dramatically affect normal brain cells (largely astrocytes) constituting the tumor microenvironment (TME). We asked if EVs from different GBM patient-derived spheroid lines would differentially alter recipient brain cell phenotypes.

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Teaching Residents at Night: Exploration of a Novel Curriculum.

Hosp Pediatr

December 2024

Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, Missouri.

Background: Implementation of a successful night curriculum has been a historical barrier to education during night rotations. Residents are tasked with teaching students and peers at night, often with little educational material to support this. To address the need for engaging night curriculum for pediatric residents, we aimed to (1) develop and implement a night curriculum with an emphasis on residents as teachers (RaTs) and (2) explore residents' experience with the RaT curriculum through a secondary qualitative analysis of reflections.

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Background: Serial positron emission tomography (PET) imaging is routinely used to monitor treatment response in patients with suspected cardiac sarcoidosis (CS). Corticosteroids remain the mainstay of therapy in CS. However, there are no data available on the cardiovascular outcomes and optimal timing interval to obtain repeat PET while factoring in the influence of corticosteroid taper in relation to surveillance imaging.

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Article Synopsis
  • Haploidentical hematopoietic cell transplantation (haplo-HCT) is being utilized more often for blood cancers, but complications such as graft vs. host disease (GvHD) still pose serious risks.
  • A study tested the JAK-1 inhibitor itacitinib alongside standard GvHD preventive care in 42 patients and found it dramatically reduced the severity of complications like cytokine release syndrome (CRS) and instances of acute GvHD.
  • Results showed high overall survival rates (80% at one year) and low rates of both acute and chronic GvHD, indicating that itacitinib is a promising addition to haplo-HCT treatment protocols.
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