771 results match your criteria: "USA Parkland Health & Hospital System[Affiliation]"

Objective: Metabolic reprogramming plays a critical role in modulating the innate and adaptive immune response, but its role in cutaneous autoimmune diseases, such as cutaneous lupus erythematosus (CLE), is less well studied. An improved understanding of the metabolic pathways dysregulated in CLE may lead to novel treatment options, biomarkers and insights into disease pathogenesis. The objective was to compare metabolomic profiles in the skin and sera of CLE and control patients using liquid chromatography-mass spectrometry (LC-MS).

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Objectives: To incorporate a longitudinal palliative care curriculum into obstetrics and gynecology (Ob-Gyn) residency that could become standardized to ensure competencies in providing end of life (EOL) care.

Methods: This was a prospective cohort study conducted among 23 Ob-Gyn residents at a tertiary training hospital from 2021 to 2022. A curriculum intervention was provided via lecture and simulation.

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Background: The current evaluation of surgical resident operative autonomy consists primarily of self-report and is prone to bias. Objective performance indicators (OPIs) generated from the da Vinci Surgical System capture objective intraoperative data providing an opportunity to evaluate the intraoperative resident experience more accurately. This study investigates the ability of OPIs to describe resident autonomy during robotic cholecystectomy.

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Patient-reported health status is an important assessment of patients with heart failure, but current approaches have substantial methodological and analytical limitations. Changes in the Kansas City Cardiomyopathy Questionnaire (KCCQ) are commonly presented as a measure of the effect of drugs and devices, most often as the between-group difference in population means or as the odds of showing threshold changes of 5, 10, 15, and 20 points. However, the presentation of mean differences is based on statistical assumptions that are routinely violated in most trials.

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Mesonephric-like adenocarcinoma (MLA) is a newly recognized type of carcinoma that occurs in the uterus and ovaries. MLA exhibits distinct morphological and immunophenotypical features similar to those of mesonephric carcinoma of the cervix or vagina, with the majority of reported tumors containing mutations. MLA is exceedingly rare and appears to be associated with aggressive clinical behavior.

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Aims: In VERTIS CV, ertugliflozin was associated with a 30% risk reduction for adjudication-confirmed, first and total hospitalizations for heart failure (HHF) in participants with type 2 diabetes and atherosclerotic cardiovascular disease. We evaluated the impact of ertugliflozin on the broader spectrum of all reported heart failure (HF) events independent of adjudication confirmation.

Methods And Results: Data from participants who received ertugliflozin (5 or 15 mg) were pooled and compared versus placebo.

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Postpartum hemorrhage assessment and targeted treatment.

Best Pract Res Clin Anaesthesiol

September 2024

Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA. Electronic address:

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide, and mitigating it is a global health priority. In this review, we discuss the measurement, assessment, and treatment of PPH. We review different methods of quantifying blood loss, including gravimetry, calibrated drapes and canisters, and colorimetric techniques.

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Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

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Introduction: Linking patients living with chronic, diet-related diseases and food insecurity to charitable food assistance, medically tailored groceries (MTGs) and food resource coaching may empower patients to better manage their health in a way that is economically sustainable. This protocol paper describes the implementation of a study evaluating MTGs and food resource coaching in a food pantry setting.

Methods And Analysis: A randomised controlled trial whereby patients of a safety-net health centre will be screened for The Emergency Food Assistance Program (TEFAP) and study eligibility.

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Chronic kidney disease (CKD) is a prevalent and progressive condition associated with significant mortality and morbidity. Diabetes is a common cause of CKD, and both diabetes and CKD increase the risk of cardiovascular disease (CVD), the leading cause of death in individuals with CKD. This review will discuss the importance of early detection of CKD and prompt pharmacological intervention to slow CKD progression and delay the development of CVD for improving outcomes.

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Ethnicity does not change burn resuscitation and time to first excision.

Burns

December 2024

Parkland Health, 5200 Harry Hines Blvd, Dallas, TX 75235, USA. Electronic address:

Health and racial disparities can limit access to preventative, trauma, and chronic disease care but have not been addressed in burn resuscitation. Over- and under-resuscitation contribute to increased overall hospital costs, and morbidity and mortality rates. The primary objective of this study was to identify potential racial disparities that may exist during the initial fluid resuscitation after burn injury.

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Aims: Sodium-glucose co-transporter-2 (SGLT2) inhibitors improve health status and outcomes in the setting of heart failure (HF) across the range of ejection fraction (EF). Baseline kidney disease is common in HF, complicates HF management and is strongly linked to worse health status. This study aimed to assess whether the treatment effects of dapagliflozin on health status vary based on estimated glomerular filtration rate (eGFR).

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Background: SGLT-2i and GLP-1RA are recommended for persons with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD); for those prescribed, little is known about reasons for discontinuation.

Methods: From the COORDINATE-Diabetes randomized trial database, the frequency and reasons for discontinuation of SGLT2i or GLP-1RA were analyzed.

Results: 1045 participants were enrolled 7/2019 to 5/2022; 290 (27.

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Background: Patients with cutaneous lupus erythematosus (CLE) can present with one or multiple different subtypes of CLE. There is limited understanding of the prevalence and associated risk factors for having multiple CLE subtype diagnoses.

Objective: This study characterized the frequency and risk factors for having multiple CLE subtypes.

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Background: Racial and ethnic disparities have been reported for HCC prognosis, although few studies fully account for clinically important factors and social determinants of health, including neighborhood socioeconomic status.

Methods: We conducted a retrospective multicenter cohort study of patients newly diagnosed with HCC from January 2010 through August 2018 at 4 large health systems in the United States. We used multivariable logistic regression and cause-specific Cox proportional hazard models to identify factors associated with early-stage HCC presentation and overall survival.

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Article Synopsis
  • Candidemia is a major concern in critically ill patients, significantly affecting their morbidity and mortality, and is linked to various risk factors.
  • A retrospective study of 91 non-neutropenic critically ill adults examined the relationship between antifungal therapy effectiveness and patient outcomes, finding that improper or delayed treatment increased mortality rates.
  • Key risk factors for higher mortality included mechanical ventilation, vasopressor therapy, end-stage renal disease, and multiple organ failures; patients receiving inadequate antifungal therapy had a much higher mortality rate (64%) compared to those receiving appropriate treatment (29%).
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Endocervical adenocarcinoma (ECA) with a micropapillary component is considered to be associated with aggressive behavior and poor prognosis. So far, only limited studies investigated this histological subtype of ECA in the literature. In this study, we present a clinicopathological analysis of 10 such tumors.

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Research is one of the American Burn Association's (ABA) strategic priorities. Advocacy is required not only to promote burn research, but also, the ABA's other strategic priorities (Prevention, Quality, and Education). The ABA convened a two-day Research and Advocacy (R&A) Summit in September 2023, to develop a roadmap for the organization's research and advocacy efforts.

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The importance of a Neonatal Intensive Care Unit (NICU) database lies in its critical role in improving the quality of care for very preterm neonates and other high-risk newborns. These databases contain extensive information regarding maternal exposures, pregnancy complications, and neonatal care. They support quality improvement (QI) initiatives, facilitate clinical research, and track health outcomes in order to identify best practices and improve clinical guidelines.

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Background: Our objectives were to determine 1) the prevalence and description of placental pathologic lesions in pregnancies complicated by SARS-CoV-2 infection compared to healthy controls and 2) whether the prevalence and/ or pattern of placental pathologic lesions differed in the few neonates who tested positive for SARS-CoV-2 in the first 48 hours of life at a busy urban county hospital.

Methods: This study included all pregnant mothers who tested positive for SARS-CoV-2 and delivered at our institution from March 2020 to June 2021, while control placentas were collected from term pregnancies without complications.

Results: Approximately 90% (n = 380/425) of placentas from pregnancies complicated by SARS-CoV-2 infections had placental pathologic lesions, compared to 32% (n = 16/50) of controls.

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Background: Hospitals within Nairobi County, Kenya, offer cervical cancer screening services. However, most female sex workers do not seek this service.

Objective: To determine uptake of cervical cancer screening among female sex workers living with HIV in Nairobi, Kenya.

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Background: Timely treatment of chronic hepatitis B (CHB) reduces risks of cirrhosis and hepatocellular carcinoma. Gaps in timely treatment persist, especially among underserved safety-net populations. We aim to evaluate gaps and disparities in CHB treatment in the United States.

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Article Synopsis
  • Inflammation may play a significant role in epilepsy, especially in patients with multiple sclerosis (MS), who have higher seizure rates than the general population.
  • This study analyzed data from the FDA Adverse Event Reporting System to investigate the connections between MS treatments and the occurrence of epilepsy.
  • Results indicated that certain medications, particularly ibrutinib, showed an inverse association with epilepsy occurrences, suggesting they could be explored for new treatment options for epilepsy.
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