195 results match your criteria: "the University of Toledo Medical Center[Affiliation]"

Introduction: Atrial fibrillation (AF) in end-stage kidney disease (ESKD) and kidney transplant (KTx) recipients presents challenges in stroke risk management. This study aimed to compare hospitalization rates for ischemic and hemorrhagic cerebrovascular events in ESKD and KTx patients with and without AF.

Methods: Using the National Inpatient Sample (2005-2019), retrospective analysis was conducted on hospitalizations for ESKD and KTx patients with and without AF.

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Objective: Due to the substantial lack of data from Iraq on ventriculoperitoneal shunt (VPS) complications, this study aims to examine the various types of complications after VPS surgery in Baghdad Medical City.

Methods: The retrospective cohort study analyzed VPS procedures at Baghdad Medical City from 2019 to 2022. The overall complication rate, including infection and shunt malfunction, was determined from patient records.

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Background: Complete heart block (CHB) is a conduction disorder that can be fatal if not treated promptly. Admission on a week or weekend day may influence the outcomes of cardiac emergencies, such as CHB.

Objectives: The purpose of this study was to determine the effects of weekday vs.

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Background And Purpose: It has been suggested that capacity for physical therapy clinical education (CE) experiences is limited; however, data remain unavailable. Regional CE networks have been suggested and may facilitate data collection and management of capacity issues. The Ohio Kentucky Consortium of Physical Therapy Programs developed a Consortium Core Network (CCN) from shared partnerships and implemented a centralized placement process.

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Purpose Artificial intelligence (AI) has rapidly gained popularity with the growth of ChatGPT (OpenAI, San Francisco, USA) and other large-language model chatbots, and these programs have tremendous potential to impact medicine. One important area of consequence in medicine and public health is that patients may use these programs in search of answers to medical questions. Despite the increased utilization of AI chatbots by the public, there is little research to assess the reliability of ChatGPT and alternative programs when queried for medical information.

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Article Synopsis
  • The Triglyceride-glucose index (TyG) serves as a marker for insulin resistance and may predict the risk of major adverse cardiac and cerebrovascular events (MACCE) in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI).
  • A study involving 13,542 patients showed that higher TyG levels, particularly in the fourth quartile, significantly correlated with an increased risk of MACCE, such as heart attacks and strokes.
  • In contrast, no significant association was found between TyG levels and MACCE in a subgroup of patients who were euglycemic, suggesting the need for further studies to confirm these findings for better clinical risk assessment.
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Article Synopsis
  • An 88-year-old man with multiple health issues was diagnosed with metastatic pancreatic neuroendocrine carcinoma after experiencing significant weight loss, nosebleeds, and back pain.
  • The case highlights the need for using atypical tumor markers, like thyroid transcription factor 1, for diagnosis and stresses the value of a collaborative, patient-focused treatment strategy for managing these aggressive tumors.
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Bilateral retinal metastasis is a rare disease that represents less than 1% of ocular metastases. Additionally, the prevalence of ocular metastases overall is only 5% to 10%. It is uncommonly found due to the absence of a lymphatic system in the eye.

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ST-segment elevation myocardial infarction (STEMI) is a critical condition characterized by the sudden obstruction of one or more coronary arteries, resulting in diminished blood flow to the heart muscle. This acute ischemic event demands swift and precise intervention to minimize myocardial damage and preserve cardiac function. Opioids, a class of potent analgesic medications, are frequently utilized in the management of STEMI-related chest pain.

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Even with comparable healthcare structure and staffing, patients presenting on weekends often face poorer outcomes, including longer wait times in the emergency department, extended hospital stays, and delays in major procedures. This discrepancy prompts questions about whether life-saving cardiac procedures, such as permanent pacemaker (PPM) implantation for atrioventricular block, also experience similar delays and differences in outcomes. We researched over 200,000 patients from the National Inpatient Sample (NIS) database to help study whether patients admitted on the weekend truly had worse outcomes than patients admitted on the weekday.

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Introduction: Bacteria can enter the bloodstream through simple actions such as brushing teeth, flossing, and even chewing food, increasing the chance of hematogenous seeding of prosthetic joints. Antibiotics before dental work in patients with orthopedic hardware is a topic of debate because of concerns for antibiotic resistance. Patients with dentures theoretically avoid this risk due to the lack of teeth and their maintenance.

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The altered anatomy in Roux-en-Y gastric bypass (RYGB) makes conventional endoscopic retrograde cholangiopancreatography (ERCP) a technically challenging procedure. EUS-directed transgastric ERCP (EDGE) and laparoscopic-assisted ERCP (LA-ERCP) are alternative modalities used with comparable efficacy and adverse events in such patients. We conducted a meta-analysis comparing EDGE and LA-ERCP to assess the efficacy and safety in patients with RYGB.

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Article Synopsis
  • Cryptococcus neoformans is a fungus that primarily affects individuals with weakened immune systems, often leading to meningoencephalitis, but cases of muscle infections are rare.
  • A 45-year-old man with extensive cryptococcal infection developed multiple muscle abscesses and osteomyelitis, which led to surgery, an amputation, and ultimately death.
  • Increased awareness and rapid diagnosis of orthopedic complications from cryptococcal infections may enhance patient outcomes.
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Modular dual mobility total hip arthroplasty (THA) can be associated with complications if the liner is malseated, which can be unappreciated intraoperatively. A meticulous surgical technique is needed to ensure that the liner is perfectly seated. In addition, a malseated liner can be missed if the postoperative films are not carefully reviewed by the surgeon.

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Update on Urticaria and Angioedema.

Med Clin North Am

July 2024

Department of Family Medicine, College of Medicine and Life Sciences at the University of Toledo Medical Center, 3333 Glendale Avenue, Toledo, OH 43614-2598, USA.

Urticaria and angioedema are caused by immunoglobulin E- and non-immunoglobulin E-mediated release of histamine and other inflammatory mediators from mast cells and basophils. Diagnosis is made clinically, and anaphylaxis must be ruled out if urticaria or angioedema is present. A limited nonspecific laboratory workup should be considered unless elements of the history or physical examination suggest specific underlying conditions.

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Prosthetic joint infections (PJIs) pose significant challenges following total joint arthroplasties and cause profound complications. They are associated with significant morbidity and mortality. One-stage revision involves the removal of the infected implant and simultaneous re-implantation of a new prosthesis in a single surgical procedure.

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Scurvy, characterized by vitamin C deficiency, typically manifests with various symptoms, most commonly skin lesions. However, the presentation of a solitary skin lesion is considered atypical. An elderly patient with a history of heavy alcohol consumption presented with a small skin lesion that developed rapidly into a solitary open wound without any preceding trauma.

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Coronavirus disease 2019 (COVID-19) predominantly causes respiratory symptoms. However, a rare segment of patients recovering from COVID-19 may develop gastrointestinal (GI) symptoms. We describe a case of a female who presented with symptoms suggestive of refractory gastroesophageal reflux disease (GERD) for 18 months following COVID-19 infection.

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Adverse childhood experiences (ACEs) are an established independent risk factor for chronic disease including obesity and hypertension; however, only women exposed to multiple ACEs show a positive relationship with BMI. Our lab has reported that maternal separation and early weaning (MSEW), a mouse model of early life stress, induces sex-specific mechanisms underlying greater blood pressure response to a chronic high fat diet (HF). Specifically, female MSEW mice fed a HF display exacerbated perigonadal white adipose tissue (pgWAT) expansion and a metabolic syndrome-like phenotype compared to control counterparts, whereas hypertension is caused by sympathoactivation in male MSEW mice.

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Objective: To report urinary bother, urinalysis changes, disease-free survival (DFS), and overall survival (OS) over 2 years for subjects enrolled in a phase I dose-escalation trial (NCT02324582) of intravesical Bacillus Calmette-Guérin (BCG) in combination with systemic pembrolizumab for recurrent or persistent high-grade non-muscle invasive bladder cancer (HGNMIBC).

Methods: Eighteen patients consented to the study. Five were screen failures.

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Artificial intelligence in gastrointestinal endoscopy: a comprehensive review.

Ann Gastroenterol

February 2024

Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA (Mohammad Al-Haddad).

Integrating artificial intelligence (AI) into gastrointestinal (GI) endoscopy heralds a significant leap forward in managing GI disorders. AI-enabled applications, such as computer-aided detection and computer-aided diagnosis, have significantly advanced GI endoscopy, improving early detection, diagnosis and personalized treatment planning. AI algorithms have shown promise in the analysis of endoscopic data, critical in conditions with traditionally low diagnostic sensitivity, such as indeterminate biliary strictures and pancreatic cancer.

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Individuals with end-stage kidney disease (ESKD) face higher cerebrovascular risk. Yet, the impact of peripheral vascular disease (PVD) and kidney transplantation (KTx) on hospitalization rates for cerebral infarction and hemorrhage remains underexplored. Analyzing 2,713,194 ESKD hospitalizations (2005-2019) using the National Inpatient Sample, we investigated hospitalization rates for ischemic and hemorrhagic cerebrovascular diseases concerning ESKD, PVD, KTx, or their combinations.

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Although gastric cancer is one of the most common types of cancer worldwide, it rarely involves metastasis to the brain. Brain metastases can present with non-specific neurological symptoms such as focal neurological deficits, personality changes, or ataxia. Unfortunately, once brain metastasis is confirmed using imaging, the average life span is approximately two to four months.

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Vitamin B6 is a water-soluble vitamin that is an important cofactor in various metabolic processes. Although rare, its consumption can sometimes result in toxicity, which typically presents with peripheral neuropathy in the early stage. While vitamin B6 toxicity is most often associated with supplemental mega-doses of more than 50 mg/day, more recent studies have shown that toxicity can occur in cases of much smaller doses as well.

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Background Screw fixation continues to be a commonly used treatment for syndesmotic disruption; however, screw breakage remains a complication post-fixation. Despite this complication, investigation on the variability of surgical placement in conjunction with syndesmotic screw characteristics affecting breakage has not been fully elucidated. The purpose of this study is to compare patients with syndesmotic screw breakage versus those with intact screws based on surgically controlled variables.

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