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Patient-centered outcomes

Olga Perelshtein Brezinov, Michal J Simchen, Sagit Ben Zekry, Rafael Kuperstein
BACKGROUND: Rheumatic mitral stenosis (MS) is a relatively rare diagnosis in the developed countries and its treatment during pregnancy is challenging due to hemodynamic changes. With the demographic changes due to recent waves of immigration an increase in the prevalence of rheumatic heart disease is expected. OBJECTIVES: To evaluate maternal and neonatal complications in patients with mitral stenosis. METHODS: During the years 2006-2017, 22 women who underwent 31 pregnancies were followed at the Sheba Medical Center in Israel...
February 2019: Israel Medical Association Journal: IMAJ
Joseph M Currier, Joshua D Foster, Charlotte vanOyen Witvliet, Alexis D Abernethy, Lindsey M Root Luna, Sarah A Schnitker, Karl VanHarn, Janet Carter
BACKGROUND: Persons contending with serious mental health difficulties often experience struggles with religious faith and/or spirituality that may also demand clinical attention. However, research has not examined the relative importance of specific forms of spiritual struggles in mental health status or treatment outcomes of psychiatric patients. METHODS: Focusing on 217 adults who completed a spiritually integrated inpatient program, this study examined (1) which struggles in Exline et al...
February 6, 2019: Journal of Affective Disorders
Narendra S Choudhary, Sanjiv Saigal, Dheeraj Gautam, Neeraj Saraf, Amit Rastogi, Sanjay Goja, Prashant Bhangui, Srinivasan Thiagrajan, Sanjay K Yadav, Saurabh Mehrotra, Vipul Rastogi, Arvinder S Soin
INTRODUCTION: There are limited data on outcomes of living donor liver transplantation (LDLT) for patients with severe alcoholic hepatitis. METHODS: The study included LDLT recipients for severe alcoholic hepatitis (n = 39) who did not improve with medical treatment and compared their outcomes with patients who underwent LDLT for alcoholic liver disease (n = 461). The diagnosis of severe alcoholic hepatitis was based on both clinical and explants data. No patients had psychiatric contraindications for liver transplant and all had good family support...
July 24, 2018: Alcohol
Ali A Asadi-Pooya, Zahra Bahrami, Maryam Homayoun
PURPOSE: The purpose of this study was to investigate the long-term outcome of patients with psychogenic nonepileptic seizures (PNES), who never visited a psychologist and never received a proper therapy for their condition (due to lack of resources). We also aimed to investigate factors potentially associated with the outcome in these patients. METHODS: We studied all patients with PNES, who were admitted to the epilepsy monitoring unit at the Shiraz Comprehensive Epilepsy Center, from 2008 until 2013...
February 11, 2019: Seizure: the Journal of the British Epilepsy Association
Nicholas A Kennedy, Gareth-Rhys Jones, Nikolas Plevris, Rebecca Patenden, Ian D Arnott, Charlie W Lees
BACKGROUND & AIMS: Mucosal healing is associated with improved outcomes in patients with Crohn's disease (CD), but assessment typically requires ileocolonoscopy. Calprotectin can be measured in fecal samples to determine luminal disease activity in place of endoscopy-this measurement is an important component of the treat to target strategy. We investigated whether levels of fecal calprotectin associate with subsequent CD progression. METHODS: We performed a retrospective study of 918 patients with CD (4218 patient-years of follow-up; median, 50...
February 14, 2019: Clinical Gastroenterology and Hepatology
Todd A Miano, Grigor Abelian, Mark J Seamon, Kristen Chreiman, Patrick M Reilly, Niels D Martin
BACKGROUND: Venous thromboembolism (VTE) events are tracked in trauma registries and by administrative datasets. Both databases are used to assess outcomes despite having varying processes for data capture. STUDY DESIGN: This study was performed at an urban, university-based, level-one trauma center from 2004-2014. Retrospective review of the trauma registry and the hospital's administrative database was performed querying for all VTEs. Each VTE was then validated through manual chart review...
February 14, 2019: Journal of the American College of Surgeons
Min-Shan Tsai, Chih-Wei Sung, Wen-Jone Chen, Po-Ya Chuang, Chih-Hung Wang, Yen-Wen Wu, Wei-Tien Chang, Wei-Ting Chen, Chien-Hua Huang
BACKGROUND: The emergent coronary angiography (CAG) is associated with better outcomes in CA survivors. However, the impact of severity and revascularization of coronary artery stenosis on outcomes in cardiac arrest (CA) survivors remains unclear. METHODS: A total of 273 non-traumatic adult CA survivors who underwent emergent CAG from January 2011 to July 2017 were retrospectively recruited. The stenosis and non-revascularization of an individual coronary artery ≥70 % were defined as significant in any of the major coronary arteries based on an operator visual estimate...
February 14, 2019: Resuscitation
Karen Bitton, Jean-Marie Michot, Emmanuel Barreau, Olivier Lambotte, Oscar Haigh, Aurélien Marabelle, Anne-Laure Voisin, Christine Mateus, Anne-Laure Rémond, Chloé Couret, Stéphane Champiat, Marc Labetoulle, Antoine Rousseau
PURPOSE: Immune checkpoint inhibitors (ICI) targeting the programmed cell death protein 1 (PD-1), or its ligand PD-L1, are the mainstay of metastatic cancer treatment. Patients receiving these treatments may develop immune-related adverse events (irAEs). This study aimed to estimate the prevalence and describe the clinical patterns of moderate to severe ocular irAEs-associated with anti-PD-(L)1 treatment. DESIGN: Prospective case series. METHODS: This study included patients recruited via i) a single-center prospective cohort and ii) a national pharmacovigilance registry between June 2014 and March 2018, and focused on patients with moderate to severe ocular irAEs following anti-PD-(L)1...
February 14, 2019: American Journal of Ophthalmology
Maya Eiger-Moscovich, Oren Tomkins-Netzer, Radgonde Amer, Zohar Habot-Wilner, Ahmed Kasb, Ronit Friling, Michal Kramer
PURPOSE: To investigate the clinical course and visual outcome of macular edema (ME) in pediatric patients with chronic noninfectious uveitis. DESIGN: Retrospective case series. METHODS: The databases of the uveitis clinics of four tertiary medical centers in Israel and the UK were searched for all children treated for uveitic ME in 2005-2015. Data were collected from the medical records as follows: demographics, diagnosis, visual acuity, clinical and imaging findings, and treatment given specifically for ME...
February 14, 2019: American Journal of Ophthalmology
Holly Bauser-Heaton, Michael Ma, Lisa Wise-Faberowski, Ritu Asija, Jennifer Shek, Yulin Zhang, Lynn F Peng, Douglas R Sidell, Frank L Hanley, Doff B McElhinney
BACKGROUND: Our approach to tetralogy of Fallot (TOF) with pulmonary atresia and major aortopulmonary collateral arteries (MAPCAs) emphasizes early single-stage unifocalization and intracardiac repair. However, a subset of patients with small native pulmonary arteries (PAs) and MAPCAs undergo unifocalization to a shunt rather than simultaneous intracardiac repair. METHODS: Patients with TOF/MAPCAs who underwent unifocalization to a systemic-to-PA shunt by a single surgeon were reviewed...
February 14, 2019: Annals of Thoracic Surgery
Daisuke Izumi, Feng Gao, Shusuke Toden, Fuminori Sonohara, Mitsuro Kanda, Takatsugu Ishimoto, Yasuhiro Kodera, Xin Wang, Hideo Baba, Ajay Goel
BACKGROUND: Although identification of lymph node (LN) metastasis is a well-recognized strategy for improving outcomes in patients with gastric cancer (GC), currently there is lack of availability of adequate molecular biomarkers that can identify such metastasis. Herein we have developed a robust gene-expression signature for detecting LN metastasis in early stage GC by using a transcriptome-wide biomarker discovery and subsequent validation in multiple clinical cohorts. METHODS: A total of 532 patients with pathological T1 and T2 GC from 4 different cohorts were analyzed...
February 13, 2019: EBioMedicine
Pavel Overtchouk, Thierry Folliguet, Frédéric Pinaud, Oliver Fouquet, Mathieu Pernot, Guillaume Bonnet, Maxime Hubert, Joël Lapeze, Jean Philippe Claudel, Said Ghostine, Alexandre Azmoun, Christophe Caussin, Konstantinos Zannis, Majid Harmouche, Jean-Philippe Verhoye, Antoine Lafont, Chekrallah Chamandi, Vito Giovanni Ruggieri, Alessandro Di Cesare, Florence Leclercq, Thomas Gandet, Thomas Modine
OBJECTIVES: This study sought to describe the procedural and clinical outcomes of patients undergoing transcarotid (TC) transcatheter aortic valve replacement (TAVR) with the Edwards Sapien 3 device. BACKGROUND: The TC approach for TAVR holds the potential to become the optimal alternative to the transfemoral gold standard. Limited data exist regarding safety and efficacy of TC-TAVR using the Edwards Sapien 3 device. METHODS: The French Transcarotid TAVR prospective multicenter registry included patients between 2014 and 2018...
February 7, 2019: JACC. Cardiovascular Interventions
Vishal Gupta, Saket Kumar, Vivek Gupta, Pradeep Joshi, Rahul Rahul, Rakesh Kumar Yadav, Amit Dangi, Abhijit Chandra
BACKGROUND: Blumgart's pancreaticojejunostomy (PJ) has been described with low pancreatic leak rates. This study aimed to evaluate our experience with this technique regarding the pancreatic leak and other perioperative outcomes. METHODS: We performed a single-center retrospective analysis of a cohort of 81 patients who underwent pancreaticoduodenectomy in our department from January 2011 to February 2018. The primary endpoint was the occurrence of a clinically relevant postoperative pancreatic fistula (CR-POPF) and analysis of its risk factors...
January 31, 2019: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Kazutaka Okita, Shingo Hatakeyama, Toshiaki Tanaka, Yoshinori Ikehata, Toshikazu Tanaka, Naoki Fujita, Yusuke Ishibashi, Hayato Yamamoto, Takahiro Yoneyama, Yasuhiro Hashimoto, Kazuaki Yoshikawa, Toshiaki Kawaguchi, Naoya Masumori, Hiroshi Kitamura, Chikara Ohyama
PURPOSE: To investigate the impact of the risk group disagreement between the Memorial Sloan Kettering Cancer Center (MSKCC) and the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) models on prognosis. PATIENTS AND METHODS: We retrospectively evaluated 176 patients with metastatic renal-cell carcinoma who were treated with tyrosine kinase inhibitors as first-line therapy in 5 hospitals between October 2008 and August 2018. The risk group classification differences between the MSKCC and the IMDC models were evaluated using criteria of agreement (identical risk group in both the MSKCC and IMDC models) and disagreement (not identical risk group in both the MSKCC and IMDC models)...
January 17, 2019: Clinical Genitourinary Cancer
Perel Baral, Elizabeth Cotter, Guangyi Gao, Jianghua He, Katy Wirtz, Akshit Sharma, Trip Zorn Iii, Gregory Muehlebach, Brigid Flynn
OBJECTIVE: Activated recombinant factor VII (rFVIIa) has been used to treat cardiac surgical bleeding in an off-label manner. This observational report analyzes the outcomes with use of a low dose and early administration of rFVIIa for cardiac surgical bleeding. DESIGN: A retrospective, observational study. SETTING: Single-center, tertiary care cardiothoracic surgical setting. PARTICIPANTS: A total of 6,862 patients underwent cardiac surgery from January 2012 to January 2018...
January 22, 2019: Journal of Cardiothoracic and Vascular Anesthesia
Keigo Shigeta, Takahiro Ota, Tatsuo Amano, Masayuki Ueda, Yuji Matsumaru, Yoshiaki Shiokawa, Teruyuki Hirano
BACKGROUND: The Tama-REgistry of Acute endovascular Thrombectomy (TREAT) is a multicenter registry of endovascular thrombectomy in the Tama area of Tokyo. The objective of this study was to confirm the real-world status of 2 paradigms of transportation. METHODS: This was a retrospective analysis of data from TREAT. Patients were divided into 2 groups and 2 periods: directly admitted to an endovascular thrombectomy-capable center (ECC; group D)/secondary transfer from a non-ECC (group S), and the first period/the second period...
February 13, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Joshua R Vest, Nir Menachemi, Shaun J Grannis, Jennifer L Ferrell, Suranga N Kasthurirathne, Ying Zhang, Yan Tong, Paul K Halverson
INTRODUCTION: Social determinants of health are critical drivers of health status and cost, but are infrequently screened or addressed in primary care settings. Systematic approaches to identifying individuals with unmet social determinants needs could better support practice workflows and linkages of patients to services. A pilot study examined the effect of a risk-stratification tool on referrals to services that address social determinants in an urban safety-net population. METHODS: An intervention that risk stratified patients according to the need for wraparound was evaluated in a stepped wedge design (i...
February 14, 2019: American Journal of Preventive Medicine
S Devroe, T Bleeser, M Van de Velde, L Verbrugge, F De Buck, J Deprest, R Devlieger, S Rex
INTRODUCTION: This retrospective, matched case-control cohort study describes the incidence, indications, anesthesia techniques and outcomes of pregnancies complicated by surgery in a single tertiary-referral hospital. METHODS: Retrospective review of the hospital records of 171 patients who had non-obstetric surgery in the current pregnancy, between 2001 and 2016. Pregnancy outcomes of these women were firstly compared with all contemporary non-exposed patients (n=35 411), and secondly with 684 non-exposed control patients, matched for age, time of delivery and parity...
January 12, 2019: International Journal of Obstetric Anesthesia
Jun Wang, Yi Yang, Rongli Yang, Xiaodong Tang, Wei Guo
INTRODUCTION: This is a retrospective study that evaluate the outcome of patients with extremity sarcoma between extramedullary plate and intramedullary nailing for the biological reconstruction after tumor resection. METHODS: 58 patients (40 treated with plate fixation and 18 with intramedullary nailing, IM group) with sarcomas of the lower and upper extremity who received biological reconstruction at our bone tumor center from November 2003 to November 2015 were reviewed for the study...
February 6, 2019: Injury
David M Shahian, David F Torchiana, Daniel T Engelman, Thoralf M Sundt, Richard S D'Agostino, Ann F Lovett, Matthew J Cioffi, James D Rawn, Vladimir Birjiniuk, Robert H Habib, Sharon-Lise T Normand
OBJECTIVES: Beginning in 2002, all 14 Massachusetts nonfederal cardiac surgery programs submitted Society of Thoracic Surgeons (STS) National Database data to the Massachusetts Data Analysis Center for mandatory state-based analysis and reporting, and to STS for nationally benchmarked analyses. We sought to determine whether longitudinal prevalences and trends in risk factors and observed and expected mortality differed between Massachusetts and the nation. METHODS: We analyzed 2003 to 2014 expected (STS predicted risk of operative [in-hospital + 30-day] mortality), observed, and risk-standardized isolated coronary artery bypass graft mortality using Massachusetts STS data (N = 39,400 cases) and national STS data (N = 1,815,234 cases)...
December 31, 2018: Journal of Thoracic and Cardiovascular Surgery
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