keyword
https://read.qxmd.com/read/38756367/characterizing-hospitalization-trajectories-in-the-high-need-high-cost-population-using-electronic-health-record-data
#1
JOURNAL ARTICLE
Scott S Lee, Benjamin French, Francis Balucan, Michael D McCann, Eduard E Vasilevskis
High utilization by a minority of patients accounts for a large share of health care costs, but the dynamics of this utilization remain poorly understood. We sought to characterize longitudinal trajectories of hospitalization among adult patients at an academic medical center from 2017 to 2023. Among 3404 patients meeting eligibility criteria, following an initial "rising-risk" period of 3 hospitalizations in 6 months, growth mixture modeling discerned 4 clusters of subsequent hospitalization trajectories: no further utilization, low chronic utilization, persistently high utilization with a slow rate of increase, and persistently high utilization with a fast rate of increase...
December 2023: Health Aff Sch
https://read.qxmd.com/read/38743486/l-2-hydroxyglutarate-remodeling-of-the-epigenome-and-epitranscriptome-creates-a-metabolic-vulnerability-in-kidney-cancer-models
#2
JOURNAL ARTICLE
Anirban Kundu, Garrett J Brinkley, Hyeyoung Nam, Suman Karki, Richard Kirkman, Madhuparna Pandit, EunHee Shim, Hayley Widden, Juan Liu, Yasaman Heidarian, Nader H Mahmoudzadeh, Alexander J Fitt, Devin Absher, Han-Fei Ding, David K Crossman, William J Placzek, Jason W Locasale, Dinesh Rakheja, Jonathan E McConathy, Rekha Ramachandran, Sejong Bae, Jason M Tennessen, Sunil Sudarshan
Tumor cells are known to undergo considerable metabolic reprogramming to meet their unique demands and drive tumor growth. At the same time, this reprogramming may come at a cost with resultant metabolic vulnerabilities. The small molecule L-2-hdroxyglutarate (L-2HG) is elevated in the most common histology of renal cancer. Similar to other oncometabolites, L-2HG has the potential to profoundly impact gene expression. Here, we demonstrate that L-2HG remodels amino acid metabolism in renal cancer cells through the combined effects on histone methylation and RNA N6-methyladenosine (m6A)...
May 14, 2024: Journal of Clinical Investigation
https://read.qxmd.com/read/38739389/blood-pressure-readmission-and-mortality-among-patients-hospitalized-with-acute-kidney-injury
#3
JOURNAL ARTICLE
Benjamin R Griffin, Mary Vaughan-Sarrazin, Qianyi Shi, Patrick Ten Eyck, Heather S Reisinger, Korey Kennelty, Mary K Good, Melissa L Swee, Masaaki Yamada, Brian C Lund, Diana I Jalal
IMPORTANCE: Acute kidney injury (AKI) complicates 20% to 25% of hospital admissions and is associated with long-term mortality, especially from cardiovascular disease. Lower systolic blood pressure (SBP) following AKI may be associated with lower mortality, but potentially at the cost of higher short-term complications. OBJECTIVE: To determine associations of SBP with mortality and hospital readmissions following AKI, and to determine whether time from discharge affects these associations...
May 1, 2024: JAMA Network Open
https://read.qxmd.com/read/38738984/-15-n-hyperpolarization-of-metronidazole-antibiotic-in-aqueous-media-using-phase-separated-signal-amplification-by-reversible-exchange-with-parahydrogen
#4
JOURNAL ARTICLE
Sergey V Sviyazov, Dudari B Burueva, Nikita V Chukanov, Ivan A Razumov, Eduard Y Chekmenev, Oleg G Salnikov, Igor V Koptyug
Metronidazole is a prospective hyperpolarized MRI contrast agent with potential hypoxia sensing utility for applications in cancer, stroke, neurodegenerative diseases, etc. We demonstrate a pilot procedure for production of ∼30 mM hyperpolarized [15 N3 ]metronidazole in aqueous media by using a phase-separated SABRE-SHEATH hyperpolarization method, with nitrogen-15 polarization exceeding 2.2% on all three 15 N sites achieved in less than 2 min. The 15 N polarization T1 of ∼12 min is reported for the 15 NO2 group at the clinically relevant field of 1...
May 13, 2024: Journal of Physical Chemistry Letters
https://read.qxmd.com/read/38736077/drug-induced-kidney-disease-revisited
#5
REVIEW
Anirban Ganguli, Narinder Pal Singh
Drug-induced kidney disease (DIKD) is a frequent cause of acute and chronic kidney disease (CKD) that leads to high morbidity, hospitalization, and increased healthcare costs. There is a need to constantly update our knowledge in this field, given the ever-burgeoning list of newer treatments that are emerging, especially in the field of cancer immunotherapy. Generalizing the complex pathways causing DIKD from different agents, the common mechanisms include direct toxicity, immune-mediated injury, and drug-induced alterations in renal blood flow...
January 2024: Journal of the Association of Physicians of India
https://read.qxmd.com/read/38735977/preoperative-fasting-glucose-value-can-predict-acute-kidney-injury-in-non-cardiac-surgical-patients-without-diabetes-but-not-in-patients-with-diabetes
#6
JOURNAL ARTICLE
Qianyun Pang, Yumei Feng, Yajun Yang, Hongliang Liu
BACKGROUND: Postoperative acute kidney injury (AKI) is a common and costly complication after non-cardiac surgery. Patients with or without diabetes could develop hyperglycemia before surgery, and preoperative hyperglycemia was closely associated with postoperative poor outcomes, but the association between preoperative fasting blood glucose level and postoperative AKI is still unclear. METHODS: Data from patients undergoing non-cardiac surgery in Chongqing University Cancer Hospital from January 1, 2017, to May 31, 2023, were collected, preoperative glucose value and perioperative variables were extracted, the primary exposure of interest was preoperative glucose value, and the outcome was postoperative AKI...
May 13, 2024: Perioperative Medicine
https://read.qxmd.com/read/38713692/multicriteria-decision-making-attributes-and-estimation-of-physicochemical-properties-of-kidney-cancer-drugs-via-topological-descriptors
#7
JOURNAL ARTICLE
Mohamad Nazri Husin, Abdul Rauf Khan, Nadeem Ul Hassan Awan, Francis Joseph H Campena, Fairouz Tchier, Shahid Hussain
Based on topological descriptors, QSPR analysis is an incredibly helpful statistical method for examining many physical and chemical properties of compounds without demanding costly and time-consuming laboratory tests. Firstly, we discuss and provide research on kidney cancer drugs using topological indices and done partition of the edges of kidney cancer drugs which are based on the degree. Secondly, we examine the attributes of nineteen drugs casodex, eligard, mitoxanrone, rubraca, and zoladex, etc and among others, using linear QSPR model...
2024: PloS One
https://read.qxmd.com/read/38670274/trends-and-costs-of-minimally-invasive-surgery-for-kidney-cancer-in-the-us-a-population-based-study
#8
JOURNAL ARTICLE
Francesco Ditonno, Antonio Franco, Celeste Manfredi, Morgan R Sturgis, Carol L Feng, Daniel F Roadman, Spencer M Mossak, Eugenio Bologna, Leslie C Licari, Cosimo De Nunzio, Nicholas J Corsi, Craig Rogers, Firas Abdollah, Alessandro Antonelli, Edward E Cherullo, Ephrem Olweny, Riccardo Autorino
OBJECTIVE: To analyze temporal trends and costs associated with the use of minimally invasive surgery (MIS) for kidney cancer in the US over the past decade. To examine the impact of social determinants of health (SDOH) on perioperative outcomes. METHODS: The PearlDiver Mariner, a national database of insurance billing records, was queried for this retrospective observational cohort analysis. The MIS population was identified and stratified according to treatment modality, using International Classification of Diseases (ICD) and current procedural terminology (CPT) codes...
April 24, 2024: Urology
https://read.qxmd.com/read/38657719/mortality-and-in-patient-outcomes-in-pheochromocytoma-patients-with-hypertensive-emergency-in-the-united-states-a-propensity-score-matched-analysis
#9
REVIEW
Margaret A Roth, Katarina Leyba, Ishan Garg, Wilfredo H Madrid, Mohammed A Quazi, Amir H Sohail, Rozi Khan, Sulaiman Sultan, Abu Baker Sheikh
INTRODUCTION: Pheochromocytoma is a rare cause of hypertensive emergency. The objective of this analysis was to compare the clinical characteristics, comorbidities, and in-hospital outcomes of patients admitted with hypertensive emergencies with and without co-existing pheochromocytoma. METHODS: A retrospective analysis of the National Inpatient Sample (NIS) Database from 2016 to 2020 was conducted, encompassing 640,395 patients hospitalized for hypertensive emergencies, including 2,535 patients diagnosed with pheochromocytoma...
April 22, 2024: Current Problems in Cardiology
https://read.qxmd.com/read/38656730/the-incidence-mortality-and-medical-expenditure-in-patients-with-asthma-in-taiwan-ten-year-nationwide-study
#10
JOURNAL ARTICLE
Kuang-Ming Liao, Pei-Jun Chen, Yu-Tung Hung, Tzu-Ju Hsu, Fuu-Jen Tsai, Te-Chun Shen
BACKGROUND: This study examines incidence, mortality, medical expenditure and prescription patterns for asthma on a national scale, particularly in Asian countries for asthma is limited. Our aim is to investigate incidence, mortality, prescription patterns and provide a comprehensive overview of healthcare utilization trends for asthma from 2009 to 2018. METHODS: We included patients diagnosed with asthma between 2009 and 2018. We excluded patients with missing demographic data...
April 24, 2024: Journal of Epidemiology and Global Health
https://read.qxmd.com/read/38637871/bilateral-wilms-tumor-with-anaplasia-a-report-from-the-children-s-oncology-group-study-aren0534
#11
JOURNAL ARTICLE
Rodrigo L P Romao, Jennifer H Aldrink, Lindsay A Renfro, Elizabeth A Mullen, Andrew J Murphy, Jack Brzezinski, Marcus M Malek, Daniel J Benedetti, Nicholas G Cost, Ethan Smith, Jeffrey S Dome, Andrew M Davidoff, Amy Treece, Lauren N Parsons, Conrad V Fernandez, Brett Tornwall, Robert C Shamberger, Arnold Paulino, John A Kalapurakal, James I Geller, Peter F Ehrlich
INTRODUCTION: The purpose of this study is to examine the outcomes in children with anaplastic bilateral Wilms tumor (BWT) from study AREN0534 in order to define potential prognostic factors and areas to target in future clinical trials. METHODS: Demographic and clinical data from AREN0534 study patients with anaplasia (focal anaplasia [FA], or diffuse anaplasia [DA]) were compared. Event-free survival (EFS) and overall survival (OS) were reported using Kaplan-Meier estimation with 95% confidence bands, and differences in outcomes between FA and DA compared using log-rank tests...
April 18, 2024: Pediatric Blood & Cancer
https://read.qxmd.com/read/38628848/impact-of-influenza-related-hospitalization-in-spain-characteristics-and-risk-factor-of-mortality-during-five-influenza-seasons-2016-to-2021
#12
JOURNAL ARTICLE
José-Manuel Ramos-Rincón, Héctor Pinargote-Celorio, Pilar González-de-la-Aleja, José Sánchez-Payá, Sergio Reus, Juan-Carlos Rodríguez-Díaz, Esperanza Merino
BACKGROUND: Estimating the global influenza burden in terms of hospitalization and death is important for optimizing prevention policies. Identifying risk factors for mortality allows for the design of strategies tailored to groups at the highest risk. This study aims to (a) describe the clinical characteristics of hospitalizations with a diagnosis of influenza over five flu seasons (2016-2017 to 2020-2021), (b) assess the associated morbidity (hospitalization rates and ICU admissions rate), mortality and cost of influenza hospitalizations in different age groups and (c) analyze the risk factors for mortality...
2024: Frontiers in Public Health
https://read.qxmd.com/read/38614853/impact-of-preoperative-plasma-potassium-levels-on-oncological-outcomes-major-complications-and-30-day-mortality-in-bladder-cancer-patients-undergoing-radical-cystectomy
#13
JOURNAL ARTICLE
Jakob Klemm, Shahrokh F Shariat, Ekaterina Laukhtina, Pawel Rajwa, Malte W Vetterlein, Victor M Schuettfort, Markus von Deimling, Roland Dahlem, Margit Fisch, Michael Rink
INTRODUCTION AND OBJECTIVES: We examined the impact of preoperative plasma potassium levels (PPLs) on outcomes in patients undergoing radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB), hypothesizing that potassium imbalances might influence outcomes. PATIENTS AND METHODS: In this retrospective study, 501 UCB patients undergoing RC from 2009 to 2017 at a tertiary center were analyzed. Blood samples collected a week prior to surgery defined normal and abnormal PPL based on institutional standards...
March 21, 2024: Clinical Genitourinary Cancer
https://read.qxmd.com/read/38612416/galectin-3-and-autophagy-in-renal-acute-tubular-necrosis
#14
JOURNAL ARTICLE
Suhail Al-Salam, Govindan S Jagadeesh, Manjusha Sudhadevi, Javed Yasin
Acute kidney injury (AKI) is a public health burden with increasing morbidity and mortality rates and health care costs. Acute tubular necrosis (ATN) is the most common cause of AKI. Cisplatin (CIS) is a platinum-based chemotherapeutic agent used in the treatment of a wide variety of malignancies such as lung, breast, ovary, testis, bladder, cervix, and head and neck cancers. Autophagy plays an important role in AKI. Galectin-3 (Gal-3) is significantly increased in renal tubules in AKI; however, its role in autophagy is not well understood...
March 22, 2024: International Journal of Molecular Sciences
https://read.qxmd.com/read/38547215/national-clinical-and-financial-outcomes-associated-with-acute-kidney-injury-following-esophagectomy-for-cancer
#15
JOURNAL ARTICLE
Ayesha P Ng, Nikhil Chervu, Corynn Branche, Syed Shahyan Bakhtiyar, Mehrab Marzban, Paul A Toste, Peyman Benharash
BACKGROUND: Esophagectomy is a complex oncologic operation associated with high rates of postoperative complications. While respiratory and septic complications have been well-defined, the implications of acute kidney injury (AKI) remain unclear. Using a nationally representative database, we aimed to characterize the association of AKI with mortality, resource use, and 30-day readmission. METHODS: All adults undergoing elective esophagectomy with a diagnosis of esophageal or gastric cancer were identified in the 2010-2019 Nationwide Readmissions Database...
2024: PloS One
https://read.qxmd.com/read/38542901/experimental-and-computational-methods-to-assess-central-nervous-system-penetration-of-small-molecules
#16
REVIEW
Mayuri Gupta, Jun Feng, Govinda Bhisetti
In CNS drug discovery, the estimation of brain exposure to lead compounds is critical for their optimization. Compounds need to cross the blood-brain barrier (BBB) to reach the pharmacological targets in the CNS. The BBB is a complex system involving passive and active mechanisms of transport and efflux transporters such as P-glycoproteins (P-gp) and breast cancer resistance protein (BCRP), which play an essential role in CNS penetration of small molecules. Several in vivo, in vitro, and in silico methods are available to estimate human brain penetration...
March 13, 2024: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://read.qxmd.com/read/38537419/telemedicine-for-multidisciplinary-urologic-cancer-care-a-prospective-single-institution-study
#17
JOURNAL ARTICLE
Frederick Okoye, Adam J Gadzinski, Rishi Sekar, Isabelle Abarro, Petros Grivas, Scott S Tykodi, Jay Liao, Jonathan Chen, Jing Zeng, Jonathan Wright, John L Gore
BACKGROUND: We rapidly implemented a telemedicine Multidisciplinary Urologic Cancer Clinic (MDUCC) at the University of Washington/Seattle Cancer Care Alliance during the peak of the COVID-19 Public Health Emergency to maintain our ability to provide multidisciplinary cancer care. We report our experiences though assessment of patient-reported outcomes from our telemedicine MDUCC. METHODS: Video visits with a urologic oncologist, medical oncologist, and radiation oncologist were conducted in the same format as our in-person MDUCC...
February 24, 2024: Clinical Genitourinary Cancer
https://read.qxmd.com/read/38517149/digital-variance-angiography-in-patients-undergoing-lower-limb-arterial-recanalization-cost-effectiveness-analysis-within-the-english-healthcare-setting
#18
JOURNAL ARTICLE
Amir Ansaripour, Eoin Moloney, Michael Branagan-Harris, Lorenzo Patrone, Mehdi Javanbakht
Aim: Digital variance angiography (DVA) is a recently developed image processing method capable of improving image quality compared with the traditionally used digital subtraction angiography (DSA), among patients undergoing lower limb x-ray angiography. This study aims to explore the potential cost-effectiveness of DVA from an English National Health Service perspective. Materials & methods: A two-part economic model, consisting of a decision tree and a Markov model, was developed to consider the costs and health outcomes associated with the use of DVA as part of current practice imaging, compared with x-ray angiography using standard DSA...
March 22, 2024: Journal of Comparative Effectiveness Research
https://read.qxmd.com/read/38510891/transcatheter-aortic-valve-replacement-tavr-versus-surgical-aortic-valve-replacement-savr-a-review-on-the-length-of-stay-cost-comorbidities-and-procedural-complications
#19
REVIEW
Jonathan Kermanshahchi, Birpartap Thind, Gabriel Davoodpour, Megan Hirsch, Jeff Chen, Akshay J Reddy, Zeyu Yu, Benjamin E Falkenstein, Daryoush Javidi
This review provides an in-depth analysis of the effect of length of stay (LOS), comorbidities, and procedural complications on the cost-effectiveness of transcatheter aortic valve replacement (TAVR) in comparison to surgical aortic valve replacement (SAVR). We found that the average LOS was shorter for patients undergoing TAVR, contributing to lower average costs associated with the procedure, although the LOS varied between patients due to the severity of illness and comorbidities present. TAVR has also been found to improve the quality of life for patients receiving aortic valve replacement compared to SAVR...
February 2024: Curēus
https://read.qxmd.com/read/38499727/renal-mass-imaging-modalities-does-body-mass-index-bmi-matter
#20
JOURNAL ARTICLE
Young Son, Mark E Quiring, Raeann M Dalton, Brian Thomas, Noah Davidson, Dayna DeVincentz, Collin Payne, Sahil H Parikh, Benjamin A Fink, Thomas Mueller, Gordon Brown
PURPOSE: Accurate measurement of renal mass size is crucial in the management of renal cancer. With the burdensome cost of imaging yet its need for management, a better understanding of the variability among patients when determining mass size remains of urgent importance. Current guidelines on optimal imaging are limited, especially with respect to body mass index (BMI). The aim of this study is to discern which modalities accurately measure renal mass size and whether BMI influences such accuracy...
March 18, 2024: International Urology and Nephrology
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