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Mortality assessment for pancreas transplants in the United States over the decade 2008-2018

World Journal of Transplantation 2023年第4期13卷 147-156页

作者： Tambi Jarmi emily Brennan Jacob Clendenon Aaron C Spaulding Department of Transplant Mayo Clinic FloridaJacksonvilleFL 32224United States Health Science Research Mayo Clinic FloridaJacksonvilleFL 32224United States

BACKGROUND Pancreas transplant is the only treatment that establishes normal glucose levels for patients diagnosed with ***,since 2005,no comprehensive analysis has compared survival outcomes of:(1)Simultaneous pancreas-kidney(SPK)transplant;(2)Pancreas after kidney(PAK)transplant;and(3)Pancreas transplant alone(PTA)to waitlist *** To explore the outcomes of pancreas transplants in the United States during the decade *** Our study utilized the United Network for Organ Sharing Standard Transplant Analysis and Research ***-and post-transplant recipient and waitlist characteristics and the most recent recipient transplant and mortality status were *** included all patients with type I diabetes listed for pancreas or kidneypancreas transplant between May 31,2008 and May 31,*** were grouped into one of three transplant types:SPK,PAK,or *** The adjusted Cox proportional hazards models comparing survival between transplanted and non-transplanted patients in each transplant type group showed that patients who underwent an SPK transplant exhibited a significantly reduced hazard of mortality[hazard ratio(HR)=0.21,95%confidence intervals(ci):0.19-0.25]compared to those not *** PAK transplanted patients(HR=1.68,95%ci:0.99-2.87)nor PTA patients(HR=1.01,95%ci:0.53-1.95)experienced significantly different hazards of mortality compared to patients who did not receive a *** When assessing each of the three transplant types,only SPK transplant offered a survival advantage compared to patients on the waiting *** and PTA transplanted patients demonstrated no significant differences compared to patients who did not receive a transplant.

关键词： Pancreas transplant Simultaneous pancreas-kidney transplant Pancreas after kidney transplant Survival Diabetes mellitus Insulin

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Excision of trochanteric bursa during total hip replacement:Does it reduce the incidence of post-operative trochanteric bursitis?

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World Journal of Orthopedics 2023年第7期14卷 533-539页

作者： Wai-Huang Teng Adeel Ditta jane Webber Oliver Pearce Division of Trauma and Orthopaedics Milton Keynes University HospitalMilton Keynes MK65LDUnited Kingdom

BACKGROUND Trochanteric bursitis is a common complication following total hip replacement(THR),and it is associated with high level of disability and poor quality of *** of the trochanteric bursa prophylactically during THR could reduce the occurrence of post-operative trochanteric *** To evaluate whether synchronous trochanteric bursectomy at the time of THR affects the incidence of post-operative trochanteric *** This retrospective cohort study was conducted in the secondary care setting at a large district general *** January 2010 and December 2020,954 patients underwent elective primary THR by two contemporary arthroplasty surgeons,one excising the bursa and the other not(at the time of THR).All patients received the same post-operative rehabilitation and were followed up for 1 *** reviewed all cases of trochanteric bursitis over this 11-year period to determine the incidence of post-THR *** proportion Z-test was used to compare incidences of trochanteric bursitis between *** 554 patients underwent synchronous trochanteric bursectomy at the time of THR whereas 400 patients did not.A total of 5 patients(incidence 0.5%)developed trochanteric bursitis following THR;4 of whom had undergone bursectomy as part of their surgical approach,1 who had *** was no statistically significant difference between the two groups(Z value 1.00,95%ci:-0.4%to 1.3%,P=0.32).There were also 8 other patients who had both trochanteric bursitis and hip osteoarthritis prior to their THR;all of whom were treated with THR and synchronous trochanteric bursectomy,and 7 had resolution of their lateral buttock pains but 1 did *** Synchronous trochanteric bursectomy during THR does not materially affect the incidence of post-operative ***,it is successful at treating patients with known trochanteric bursitis and osteoarthritis requiring THR.

关键词： Total hip replacement Trochanteric bursectomy Trochanteric bursitis Greater trochanteric pain syndrome

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Resource utilisation among patients transferred for intracerebral haemorrhage

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Stroke & Vascular Neurology 2019年第4期4卷 223-226页

作者： Kori Sauser Zachrison emily Aaronson Sadiqa Mahmood Jonathan Rosand Anand Viswanathan Lee H Schwamm Joshua N Goldstein Department of Emergency Medicine Massachusetts General HospitalBostonMassachusettsUSA Department of Emergency Medicine Harvard Medical SchoolBostonMassachusettsUSA Health Catalyst CambridgeMassachusettsUSA Department of Neurology Massachusetts General HospitalBostonMassachusettsUSA Department of Neurology Harvard Medical SchoolBostonMassachusettsUSA

background Patients with intracerebral haemorrhage(ICH)are frequently transferred between hospitals for higher level of *** aimed to identify factors associated with resource utilisation among patients with ICH admitted to a single academic *** We used a prospectively collected registry of consecutive patients with primary ICH at an urban academic hospital between 1 January 2005 and 31 December *** primary outcome was use of either intensive care unit(ICU)admission or surgical *** regression examined factors associated with the outcome,controlling for age,sex,Glasgow coma score(GCS)and ICH *** Of the 2008 patients included,887(44.2%)received ICU stay or surgical *** patients were younger(71 vs 74 years,pciated with ICU stay or surgical intervention were age>65 years(OR 0.38,95% ci 0.21 to 0.69),GCSci 1.01 to 1.52)and ICH score>0(OR 2.23,95% ci 1.70 to 2.91).Conclusion Among this cohort of primary patients with ICH,GCS of 15 and ICH score of 0 were associated with less frequent use of ICU or *** results should be validated in a larger sample but may be valuable for hospitals considering which patients with ICH could safely remain at the referring facility.

关键词： patients admitted Glasgow

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Incident frailty and cognitive impairment by heart failure status in older patients with atrial fibrillation: the SAGE-AF study

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Journal of Geriatric Cardiology 2020年第11期17卷 653-658页

作者： Wei-Jia WANG Darleen Lessard jane Saczynski Robert J Goldberg Alan S.Go Tenes Paul Ely Gracia David D McManus Department of Medicine University of Massachusetts Medical SchoolWorcesterMAUSA Department of Population and Quantitative Health Sciences University of Massachusetts Medical SchoolWorcesterMAUSA Department of Pharmacy and Health System Sciences Northeastern UniversityBostonMAUSA Division of Research Kaiser Permanente Northern CaliforniaOaklandCAUSA

Background Atrial fibrillation(AF) and heart failure(HF) frequently co-occur in older individuals. Among patients with AF, HF increases risks for stroke and death, but the associations between HF and incident cognition and physical impairment remain unknown. We aimed to examine the cross-sectional and prospective associations between HF, cognition, and frailty among older patients with AF. Methods The SAGE-AF(Systematic Assessment of Geriatric Elements in AF) study enrolled 1244 patients with AF(mean age 76 years, 48% women) from five practices in Massachusetts and Georgia. HF at baseline was identified from electronic health records using ICD-9/10 codes. At baseline and 1-year, frailty was assessed by Cardiovascular Health Survey score and cognition was assessed by the Montreal Cognitive Assessment. Results Patients with prevalent HF(n = 463, 37.2%) were older, less likely to be non-Hispanic white, had less education, and had greater cardiovascular comorbidity burden and higher CHA2 DS2 VASC and HAS-BLED scores than patients without HF(all P's ciated with both prevalent frailty(adjusted odds ratio [a OR]: 2.38, 95% confidence interval [ci]: 1.64-3.46) and incident frailty at 1 year(a OR: 2.48, 95% ci: 1.37-4.51). HF was also independently associated with baseline cognitive impairment(a OR: 1.60, 95% ci: 1.22-2.11), but not with developing cognitive impairment at 1 year(a OR 1.04, 95%ci: 0.64-1.70). Conclusions Among ambulatory older patients with AF, the co-existence of HF identifies individuals with physical and cognitive impairments who are at higher short-term risk for becoming frail. Preventive strategies to this vulnerable subgroup merit consideration.

关键词： Atrial fibrillation Cognitive impairment Heart failure Frailty

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Systemic postnatal corticosteroid use for the prevention of bronchopulmonary dysplasia and its relationship to early neurodevelopment in extremely preterm

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World Journal of Pediatrics 2023年第6期19卷 586-594页

作者： Emilia Esterman Traci-Anne Goyen Pranav Jani Gemma Lowe jane Baird Rajesh Maheshwari Daphne D’Cruz Melissa Luig Dharmesh Shah Department of Neonatology Westmead HospitalWestmeadAustralia Faculty of Medicine and Health The University of SydneySydneyAustralia

Background Systemic postnatal corticosteroid use in extremely preterm infants poses a risk of adverse neurodevelopmental *** study explores their use beyond seven days of age with early neurodevelopmental assessments during the fidgety period(9-20 weeks postterm age).Methods This retrospective single-center cohort study included inborn extremely preterm infants from 1 January 2014 to 31 December *** infants,those with congenital or genetic abnormalities,and those who received postnatal cor-ticosteroids for nonrespiratory reasons were *** cohort was dichotomized based on the status of corticosteroid *** neurodevelopmental outcomes were reported using Prechtl's General Movements *** Of the 282 infants,67(23.75%)received *** these,34(50.75%)received them for dependency on invasive ventilation(intermittent positive-pressure ventilation),and the remainder received them for dependency on non-invasive ventilation continuous positive airway pressure(CPAP)or bi-level positive airway pressure(BiPAP).Abnormal or absent fidgety movements were observed in 13% of infants(7/54)who received corticosteroids compared to 2% of infants(3/146)who did *** increased odds for an abnormal general movements assessment from corticosteroid use after adjusting for gestational age[adjusted odds ratio(aOR)=5.5,95% confidence interval(ci)=1.14-26.56]was *** motor optimality scores differed between the two groups[corticosteroid group:25.5(23-26)versus no-corticosteroid group:26(24-28);z=-2.02].A motor optimality scoreci 1.28-27.74).Conclusions Abnormal early neurodevelopment was observed in infants who received systemic postnatal *** relationship between these findings and other factors influen

关键词： Corticosteroids Early neurodevelopment General movement assessment Preterm infants

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Satisfaction with patient-doctor relationships in inflammatory bowel diseases:Examining patient-initiated change of specialist

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World Journal of Gastroenterology 2012年第18期18卷 2212-2218页

作者： Daniel R van Langenberg jane M Andrews Department of Gastroenterology and Hepatology Royal Adelaide HospitalSchool of MedicineUniversity of AdelaideSouth Australia 5000Australia Department of Gastroenterology and Hepatology Eastern Health Clinical SchoolMonash UniversityVictoria 3128Australia

AIM:To assess the reasons for,and factors associated with,patient-initiated changes in treating specialist in inflammatory bowel diseases(IBD).METHODS:Prospectively identified IBD patients(n = 256) with ≥ 1 encounter at a metropolitan hospital were surveyed,including whether they had changed treating specialist and *** reasons included loss of confidence,disagreement,and/or personality clash with the ***:Of 162 respondents,70(43%) had ever changed specialists;30/70(43%) for negative reasons,52/70(74%) in the preceding *** with negative reasons for changing(n = 30) were younger(median,35.2 years vs 45.3 years),had higher IBD knowledge(median,5.0 years vs 4.0 years),yet had lower medication adherence and satisfaction scores(median,19.0 years vs 22.0 years,14.0 years vs 16.0 years respectively,Mann-Whitney tests,all P ci(1.3-5.4),2.2(1.0-4.7),5.56(1.92-16.67),2.0(1.3-3.0),eachP cialist appears associated with patient-related(age,nonadherence) and contemporaneous disease-related factors(recent relapse) which,where modifiable,may enhance patient-doctor relationships and therefore quality of care.

关键词： Inflammatory bowel disease Patient-doctor relationship Quality of care Disease outcomes Quality of life

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Genetic polymorphisms predict response to anti-tumor necrosis factor treatment in Crohn's disease

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World Journal of Gastroenterology 2017年第27期23卷 4958-4967页

作者： Uri Netz jane Victoria Carter Maurice Robert Eichenberger Gerald Wayne Dryden Jianmin Pan Shesh Nath Rai Susan Galandiuk Price Institute of Surgical Research the Hiram C.Polk Jr.MD Department of SurgeryUniversity of Louisville School of Medicine Department of Surgery A Soroka University Medical Center Faculty of Health Sciences Ben-Gurion University of the Negev Department of Medicine Division of GastroenterologyHepatology and Nutrition University of Louisville School of Medicine Louisville Department of Bioinformatics and Biostatistics University of Louisville School of Public Health and Information Sciences

To investigate genetic factors that might help define which Crohn’s disease (CD) patients are likely to benefit from anti-tumor necrosis factor (TNF) therapy. METHODSThis was a prospective cohort study. Patients were recruited from a university digestive disease practice database. We included CD patients who received anti-TNF therapy, had available medical records (with information on treatment duration and efficacy) and who consented to participation. Patients with allergic reactions were excluded. Patients were grouped as ever-responders or non-responders. Genomic DNA was extracted from peripheral blood, and 7 single nucleotide polymorphisms (SNPs) were assessed. The main outcome measure (following exposure to the drug) was response to therapy. The patient genotypes were assessed as the predictors of outcome. Possible confounders and effect modifiers included age, gender, race, and socioeconomic status disease, as well as disease characteristics (such as Montreal criteria). RESULTS121 patients were included. Twenty-one were non-responders, and 100 were ever-responders. Fas ligand SNP (rs763110) genotype frequencies, TNF gene -308 SNP (rs1800629) genotype frequencies, and their combination, were significantly different between groups on multivariable analysis controlling for Montreal disease behavior and perianal disease. The odds of a patient with a Fas ligand CC genotype being a non-responder were four-fold higher as compared to a TC or TT genotype (P = 0.009, OR = 4.30, 95%ci: 1.45-12.80). The presence of the A (minor) TNF gene -308 allele correlated with three-fold higher odds of being a non-responder (P = 0.049, OR = 2.88, 95%ci: 1.01-8.22). Patients with the combination of the Fas ligand CC genotype and the TNF -308 A allele had nearly five-fold higher odds of being a non-responder (P = 0.015, OR = 4.76, 95%ci: 1.35-16.77). No difference was seen for the remaining SNPs. CONCLUSIONThe Fas-ligand SNP and TNF gene -308 SNP are associated with anti-TNF treatment

关键词： Anti-tumor necrosis factor Fas ligand Antibody Response Crohn’s disease Single nucleotide polymorphisms Genotype Tumor necrosis factor gene

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Hearing loss and cognitive decline among older adults with atrial fibrillation:the SAGE-AF study

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Journal of Geriatric Cardiology 2020年第4期17卷 177-183页

作者： Wei-Jia WANG Darleen Lessard Hawa Abu David D.McManus Tanya Mailhot Jerry H.Gurwitz Robert J.Goldberg jane Saczynski Division of Cardiovascular Medicine Department of MedicineUniversity of Massachusetts Medical SchoolWorcesterMAUSA Department of Population and Quantitative Health Sciences University of Massachusetts Medical SchoolWorcesterMAUSA Department of Pharmacy and Health System Sciences Northeastern UniversityBostonMAUSA Meyers Primary Care Institute University of Massachusetts Medical SchoolWorcesterMAUSA

Objective To examine the association between hearing loss and cognitive function cross-sectionally and prospectively among older adults with atrial fibrillation(AF).Methods Patients with AF≥65-year-old(n=1244)in the SAGE(Systematic Assessment of Geriatric Elements)-AF study were recruited from five internal medicine or cardiology clinics in Massachusetts and *** was assessed by a structured questionnaire at *** function was assessed by Montreal Cognitive Assessment(MoCA)at baseline and one *** impairment was defined as score≤23 on the *** associations between hearing loss and cognitive function were examined by multivariable adjusted logistic *** Participants with hearing loss(n=451,36%)were older,more likely to be male,and have depressive symptoms than patients without hearing *** baseline,528(42%)participants were cognitively *** with hearing loss were significantly more likely to have cognitive impairment at baseline[adjusted odds ratio(OR)=1.37,95%confidence interval(ci):1.05–1.81].Among the 662 participants who did not have cognitive impairment at baseline and attended the one-year follow-up visit,106(16%)developed incident cognitive *** with,versus those without,hearing loss were significantly more likely to develop incident cognitive impairment at one year(adjusted OR=1.68,95%ci:1.07–2.64).Conclusions Hearing loss is a prevalent but under-recognized factor associated with cognitive impairment in patients with *** for hearing loss may be indicated among these patients to identify individuals at high-risk for adverse outcomes.

关键词： Atrial fibrillation Cognitive function Hearing

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Maternal and Neonatal Factors Associated with Mortality of Preterm Babies Admitted in Newborn Unit of Kenyatta National Hospital, Kenya

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Open Journal of Obstetrics and Gynecology 2022年第12期12卷 1219-1236页

作者： Angela Mwangi Okubatsion Tekeste Okube jane Kamau School of Nursing The Catholic University of Eastern Africa Nairobi Kenya

Background: Preterm birth is a primary cause of neonatal morbidity and mortality especially in low-income countries. Although understanding the preventable factors of neonatal deaths in preterm infants is required for timely interventions, data on those factors is lacking in Kenya. We attempted to determine mortality and its associated factors in preterm babies in Kenya. Methods and Materials: A hospital-based, prospective study was implemented from July 2019 to October 2019 involving 163 preterm neonates and their mothers admitted at Kenyatta National Hospital. A systematic random sampling method was used to recruit the study participants. Data on mortality and the associated factors in preterm neonates were collected using a pretested questionnaire for mothers and neonatal medical records. Data was analyzed using descriptive and inferential statistics. Results: The mortality rate was 18.4%. Of the neonates who died, respiratory distress syndrome (63.3%) and neonatal sepsis (20.0%) were documented as the primary causes. Neonates born of single mother (AOR = 8.006, 95% ci 2.267 to 28.272, p = 0.001), unemployed (6.960, 1.059 - 45.757, p = 0.043), self-employed (4.040, 1.067 - 15.302, p = 0.040), anemic (7.465, 2.530 - 22.023, p citated at birth (54.406, 6.807 - 434.851, p < 0.001) were likely to die. Conclusion: High mortality rates of preterm neonates are attributed to both maternal and neonatal factors. Focused antenatal care should aim at early identification of high-risk mothers for early management of bleeding during pregnancy, close monitoring of nutritional status for mothers and health education.

关键词： Preterm Babies Mortality Rate Factors Associated with Preterm Babies’ Mor-tality

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呼啸山庄

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英语画刊(高中版) 2017年第30期 3-5页

作者：艾米莉·勃朗特

《呼啸山庄》是英国女作家艾米莉·勃朗特的作品,是19世纪英国文学的代表作之一,根据这部小说改编的影视作品至今久演不衰。它被人认为是英国文学史上一部"最奇特的小说",字里行间充满着丰富的想象和狂飙般猛烈的情感,具有震撼人心的艺... 详细信息

《呼啸山庄》是英国女作家艾米莉·勃朗特的作品,是19世纪英国文学的代表作之一,根据这部小说改编的影视作品至今久演不衰。它被人认为是英国文学史上一部"最奇特的小说",字里行间充满着丰富的想象和狂飙般猛烈的情感,具有震撼人心的艺术力量。本文节选自该书简写版第一章和第二章。

关键词：希斯克利夫呼啸山庄凯瑟琳《圣经》

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