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Sex differences after PCI are not explained by comorbidities. PCI术后的性别差异无法用合并症来解释。
Q3 Medicine Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2454183
Cara East
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引用次数: 0
From toasted skin to tumors: a retrospective nationwide case-control analysis investigating the link between erythema ab igne and various skin cancers.
Q3 Medicine Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2458993
Kritin K Verma, Maitreyi Dhavala, Jalyn Vo, Tejas P Joshi, Ida F Orengo, Michelle B Tarbox, Daniel P Friedmann, Zeena Y Nawas

This study investigated erythema ab igne (EAI) and comorbid skin cancers. Each EAI case, searched by ICD-10-CM code L59.0 in the All of Us database, was compared to four controls, matched by sex at birth, age, and self-identified race/ethnicity. Demographics and skin cancer comorbidities were assessed with odds ratios (ORs) and 95% confidence intervals (CIs) using Wald's method. EAI was most prevalent between 60 and 70 years of age. A female-to-male ratio of 1:1 was observed between ages 40 and 50. EAI patients had a statistically significant increased risk of basal cell carcinoma (OR, 10.67; 95% CI, 2.76-41.30; P < 0.001), squamous cell carcinoma (OR, 27.84; 95% CI, 1.42-545.59; P = 0.03), and melanoma (OR, 8.00; 95% CI, 1.43-44.60; P = 0.02). Additional tumors were analyzed, but insufficient case/control data was obtained from the database. In conclusion, EAI is positively correlated with skin cancers. Awareness and prevention of EAI is warranted.

本研究调查了点状红斑(EAI)和合并皮肤癌的情况。根据我们所有人数据库中的 ICD-10-CM 代码 L59.0 搜索到的每个 EAI 病例都与四个对照组进行了比较,对照组的出生性别、年龄和自我认定的种族/人种相匹配。人口统计学和皮肤癌合并症的评估采用了沃尔德方法,得出了几率比(OR)和 95% 的置信区间(CI)。EAI在60至70岁之间最为普遍。在 40 至 50 岁之间,女性与男性的比例为 1:1。EAI患者罹患基底细胞癌(OR,10.67;95% CI,2.76-41.30;P = 0.03)和黑色素瘤(OR,8.00;95% CI,1.43-44.60;P = 0.02)的风险在统计学上显著增加。还对其他肿瘤进行了分析,但未能从数据库中获得足够的病例/对照数据。总之,EAI 与皮肤癌呈正相关。应提高对 EAI 的认识并加以预防。
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引用次数: 0
Sex differences in in-hospital outcomes and readmission rates after percutaneous coronary intervention.
Q3 Medicine Pub Date : 2025-01-30 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2452113
Jackeline P Vajta Gomez, Dae Yong Park, Maxwell D Eder, Seokyung An, Angela Lowenstern, Michelle D Kelsey, Jennifer A Rymer, Pamela S Douglas, Michael G Nanna

Background: Previous studies have reported worse outcomes in women following percutaneous coronary intervention (PCI), but contemporary studies examining sex differences in in-hospital outcomes and 90-day readmission risk are lacking. Therefore, we sought to compare 90-day readmission rates and in-hospital adverse outcomes after PCI.

Methods: We used the United States National Readmissions Database to stratify all inpatient PCIs from 2017 to 2018 by sex. We then performed propensity score matching of the two groups based on demographics, medical history, hospital characteristics, clinical presentation, socioeconomic status, and procedures. The primary outcome of interest was 90-day readmission to the hospital. Secondary outcomes included 30-day readmission, in-hospital mortality, and additional in-hospital outcomes. We performed Cox proportional-hazards modeling to compare the hazard of readmission between women and men and logistic regression to calculate odds ratios for the secondary outcomes of interest.

Results: After propensity score matching, 206,556 women and 205,134 men were included. At index hospitalization, women experienced higher odds of in-hospital mortality, hypovolemic shock, and need of blood transfusion, while men experienced higher odds of cardiac arrest, intracranial hemorrhage, and acute kidney injury. Women had a higher hazard of 30-day readmission (hazard ratio 1.16, 95% confidence interval 1.14-1.18, P < 0.01) and 90-day readmission (hazard ratio 1.14, 95% confidence interval 1.12-1.15), with the greatest difference seen among younger women <45 years of age. Findings were similar after stratification into different age groups and clinical presentations.

Conclusion: Substantial sex differences in outcomes after PCI persist, with variable sex differences in in-hospital complications, and women at higher risk of 30- and 90-day readmission to the hospital. Given the clinical and reimbursement implications of readmissions to patients and health systems, urgent efforts are needed to close these gaps.

{"title":"Sex differences in in-hospital outcomes and readmission rates after percutaneous coronary intervention.","authors":"Jackeline P Vajta Gomez, Dae Yong Park, Maxwell D Eder, Seokyung An, Angela Lowenstern, Michelle D Kelsey, Jennifer A Rymer, Pamela S Douglas, Michael G Nanna","doi":"10.1080/08998280.2025.2452113","DOIUrl":"10.1080/08998280.2025.2452113","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have reported worse outcomes in women following percutaneous coronary intervention (PCI), but contemporary studies examining sex differences in in-hospital outcomes and 90-day readmission risk are lacking. Therefore, we sought to compare 90-day readmission rates and in-hospital adverse outcomes after PCI.</p><p><strong>Methods: </strong>We used the United States National Readmissions Database to stratify all inpatient PCIs from 2017 to 2018 by sex. We then performed propensity score matching of the two groups based on demographics, medical history, hospital characteristics, clinical presentation, socioeconomic status, and procedures. The primary outcome of interest was 90-day readmission to the hospital. Secondary outcomes included 30-day readmission, in-hospital mortality, and additional in-hospital outcomes. We performed Cox proportional-hazards modeling to compare the hazard of readmission between women and men and logistic regression to calculate odds ratios for the secondary outcomes of interest.</p><p><strong>Results: </strong>After propensity score matching, 206,556 women and 205,134 men were included. At index hospitalization, women experienced higher odds of in-hospital mortality, hypovolemic shock, and need of blood transfusion, while men experienced higher odds of cardiac arrest, intracranial hemorrhage, and acute kidney injury. Women had a higher hazard of 30-day readmission (hazard ratio 1.16, 95% confidence interval 1.14-1.18, <i>P</i> < 0.01) and 90-day readmission (hazard ratio 1.14, 95% confidence interval 1.12-1.15), with the greatest difference seen among younger women <45 years of age. Findings were similar after stratification into different age groups and clinical presentations.</p><p><strong>Conclusion: </strong>Substantial sex differences in outcomes after PCI persist, with variable sex differences in in-hospital complications, and women at higher risk of 30- and 90-day readmission to the hospital. Given the clinical and reimbursement implications of readmissions to patients and health systems, urgent efforts are needed to close these gaps.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":"38 2","pages":"159-169"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Teaching and assessing in the operating room.
Q3 Medicine Pub Date : 2025-01-28 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2025.2454210
Thomas Cox, John Preskitt, Jennifer Mooney, Julie Higginbotham

In the operating room of a teaching hospital, there is a need to balance surgical efficiencies, patient safety issues, and time management with preparing residents for mature practice. Gaps exist between attendings' perspectives and residents' perspectives on the quality of surgical teaching, wherein residents may perceive an unfocused stream of talk rather than a direct, structured approach. Based on a guided discovery learning model and a review of existing approaches for surgical teaching, the BID model-Briefing, Intraoperative, Debriefing-was applied for teaching in the operating room. The briefing adopts the precepts of deliberate practice while focusing on a small number of specific learning objectives. The intraoperative teaching segment consists of immediate feedback and guidance directed by the learning objectives. The debriefing element solidifies the learning that occurred and allows residents an opportunity to reflect on their performance. This approach guides future practice while fitting within the busy constraints of teaching surgeons.

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引用次数: 0
Walking the tightrope: toward clinical equipoise in portal vein thrombosis.
Q3 Medicine Pub Date : 2025-01-09 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2024.2449320
Lawrence R Schiller
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引用次数: 0
Airway management-being prepared for the difficult case. 气道管理--为疑难病例做好准备。
Q3 Medicine Pub Date : 2025-01-07 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2024.2448614
Michael A Ramsay
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引用次数: 0
Carrel, Abraham Flexner, and Osler: selected World War I correspondence.
Q3 Medicine Pub Date : 2025-01-02 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2024.2441615
Mathieu Ginier-Gillet

The relationship between Alexis Carrel, who received the Nobel Prize in Physiology or Medicine in 1912, and Simon Flexner, director of the Rockefeller Institute for Medical Research, is well documented. However, Carrel's collaboration with Abraham Flexner, a key figure in US medical reform, is less widely recognized, and it seems there are no previous mentions of a connection with William Osler. This historical vignette offers insights into the interactions among these three figures during World War I. Five letters, preserved in the library of the National Academy of Medicine in Paris, are presented in full.

1912 年获得诺贝尔生理学或医学奖的亚历克西斯-卡雷尔(Alexis Carrel)与洛克菲勒医学研究所所长西蒙-弗莱克斯纳(Simon Flexner)之间的关系有据可查。然而,卡雷尔与美国医疗改革的关键人物亚伯拉罕-弗莱克斯纳的合作却鲜有人知,似乎也没有人提到过他与威廉-奥斯勒的关系。巴黎国家医学院图书馆保存了五封信的全文。
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引用次数: 0
Implementation of an oxytocin bolus protocol for cesarean delivery at a Texas level IV maternal center: a single-center retrospective study.
Q3 Medicine Pub Date : 2025-01-02 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2024.2446021
Brittany Hood, Emily E Sharpe, Carmen Gomez Fitzpatrick, Annarose Dement, Claudia Serrano, Jessica C Ehrig, Chandni Raiyani, Michael P Hokfamp

Objective: We hypothesized that patients who underwent cesarean delivery and received oxytocin boluses followed by an infusion would have a lower incidence of secondary uterotonic administration compared to patients who had an oxytocin infusion without boluses.

Methods: Patients who had cesarean deliveries at our hospital from September 1, 2021 through December 31, 2021 and from September 1, 2022 through December 31, 2022, corresponding to the oxytocin bolus and oxytocin infusion cohorts, respectively, were included. Patient demographic, physical, and clinical characteristic data were collected by a study investigator. Intramyometrial oxytocin, intramuscular methylergonovine, intramuscular carboprost tromethamine, and sublingual misoprostol were defined as secondary uterotonics.

Results: There were 266 and 283 patients in the oxytocin bolus and oxytocin infusion cohorts, respectively. The odds ratio for patients in the oxytocin bolus cohort receiving a secondary uterotonic was 0.25 (95% confidence interval 0.16, 0.41; P < 0.01).

Conclusion: Patients in the oxytocin bolus cohort were approximately 75% less likely to receive a secondary uterotonic agent compared to patients in the oxytocin infusion cohort. A limitation of this study was that we defined intramyometrial administration of oxytocin as a secondary uterotonic, and our results may not be generalizable to hospitals that do not use intramyometrial oxytocin.

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引用次数: 0
Exploring current practices and perspectives on gastric varices management in the US.
Q3 Medicine Pub Date : 2025-01-02 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2024.2446019
Ahmad Moussawi, Ranjeeta Bahirwani
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引用次数: 0
Airway management for patients who underwent appendectomy for the indication of acute appendicitis at a Texas tertiary care center: a single center retrospective study. 德克萨斯州一家三级医疗中心对以急性阑尾炎为指征接受阑尾切除术的患者的气道管理:一项单中心回顾性研究。
Q3 Medicine Pub Date : 2024-12-27 eCollection Date: 2025-01-01 DOI: 10.1080/08998280.2024.2443878
Dylan Noble, Val Lumani, Macy Meyer, Lindsay Howe, Michael P Hofkamp

Background: The primary aim of our study was to determine the frequency of video laryngoscopy (VL) use on the first intubation attempt for patients who underwent appendectomy for acute appendicitis at our hospital.

Methods: Patients who had an appendectomy for the indication of acute appendicitis at Baylor Scott & White Medical Center - Temple between January 1, 2021, and December 31, 2023, were included in our study. Study investigators extracted demographic, physical, and clinical data from our electronic medical record.

Results: A total of 533 and 70 patients had direct laryngoscopy (DL) and VL for their first intubation attempts, respectively. Among these, 518 (97.2%) and 53 (75.7%) performed with DL and VL, respectively, were successful on the first attempt (P < 0.001). Patients who had VL for the first intubation attempt were more likely to be male, older, have a higher body mass index, and have a higher incidence of previous airway management with VL, appendiceal perforation, nasopharyngeal tube placement, and SARS-CoV-2 infection compared to patients who had DL.

Conclusion: Approximately 12% of our patients who underwent appendectomy for acute appendicitis had VL on the first intubation attempt, and these patients were more complex than those who had DL.

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引用次数: 0
期刊
Baylor University Medical Center Proceedings
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