Scholarly Commons @ Baystate Health
Not a member yet
8474 research outputs found
Sort by
Evaluation of the NICU Cuddler Program
No full texthttps://scholarlycommons.libraryinfo.bhs.org/nursing_artof_questioning_innovation2025/1007/thumbnail.jp
Sleep Matters: Reducing Nighttime Disruptions for Older Adults on Daly 6A
No full texthttps://scholarlycommons.libraryinfo.bhs.org/nursing_artof_questioning_innovation2025/1030/thumbnail.jp
Subclinical mastitis during lactation: a modifiable risk factor for breast cancer?
No full textChronic inflammation likely contributes to breast cancer risk, but epidemiologic studies are inconclusive. Two types of inflammatory episodes in breast tissue, referred to here as clinical mastitis and subclinical mastitis, have received little to no attention as risk factors for breast cancer. Clinical mastitis represents an acute painful inflammatory state of the breast that in most cases will be quickly treated and resolved. In contrast, subclinical mastitis remains undetected in most cases and may represent chronic inflammation. Based on the concentration of sodium (Na) and cytokines in milk, several publications suggest that subclinical mastitis is relatively common and can persist for extended periods. We propose that subclinical mastitis is a modifiable risk factor for breast cancer. This chronic subclinical inflammatory profile in breast tissue may cause genetic instability and perturb epigenetic mechanisms leading to cancer. We suggest studies to determine the extent that subclinical mastitis is associated with breast cancer risk.
Keywords: C-reactive protein (CRP); breast cancer risk; chronic inflammation; cytokines; mammary epithelium permeability (MEP); subclinical mastitis
SCAI Position Statement on Intracardiac Echocardiography to Guide Structural Heart Disease Interventions
No full textAs structural heart disease interventions rapidly evolve, demand for minimally invasive intraprocedural imaging techniques has increased. Intracardiac echocardiography (ICE) has emerged as a valuable imaging modality, offering real-time, high-resolution visualization of cardiac structures without the need for general anesthesia. This position statement from the Society for Cardiovascular Angiography & Interventions outlines the clinical applications, advantages, limitations, and implementation strategies for ICE in guiding transcatheter structural heart disease procedures. The document details standardized ICE imaging protocols and views for interventions involving the mitral, tricuspid, and pulmonary valves, as well as left atrial appendage occlusion atrial septal defect, and patent foramen ovale closure. It emphasizes the importance of operator training, physician workflows, and institutional readiness for successful ICE integration. The statement also advocates for updated reimbursement models that reflect the complexity and value of ICE-guided procedures and calls for further research comparing ICE and transesophageal echocardiography outcomes.
Keywords: intracardiac echocardiography; left atrial appendage occlusion; mitral valve; pulmonary valve; transesophageal echocardiography; transseptal puncture; tricuspid valve
Corrigendum to \u272025 SCAI/HRS Clinical Practice Guidelines on Transcatheter Left Atrial Appendage Occlusion\u27: [Journal of the Society for Cardiovascular Angiography & Interventions. Volume 4, Issue 9 (2025) 103783]
No full textThe Pharmacist\u27s Role in the Care of Pediatric Emergency Department Patients
No full textThe Pediatric Pharmacy Association (PPA) strongly urges health care institutions to establish and support the pharmacist\u27s role in pediatric emergency department (ED) settings. Adult patient-centric guidelines have firmly established the general role of the pharmacist and pharmacy services in emergency medicine; however, pediatric pharmacy presence is often considered in case-based scenarios, such as pediatric cardiopulmonary resuscitation events. PPA recommends supporting the pharmacist\u27s role in all pediatric ED settings and scenarios including, but not limited to, participation in direct patient care activities, education, safety, improvement initiatives, and transitions of care. Further, PPA advocates for the provision of appropriate training, credentialing, and ongoing mentorship and competency in these areas.
Keywords: emergency; emergency department; patient care; pediatrics; pharmacist
Outcomes of Percutaneous Coronary Intervention in Patients with Inflammatory Bowel Disease: A Propensity-Score Matched Analysis
No full textPrognostic implications of factor VIII levels in African Americans: insights from a propensity-matched US-based multicenter retrospective analysis
No full textElevated levels of coagulation factor VIII (FVIII) are more commonly observed in African Americans (AAs) and have been linked to higher risks of thromboembolism and other cardiovascular comorbidities. However, the prognostic implications of elevated FVIII levels in AAs have not been well-studied. We queried the TriNetX (August 2005 to August 2019) to compare AAs with FVIII \u3e 200% to those with 50-200%. A propensity score match (PSM) was used to adjust for potential confounders. Primary outcomes were assessed within five years after the index FVIII and included major adverse cardiovascular events (MACE), while exploratory outcomes included venous thromboembolism (VTE), cerebrovascular events, new-onset heart failure (HF), HF exacerbations, and all-cause mortality. A survival analysis using log-rank tests, Kaplan-Meier curves, and a univariate Cox regression was performed to investigate the association of FVIII with the time to development of each outcome after PSM through the hazard ratio (HR). A multivariate-adjusted analysis was performed before PSM for select outcomes. An E-sensitivity analysis was implemented to assess the association of unmeasured confounders post-PSM. Initially, 11,199 patients were identified from the TriNetX database. After PSM, 3,833 patients with balanced baseline characteristics were included in each cohort. Patients with elevated FVIII had a higher 5-year risk of MACE (HR: 1.14, 95% CI: 1.02-1.27, P = 0.017), VTE (HR: 1.23, 95% CI: 1.11-1.35, P \u3c 0.001), new-onset HF (HR: 1.41, 95% CI: 1.14-1.74, P = 0.001), and mortality (HR: 1.37, 95% CI: 1.20-1.57, P \u3c 0.001). In adjusted models, the association between FVIII and new-onset HF attenuated after accounting for vWF and comorbidities, while the mortality risk remained significant (HR: 1.53, 95% CI: 1.34-1.73, P \u3c 0.001). No significant association was found between FVIII and HF exacerbation. Elevated FVIII levels in AAs are linked to a higher risk of adverse cardiovascular outcomes, including new-onset HF. Future research should explore the dynamic interaction of FVIII with these outcomes, including its potential causal role and its use as a marker for the development of these conditions.
Keywords: African Americans; Factor VIII; MACE; Mortality; TriNetX
Identifying Barriers to Hand Hygience Compliance Using a Walk-Through, Talk-Through (WT3) Tool on the Children\u27s and Adolescent Unit
No full texthttps://scholarlycommons.libraryinfo.bhs.org/nursing_artof_questioning_innovation2025/1005/thumbnail.jp
Statin-Induced Immune-Mediated Necrotizing Myopathy: A Case Report of a Rare and Underrecognized Cause of Progressive Weakness
No full textStatin-induced necrotizing autoimmune myopathy is a rare immune-mediated process that leads to muscle necrosis and occurs following exposure to statin therapy. The diagnostic clue for this disorder stems from the development of a proximal muscle weakness associated with the elevation of creatine kinase levels in association with the use of statin medication. Management mainly includes discontinuation of the statin medication, pursuing a tissue diagnosis, and early initiation of immunosuppressive therapy to preserve and regain muscle strength. We present the case of a 54-year-old patient with statin-induced necrotizing autoimmune myopathy who developed proximal muscle weakness a few months after initiation of statin therapy, was positive for anti-HMGCR (anti-hydroxy-methyl-glutaryl coA reductase) autoantibodies, and had evidence of muscle necrosis with minimal cellular infiltration on muscle biopsy. A definitive diagnosis can often be made without biopsy in the presence of positive anti-HMGCR antibodies and a compatible clinical presentation, though biopsy remains valuable for seronegative or atypical cases. He was treated with immunosuppressive therapy using intravenous immunoglobulins and was noted to have a good response. This case report highlights the importance of early recognition of statin-related adverse effects that require urgent evaluation and timely therapy to preserve and improve the functional status of a patient.
Keywords: endocrine myopathy; immune-mediated necrotizing myopathy; lower limb weakness; statin induced necrotizing autoimmune myopathy; statin-induced myopathy