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Mobility in Critically Ill Patients
No full texthttps://digitalcommons.providence.org/covenant_nurses_week_2025/1011/thumbnail.jp
Individualized dynamic risk assessment and treatment selection for multiple myeloma.
No full textBACKGROUND: Individualized treatment decisions for multiple myeloma (MM) patients require accurate risk stratification that accounts for patient-specific consequences of cytogenetic abnormalities on disease progression.
METHODS: Previously, SYstems Genetic Network AnaLysis (SYGNAL) of multi-omics tumor profiles from 881 MM patients generated a mmSYGNAL network of transcriptional programs underlying disease progression across MM subtypes. Here, through machine learning on activity profiles of mmSYGNAL programs we have generated a unified framework of cytogenetic subtype-specific models for individualized risk classifications and prediction of treatment response.
RESULTS: Testing on 1,367 patients across five independent cohorts demonstrated that the framework of mmSYGNAL risk models significantly outperformed cytogenetics, International Staging System, and multi-gene biomarker panels in predicting PFS at primary diagnosis, pre- and post-transplant and even after multiple relapses, making it useful for individualized risk assessment throughout the disease trajectory. Further, treatment response predictions were significantly concordant with efficacy of 67 drugs in killing myeloma cells from eight relapsed refractory patients. The model also provided new insights into matching MM patients to drugs used in standard of care, at relapse, and in clinical trials.
CONCLUSION: Activities of transcriptional programs offer significantly better prognostic and predictive assessments of treatments across different stages of MM in an individual patient
Enhanced Recovery After Adult Brain Tumor Surgery: A Proposed Succinct Evidence-Based Protocol.
No full textBACKGROUND AND OBJECTIVES: Enhanced recovery after surgery (ERAS) for brain tumor surgery holds promise for improving outcomes. However, its lack of standardization has led to financial and logistic barriers, hindering its widespread adoption and optimization. This study seeks to identify ERAS variables across the preoperative, intraoperative, and postoperative phases associated with shorter hospital length of stay (LOS), decreased postoperative pain, and reduced costs.
METHODS: A comprehensive literature search was performed to include MEDLINE, Embase, Cochrane Library, and Scopus from January 1, 2020, to December 31, 2023. Eligible studies were selected based on predefined inclusion/exclusion criteria. Additional references were hand-picked by the authors when appropriate. Statistical methods were used to identify variables linked to improved outcomes, such as LOS, cost, and pain control.
RESULTS: Of the 278 abstracts, 50 met eligibility criteria, leading to 16 final full-text articles for the study, covering 2296 patients. Variables significantly reducing LOS on multivariable regression analysis included preoperative social assessment for discharge planning (β = -3.95, CI: -5.45 to -2.45, P \u3c .001), nutritional counseling and preoperative optimization (β = -1.90, CI: -2.98 to -0.81, P \u3c .01), intraoperative prophylactic antibiotics (β = -2.41, CI: -4.98 to 0.15, P \u3c .06), extubation in the operating room (β = -4.39, CI: -8.36 to -0.42, P = .033), postoperative patient education on discharge instructions (β = -3.9, CI: -6.24 to -1.56, P \u3c .01), opiate-sparing analgesia (β = -2.8, CI: -4.93 to 0.67, P = .017), and early mobility (β = -1.95, CI: -3.86 to -0.04, P = .046). Multivariable logistic regression demonstrated that ERAS protocols with a local/regional anesthetic block during the intraoperative period significantly predicted a pain benefit (odds ratio = 28, CI: 1.95 to 181.2, P = .03).
CONCLUSION: Based on the results from the present analysis, the authors synthesize an ERAS protocol for patients undergoing brain tumor surgery with key elements that demonstrated a significant influence on the measured outcomes
Knowing Well, Being Well: well-being born of understanding: Access to GLP-1s: Where Do Employers Fit in?
No full textAntibiotic Lock Therapy fpr Dialysis Catheters: Implementation at an Urban Hospital
No full texthttps://digitalcommons.providence.org/swedish_fish_2025/1017/thumbnail.jp
Microlearning as an Education Strategy in Perianesthesia
No full texthttps://digitalcommons.providence.org/swedish_fish_2025/1015/thumbnail.jp
Improving Clinical Care for Cochlear Implant Recipients: The Coupling of Health-Related-Quality-of-Life and Clinical Speech Measures
No full texthttps://digitalcommons.providence.org/swedish_fish_2025/1004/thumbnail.jp
Reducing Respiratory Compromise In The Cardiac Cath Lab With An Innovative Practice Change
No full texthttps://digitalcommons.providence.org/swedish_fish_2025/1001/thumbnail.jp
Once-daily versus twice-daily oral vancomycin for secondary prevention of Clostridioides difficile infection in patients treated with systemic antibiotics
No full texthttps://digitalcommons.providence.org/swedish_fish_2025/1000/thumbnail.jp
