11210 research outputs found
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Inside AWAMC, January 2009
No full textAurora West Allis Medical Center, West Allis, WI: Inside AWAMC is a monthly newsletter for employees, volunteers, and guests of the hospital. This issue has a feature on improving patient experiences.https://institutionalrepository.aah.org/alldocuments/2207/thumbnail.jp
Late Loeys-Dietz syndrome diagnosis in an adolescent with severe phenotype
No full textBackground: Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder (CTD) with musculoskeletal, craniofacial, and cardiovascular features with a prevalence of approximately 1:50,000. Morbidity and mortality often occur earlier in patients with LDS compared to patients with other CTDs.
Case summary: We present a teenager with subacute heart failure, 4/6 holosystolic murmur with diastolic rumble, facial differences, and arachnodactyly. She had genotype-positive, phenotype-positive LDS including an atrial septal defect, severely dilated great arteries/ventricles, and depressed systolic function, requiring prompt medical and surgical therapy.
Discussion: To our knowledge, this is the first case of LDS with such dramatic atrial and ventricular dilation, likely the result of shunting, valve regurgitation, and underlying CTD.
Take-home messages: LDS can be aggressive in young patients; screening and diagnosis should be prompt when LDS is suspected. Elective repair of the aorta is indicated at smaller absolute diameters in LDS. Intervention lowers risk of a sudden, potentially life-ending cardiac event
Comparative analysis of vaginal inflammatory cytokines among HPV-positive and HPV-negative women in Manila, Philippines
No full textProblem: Human papillomavirus (HPV) is considered the necessary cause of cervical cancer. Studies showed that disruption of the inflammatory milieu in the cervicovaginal mucosa can promote the persistence of HPV, which can result in cervical carcinogenesis. This study determined sociodemographic factors and vaginal inflammatory cytokines associated with HPV infection in Manila, Philippines.
Method: Cervicovaginal swab samples from 110 sexually active women, ages 21 and above, from Manila, diagnosed using real-time PCR, were selected for comparative expression analysis using sandwich-type ELISA of the cytokines IL-6, IL-8, IL-1b, IL-10, and TNF-α. Independent t-test, Wilcoxon Rank Sum, and Chi-square test were employed. Multivariable logistic regression was conducted to determine factors associated with HPV infection.
Results: Sociodemographic and behavioral factors analyzed in this study did not show a significant association with HPV infection. IL-8 was significantly lower (p \u3c 0.0001) while IL-10 was significantly higher (p \u3c 0.001) in the HPV-positive group compared to the HPV-negative samples. Multivariable logistic regression showed that higher IL-1b (OR: 1.007; 95% CI: 1.003-1.012) and lower IL-8 levels (OR: 0.979; 95% CI: 0.970-0.989) were associated with increased odds of HPV infection. IL-8 promotes neutrophil recruitment and viral clearance, IL-1β drives inflammation but may foster persistence via IL-17 induction, and IL-10 suppresses antiviral immunity, enabling HPV evasion.
Conclusion: This study showed that lower IL-8 and higher IL-1β levels were independent predictors of HPV infection. These changes in the microenvironment may control immune cell infiltration and help establish HPV infection
AI-generated diet and exercise recommendations for cardiovascular health compared to established cardiology society guidelines
No full textBackground and aim: As numerous individuals turn to the internet for initial guidance, health literacy is crucial for establishing sound health practices within the broader society. Although diet and exercise are crucial for prevention, artificial intelligence (AI) models can offer accurate health information; cardiovascular disease (CVD) continues to be a significant source of morbidity and mortality. The increasing application of AI in healthcare necessitates a thorough evaluation of the efficacy of large language models (LLMs) in providing dependable health recommendations. This study aimed to assess the appropriateness, biases, and clinical relevance of diet and exercise recommendations produced by four prominent language models (ChatGPT {San Francisco, CA: OpenAI}, Claude AI {San Francisco, CA: Anthropic}, DeepSeek AI {Hangzhou, China: DeepSeek}, Google Gemini {Google LLC: Mountain View, CA}) in relation to established cardiovascular disease association guidelines from the American Heart Association/American College of Cardiology (AHA/ACC) and the European Society of Cardiology (ESC).
Methods: A cross-sectional study was conducted using 15 standardized questions (five on physical activity, 10 on diet) evaluated by a primary care physician and a cardiology fellow. A cardiologist reviewed discrepancies in the evaluations by the two examiners; in such instances, the final grade was established by the median of the grades assigned by all three examiners. Based on compliance with AHA/ACC and ESC guidelines, responses were rated as appropriate, appropriate but insufficient, partially inappropriate, or entirely inappropriate.
Results: Ninety percent of responses from ChatGPT, Claude AI, and DeepSeek AI met established cardiovascular health standards, indicating superior performance among the language models. All five recommendations for physical activity were deemed appropriate. Google Gemini had a performance level of 80%, while 90% of the outcomes from the three LLMs were suitable for nutritional guidance. Particularly concerning carbohydrate and added sugar intake, all models struggled to provide precise quantitative guidance. Exercise recommendations indicated a slight preference for AHA/ACC guidelines.
Conclusions: While LLMs demonstrate potential for accessible health information sources, they cannot replace expert medical advice. This study highlights the need for continued medical professional interpretation and tailored healthcare guidance. Future advances should concentrate on raising the specificity of health recommendations and guaranteeing a fairer interpretation of international guidelines
Alpha-1 antitrypsin deficiency: Genetics, clinical manifestations, AI prognostics, and advanced imaging in liver disease
No full textAlpha-1 Antitrypsin Deficiency (AATD) is a genetic disorder caused by mutations in the SERPINA1 gene, resulting in reduced or dysfunctional alpha-1 antitrypsin protein. This deficiency leads to progressive lung and liver diseases, including emphysema, chronic obstructive pulmonary disease (COPD), and cirrhosis. Despite its clinical significance, AATD remains underdiagnosed, delaying treatment. This review explores the molecular mechanisms of AATD, emphasizing Z-AAT protein accumulation in hepatocytes and excessive protease activity in the lungs.
Advancements in imaging modalities—such as CT, MRI, dark-field radiography, and hyperpolarized MRI—enhance early diagnosis and disease monitoring. Novel therapies are reshaping AATD management, including siRNA therapies (fazirsiran, belcesiran), gene-editing techniques (CRISPR-Cas9), regenerative approaches, autophagy-enhancing drugs, proteostasis regulators, aerosolized AAT, and artificial intelligence (AI) for real-time disease tracking via wearable devices.
The integration of AI, advanced imaging, and emerging therapies represents a paradigm shift in AATD diagnosis and treatment. This review highlights the need for a multidisciplinary approach, early intervention, and personalized medicine to improve outcomes in both pulmonary and hepatic complications
The Pulse, 1990 Spring
No full textDreyer Medical Clinic, Aurora, IL: An issue of The Pulse, a publication for Dreyer Medical Clinic patients. This was a newsletter published for patients reporting on Dreyer news, events, classes, and staffing updates.https://institutionalrepository.aah.org/alldocuments/2044/thumbnail.jp
Nursing Now, 2010, Vol 9 Iss 4
No full textAdvocate Christ Medical Center and Hope Children\u27s Hospital, Oak Lawn, IL: Internal newsletter publication written by nurses for nurses and published 6 times a year (bi-monthly). The mission of NURSING Now was to communicate, educate and motivate CMC nursing professionals towards continued excellence.https://institutionalrepository.aah.org/alldocuments/2127/thumbnail.jp
Ticagrelor monotherapy following short-term DAPT in ACS undergoing PCI: A systematic review and meta-analysis
No full textBackground:Dual antiplatelet therapy (DAPT) for 1 year after acute coronary syndrome (ACS) in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is the standard of care. However, it is associated with a higher incidence of bleeding events. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the safety and efficacy of short-term DAPT.
Aims:This study aimed to assess the relative risk of major and minor bleeding, net adverse clinical and cerebral events (NACCE), and all-cause mortality in patients with ACS undergoing PCI with DES, comparing ticagrelor-based short-term DAPT (≤ 3 months) followed by ticagrelor monotherapy for up to 12 months versus 12-month DAPT. The secondary endpoint evaluated the relative risk of complications, including myocardial infarction, stroke, stent thrombosis, repeat revascularization, and cardiovascular mortality.
Methods:A systematic search of PubMed, Scopus, and Cochrane Central was conducted for eligible RCTs. A subgroup analysis of ultrashort-term DAPT (≤ 1 month) followed by ticagrelor monotherapy for up to 12 months was also performed. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model.
Results:Five RCTs were included with a total of 21,407 patients. Short-term DAPT was associated with a significant reduction in major bleeding (RR 0.50; 95% CI 0.38-0.66; p \u3c 0.01), minor bleeding (RR 0.53; 95% CI 0.35-0.80; p \u3c 0.01), NACCE (RR 0.71; 95% CI 0.59-0.85; p \u3c 0.01), and all-cause mortality (RR 0.78; 95% CI 0.62-0.98; p =0.04).
Conclusions:Short-term DAPT followed by ticagrelor monotherapy up to 12 months was associated with a significant reduction in major and minor bleeding, NACCE, and all-cause mortality compared to 12-month DAPT. There were no significant differences in myocardial infarction, stroke, stent thrombosis, repeat revascularization, or cardiovascular mortality. Major bleeding and NACCE remained consistently reduced in the subgroup analysis
Social media use and the relationship with colorectal cancer screening among foreign-born populations in the United States
No full textBackground: Social media (SM) has emerged as a tool for health-related usage among US adults, including cancer screening promotion. Here, we aimed to assess the differences in health-related SM use between US and foreign-born adults and the relationship between health-related SM use and colorectal (CRC) screening practices.
Methods: Using data from the fifth edition of the National Cancer Institute\u27s Health Information National Trends Survey (HINTS 5), cycle 2, we compared the differences in health-related SM use between US and foreign-born adults and the effects of SM use on CRC screening by country of birth. We included adults aged 50-75 and excluded participants with a history of CRC. The primary endpoint was CRC screening, which was determined by self-reported CRC screening using colonoscopy, sigmoidoscopy, or stool occult blood testing.
Results: Our study included 1,812 adults, of whom 236 (13.0%) were foreign-born. Most participants (72.1%) reported undergoing CRC screening. Interestingly, we found no discernible difference in health-related SM use [odds ratio [OR] 0.91; 95% CI (0.49, 1.69)] between US and foreign-born adults. Furthermore, our analysis revealed that SM use did not influence CRC screening practices among either group (US-born: 0.88 [95% CI: 0.50, 1.52], foreign-born 0.52 [0.10, 2.51]).
Conclusion: Contrary to previous studies, which showed a positive relationship between SM use and satisfactory health-related practices, we found that although foreign-born adults use SM as much as US-born adults, there was no significant relationship between SM use and CRC screening