11210 research outputs found
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The Pulse, 1998, V8 N3, Summer
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/2078/thumbnail.jp
The Pulse, 2002, V10 N2, 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/2091/thumbnail.jp
Dr. Sarah Susmano, Pediatrics
No full textDreyer Medical Clinic, Aurora, IL: Dr. Susmano, pediatrics physician, working at her desk.https://institutionalrepository.aah.org/allimages/1162/thumbnail.jp
Impact of the fetal echocardiogram on maternal depression and well-being
No full textFetal echocardiography allows for prenatal diagnosis of congenital heart disease (CHD). The objective of this study is to assess for the impact of fetal echocardiogram on levels of well-being and depression in pregnant women. Adult pregnant women carrying a fetus \u3c 31-week gestational age were enrolled in the prospective observational study from February 2022 to June 2022. These subjects were split into two cohorts: those with CHD and those without CHD. Surveys were distributed prior to the fetal echocardiogram, six weeks later and six weeks after delivery. These surveys consisted of the Edinburgh Postpartum Depression Scale (EPDS) and questions about topics, such as anxiety and social support. Of the 152 subjects enrolled, 14 women had a fetus with CHD and 138 women had a fetus without CHD. Initial EPDS scores were elevated for the study population compared to the general population. Six weeks later, EPDS scores remained elevated. For the post-partum surveys, the EPDS scores were decreased below the rate of the general population for the group without CHD and similar to the general population rate for the CHD group. Anxiety, worry, and guilt remained low for both groups after the initial survey. Counseling from the pediatric cardiologist may help decrease anxiety and worry. Social support, like support groups, may be helpful for women carrying a fetus with CHD
COASTing through bedside report: An innovative approach to safe transitions of care
No full textBackground: Bedside shift report improves patient satisfaction, peer accountability, communication, and decreases safety events.
Local problem: Clinical practice of bedside report varied prior to the pandemic. Due to limited personal protective equipment and exposure risk, bedside report was halted during the pandemic.
Approach: The Iowa Model of Evidence-Based Practice was used to guide this project. To standardize communication during bedside report, safety data and literature were reviewed and grouped by themes. The acronym COAST was developed, consisting of code status, oxygen, access, safety, and tubes/drains. These elements were to be discussed at the bedside during handoff.
Results: Compliance with completing elements of COAST increased during the pilot, 9- and 12-month sustainment periods. Additional safety-related outcomes of cardiopulmonary resuscitation wristband application, falls, and good catches improved. Notably, overtime declined.
Conclusions: A bedside report with standardized communication focusing on safety elements can improve compliance with adoption and patient safety outcomes
Changes in adequacy of splanchnic oxygen delivery and splanchnic artery doppler after bolus feedings in infants: A systematic review and meta-analysis
No full textBackground: Current practice regarding timing of feed initiation and feed tolerance largely relies on anecdotal practice and protocols. This study aims to provide an objective measure to guide clinical practice by analyzing changes in splanchnic regional oxygen saturation and Doppler patterns with feeds.
Methods: A systematic review was performed. Inclusion criteria were: 1) patients under 1 year of age; 2) splanchnic regional oxygen saturation with near infrared spectroscopy before and after feeds or mesenteric Doppler findings before and after feeds; and 3) clinical parameters must have been presented as either mean and standard deviation or median and range. Endpoints of interest included splanchnic regional oxygen saturation, splanchnic systolic velocity, and splanchnic diastolic velocity. Meta-analyses were conducted using an inverse-variance model. The pooled effects are reported as mean difference and 95% confidence interval. Meta-regression was conducted for each endpoint with the following independent variables entered into the model: study year, gestational age, birth weight, time to measurement, and age at time of study.
Results: This study included 8 studies with a total of 240 patients. Splanchnic regional oxygen saturation did not significantly differ after feeds (mean difference +1.0, 95% CI -2.9 to 4.9, p-value 0.62). Sensitivity analyses demonstrated that gestational age under 28 weeks was associated with a significant decrease in splanchnic regional oxygen saturation and GA over 30 weeks was not. Splanchnic artery systolic velocity was significantly higher after feeds (mean difference +34.0 cm/s, 95% CI 11.1-57.0 cm/s, p-value \u3c 0.01). Sensitivity analyses for gestational age and birth weight did not find any significant difference in pooled effect.
Conclusion: Splanchnic regional oxygen saturation was significantly decreased after feeds in those patients under 28 weeks of gestation compared to those over 30 weeks. Systolic and diastolic Doppler velocities were significantly higher after feeds without differences in gestational age
Participant personal characteristics and adherence to oral capsules: A secondary analysis of a randomized placebo-controlled trial of antenatal probiotics
No full textBackground:Adherence to study interventions is critical to the conduct of randomized controlled trials (RCTs). The relationships between participant characteristics and intervention adherence are understudied in pregnant populations. The purpose of this study was to conduct a secondary analysis of adherence to study capsules in a double-masked, placebo-controlled RCT of a probiotic intervention to reduce antenatal Group B Streptococcus colonization, in relationship to participant characteristics.
Methods:We analyzed the relationship between capsule adherence rates and demographic characteristics among 81 RCT participants. Categorical variables were reported using counts and percentages, and continuous variables were expressed as means along with their standard deviations. For the univariate analyses, we compared demographic variables with adherence scores. A multivariate linear regression model was used to identify predictors of adherence.
Results:Average adherence was similar for control and probiotic group participants (P = .86) Univariate analysis showed that average adherence increased directly with age, education, and income. Participants who were partnered or living with others had higher average adherence compared with those who were single and living alone. Asian and White participants had the highest and Black participants had the lowest average, and there was no difference based on Hispanic ethnicity. Adjusting for all the variables in the regression, participants who identified as Black were significantly less likely to adhere to capsules than White participants, and those who were married or living with partners were more likely to adhere than the single participants.
Discussion:Diverse participants are critically important to RCTs. This secondary analysis provides evidence that participant characteristics and the social determinants of health play an important role in adherence to self-administered interventions in RCTs, although more research is needed. Our findings suggest that intentional consideration of RCT participant characteristics may allow for the development and tailoring of strategies to enhance intervention adherence. The study was registered on ClinicalTrials.gov (NCT03696953) on January 10, 2018
The Pulse, 1991 Fall
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/2046/thumbnail.jp
The Pulse, 1990 Winter
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/2045/thumbnail.jp
Changes in serum potassium in people with type 2 diabetes taking sodium-glucose co-transporter-2 inhibitors
No full textStudy objective:The primary objective of this study was to determine if there was a significant change in potassium levels with sodium-glucose co-transporter-2 (SGLT2) inhibitor therapy in people with type 2 diabetes (T2D). A co-primary objective was to evaluate which factors may predispose a patient to changes in potassium levels.
Design:Multicenter retrospective cohort chart review.
Data source:Study patients were identified through an electronic medical record-generated report if they had T2D and were prescribed an SGLT2 inhibitor from January 2013 to September 2019.
Patients:Patients were included if they had T2D, were receiving care at Advocate Medical Group, and were confirmed to have taken one of the four SGLT2 inhibitors available at the time of study approval, canagliflozin, dapagliflozin, empagliflozin, or ertugliflozin, for at least 7 days. Patients were excluded if they did not have a basic metabolic panel or comprehensive metabolic panel recorded 1 year prior to or 6 months after SGLT2 inhibitor therapy initiation.
Results:Data extraction from the electronic medical record identified 6425 patients receiving an SGLT2 inhibitor, of which 1926 met inclusion criteria. The SGLT2 inhibitor most prescribed was canagliflozin (43.7%), followed by empagliflozin (36.9%) and dapagliflozin (19.4%). Concomitant baseline medications were thiazide diuretics (27.5%); angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, or angiotensin receptor-neprilysin inhibitors (72.1%); and/or mineralocorticoid receptor antagonists (27.2%). A statistically significant change in potassium levels was found with dapagliflozin (p = 0.018); albeit not clinically significant. No other statistically significant changes or patterns were identified. The overall mean change in serum potassium from baseline was 0.021 mmol/L within 3 months; 0.007 mmol/L from 3 to 5.9 months; -0.017 mmol/L within 6-12 months; and 0.004 mmol/L after more than 12 months.
Conclusions:No clinically significant increase or decrease in potassium levels was observed upon initiation of SGLT2 inhibitor therapy in patients with T2D. This was consistent across background medication use and patient-specific factors. Baseline potassium should not be a factor in initiating SGLT2 inhibitor therapy, if clinically indicated, in patients with T2D