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Migraines Are a Pain - Especially When They Are Not Migraines: A Case of an Atypical Headache
No full textConnecting librarians to purpose using Springshare\u27s NPS tool
No full textBackground: The Advocate Health - Midwest Library wanted to help library staff feel a stronger connection between their work and the organization’s mission. Patrons rarely provide feedback on how library services and resources were utilized, and staff felt disconnected from their contribution to patient care and safety as demonstrated on our annual culture of safety survey. We identified Springhare’s NPS (Net Promotor Score) tool as an easy way to connect with our patrons and to demonstrate our contribution to organizational mission to library staff.
Description: We used NPS to solicit feedback on our literature search service. NPS is an add-on module to LibAnswers. This one-question survey asks how likely a user is to recommend on a scale from 0 to 10. We modified the default question to ask how likely patrons were to recommend our literature search service to other employees. NPS provides an optional rating-based or generic follow-up question. We asked a different question for each of the three rating categories to gather feedback to help us understand the impact of the literature search results or to improve the service. Promotors (9-10 rating) were asked how the search was effective for their work, passive responders (7-8 rating) if anything could be improved, and detractors (0-6 rating) what went wrong and how it could be improved. We solicited survey responses via an email campaign and gathered patron emails from LibAnswers tickets from the past 6 months. We received 139 survey responses (29.7% response rate), and the results were overwhelmingly positive. 132 responses were promoters, 5 were passive, and 2 were detractors, for an overall NPS® score of 94 (out of 100). The NPS® score, statistics, and select comments from promotors were disseminated to library staff.
Conclusions: NPS was easy to set-up and provided a simple and customizable tool to survey patrons, and to view, interpret, and present survey results. We successfully showed that our literature search service is valued by patrons and that we make an impact on patient care and organizational mission
The Efemoral Vascular Scaffold System (EVSS): A Novel, Resorbable, Sirolimus-Eluting Device for Percutaneous Peripheral Intervention (PPI)
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Age-Based Temporal Trends of In-Hospital Outcomes for Cardiogenic Shock Treated With Impella After Acute Myocardial Infarction
No full textTrends in the Use and Characteristics of Chiropractic Services in a Large Private Integrated Health Care System
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Hyperglycemia management in patients receiving parenteral nutrition: A retrospective review of glycemic control management
No full textPurpose: Hospitalized patients receiving parenteral nutrition (PN) often require insulin to manage hyperglycemia. Glycemic control is crucial for improving patient outcomes, and insulin, administered either subcutaneously or within the PN, is the mainstay of treatment for hyperglycemia. No established standard of care exists for the preferred route of insulin administration in patients receiving PN.
Methods: A multicenter, retrospective review of patients receiving PN was conducted between August 31, 2023, and August 31, 2024, to compare the effects of two insulin regimens on glycemic control. This review included adults aged ≥ 18 years on continuous PN and had received insulin therapy, either subcutaneously or within the PN formulation. The primary outcome - glycemic control - was assessed by the percentage of glucose levels within the target range (70 to 180 mg/dL).
Results: A total of 66 patients were included in the review. Seventeen patients (51.5%) in the subcutaneous insulin group had greater than 70% of glucose levels within the target range compared to 12 patients (36.4%) in the insulin-within-PN group. Seventeen patients (51.5%) in the subcutaneous group experienced more than 25% of glucose levels in the hyperglycemic range compared to 22 patients (66.7%) in the insulin-within-PN group. The incidence of hypoglycemia was similar between groups, with four patients in the subcutaneous insulin group and five patients in the insulin within the PN group.
Conclusion: These results suggest glycemic control was comparable between groups, with a non-significant trend favoring the subcutaneous insulin group
Methylprednisolone for infant heart surgery: Subpopulation analyses of a randomized controlled trial
No full textObjectives: Evaluate benefits and harms of prophylactic intraoperative methylprednisolone in subpopulations undergoing infant heart surgery.
Design: Subpopulation analyses of The Steroids to Reduce Systemic Inflammation after Infant Heart Surgery (STRESS) trial, a double-blind randomized placebo-controlled trial.
Setting: Twenty-four congenital heart centers.
Patients: Infants (\u3c 1 yr old) undergoing heart surgery with cardiopulmonary bypass. Patients stratified by Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart Surgery (STAT) mortality category, age, gestational age, and presence of chromosomal or syndromic diagnosis (CSD).
Interventions: Methylprednisolone (30 mg/kg) vs. placebo administered into cardiopulmonary bypass pump-priming fluid.
Measurements and main results: Six postoperative outcomes: steroid use, acute kidney injury (AKI), thrombosis, infections, prolonged mechanical ventilation, peak blood glucose levels, and insulin exposure. One thousand two hundred patients received methylprednisolone or placebo. Beneficial effects associated with methylprednisolone included reduced use of postoperative hydrocortisone in neonates (odds ratio [OR], 0.39 [0.25-0.60]), both STAT category groups (1-3: OR, 0.64 [0.46-0.89]; 4-5: OR, 0.57 [0.34-0.97]), term infants (OR, 0.63 [0.47-0.83]), and those without CSD (OR, 0.63 [0.46-0.86]). Methylprednisolone was associated with lower thrombosis occurrence among neonates (OR, 0.37 [0.16-0.87]) and term infants (OR, 0.38 [0.19-0.75]). Adverse associations included increased thrombosis among premature infants (p = 0.005), increased AKI among neonates (OR, 1.55 [1.02-2.37]) and those following STAT category 1-3 operations (OR, 1.34 [1.02-1.75]), and increased peak blood glucose levels and insulin exposure (all subgroups; p \u3c 0.001). No increase in overall infection or reduction in prolonged mechanical ventilation with methylprednisolone.
Conclusions:Both beneficial and adverse associations were observed with prophylactic methylprednisolone. Reduction in postoperative hydrocortisone administration and absence of increased infection rates are arguments favoring prophylactic methylprednisolone use. Methylprednisolone was associated with increased peak blood glucose levels and a neutral to harmful association with odds of AKI. These data suggest certain subpopulations may benefit from prophylactic intraoperative methylprednisolone without significant harm