11210 research outputs found
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Inside Aurora Sinai Medical Center, 2003 March
No full textAurora Sinai Medical Center, Milwaukee, WI: Internal employee newsletter with workplace anniversaries, news, and events.https://institutionalrepository.aah.org/alldocuments/2249/thumbnail.jp
Obstructive sleep apnea, resting heart rate, and glycemic variability in adults with maturity-onset diabetes of the young
No full textObstructive sleep apnea (OSA) is a common condition strongly linked to increased cardiovascular risk and poor glycemic control. Little is known about OSA, cardiovascular risk, and glycemia in maturity-onset diabetes of the young (MODY), an inherited form of diabetes, which is different than both type 1 and type 2 diabetes. We assessed OSA, resting heart rate (RHR), an important prognostic marker of cardiovascular disease, and glycemic variability among the most common subtypes of MODY, glucokinase (GCK)-MODY, and transcription factor (TF)-related MODY (HNF1A, HNF4A, and HNF1B). Adults with GCK-MODY (n = 63) and TF-related MODY (n = 60) and control subjects without diabetes (n = 65) were screened for OSA by home sleep test. Glycemic variability (continuous glucose monitoring) and RHR (wearable sleep-activity tracker) were concomitantly assessed for 2 weeks at home. Data from 188 subjects (2,853 recorded days) were analyzed. Subjects with TF-related MODY, compared with those with GCK-MODY or control subjects, had more OSA (48.3%, 27.0%, and 30.8%, respectively; P = 0.033), higher RHR (72.8 ± 10.8, 65.2 ± 7.9, and 67.3 ± 7.7 bpm, respectively; P \u3c 0.001), and higher glycemic variability (coefficient of variation of glucose 31.6 ± 6.0%, 17.3 ± 4.5%, and 17.5 ± 4.0%, respectively; P \u3c 0.001). Greater severity of OSA and higher RHR were associated with higher glycemic variability. These findings may have important clinical implications for cardiovascular risk assessment in MODY
Tucatinib plus trastuzumab for chemotherapy-refractory, HER2+, RAS wild-type metastatic colorectal cancer (MOUNTAINEER): Final analysis
No full textMOUNTAINEER was a multicenter, open-label, phase 2 trial (NCT03043313) that evaluated the efficacy and safety of tucatinib plus trastuzumab, a dual HER2-targeted chemotherapy-free regimen. Patients were included if they had chemotherapy-refractory, HER2+, RAS wild-type unresectable or metastatic colorectal cancer. This final analysis reports updated efficacy and safety after a median follow-up of 32.4 months. Of the 84 patients who received tucatinib plus trastuzumab, the confirmed objective response rate was 39.3%; median duration of response was 15.2 months. Median progression-free survival was 8.1 months and overall survival was 23.9 months. Efficacy was relatively similar across central HER2+ testing methods. No clear association of treatment response with co-occurring biomarker alterations was seen. Few patients discontinued treatment due to adverse events; no treatment-emergent deaths occurred. Tucatinib plus trastuzumab showed clinically meaningful efficacy and favorable safety. Efficacy was observed irrespective of central HER2+ testing methods and in patients with heterogeneous tumor biomarker profiles
Radiation realities: Radiation safety practices and awareness among interventional echocardiographers in the United States
No full textPost-lobectomy lung abscess
No full textA residual lung parenchyma abscess following pulmonary resection for lung cancer is a rare and potentially serious condition. We present a case of successful nonoperative management of a lung abscess that developed after a right upper lobectomy for adenocarcinoma in a 76-year-old man who experienced systemic symptoms 6 weeks after his initial surgery. Imaging revealed an abscess in the previous surgical cavity. We discuss management strategies and challenges associated with this uncommon condition
Troponins and echocardiography: Role in detecting myocardial injury in burn patients
No full textSevere burn injuries result in a massive systemic inflammatory and hypermetabolic response, often disrupting multiple organ systems, including the cardiovascular system. Cardiac troponins are frequently elevated in burn patients, but the interpretation of these elevations is hardly straightforward. Sometimes, elevated troponin means type 1 myocardial infarction (MI) due to an acute coronary event, but it might also reflect type 2 MI due to an imbalance between body oxygen demand and supply, or even non-ischemic myocardial injury from things like overwhelming inflammation, sepsis, or direct thermal effects on the heart itself. This narrative review explores the prevalence, underlying pathophysiological mechanisms, diagnostic challenges, and prognostic implications of troponin elevation in burn patients. We discussed the limitations of applying conventional MI diagnostic criteria in this unique population. The role of electrocardiographic and echocardiographic assessment, as well as the potential utility of high-sensitivity troponin assays, is also discussed. Understanding of how burn pathophysiology relates to myocardial injury is essential for accurate diagnosis, improved management, and better outcomes in this highly vulnerable group of patients
Fetal skull fracture with overlying hematoma after a high-speed motor vehicle collision with limited maternal trauma
No full textInside Aurora Sinai Medical Center, 2002 April
No full textAurora Sinai Medical Center, Milwaukee, WI: Internal employee newsletter with workplace anniversaries, news, and events.https://institutionalrepository.aah.org/alldocuments/2240/thumbnail.jp
Inside Aurora Sinai Medical Center, 2003 June
No full textAurora Sinai Medical Center, Milwaukee, WI: Internal employee newsletter with workplace anniversaries, news, and events.https://institutionalrepository.aah.org/alldocuments/2252/thumbnail.jp
Change in head impact exposure following return-to-sport in concussed football athletes
No full textPurpose: Following sport-related concussions, early head impact exposure and premature return-to-sport are known to increase risk of repeat concussion in football athletes, yet athletes\u27 true post-injury head impact exposure profiles (i.e., characteristics of recorded head impacts over a given time period) and biomechanical progression have not been explored. Accordingly, this study explored how head impact exposure in American college football athletes was altered during their return to sport from concussion, particularly within the same athletic season.
Methods: This analysis compared daily volume of head impacts following concussion with pre-injury levels using head impact exposure profiles of fifty-two concussed collegiate football athletes from six NCAA Division I programs, and further compared these athletes to team- and position-matched controls to minimize season- or team-related factors. Additionally, this study provided an analysis of the possible association between duration of recovery and change in head impact exposure following concussion using continuous linear regression.
Results: When comparing to pre-injury levels, 75% of concussed athletes reduced their head impact exposure in their immediate return-to-sport, while over 40% of concussed athletes did not reach their pre-injury level of head impact exposure at any point during the remainder of the concussion season segment. Furthermore, concussed athletes significantly decreased their head impact exposure over their immediate return-to-sport period when compared to team- and position-matched healthy, non-concussed athletes over the same time period. Finally, longer post-concussion recovery times were associated with larger decreases in head impact exposure after return-to-sport.
Conclusions: This study provides evidence for a shift in head impact exposure after returning from concussion, seen most strongly in the immediate days after return-to-sport. These findings align with the recent shift toward more conservative post-concussion management seen across multiple sports and playing levels