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Adherence to the PRISMA 2020 Guideline: An Evaluation of Meta-Analyses and Systematic Reviews Published in Pharmacy Journals.
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This cross-sectional evaluation study found that, on average, published meta-analyses in pharmacy journals are adherent to PRISMA best practices, though several areas, related to background and rationale of the study, discussion items, and search strategy, were identified for improvement
Using a modified Delphi panel to develop best practices in course evaluations of teaching.
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This study generated best practices colleges of pharmacy should employ when conducting student evaluations of teaching and courses
TRANSCATHETER AORTIC VALVE IMPLANTATION VS SURGICAL AORTIC VALVE REPLACEMENT IN SOLID ORGAN TRANSPLANT RECIPIENTS: READMISSION RATES AND HEALTH-CARE BURDEN
Get PDFBackground Transcatheter Aortic Valve Implantation (TAVI) outnumbers Surgical Aortic Valve Replacement (SAVR) for Aortic Stenosis in the US. Readmission rates and the healthcare burden of these procedures in Solid Organ Transplant (SOT) recipients are poorly studied.
Methods National Readmission Database (2016-2020) was used to identify SOT recipients (Renal, Heart, Kidney, Lung & Pancreas) undergoing TAVI or SAVR. Propensity score matching (PSM) was used to remove confounding factors from outcomes. Descriptive and regression based analysis was performed.
Results Among 3,394 hospitalizations for Aortic Valve Replacement, 2,181 underwent TAVI & 1,213 underwent SAVR. SAVR was associated with higher median LOS (10 vs 2 days) and total cost (57,014) in index admission and subsequent readmissions [p\u3c0.001]. From 2016-2020, median LOS (3 to 2 days, p-trend\u3c0.001) and total cost (54,221, p-trend: 0.002) decreased in the TAVI group but remained the same in the SAVR group (p-value\u3e0.05). Although readmission rates were similar in the two groups, SAVR was associated with higher major adverse cardiovascular events (32.2% vs 19.9%) and net adverse events (82.2% vs 57.2%) at 90-day interval [p\u3c0.001] and subsequently at 180-day interval [p\u3c0.001].
Conclusion In SOT recipients, SAVR is associated with higher median LOS, resource utilization & adverse outcomes on readmission analysis. TAVI has lower resource utilization, and it continues to decrease from 2016-2020
Heavy users, mobile gamers, and social networkers: Patterns of objective smartphone use in parents of infants and associations with parent depression, sleep, parenting, and problematic phone use.
Get PDFSmartphone use during parenting is common, which may lead to distraction (also known as technoference). However, it is likely that some phone activities are less disruptive to parents and children. In this study, we explored smartphone use (via passive sensing across 8 days) within 264 parents of infants, measuring parents\u27 application use on their phone (e.g., messaging, social media, mobile gaming, video chat) and phone use across contexts (e.g., during feeding and at bedtime). We utilized latent profile analysis to identify profiles of users, revealing five user types
ARDS and prone positioning
No full textEvery nurse should know about this life-saving maneuver. Takeaways: Prone positioning has been a treatment option for acute respiratory distress syndrome in critically ill patients. Since the COVID-19 pandemic, awake prone positioning has been utilized as a treatment option for non-intubated patients to improve oxygenation and to help prevent the need for mechanical ventilation. Moving patients to the prone position requires a team of caregivers to ensure patient and staff safety
Malignant Pleural Mesothelioma: A Comprehensive Review.
Get PDFMesotheliomas are hyperplastic tumors that envelop the serosal membranes that safeguard the body\u27s external surfaces. Although certain instances may exhibit indolent characteristics, a significant number of tumors demonstrate rapid progression and a poor prognosis. Mesotheliomas are typically categorized as benign or malignant, with malignant mesothelioma being more frequently linked to asbestos exposure. Malignant pleural mesothelioma (MPM) predominantly impacts males and often emerges in the late 50 s or beyond, characterized by a median age of early 70 s among patients exposed to asbestos lasting from 2 to 4 decades. Respiratory exposure to asbestos particles leads to the development of malignant mesothelioma, characterized by recurrent inflammation, disruption of cell division, activation of proto-oncogenes, and generation of free radicals. In pleural mesothelioma, BAP1, CDKN2A, and NF are the most often mutated genes. Accurate diagnosis and assessment usually require the use of chest computed tomography (CT) scans, magnetic resonance imaging (MRI), and positron emission tomography (PET). Radiation therapy, immunotherapy, chemotherapy, and surgery are some of the treatment options that are currently available. This systematic review provides a comprehensive analysis of the latest research, biomarkers, evaluation, and management strategies for malignant pleural mesothelioma
Nationwide Outcomes in Intermediate to High-Risk Pulmonary Embolism Treated with Catheter-based Therapies
Get PDFBackground The mortality rate of pulmonary embolism is as high as 30% and affects 900,000 individuals in the United States per year. Catheter-based therapies (CBT), including catheter-directed thrombolysis (CDT) and mechanical thrombectomy (MT), have been developed to treat patients with intermediate- and high-risk pulmonary embolisms. This study aims to characterize the outcomes in patients admitted with intermediate or high-risk pulmonary embolism treated with MT compared with CDT. Methods The 2020 National Inpatient Sample data was used to analyze outcomes in hospitalized pulmonary embolism patients who received CDT and MT. The primary and secondary outcomes were in-hospital mortality, length of hospital stay, and significant bleeds, including gastrointestinal or brain bleeds. Results 82,179 cases of pulmonary embolism were identified. 2,951 cases (3.6%) received catheter-based therapies (CBT), of which 1,513 (51.27%) received CDT, 1308 (44.32%) received MT, and 130 (4.41%) received a combination of CDT and MT. There were no differences in the incidence of major complications between the MT and CDT groups, including gastrointestinal bleeding (p=0.14) and intracranial bleeding (p=0.26). The length of stay (6.65 vs. 5.46 days, p\u3c0.001) was higher in the MT group than in the CDT. In the multivariate analysis, MT was associated with increased all-cause inpatient mortality (OR 2.41, 95% CI 1.72-3.39, p\u3c0.001). In addition, patients were more likely to get MT than CDT if they had saddle pulmonary embolism (OR 1.28, 95% CI 1.10-1.50, p=0.002), were admitted to medium-sized (OR 1.45, 95% CI 1.14-1.84, p=0.002) or large-sized hospitals (OR 1.73, 95% CI 1.39-2.15, p\u3c0.001), were admitted to urban teaching hospitals (OR 1.93, 95% CI 1.26-2.93, p=0.002), or were older (OR 1.009, 95% CI 1.004-1.014, p\u3c0.001). Conclusions Our study shows that CBT use is still limited in PE patients, and the use of MT is lower than CDT. Patients who received MT had increased all-cause inpatient mortality compared to those who received CDT
Discharge antibiotic use in patients hospitalized with chronic obstructive pulmonary disease (COPD) exacerbations.
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This medication use evaluation identified opportunities for improved prescribing in this population. The majority of patients receiving antibiotics had increased dyspnea only. Because of this, 90% of patients did not receive antibiotics appropriately; 94% received an excessive duration. The majority of patients had no prior to admission COPD maintenance therapy, potentially related to lack of baseline FEV1 data required for initiating therapy classification
Stepping back: evaluating antipseudomonal antibiotic use in diabetic foot infection.
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This study found that anti-pseudomonal (PsA) coverage is overutilized in diabetic foot infection (DFI), even when broad qualifying criteria are applied. The proposed criteria were poor predictors of PsA growth, which was present in a small number of cases. Patients who did grow PsA were somewhat more likely to have severe DFI, history of DFI, and 90-day history of admission or anti-PsA antibiotic use, but many patients without PsA growth also met these criteria
Issue 12: Pulmonary &Critical Care Insider
Get PDFPulmonary & Critical Care Insider Issue 12
Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.
The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health.
Topics: Original Study Summaries, Viewpoints, and Snapshots
Early COPD & Asthma Diagnosis & Treatment, ENHANCE trial, ANNEXA-I trial, Angiotensin II Use in Vasodilatory Shock, Ammonia in Liver Failure, Pirfenidone and more