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https://www.readbyqxmd.com/read/29571927/implicit-physician-biases-in-periviability-counseling
#1
Natasha Shapiro, Elena V Wachtel, Sean M Bailey, Michael M Espiritu
OBJECTIVE: To assess whether neonatologists show implicit racial and/or socioeconomic biases and whether these are predictive of recommendations at extreme periviability. STUDY DESIGN: A nationwide survey using a clinical vignette of a woman in labor at 232/7 weeks of gestation asked physicians how likely they were to recommend intensive vs comfort care. Participants were randomized to 1 of 4 versions of the vignette in which racial and socioeconomic stimuli were varied, followed by 2 implicit association tests (IATs)...
June 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/28807693/safety-and-feasibility-of-rehabilitation-interventions-in-children-undergoing-hematopoietic-stem-cell-transplant-with-thrombocytopenia
#2
Katarzyna Ibanez, Noel Espiritu, Regine L Souverain, Laura Stimler, Lauren Ward, Elyn R Riedel, Rachel Lehrman, Farid Boulad, Michael Dean Stubblefield
OBJECTIVE: To analyze the relation between platelet counts, intensities of physical therapy (PT) and occupational therapy (OT) services received, and frequencies of bleeding complications in children undergoing hematopoietic stem cell transplant (HSCT) during a period of severe thrombocytopenia. DESIGN: Retrospective review study. SETTING: Tertiary care hospital. PARTICIPANTS: Children (N=63; age, <18y) hospitalized for HSCT in 2010 and 2011 who received PT and OT services while markedly thrombocytopenic (platelet count, ≤50K/mcL)...
February 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28803228/utility-of-routine-urine-cmv-pcr-and-total-serum-igm-testing-of-small-for-gestational-age-infants-a-single-center-review
#3
Michael M Espiritu, Sean Bailey, Elena V Wachtel, Pradeep V Mally
BACKGROUND: Due to the extremely low incidence of TORCH (toxoplasmosis, rubella, CMV, herpes simplex virus) infections, diagnostic testing of all small for gestational age (SGA) infants aimed at TORCH etiologies may incur unnecessary tests and cost. OBJECTIVE: To determine the frequency of urine CMV PCR and total IgM testing among infants with birth weight <10% and the rate of test positivity. To evaluate the frequency of alternative etiologies of SGA in tested infants...
January 26, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27142621/challenges-and-opportunities-in-the-provision-of-surgical-care-in-vanuatu-a-mixed-methods-analysis
#4
S Young, W R G Perry, B Leodoro, V Nosa, I Bissett, J A Windsor, A J Dare
BACKGROUND: The Pacific island nation of Vanuatu faces a number of challenges in delivering surgical care to its population. We aimed to understand and document the barriers, opportunities and required actions to improve surgical care in the country using a mixed methods analysis which incorporated the perspectives of local health stakeholders. METHODS: A baseline quantitative assessment of surgical capacity in Vanuatu was carried out using the WHO situational analysis tool...
August 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/26946418/use-of-cpap-in-patients-with-obstructive-sleep-apnea-admitted-to-the-general-ward-effect-on-length-of-stay-and-readmission-rate
#5
G Kamel, K Munzer, J Espiritu
BACKGROUND: Obstructive sleep apnea (OSA) has been associated with multiple cardiovascular comorbidities. Despite increased awareness of OSA and its treatments, the management of OSA in the hospital setting remains below expectations. METHODS: We retrospectively reviewed the demographics, clinical characteristics, and hospital course on 413 consecutive patients with a history of OSA on domiciliary CPAP therapy admitted to the general medical ward and analyzed the prevalence of CPAP use and its effect on length of stay (LOS), 30-day readmission rate, and time-to-readmission in our tertiary care teaching hospital...
September 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/25777366/predicting-postoperative-complications-of-inguinal-lymph-node-dissection-for-penile-cancer-in-an-international-multicentre-cohort
#6
MULTICENTER STUDY
Jared M Gopman, Rosa S Djajadiningrat, Adam S Baumgarten, Patrick N Espiritu, Simon Horenblas, Yao Zhu, Chris Protzel, Julio M Pow-Sang, Timothy Kim, Wade J Sexton, Michael A Poch, Philippe E Spiess
OBJECTIVES: To assess the potential complications associated with inguinal lymph node dissection (ILND) across international tertiary care referral centres, and to determine the prognostic factors that best predict the development of these complications. MATERIALS AND METHODS: A retrospective chart review was conducted across four international cancer centres. The study population of 327 patients underwent diagnostic/therapeutic ILND. The endpoint was the overall incidence of complications and their respective severity (major/minor)...
August 2015: BJU International
https://www.readbyqxmd.com/read/25384488/evacuation-of-a-neonatal-intensive-care-unit-in-a-disaster-lessons-from-hurricane-sandy
#7
Michael Espiritu, Uday Patil, Hannaise Cruz, Arpit Gupta, Heideh Matterson, Yang Kim, Martha Caprio, Pradeep Mally
NICU patients are among those potentially most vulnerable to the effects of natural or man-made disaster on a medical center. The published data on evacuations of NICU patients in the setting of disaster are sparse. In October of 2012, New York University Langone Medical Center was evacuated during Hurricane Sandy in the setting of a power outage secondary to a coastal surge. In this setting, 21 neonates were safely evacuated from the medical center's NICU to receiving hospitals within New York City in a span of 4...
December 2014: Pediatrics
https://www.readbyqxmd.com/read/25251966/the-merits-of-cytology-in-the-workup-for-upper-tract-urothelial-carcinoma-a-contemporary-review-of-a-perplexing-issue
#8
E F Sverrisson, T Kim, P N Espiritu, W J Sexton, J M Pow-Sang, J Dhillon, P E Spiess
INTRODUCTION: The importance of upper tract cytology for evaluating tumors is unclear. We correlated upper tract cytology with histologic findings in patients who underwent nephroureterectomy for upper tract urothelial carcinoma (UTUC) at a single tertiary care referral center. MATERIALS AND METHODS: 137 patients underwent nephroureterectomy between 2004 and 2012. 18 patients were excluded (benign tumors, atrophic kidneys with the remaining 119 patients serving as our study population)...
July 2014: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/24900291/discovery-of-psi-353661-a-novel-purine-nucleotide-prodrug-for-the-treatment-of-hcv-infection
#9
Wonsuk Chang, Donghui Bao, Byoung-Kwon Chun, Devan Naduthambi, Dhanapalan Nagarathnam, Suguna Rachakonda, P Ganapati Reddy, Bruce S Ross, Hai-Ren Zhang, Shalini Bansal, Christine L Espiritu, Meg Keilman, Angela M Lam, Congrong Niu, Holly Micolochick Steuer, Phillip A Furman, Michael J Otto, Michael J Sofia
Hepatitis C virus afflicts approximately 180 million people worldwide, and the development of direct acting antivirals may offer substantial benefit compared to the current standard of care. Accordingly, prodrugs of 2'-deoxy-2'-fluoro-2'-C-methylguanosine monophosphate analogues were prepared and evaluated for their anti-HCV efficacy and tolerability. These prodrugs demonstrated >1000 fold greater potency than the parent nucleoside in a cell-based replicon assay as a result of higher intracellular triphosphate levels...
February 10, 2011: ACS Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/22826481/community-based-rapid-oral-human-immunodeficiency-virus-testing-for-tuberculosis-patients-in-lima-peru
#10
Adrianne K Nelson, Adolfo Caldas, Jose Luis Sebastian, Maribel Muñoz, Cesear Bonilla, Jose Yamanija, Oswaldo Jave, Christina Magan, Judith Saldivar, Betty Espiritu, Gustavo Rosell, Jaime Bayona, Sonya Shin
Among tuberculosis patients, timely diagnosis of human immunodeficiency virus (HIV) co-infection and early antiretroviral treatment are crucial, but are hampered by a myriad of individual and structural barriers. Community-based models to provide counseling and rapid HIV testing are few but offer promise. During November 2009-April 2010, community health workers offered and performed HIV counseling and testing by using the OraQuick Rapid HIV-1/2 Antibody Test to new tuberculosis cases in 22 Ministry of Health establishments and their household contacts (n = 130) in Lima, Peru...
September 2012: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/22715178/postinfectious-gastrointestinal-disorders-following-norovirus-outbreaks
#11
Chad K Porter, Dennis J Faix, Danny Shiau, Jennifer Espiritu, Benjamin J Espinosa, Mark S Riddle
BACKGROUND: The US Centers for Disease Control and Prevention estimates 20.9 million norovirus infections annually in the United States. Although the acute disease burden is sizeable, emerging data suggest norovirus may be associated with chronic gastrointestinal problems. We identified known outbreaks in US military recruits and used the Defense Medical Encounter Database (DMED) to identify the risk of new onset functional gastrointestinal disorders (FGD) and gastroesophageal reflux disease (GERD)...
October 2012: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/22525176/training-fellows-for-retinopathy-of-prematurity-care-a-web-based-survey
#12
Ryan K Wong, Camila V Ventura, Michael J Espiritu, Yoshihiro Yonekawa, Laure Henchoz, Michael F Chiang, Thomas C Lee, Robison V Paul Chan
PURPOSE: To characterize the training received by pediatric ophthalmology and retina fellows in retinopathy of prematurity (ROP) management. METHODS: Pediatric ophthalmology and retina fellowship programs were emailed a Web-based survey to assess fellowship training in ROP management. RESULTS: Of 140 programs contacted, 42 (30%) participated, resulting in 87 surveys for analysis. Of the 87 respondents, 25 (29%) reported that two-thirds or less of ROP examinations performed by fellows were also seen by an attending...
April 2012: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/21368011/mental-health-burden-among-impoverished-hiv-positive-patients-in-peru
#13
Sonya Shin, Maribel Muñoz, Adolfo Caldas, Ying Wu, Jhon Zeladita, Milagros Wong, Betty Espiritu, Eduardo Sanchez, Miriam Callacna, Christian Rojas, Jorge Arevalo, Jose Luis Sebastian, Jaime Bayona
HIV and poor mental health are intricately related. In settings of poverty, both are often rooted in structural factors related to material and social deprivation. We performed a qualitative analysis to understand factors contributing to poor emotional health and its impact among impoverished Peruvian HIV-infected individuals. We conducted focus group discussions with patients and providers consisting of semistructured, open-ended questions. Qualitative analysis provided insight into the profound impact of depression, isolation, stigma, and lack of social support among these patients...
January 2011: Journal of the International Association of Physicians in AIDS Care: JIAPAC
https://www.readbyqxmd.com/read/20810935/dural-tears-in-spine-surgery
#14
REVIEW
Michael T Espiritu, Alfred Rhyne, Bruce V Darden
Dural tears are among the most commonly seen complications in spine surgery. Most studies in the literature indicate that long-term outcomes are not negatively affected, provided that the tears are diagnosed early and managed appropriately. Direct suture repair remains the preferred method for the management of durotomy caused by or found during surgery. However, recent literature reports encouraging results with sutureless repair. Understanding dural anatomy, dural healing, and cerebrospinal fluid dynamics is helpful in choosing among the available management options for dural tear...
September 2010: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/19525152/donor-site-complications-of-autogenous-nonvascularized-fibula-strut-graft-harvest-for-anterior-cervical-corpectomy-and-fusion-surgery-experience-with-163-consecutive-cases
#15
Ahmad Nassr, Mustafa H Khan, Mir H Ali, Michael T Espiritu, Steven E Hanks, Joon Y Lee, William F Donaldson, James D Kang
BACKGROUND CONTEXT: The fibula is a source of bone graft for reconstruction of the appendicular and axial skeleton. PURPOSE: The aim of this study is to determine donor-site complications and morbidity in a large series of patients who underwent autogenous fibula harvesting for anterior cervical corpectomy and fusion (ACCF) surgery. STUDY DESIGN/SETTING: Retrospective review (Level III). PATIENT SAMPLE: One hundred sixty-three patients over an eight-year period who underwent ACCF with autogenous fibula...
November 2009: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/19385579/prevention-identification-and-treatment-of-inadequate-decompression-of-the-cervical-spine
#16
Clinton J Devin, Michael T Espiritu, James D Kang
Inadequate decompression is one of the most common reasons for failed spinal surgery. Understanding the common areas where neural impingement occurs in the cervical spine, recognizing these changes on imaging studies, and recognizing the clinical manifestations help provide an intraoperative template for thorough decompression. A thorough preoperative workup assesses sagittal alignment of the cervical spine, determines if instability exists, identifies the location of the compression, and determines the etiology of the compressive lesion...
2009: Instructional Course Lectures
https://www.readbyqxmd.com/read/18614919/burden-of-depression-among-impoverished-hiv-positive-women-in-peru
#17
Diana Ying Wu, Maribel Munoz, Betty Espiritu, Jhon Zeladita, Eduardo Sanchez, Miriam Callacna, Christian Rojas, Jorge Arevalo, Adolfo Caldas, Sonya Shin
OBJECTIVES: In resource-poor settings, the mental health burden among HIV-positive women is exacerbated by poverty. We sought to describe the extent, risk factors, and experience of depression among impoverished HIV-positive women living in Lima, Peru. METHODS: This is a case series of 78 HIV-positive women in Lima, Peru. We measured depression, stigma, and social support and performed a multivariable analysis to identify factors associated with depression. RESULTS: Among 78 HIV-positive patients, 68% were depressed...
August 1, 2008: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/17408101/-risk-factors-for-birth-injuries
#18
Heladia García, Jorge Rubio-Espíritu, Maria Teresa Islas-Rodríguez
OBJECTIVE: To identify risk factors associated with birth trauma. SETTING: Servicio de Neonatología, Hospital General "Dr. Manuel Gea González", Secretaría de Salud. DESIGN: Case-control, prolective study. PATIENTS: There were 129 cases and 134 controls. MEASURES: We recorded the following variables: a) maternal and delivery: age, weight, height, prenatal care, pre-existing disease or gestational disease, mode of delivery, anesthetic management during labor, use of external maneuvers or forceps; b) newborn: birth weight, gestational age, academic degree of attendant physician at delivery, and type of birth injury...
September 2006: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
https://www.readbyqxmd.com/read/17101805/scaling-up-hiv-treatment-in-peru-applying-lessons-from-dots-plus
#19
Jose Luis Sebastian, Maribel Munoz, Eda Palacios, Beatriz Espiritu, Lorena Mestanza, Katiuska Chalco, Karim Llaro, Dalia Guerra, Sonya Shin, Jaime Bayona
Many countries with financial support for HIV treatment experience delays in scale-up because of bureaucratic, operational, and technical obstacles. The authors describe the Peruvian National HIV Program's response to such challenges. A team of consultants experienced in the scale-up of the Peruvian national program to treat multidrug-resistant tuberculosis worked with the national HIV program to identify and address key factors contributing to slow enrollment of HIV patients into the antiretroviral treatment program...
December 2006: Journal of the International Association of Physicians in AIDS Care: JIAPAC
https://www.readbyqxmd.com/read/16935736/comparison-of-bacteriostatic-normal-saline-and-lidocaine-used-as-intradermal-anesthesia-for-the-placement-of-intravenous-lines
#20
RANDOMIZED CONTROLLED TRIAL
Pamela E Windle, Meggie L Kwan, Honey Warwick, Agnes Sibayan, Charito Espiritu, Jennifer Vergara
Pain with intravenous (IV) insertion is a common fear for preoperative patients. As perianesthesia nurses, we take the necessary measures to minimize the discomfort and anxiety of our patients. Several research studies have found the use of bacteriostatic normal saline (BNS) to produce a less painful, yet equally effective, safer, and less expensive alternative method for intradermal anesthesia. The purpose of this study was to determine whether a difference existed in pain with intradermal injection and pain with venipuncture when intradermal anesthesia was used...
August 2006: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
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