Beaumont Health

About: Beaumont Health is a nonprofit organization based out in Royal Oak, Michigan, United States. It is known for research contribution in the topics: Medicine & Population. The organization has 1483 authors who have published 1448 publications receiving 15407 citations. The organization is also known as: William Beaumont Health System & Beaumont Hospitals.

Massive hemoptysis due to bronchopulmonary arterial fistula successfuly treated with amplatzer plug occlusion

Abstract: We present the case of a 59-year-old male with massive hemoptysis secondary to a bronchopulmonary artery fistula formed as the result of a perihilar lung cancer. The hemoptysis was successfully treated by Amplatzer Plug (St. Jude Medical) embolization of the supplying pulmonary artery branch. At the same time, bronchoscopy was performed to tamponade the patients bleeding and avoid exsanguination. Biopsy of the mass demonstrated poorly differentiated non small cell carcinoma. Post procedure day 13 the patient underwent staging with PET CT which showed localized disease. His hemoptysis resolved.

Small Fiber Polyneuropathy in Hunner Lesion and Non-Hunner Lesion Interstitial Cystitis/Bladder Pain Syndrome.

Abstract: Objective This study aimed to determine whether small fiber polyneuropathy (SFPN) diagnosis differs between Hunner lesion interstitial cystitis/bladder pain syndrome (HL IC/BPS) and non-Hunner lesion IC/BPS (NHL IC/BPS). Methods This was a pilot study of 20 women with IC/BPS. Results from baseline questionnaires, such as Genitourinary Pain Index, Interstitial Cystitis Symptom Index/Interstitial Cystitis Problem Index (ICSI/ICPI), Patient Health Questionnaire-2, were collected.Two punch biopsies were performed on each patient: distal leg and thigh. The samples were evaluated for intraepidermal nerve fiber density. One intraepidermal nerve fiber density less than the fifth percentile, regardless of site, indicated a positive SPFN diagnosis. Results Twenty patients were enrolled; 10 HL IC/BPS and 10 NHL IC/BPS. The HL IC/BPS group was found to be significantly older than the NHL IC/BPS group (63 vs 48 years, P = 0.007). No significant differences were found in employment or relationship statuses, or in levels of education or comorbidities between the 2 groups.Sixty percent (6/10) of patients had SFPN in the NHL IC/BPS group compared with 40% (4/10) in the HL IC/BPS group. No significant differences were seen in SFPN positivity (P = 0.3) or Genitourinary Pain Index, Patient Health Questionnaire-2, or Interstitial Cystitis Symptom Index/Interstitial Cystitis Problem Index scores between the NHL and HL IC/BPS groups. Conclusions Similar to previously published studies, 60% of NHL IC/BPS patients in this cohort were positive for SFPN compared with only 40% of the HL IC/BPS patients. Larger studies may be needed to realize the full impact of SFPN in IC/BPS.

Safety of apixaban compared to warfarin in hemodialysis patients: Do antiplatelets make a difference?

Abstract: BACKGROUND Data on the safety of apixaban compared to warfarin in hemodialysis (HD) patients are accumulating, but the impact of concomitant antiplatelet use is unknown OBJECTIVES Compare hemorrhagic risk and impact of antiplatelets in HD patients receiving oral anticoagulants (OAC) METHODS Retrospective, multi-center study of HD patients started on OAC inpatient over 5 years RESULTS 707 patients were included: 563 received warfarin, and 144 received apixaban 197 had bleeding, most in the warfarin group (173 [301%] vs 24 [167%] in the apixaban group), P-value < 01) However, with concomitant antiplatelet use, frequencies were similar (314% vs 250%; P-value = 292) Cumulative incidence using bleeding as event of interest and death as competing risk showed higher rates of bleeding with warfarin In a multivariate model, apixaban was associated with a lower hemorrhagic risk (hazard ratio [HR] 055 [95% confidence interval {CI} 035-086}) Apixaban showed lower hemorrhagic risk alone (HR 024, 95% CI 010-055) and similar risk when administered with antiplatelets (HR 093, 95% CI 055-156) CONCLUSIONS Apixaban is associated with less bleeding in HD patients compared to warfarin, but concomitant antiplatelet use may negate the safety advantage Prospective trials are warranted to determine the impact of antiplatelets on apixaban safety

Mediational Pathways Among Trait Impulsivity, Heroin-use Consequences, and Current Mood State.

Abstract: Background: This study examined whether lifetime heroin-use consequences mediate the relationship between trait impulsivity and three current mood outcomes: depression symptoms, stress levels, and ...