Showing papers by "New York Methodist Hospital published in 2022"
TL;DR: In this paper , the impact of diabetes mellitus on spinal cord injury (SCI) after open descending thoracic and thoraco-abdominal aneurysm repair (DTAAAR) was investigated.
Abstract: To discern the impact of diabetes mellitus (DM) on spinal cord injury (SCI) after open descending thoracic and thoraco-abdominal aneurysm repair (DTAAAR).Compared to euglycemia, hyperglycemia and ketosis make neurons respectively more vulnerable and more resilient to ischemia.During the study period (1997-2021), patient who underwent DTAAAR were dichotomized according to the presence/absence of DM. The latter was investigated as predictor of our primary (SCI) and secondary (operative mortality, myocardial infarction, stroke, need for tracheostomy, de-novo dialysis, and survival) endpoints. Two-level risk-adjustment employed maximum likelihood conditional regression after 1:2 propensity-score matching.DTAAAR was performed in 934 patients. Ninety-two diabetics were matched to 184 non-diabetics. All preoperative variables had a standardized mean difference <0.1 between the matched groups. Patients with DM had higher SCI (6.5% vs. 1.6%, P 0.03) and operative mortality (14.1% vs. 6.0%, P 0.01), while the other secondary endpoints were similar between groups in the matched sample. DM was an independent predictor for SCI in the matched sample (OR 5.05, 95% CI 1.17 to 21.71). Matched patients with DM presented decreased survival at 1 (70.2% vs. 86.2%), 5 (50.4% vas 67.5%), 10 years (31.7% vs. 36.7%) (P 0.03). The results are summarized in the graphical abstract.DM is associated to increased operative mortality and decreased survival, and it is an independent predictor of SCI after open DTAAAR. Strict perioperative glycemic control should be implemented, and exogenous ketones should be investigated as neuroprotective agents to reduce such adverse events.
2 citations
21 Mar 2022
TL;DR: In this article , the authors classified decidual vasculopathy into three types: acute atherosis, fibrinoid medial necrosis, and mural arterial hypertrophy.
Abstract: There are 3 types of decidual vasculopathy, namely, acute atherosis, fibrinoid medial necrosis, and mural arterial hypertrophy. Persistence of vascular trophoblasts is also known to be related to maternal vascular malperfusion, but detailed study is lacking.To define atherosis of trophoblast type and distinguish it from atherosis of macrophage type with clinical significance.A total of 1322 placentas from 2021 were collected with clinical, neonatal, and placental information, and routine placental pathology examination was performed. Decidual vasculopathy was classified on the basis of the new classification scheme including atherosis of macrophage type, atherosis of trophoblast type, fibrinoid medial necrosis, mural arterial hypertrophy, and mixed-type vasculopathy. The significance of these morphologic changes was examined on the basis of clinical, neonatal, and placental pathology features.Decidual vasculopathy is classified as classic type, mural hypertrophy, and mixed type. Classic-type vasculopathy is further separated as atherosis and fibrinoid medial necrosis. Atherosis is defined as atherosis of macrophage type and atherosis of trophoblast type. Each category of decidual vasculopathy was evaluated in association with maternal, neonatal, and placental pathologic findings. Atherosis of macrophage type and mixed-type vasculopathy showed statistically significant association with preeclampsia/pregnancy-induced hypertension, low birth weight, and low placental weight. Atherosis of trophoblast type was associated with lower placental weight but not with other specific clinical features. Neonates of female sex were associated with mural arterial hypertrophy.Atherosis of trophoblast type is a distinct pathologic feature in late pregnancy, and it is associated with lower placental weight. New classification of decidual vasculopathy helps with better stratification and categorization of placental maternal vascular abnormalities of late pregnancy.
2 citations
TL;DR: In this paper , the metallic Ni nanocrystals are evenly distributed in V2O3 hollow nanoprisms wrapped by nitrogen-doped carbon through a facile self-template method.
1 citations
18 Jun 2022
TL;DR: Clinical decision support (CDS) provides clinicians, staff, patients, or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and health care as mentioned in this paper .
Abstract: Clinical decision support (CDS) provides clinicians, staff, patients, or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and health care. CDS encompasses a variety of tools to improve decision-making in the clinical workflow. CDS includes computerized alerts and reminders to care providers and patients; clinical guidelines; condition-specific order sets; focused patient data reports and summaries; documentation templates; diagnostic support; and contextually relevant reference information.
01 Jan 2022
18 Jun 2022
TL;DR: In this paper , the authors look into the current state of use of EHR and improve its design to better fit physician workflow and remove redundancies, while also reevaluating its current emphasis on regulatory and administrative requirements.
Abstract: To achieve the maximum potential of EHR, it is essential to look into its current state of use and improve its design to better fit physician workflow and remove redundancies, while also reevaluating its current emphasis on regulatory and administrative requirements.
01 Jan 2022