Saint Francis University

About: Saint Francis University is a education organization based out in Loretto, Pennsylvania, United States. It is known for research contribution in the topics: Population & Osteoblast. The organization has 1694 authors who have published 2038 publications receiving 87149 citations.

Propofol or process: what really affects efficiency?

Abstract: Due to increased public awareness, the number of endoscopic procedures performed per year is rapidly increasing. In lieu of expanding endoscopy units, current practices are being reviewed to improve unit efficiency without compromising patient care. Changing from a traditional medication regimen of demerol/versed or fentanyl/versed to propofol for moderate sedation is currently controversial. Studies using propofol are being conducted to measure recovery times, safety of administration by healthcare providers other than anesthesia providers, cost/benefit ratios, and patient satisfaction. In order to measure the benefits of propofol versus a traditional medication regimen, a retrospective review of 1,056 charts was conducted to evaluate the difference in procedure and post-procedure time between sedation groups before and after a process change. In this study, the use of propofol was associated with a statistically significant shorter mean procedure time (p <.001) and nonsignificant post-procedure time (p =.056) than a traditional regimen; however, a statistically significant reduction in mean times was demonstrated by changes in process (p <.001). The use of propofol demonstrated an actual total time savings of 5.3 minutes per case after the process change. This difference was not large enough for the authors to change current practice of traditional medication for moderate sedation when all other issues related to propofol were taken into consideration.

The Impact of Methamphetamine Use on Trauma Patients at a Level I Trauma Center: A 10-Year Retrospective Review.

Abstract: The effects of methamphetamines (MAs) on trauma patient outcomes have been evaluated, but with discordant results. The purpose of this study was to identify hospital outcomes associated with MA use after traumatic injury. Retrospective review of adult trauma patients admitted to an American College of Surgeons verified-Level I trauma center who received a urine drug screen (UDS) between January 1, 2004 and December 31, 2013. Logistic regression analysis was used to identify factors associated with mortality. Patients with a negative UDS were used as controls. Among the 2321 patients included, 75.1 per cent were male, 81.9 per cent were white, and the average age was 39. Patients were grouped by UDS results (negative, MA only, other drug plus MA, or other drug without MA). A positive drug screen result of other drug without MA demonstrated a significantly lower risk for mortality, but longer intensive care unit and hospital length of stay, as well as increased ventilator days than negative results. Results of MA only did not alter the risk of mortality. These findings suggest that patients who test positive for MAs are not at an increased risk of in-hospital mortality when compared with patients having a negative drug screen.

End-of-life prescribing of aspirin in patients with breast or colorectal cancer.

Abstract: Objectives The aim of this study was to evaluate the influence of an approaching cancer death on end-of-life aspirin use, a frequently prescribed medication for cardiovascular disease prevention. Methods This study was conducted using linked cancer registry and prescribing data. Breast (n=1151) and colorectal (n=1859) cancer decedents were matched to cancer survivors and the probability of either initiating aspirin, or continuing established aspirin use, was estimated in consecutive periods over the 5 years approaching a cancer-specific death (decedents) or matched index date (survivors). Results Using the linked data sets, we identified patients who died of their cancer (decedents) between 1 January 2001 and 31 December 2009. In the 5 years prior to death, we compared (1) the probability of initiating aspirin use for the first time, and (2) the probability of continuing aspirin use. In comparison to matched cancer survivors, an approaching cancer death was not associated with a reduction in aspirin initiation by breast or colorectal cancer decedents. However, the probability of continuing established aspirin use declined considerably in the 24 months approaching death and at the time of a death was significantly lower for breast (risk difference (RD) −0.26, 95% CI −0.33 to −0.20) and colorectal (RD −0.38, 95% CI −0.46 to −0.30) cancer decedents versus matched survivors. Conclusion A significant proportion of patients discontinue their aspirin in the time approaching a breast or colorectal cancer-specific death. The safety and benefits of this are unclear and empirical data are needed to guide decisions about aspirin use in the end of life.