St. Jude Medical Center

About: St. Jude Medical Center is a healthcare organization based out in Fullerton, California, United States. It is known for research contribution in the topics: MEDLINE & Breast cancer. The organization has 93 authors who have published 150 publications receiving 13717 citations.

Increased Recovery and Survival in Patients With COVID-19 Respiratory Failure Following Treatment with Aviptadil: Report #1 of the ZYESAMI COVID-19 Research Group

Abstract: Background: Respiratory failure is a lethal complication of COVID-19 that has remained resistant to drug therapy. Vasoactive Intestinal Peptide (VIP) has been granted Emergency Use Authorization and or Compassionate Care Authorization in multiple countries and is shown to upregulate surfactant production, inhibit cytokine synthesis, prevent cytopathy, and blocks replication of the SARS-CoV-2 virus in pulmonary cells. The aim of this study is to determine whether aviptadil (synthetic VIP) can improve survival and recovery in patients with COVID-19 respiratory failure compared to placebo. Methods: A multicenter, placebo-controlled trial in 196 patients with COVID-19 respiratory failure randomized 2:1 to receive 3 days of intravenous aviptadil (synthetic VIP) or placebo. The primary endpoint was “alive and free from respiratory failure at day 60.” We additionally studied the mechanistic effect of aviptadil on blocking cytokine production and its linkage to survival and recovery from respiratory failure. Analysis was by modified intent to treat using a prespecified regression model. Findings: When controlling for baseline severity and site of care, patients treated with aviptadil were significantly more likely to be alive and free from respiratory failure at 60 days, compared to those treated with placebo (P=.02) and demonstrated significance on numerous other clinical endpoints. Without controlling for site of care, a two-fold increased odds of survival was seen at 60 days (95% CI 1.0 – 3.9; P=.035). Biomarker analysis demonstrates that aviptadil significantly decreased the probability of an IL-6 increase relative to placebo (50% vs. 71%; p=.04) and that preventing this cytokine rise was highly correlated with survival and recovery (P<.0001) regardless of baseline severity or treatment site. Interpretation: Treatment with aviptadil improves the likelihood of recovery from respiratory failure and survival at 60 days post treatment in critically ill patients with respiratory failure caused by COVID-19. This efficacy is supported by biomarker evidence that aviptadil prevents the rise in cytokines that are widely believed to predispose to morbidity and mortality in COVID-19.

Reflections Regarding the Social Ecological Model to Address Obesity in Southern California Youth

Abstract: Childhood overweight and obesity has been a significant public health concern in the United States for decades. School-based obesity prevention programs have been one strategy to address this issue. This article describes the implementation of a knowledge-based, healthy eating intervention delivered to 4th and 5th graders in a southern California school district. Trained graduate students implemented a nutrition education curriculum, consisting of three monthly lessons that would eventually be utilized and sustained by the schools’ Physical Education (PE) teachers in the following school year. As such, the intervention drew upon the Social Ecological Model (SEM) to describe how nutrition education could be implemented in a sustainable way to future generations of youth. Students were assessed on their knowledge and dietary behaviors at pre-test and after the final lesson. Students’ overall nutritional knowledge significantly increased from pre-test to post-test; however their self-reported eating behaviors (e.g., low fruit and vegetable consumption, and high consumption of chips, soda, and sweets) largely remained the same. Although the findings of this study were largely non-significant, we conclude that future interventions, which creatively address different levels of the target population’s environment, may have promise if they are sufficiently dosed.

Follow-up Management of the Paced Patient

Abstract: The recommendation and subsequent implantation of a pacemaker constitutes a therapeutic prescription with the same long-term responsibility for the periodic assessment of the continued appropriateness of that therapy as with the prescription of any pharmacologic agent. The multiplicity of programmable options available in the modern pacemaker allows the physician to titrate the dose of pacing in a manner similar to the periodic adjustment of the dose of a medication. A prime example is renal failure which commonly requires a decrease in the dose of some medications necessitated by a reduction in renal clearance, this same condition may require an increase in the programmed output of the pacemaker if the patient is prone to hyperkalemia because of associated rises in the capture threshold. This chapter will review multiple aspects and techniques associated with the routine follow-up of the pacing system including biventricular systems.

Health Care Reform Hits the Laboratory: What (Almost) Happened in California

Abstract: In 1994, four medical technologists met with a state senator to present the laboratorians' side in proposed health care legislation. Pictured here are Catherine L. Martin, MT(ASCP); the author, Fred L. Buxton, Jr, MA, MT(ASCP); and Sen John R, Lewis. Not pictured are Barbara Esparza, MT(ASCP); and Mike McCoy, MT(ASCP)SBB. (Photo of Ms Martin and Mr Buxton courtesy of the author. Photo of the California State Building courtesy of the Sacramento Convention and Visitor's Bureau. Photo of Sen Lewis courtesy of Sen Lewis' office