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Institution

Stormont Vail Health

HealthcareTopeka, Kansas, United States
About: Stormont Vail Health is a healthcare organization based out in Topeka, Kansas, United States. It is known for research contribution in the topics: Ferritin & Population. The organization has 22 authors who have published 27 publications receiving 154 citations.

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Journal ArticleDOI
16 Feb 2021
TL;DR: In this paper, the authors performed a retrospective cross-sectional analysis of Nationwide Inpatient Sample (2016-2017) in adults' hospitalizations to identify prevalence and association of cardiovascular diseases and cerebrovascular disorders (CeVD) among early and late transient ischemic attack (TIA) patients among US hospitalizations.
Abstract: Literature reported, 9–17% transient ischemic attack (TIA) patients have a vascular event within 90 days, but there is limited data on long-term risk involvement of vascular events following TIA. To identify prevalence and association of cardiovascular diseases (CVD) and cerebrovascular disorders (CeVD) among early and late transient ischemic attack (TIA) patients among US hospitalizations. We performed a retrospective cross-sectional analysis of Nationwide Inpatient Sample (2016–2017) in adults’ hospitalizations. Early TIA (primary diagnosis), late TIA (secondary diagnosis), and vascular events including CVD (atrial fibrillation (Afib), ischemic heart disease (IHD), angina, acute myocardial infarction (MI)) and CeVD (acute ischemic stroke (AIS), intracerebral hemorrhage (ICeH), and subarachnoid hemorrhage (SAH)) among TIA were identified using ICD 10 CM codes. Prevalence of vascular events was compared among patients with TIA and without TIA. Weighted analysis to account for sampling strategy using mixed-effect multivariable survey logistic regression was performed to evaluate odds of having vascular events among TIA in comparison with non-TIA. Among 71,473,874 US hospitalizations, 0.38% and 5.92% patients had early and late TIA, respectively. Patients with late TIA had a higher prevalence of acute MI (4.9 vs 0.5 vs 3.4%), IHD (44 vs 28.6 vs 20.6%), angina (0.3 vs 0.2 vs 0.2%), Afib (22 vs 15.3 vs 10.9%), AIS (5.3 vs 0.6 vs 2%), SAH (0.2 vs 0.03 vs 0.1%) and ICeH (0.8 vs 0.04 vs 0.4%) compared with early TIA and no-TIA, respectively (p < .0001). Patients with late TIA had 23% higher risk of having Afib (aOR 1.23; 95% CI 1.22–1.23) and higher odds of having IHD (1.52; 1.52–1.53), AIS (1.72; 1.70–1.74), and ICeH (1.29; 1.25–1.33). We found a higher prevalence and risk of vascular events in patients with late TIA among US hospitalizations. Hence, a thorough clinical investigation and long-term follow-up of TIA patients may mitigate the risk of future vascular events and associated health care burden.
Journal ArticleDOI
01 Jun 2022
TL;DR: In this article , the authors discuss and review the rare presentation of multiple acute ischemic strokes in Hypereosinophilic syndrome (HES) and present the diagnosis of a T-lymphocyte variant of HES.
Abstract: Hypereosinophilic syndrome (HES) is a rare condition associated with hypereosinophilia and associated with multi-organ damage. HES presents with neurological manifestations such as ischemic strokes, encephalopathy, peripheral neuropathy, and/or venous sinus thrombosis. This article discusses and reviews the rare presentation of multiple acute ischemic strokes in HES. A 51-year-old male presented with right forearm numbness for a week; two days onset of the left arm and hand weakness, gait instability, intermittent disorientation, dark spots in vision; and intermittent dysarthria. MRI showed multiple small strokes in bilateral cerebral and cerebellar areas. He had leukocytosis with 53% eosinophils. TTE and TEE were negative for thrombus. A cerebral angiogram remained negative for vasculitis. Bone marrow biopsy revealed 40% eosinophils with abnormal T-lymphocytes with phenotyping positive for CD3- CD4+. His-final diagnosis was a T-lymphocyte variant of HES. A 39-year-old right-handed male presented with changes in mental status. A day prior to the presentation, he woke up with headache, dizziness, blurry vision, right arm weakness, subsequently found to have gait imbalance, and falls. He had leukocytosis with 60% eosinophils. Brain MRI showed innumerable acute tiny strokes in bilateral cerebral hemispheres and cerebellum. Cardiac MRI showed multiple cardiac thrombi with increased left ventricular thickness. Bone marrow aspirate showed eosinophilia with minimal monoclonal B-cell population. The diagnosis was consistent with HES. Both patients responded well to steroids with a resolution of eosinophilia. HES can have an initial presentation of multifocal ischemic infarcts. Multiple acute ischemic strokes in the presence of hematological abnormalities should lead to suspicion for blood dyscrasia.
Journal ArticleDOI
25 Jun 2020
TL;DR: Important aspects of the project were the evaluation of antimicrobial prescribing habits for a midwest ED and identification of potential complications requiring future interventions for follow-up or preventative measures to assist in patient care and community health.
Abstract: Introduction Antibiotic stewardship utilizes interprofessional collaborative practices, including professionals from medicine, pharmacy, nursing, social services, and clinical laboratory science, to identify potential problems proactively A tertiary care integrated health system's Emergency Department (ED) aimed to identify antimicrobials prescribed to the outpatient community as part of a proactive antimicrobial stewardship project Methods A pilot, prospective, snapshot of a tertiary community hospital's outpatient antimicrobial prescribing habits was conducted All subjects were identified via a daily report of patients discharged from the ED over 30 days in the summer of 2017 and individually reviewed for prescribed antimicrobial(s) Exclusions were hospital admission, antimicrobial sensitivity, and antimicrobial courses less than five days or more than 14 days The primary goal was determining the number of antimicrobial oral tablets/capsule prescriptions to adult outpatients within a 5 to 14-day treatment window Secondary goals were to include the diagnosis, non-capsule/tablet antimicrobial, pediatric patients, and prescriptions outside the treatment window Results Total number of antimicrobial prescriptions over the 30-day period was 653 in 5,520 individual visits Total number of adults prescribed oral antimicrobials was 467 (156 daily) Patients were diagnosed with infections including urinary tract, cellulitis, soft tissue injury, abscess, upper respiratory, dental caries, gastrointestinal, sexually transmitted, otitis media/externa, pneumonia, viral, pyelonephritis, tick-borne, fungal, Bell's Palsy, and sepsis The number of non-adult, non-oral, and outside window treatment antimicrobial prescriptions were 186 (62 daily) With an average 184 patients treated in the ED daily, approximately 118% received antimicrobial treatment on discharge Conclusion Important aspects of the project were the evaluation of antimicrobial prescribing habits for a midwest ED and identification of potential complications requiring future interventions for follow-up or preventative measures to assist in patient care and community health Areas of practice improvement were identified inadvertently as a result of this project Potential future studies included seasonal variability, whether the patient obtained a prescription and complied with treatment, and differences between inpatient and outpatient antimicrobial prescribing practices

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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
20231
20221
202110
20202
20194
20181