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11.
Engmann C Walega P Aborigo RA Adongo P Moyer CA Lavasani L Williams J Bose C Binka F Hodgson A 《Tropical medicine & international health : TM & IH》2012,17(3):272-282
Objective To calculate perinatal mortality (stillbirth and early neonatal death: END) rates in the Upper East region of Ghana and characterize community‐based stillbirths and END in terms of timing, cause of death, and maternal and infant risk factors. Methods Birth outcomes were obtained from the Navrongo Health and Demographic Surveillance System over a 7‐year period. Results Twenty thousand four hundred and ninty seven pregnant women were registered in the study. The perinatal mortality rate was 39 deaths/1000 deliveries, stillbirth rate 23/1000 deliveries and END rates 16/1000 live births. Most stillbirths were 31 weeks gestation or less. Prematurity, first‐time delivery and multiple gestation all significantly increased the odds of perinatal death. Approximately 70% of END occurred during the first 3 postnatal days, and the most common causes of death were birth asphyxia and injury, infections and prematurity. Conclusion Stillbirths and END remain a significant problem in Navrongo. The main causes of END occur during the first 3 days and may be modifiable with simple targeted perinatal policies. 相似文献
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Gaurav Gupta Idris Yakubu Chandra S. Bhati Yiran Zhang Le Kang Julie A. Patterson Ayana Andrews‐Joseph Anam Alam Andrea Ferreira‐Gonzalez Dhiren Kumar Irfan K. Moinuddin Layla Kamal Anne L. King Marlon Levy Amit Sharma Adrian Cotterell Trevor W. Reichman Aamir Khan Pamela Kimball Rodney Stiltner Mary Baldecchi Nathaniel Brigle Todd Gehr Richard K. Sterling 《American journal of transplantation》2020,20(3):739-751
We conducted an adaptive design single‐center pilot trial between October 2017 and November 2018 to determine the safety and efficacy of ultra‐short‐term perioperative pangenotypic direct acting antiviral (DAA) prophylaxis for deceased hepatitis C virus (HCV)‐nucleic acid test (NAT) positive donors to HCV negative kidney recipients (D+/R?). In Group 1, 10 patients received one dose of SOF/VEL (sofusbuvir/velpatasvir) pretransplant and one dose on posttransplant Day 1. In Group 2A (N = 15) and the posttrial validation (Group 2B; N = 25) phase, patients received two additional SOF/VEL doses (total 4) on Days 2 and 3 posttransplant. Development of posttransplant HCV transmission triggered 12‐week DAA therapy. For available donor samples (N = 27), median donor viral load was 1.37E + 06 IU/mL (genotype [GT]1a: 70%; GT2: 7%; GT3: 23%). Overall viral transmission rate was 12% (6/50; Group 1:30% [3/10]; Group 2A:13% [2/15]; Group 2B:4% [1/25]). For the 6 viremic patients, 5 (83%) achieved sustained virologic response (3 with first‐line DAA therapy; and two after retreatment with second‐line DAA). At a median follow‐up of 8 months posttransplant, overall patient and allograft survivals were 98%, respectively. The 4‐day strategy reduced viral transmission to 7.5% (3/40; 95% confidence interval [CI]: 1.8%‐20.5%) and could result in avoidance of prolonged posttransplant DAA therapy for most D+/R ? transplants. 相似文献
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Panahipour Layla Nasserzare Shayesteh Amer Zeinab Brücke Friedrich Stähli Alexandra Kreissl Alexandra Haiden Nadja Gruber Reinhard 《Clinical oral investigations》2019,23(4):1959-1966
Clinical Oral Investigations - Milk can reduce intestinal tissue damage in colitis models, and protects infants against necrotizing enterocolitis. However, whether milk can decrease inflammation... 相似文献
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Waheed Anem Fongemie Justin Gopal Srila Esham Kimberly S. Richardson-Weber Leslie Zhang Lulu Van Doren Layla Buchsbaum Rachel J. Comenzo Raymond L. 《Journal of thrombosis and thrombolysis》2020,50(3):715-717
Journal of Thrombosis and Thrombolysis - 相似文献
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Layla Parast Megan Mathews Steven Martino William G. Lehrman Debra Stark Marc N. Elliott 《Journal of general internal medicine》2022,37(1):49
BackgroundPrevious work has demonstrated racial/ethnic differences in emergency department (ED) utilization, but less is known about racial/ethnic differences in the experience of care received during an ED visit.ObjectiveTo examine differences in self-reported healthcare utilization and experiences with ED care by patients’ race/ethnicity.DesignAdult ED patients discharged to community (DTC) were surveyed (response rate: 20.25%) using the Emergency Department Patient Experience of Care (EDPEC) DTC Survey. Linear regression was used to estimate case-mix-adjusted differences in patient experience between racial/ethnic groups.Participants3122 survey respondents who were discharged from the EDs of 50 hospitals nationwide January–March 2016.Main MeasuresSix measures: getting timely care, doctor and nurse communication, communication about medications, receipt of sufficient information about test results, whether hospital staff discussed the patient’s ability to receive follow-up care, and willingness to recommend the ED.Key ResultsBlack and Hispanic patients were significantly more likely than White patients to report visiting the ED for an ongoing health condition (40% Black, 30% Hispanic, 28% White, p<0.001), report having visited an ED 3+ times in the last 6 months (26% Black, 25% Hispanic, 19% White, p<0.001), and report not having a usual source of care (19% Black, 19% Hispanic, 8% White, p<0.001). Compared with White patients, Hispanic patients more often reported that hospital staff talked with them about their ability to receive needed follow-up care (+7.2 percentile points, p=0.038) and recommended the ED (+7.2 points, p=0.037); Hispanic and Black patients reported better doctor and nurse communication (+6.4 points, p=0.008; +4 points, p=0.036, respectively).ConclusionsHispanic and Black ED patients reported higher ED utilization, lacked a usual source of care, and reported better experience with ED care than White patients. Results may reflect differences in care delivery by staff and/or different expectations of ED care among Hispanic and Black patients.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-021-06738-0.KEY WORDS: emergency department, patient experience, utilization, race, communication 相似文献
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Julia Torabi Juan P. Rocca Krystina Choinski Katherine Lorenzen Camille Yongue Michelle L. Lubetzsky Melvon E. Herbert Attasit Chokechanachaisakul Maria Ajaimy Layla Kamal Enver Akalin Milan Kinkhabwala Jay A. Graham 《Clinical transplantation》2018,32(1)
Background
We analyze our outcomes utilizing imported allografts as a strategy to shorten wait list time for pancreas transplantation.Methods
This is an observational retrospective cohort of 26 recipients who received either a locally procured (n = 16) or an imported pancreas graft (n = 10) at our center between January 2014 and May 2017. Wait list times of this cohort were compared to UNOS Region 9 (New York State and Western Vermont). Hospital financial data were also reviewed to analyze the cost‐effectiveness of this strategy.Results
Imported pancreas grafts had significantly increased cold ischemia times (CIT) and peak lipase (PL) levels compared to locally procured grafts (CIT 827 vs 497 minutes; P = .001, PL 563 vs 157 u/L; P = .023, respectively). There were no differences in graft or patient survival. The median wait time was significantly lower for simultaneous kidney‐pancreas transplants at our center (518 days, n = 21) compared to Region 9 (1001 days, n = 65) P = .038. Despite financial concerns, the cost of transport for imported grafts was offset by lower standard acquisition costs.Conclusions
Imported pancreas grafts may be a cost‐effective strategy to increase organ utilization and shorten wait times in regions with longer waiting times. 相似文献20.
Oleg S Gorbatyuk Shoudong Li Kevin Nash Marina Gorbatyuk Alfred S Lewin Layla F Sullivan Ronald J Mandel Weijun Chen Craig Meyers Fredric P Manfredsson Nicholas Muzyczka 《Molecular therapy》2010,18(8):1450-1457
Two small-interfering RNAs (siRNAs) targeting α-synuclein (α-syn) and three control siRNAs were cloned in an adeno-associated virus (AAV) vector and unilaterally injected into rat substantia nigra pars compacta (SNc). Reduction of α-syn resulted in a rapid (4 week) reduction in the number of tyrosine hydroxylase (TH) positive cells and striatal dopamine (DA) on the injected side. The level of neurodegeneration induced by the different siRNAs correlated with their ability to downregulate α-syn protein and mRNA in tissue culture and in vivo. Examination of various SNc neuronal markers indicated that neurodegeneration was due to cell loss and not just downregulation of DA synthesis. Reduction of α-syn also resulted in a pronounced amphetamine induced behavioral asymmetry consistent with the level of neurodegeneration. In contrast, none of the three control siRNAs, which targeted genes not normally expressed in SNc, showed evidence of neurodegeneration or behavioral asymmetry, even at longer survival times. Moreover, co-expression of both rat α-syn and α-syn siRNA partially reversed the neurodegenerative and behavioral effects of α-syn siRNA alone. Our data show that α-syn plays an important role in the rat SNc and suggest that both up- and downregulation of wild-type α-syn expression increase the risk of nigrostriatal pathology. 相似文献