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  • 1
    Online Resource
    Online Resource
    Left ventricular unloading via percutaneous assist device during extracorporeal membrane oxygenation in acute myocardial infarction and cardiac arrest
    SAGE Publications ; 2024
    In:  The International Journal of Artificial Organs
    Details
    In: The International Journal of Artificial Organs, SAGE Publications
    Abstract: A feared complication of an acute myocardial infarction (AMI) is cardiac arrest (CA). Even if return of spontaneous circulation is achieved, cardiogenic shock (CS) is common. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) supports patients with CS and is often used in conjunction with an Impella device (2.5 and CP) to off-load the left ventricle, although limited evidence supports this approach. Methods: The goal of this study was to determine whether a mortality difference was observed in VA-ECMO alone versus VA-ECMO with Impella (ECPELLA) in patients with CS from AMI and CA. A retrospective chart review of 50 patients with AMI-CS and CA and were supported with VA-ECMO ( n = 34) or ECPELLA ( n = 16) was performed. The primary outcome was all-cause mortality at 6-months from VA-ECMO or Impella implantation. Secondary outcomes included in-hospital mortality and complication rates between both cohorts and intensive care unit data. Results: Baseline characteristics were similar, except patients with ST-elevation myocardial infarction were more likely to be in the VA-ECMO group ( p = 0.044). The ECPELLA cohort had significantly worse survival after VA-ECMO (SAVE) score ( p = 0.032). Six-month all-cause mortality was not significantly different between the cohorts, even when adjusting for SAVE score. Secondary outcomes were notable for an increased rate of minor complications without an increased rate of major complications in the ECPELLA group. Conclusions: Randomized trials are needed to determine if a mortality difference exists between VA-ECMO and ECPELLA platforms in patients with AMI complicated by CA and CS.
    Type of Medium: Online Resource
    ISSN: 0391-3988 , 1724-6040
    URL: Article
    DOI: 10.1177/03913988241254978
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2024
    detail.hit.zdb_id: 1474999-3
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  • 2
    Online Resource
    Online Resource
    Predictors and Influence of Goal Orientation on Self-Management and Health-Related Quality of Life after Lung Transplant
    SAGE Publications ; 2015
    In:  Progress in Transplantation Vol. 25, No. 3 ( 2015-09), p. 230-242
    Details
    In: Progress in Transplantation, SAGE Publications, Vol. 25, No. 3 ( 2015-09), p. 230-242
    Abstract: Lung transplant recipients are encouraged to perform self-management behaviors to maximize health outcomes; however, performance is often less than ideal. Goal orientation is known to influence achievement of academic goals, but the influence of goal orientation on performance of self-management is unknown. Objectives— To identify characteristics at transplant that are predictive of higher goal orientation and examine relationships between Goal Orientation Index (GOI) subscores (Acting, Planning, Reflecting), self-management behaviors (adhering, self-monitoring, and communicating critical changes), and health-related quality of life (HRQOL) at 1 year after transplant. Design— A descriptive, secondary analysis of data from 33 lung transplant recipients who were assessed at transplant and followed for 1 year as part of a clinical trial. GOI subscores were dichotomized at the median to categorize recipients with high and low goal orientation. Logistic regression was used to identify predictors of higher GOI subscores. Correlations between higher GOI subscores, self-management, and HRQOL were examined. Results— Lung transplant recipients reported relatively high mean GOI subscores (Acting, Planning, and Reflecting) and the 3 subscores were correlated ( r = 0.31–0.86). Self-care agency was the only significant predictor ( P = .04) of higher GOI (Reflecting). Lung transplant recipients with higher Planning and Reflecting subscores were more likely to adhere ( r = 0.36 and 0.46, respectively). Recipients with higher GOI subscores reported significantly better mental HRQOL ( r = 0.42–0.36). Recipients with higher GOI Planning or Acting subscores reported significantly less anxiety ( r = −0.39–0.46) and fewer depressive symptoms ( r = −0.40–0.43). Conclusion— Assessing goal orientation may offer a novel approach for promoting adherence and HRQOL after lung transplant.
    Type of Medium: Online Resource
    ISSN: 1526-9248 , 2164-6708
    URL: Article
    DOI: 10.7182/pit2015189
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2864264-8
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  • 3
    Online Resource
    Online Resource
    The Role of Anti-Racist Community-Partnered Praxis in Implementing Restorative Circles Within Marginalized Communities in Southern California During the COVID-19 Pandemic
    SAGE Publications ; 2023
    In:  Health Promotion Practice Vol. 24, No. 2 ( 2023-03), p. 232-243
    Details
    In: Health Promotion Practice, SAGE Publications, Vol. 24, No. 2 ( 2023-03), p. 232-243
    Abstract: The COVID-19 pandemic has exacerbated the adverse influence of structural racism and discrimination experienced by historically marginalized communities (e.g., Black, Latino/a/x, Indigenous, and transgender people). Structural racism contributes to trauma-induced health behaviors, increasing exposure to COVID-19 and restricting access to testing and vaccination. This intersection of multiple disadvantages has a negative impact on the mental health of these communities, and interventions addressing collective healing are needed in general and in the context of the COVID-19 pandemic. The Share, Trust, Organize, and Partner COVID-19 California Alliance (STOP COVID-19 CA), a statewide collaborative of 11 universities and 75 community partners, includes several workgroups to address gaps in COVID-19 information, vaccine trial participation, and access. One of these workgroups, the Vaccine Hesitancy Workgroup, adopted an anti-racist community-partnered praxis to implement restorative circles in historically marginalized communities to facilitate collective healing due to structural racism and the COVID-19 pandemic. The project resulted in the development of a multilevel pre-intervention restorative process to build or strengthen community–institutional partnerships when procurement of funds has been sought prior to community partnership. This article discusses this workgroup’s role in advancing health justice by providing a community-based mental health intervention to marginalized communities in Southern California while using an antiracist praxis tool to develop a successful community–institutional partnership and to live up to the vision of community-based participatory research.
    Type of Medium: Online Resource
    ISSN: 1524-8399 , 1552-6372
    URL: Article
    DOI: 10.1177/15248399221132581
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2036801-X
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  • 4
    Online Resource
    Online Resource
    Relationship of intraoperative perfusion parameters to the need for immediate extracorporeal support following heart transplantation
    SAGE Publications ; 2021
    In:  Perfusion Vol. 36, No. 7 ( 2021-10), p. 704-709
    Details
    In: Perfusion, SAGE Publications, Vol. 36, No. 7 ( 2021-10), p. 704-709
    Abstract: We sought to assess the relationship of intraoperative perfusion parameters while on cardiopulmonary bypass, including oxygen delivery (DO 2 ), to the need for ECMO following orthotopic heart transplantation (OHT). Methods: We included all adult ( 〉 18 years old) OHTs performed at our institution since implementation of an electronic perfusion record (March 2019-February 2020). Multi-organ transplants were excluded. The primary outcome was the need for immediate venoarterial ECMO in the OR following OHT. Univariable statistics were computed across demographic, clinical, operative, and perfusion variables, including oxygen delivery (DO 2 ) measured each minute. Results: Fifty-three OHT were included with a median age of 54 years (interquartile range, 45-61). The primary outcome occurred in eight patients (15.1%). A significantly greater proportion of patients requiring ECMO had ischemic cardiomyopathy (50.0% (4/8) vs. 15.6% (7/45), p = 0.02) and had preoperative ventricular assist devices (37.5% (3/8) vs. 8.9% (4/45), p = 0.03). Median bypass times were longer in the ECMO group (217 vs. 147 minutes, p = 0.001). Phenylephrine doses were nonsignificantly higher in ECMO patients (4.1 vs. 1.9 mg, p = 0.10). No significant differences were observed in single-point median DO 2 (275 vs. 294 mL O 2 /min/m 2 BSA, p = 0.17) and nadir DO 2 (226 vs. 222, p = 0.94), but increasing time and depth of DO2 below a threshold of 300 mL O 2 /min/m 2 BSA (i.e. area over the DO 2 curve (AOC) but below threshold) was significantly associated with the need for postoperative ECMO (p = 0.04). Conclusion: This is the first study to examine the relationship of perfusion parameters, including oxygen delivery, to outcomes following heart transplantation. We note that DO 2   〈  300-AOC was significantly associated with the need for postoperative ECMO following heart transplant. Further study will clarify whether potential DO 2 differences in patients who require post-OHT ECMO reflect vasoplegia, or a more causative relationship which might be leveraged to improve outcomes.
    Type of Medium: Online Resource
    ISSN: 0267-6591 , 1477-111X
    URL: Article
    DOI: 10.1177/0267659120958153
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2029611-3
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  • 5
    Online Resource
    Online Resource
    Clinical trials of health information technology interventions intended for patient use: Unique issues and considerations
    SAGE Publications ; 2013
    In:  Clinical Trials Vol. 10, No. 6 ( 2013-12), p. 896-906
    Details
    In: Clinical Trials, SAGE Publications, Vol. 10, No. 6 ( 2013-12), p. 896-906
    Abstract: Despite the proliferation of health information technology (IT) interventions, descriptions of the unique considerations for conducting randomized trials of health IT interventions intended for patient use are lacking. Purpose Our purpose is to describe the protocol to evaluate Pocket PATH ® (Personal Assistant for Tracking Health), a novel health IT intervention, as an exemplar of how to address issues that may be unique to a randomized controlled trial (RCT) to evaluate health IT intended for patient use. Methods An overview of the study protocol is presented. Unique considerations for health IT intervention trials and strategies are described to maintain equipoise, to monitor data safety and intervention fidelity, and to keep pace with changing technology during such trials. Lessons Learned The sovereignty granted to technology, the rapid pace of changes in technology, ubiquitous use in health care, and obligation to maintain the safety of research participants challenge researchers to address these issues in ways that maintain the integrity of intervention trials designed to evaluate the impact of health IT interventions intended for patient use. Conclusions Our experience evaluating the efficacy of Pocket PATH may provide practical guidance to investigators about how to comply with established procedures for conducting RCTs and include strategies to address the unique issues associated with the evaluation of health IT for patient use.
    Type of Medium: Online Resource
    ISSN: 1740-7745 , 1740-7753
    URL: Article
    DOI: 10.1177/1740774513493149
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2159773-X
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  • 6
    Online Resource
    Online Resource
    Application of Comprehensive Genomic Profiling-Based Next-Generation Sequencing Assay to Improve Cancer Care in a Developing Country
    SAGE Publications ; 2023
    In:  Cancer Control Vol. 30 ( 2023-04)
    Details
    In: Cancer Control, SAGE Publications, Vol. 30 ( 2023-04)
    Abstract: Identifying actionable oncogenic mutations have changed the therapeutic landscape in different types of tumors. This study investigated the utility of comprehensive genomic profiling (CGP), a hybrid capture-based next-generation sequencing (NGS) assay, in clinical practice in a developing country. Methods In this retrospective cohort study, CGP was performed on clinical samples from patients with different solid tumors recruited between December 2016 and November 2020, using hybrid capture-based genomic profiling, at the individual treating physicians’ request in the clinical care for therapy decisions. Kaplan–Meier survival curves were estimated to characterize the time-to-event variables. Results Patients median age was 61 years (range: 14–87 years), and 64.7% were female. The most common histological diagnosis was lung primary tumors, with 90 patients corresponding to 52.9% of the samples (95% CI 45.4-60.4%). Actionable mutations with FDA-approved medications for specific alterations correspondent to tumoral histology were identified in 58 cases (46.4%), whereas other alterations were detected in 47 different samples (37.6%). The median overall survival was 15.5 months (95% CI 11.7 months-NR). Patients who were subjected to genomic evaluation at diagnosis reached a median overall survival of 18.3 months (95% CI 14.9 months-NR) compared to 14.1 months (95% CI 11.1 months-NR) in patients who obtained genomic evaluation after tumor progression and during standard treatment ( P = .7). Conclusion CGP of different types of tumors identifies clinically relevant genomic alterations that have benefited from targeted therapy and improve cancer care in a developing country to guide personalized treatment to beneficial outcomes of cancer patients.
    Type of Medium: Online Resource
    ISSN: 1073-2748 , 1526-2359
    URL: Article
    DOI: 10.1177/10732748231175256
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2004182-2
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