Among a high-risk adolescent sample, primarily health-seeking behaviors increased the odds of HPV vaccination, reinforcing the importance of providers using various routine preventative visits as opportunities/cues to vaccine.
This study examines the prevalence of trauma experiences and traumatic stress in a diverse group of Asian American middle school students from a large urban school district. Descriptive statistics document the mean number of self-reported trauma experiences and posttraumatic stress subscale scores and how these rates differ by students’ gender and Asian ethnic subgroups (including Chinese, Filipino, Japanese, Korean, Samoan, Southeast Asian, and Other). Furthermore, we assess the degree to which 1 or more traumatic events is associated with students’ self-reported symptoms of severe traumatic stress and the types of traumatic events that are the most powerful predictors of elevated stress. These in-depth findings underscore the need for routine, school-based screening to identify and bring culturally competent, trauma-informed support and interventions to Asian American middle school students experiencing traumatic stress.
Background: Renal impairment is common among patients with heart failure and portends worse outcomes. We sought to describe the impact of euvolemia maintenance via pulmonary artery pressure-guided management of heart failure on the trajectory of kidney function. Hypothesis: We hypothesized that PAP-guided management is associated with slowing eGFR decline in heart failure patients. Methods: We retrospectively reviewed kidney function 1 year prior to implant, and 1 year after implantation of a wireless pulmonary-artery hemodynamic monitoring sensor (CardioMEMS, St Jude Medical, St Paul, MN). Glomerular filtration rate (eGFR) was estimated using standard equations (MDRD, Cockroft-Gault, and CKD-EPI). Standardized annual change in eGFR was compared prior to and after CardioMEMS implantation using related-samples Wilcoxon Signed Rank Test. Results: A total of 70 patients were included with a median age of 74 [67-79] years. Forty-two patients (60%) were male and 53 (76%) were white. Their median left ventricular ejection fraction was 41% . Median eGFR before CardioMEMS implantation decreased from 61 to 48 [30-64] ml/ min/1.73 m 2 (P<0.001) but did not change after CardioMEMs implantation (44 [30-67] ml/min/1.73 m 2 , P=0.17). Annualized rate of eGFR change was -6.1 [-18.6 to 2.2] ml/min/1.73 m 2 before vs -1.1 [-9.6 to 4.0] ml/min/1.73 m 2 after CardioMEMS (P=0.046). This difference was more pronounced among patients <74 years (P=0.009), with left ventricular ejection fraction 50% (P=0.039), RA pressure <10 mmHg (P=0.022), eGFR 60 (P=0.015), diabetes (P=0.019), not receiving ACE/ARB (P=0.025) and not receiving aldosterone antagonists (P=0.045). Conclusions: Decline in kidney function slows down after the maintenance of euvolemia with pulmonary artery pressure-guided therapy of heart failure.Background: In recent years, there has been an emphasis on multidisciplinary team (MDT) care of the heart failure (HF) patient. A dedicated HF MDT was created on the 1 st of January 2017 at Cleveland Clinic Abu Dhabi; consisting of HF cardiologists, clinical pharmacists and HF nurses. This study aims to assess the impact of a dedicated HF MDT on the mortality, length of stay and readmission rate in patients who are admitted with acute HF decompensation. Methods: A retrospective review of the patients' charts was conducted. We identified patients who were admitted for acute exacerbation of HF between the years 2015 and 2017. Group 1 consisted of 90 patients who were admitted prior to the creation of the HF MDT, while Group 2 consisted of 94 patients who were admitted after the establishment of the team. The groups were propensity-matched in order to account for any confounding variables between the two patient populations. Results: Table 1 shows the baseline characteristics on admission of patients in both Group 1 and Group 2. The majority of patients in both groups had HFrEF. There were no significant differences between the two groups in terms of the baseline characteristics outlined. Table 2 highlights the differences in outcom...
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