Hypothetical treatment of patients with non‐alcoholic steatohepatitis: Potential impact on important clinical outcomes

2019 ◽  
Vol 40 (2) ◽  
pp. 308-318
Author(s):  
Zobair M. Younossi ◽  
Radhika P. Tampi ◽  
Fatema Nader ◽  
Issah M. Younossi ◽  
Rebecca Cable ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Alcoholic Steatohepatitis ◽  
Hypothetical Treatment ◽  
Potential Impact

Blood, Sweat, Toil, and Tears of Surgical Training. Part I: Blood

2007 ◽  
Vol 15 (4) ◽  
pp. 307-309 ◽  
Author(s):  
Andrew J Drain ◽  
Jonathon I Ferguson ◽  
Sharon Wilkinson ◽  
Samer AM Nashef
Keyword(s):  
Adverse Effect ◽  
Blood Loss ◽  
Operating Room ◽  
Clinical Outcomes ◽  
Surgical Training ◽  
Clinical Service ◽  
Significant Difference ◽  
Potential Impact ◽  
The Impact ◽  
Cardiac Operations

There may be conflict between the requirements of surgical training and those of the clinical service if training has an impact on clinical outcomes. One area of potential impact is perioperative blood loss. We compared total and 12-hour blood loss after 2,079 consecutive cardiac operations performed over 2 years by trainees and consultants. One- and two-way analyses of variance with EuroSCORE and surgeon status as factors were carried out to evaluate the impact of surgeon status on blood loss. There was no difference in blood loss between consultants and trainees. We also compared the rates between consultants and trainees of patients returning to the operating room due to bleeding. This showed a significant difference, with trainees having a higher rate of investigation for bleeding. Cardiac surgical training can be achieved without an adverse effect on blood loss, but it may be associated with a higher rate of re-intervention for bleeding.

Potential impact of socioeconomic differences on clinical outcomes in international clinical trials

2001 ◽  
Vol 141 (6) ◽  
pp. 1019-1024 ◽  
Author(s):  
Marcelo C. Shibata ◽  
Marcus D. Flather ◽  
Diego Perez de Arenaza ◽  
Duolao Wang ◽  
J.Conor O’Shea
Keyword(s):  
Clinical Trials ◽  
Clinical Outcomes ◽  
Socioeconomic Differences ◽  
Potential Impact

scholarly journals An integrated deep mutational scanning approach provides clinical insights on PTEN genotype-phenotype relationships

2019 ◽  
Author(s):  
Taylor L. Mighell ◽  
Stetson Thacker ◽  
Eric Fombonne ◽  
Charis Eng ◽  
Brian J. O’Roak
Keyword(s):  
Clinical Outcomes ◽  
Cleveland Clinic ◽  
Single Amino Acid ◽  
Odds Ratios ◽  
Risk Levels ◽  
Clinical Presentations ◽  
Germline Variation ◽  
Potential Impact ◽  
Molecular Phenotypes ◽  
Risk Of Cancer

AbstractGermline variation in PTEN results in variable clinical presentations, including benign and malignant neoplasia and neurodevelopmental disorders. Despite decades of research, it remains unclear how PTEN genotype is related to clinical outcomes. In this study, we combined two recent deep mutational scanning (DMS) datasets probing the effects of single-amino acid variation on enzyme activity and steady-state cellular abundance with the largest well-curated clinical cohort of PTEN-variant carriers. We sought to connect variant-specific molecular phenotypes to the clinical outcomes of individuals with PTEN variants. We found that DMS data partially explain quantitative clinical traits, including head circumference and Cleveland Clinic (CC) score, which is a semi-quantitative surrogate of disease burden. We built a logistic regression model using DMS and CADD scores to separate clinical PTEN variation from gnomAD control-only variation with high accuracy (AUC = 0.892). Using a survival-like analysis, we identified molecular phenotype groups with differential risk of early-onset as well as lifetime risk of cancer. Finally, we identified classes of DMS-defined variants with significantly different risk levels for classical hamartoma-related features (odds ratios range of 4.1-102.9). In stark contrast, the risk for developing autism or developmental delay does not significantly change across variant classes (odds ratios range of 5.4-12.4). Together, these findings highlight the potential impact of combining DMS datasets with rich clinical data, and provide new insights that may guide personalized clinical decisions for PTEN-variant carriers.

Long-term metformin use may improve clinical outcomes in diabetic patients with non-alcoholic steatohepatitis and bridging fibrosis or compensated cirrhosis

2019 ◽  
Vol 50 (3) ◽  
pp. 317-328 ◽  
Author(s):  
Eduardo Vilar-Gomez ◽  
Raj Vuppalanchi ◽  
Archita P. Desai ◽  
Samer Gawrieh ◽  
Marwan Ghabril ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Diabetic Patients ◽  
Alcoholic Steatohepatitis ◽  
Compensated Cirrhosis

scholarly journals 1549. Impact of New Fluoroquinolone Breakpoints on Enterobacteriaceae Susceptibility Rates and Clinical Outcomes

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S565-S565
Author(s):  
Natasha N Pettit ◽  
Cynthia T Nguyen ◽  
Jennifer Pisano ◽  
Angella Charnot-Katsikas
Keyword(s):  
Length Of Stay ◽  
Clinical Outcomes ◽  
Medical Center ◽  
Single Center ◽  
Blood Isolate ◽  
Single Center Study ◽  
Potential Impact ◽  
Poor Outcomes ◽  
The Impact ◽  
Center Study

Abstract Background In January 2019, the Clinical and Laboratory Standards Institute (CLSI) lowered the Fluoroquinolone (FQ) susceptibility breakpoints for Enterobacteriaceae. The new breakpoints were updated primarily based on FQ pharmacodynamics, and only limited clinical data. We sought to evaluate clinical outcomes among patients who received an FQ for infection with Enterobacteriaceae with MIC values that would now be considered resistant, using the new interpretive criteria. We also assessed the potential impact of the new breakpoints on overall blood and urine Enterobacteriaceae susceptibility rates at our medical center. Methods All positive blood and urine cultures with Enterobacteriaceae between September 1, 2018 and February 28, 2019 were included. Enterobacteriaceae isolates with ciprofloxacin MICs of 0.5 and 1 µg/mL (based on new breakpoints, now considered non-susceptible) were identified. We assessed the length of stay (LOS), mortality, and 30-day readmissions among patients who received an FQ for treatment. The impact of the new breakpoints on overall Enterobacteriaceae susceptibilities from urine and blood isolates was also determined. Results A total of 1,761 cultures (191 blood, 1,570 urine) grew Enterobacteriaceae. One-hundred and twenty-five (7%) cultures grew isolates with a ciprofloxacin MIC of 0.5 or 1 µg/mL. Eighteen patients with Enterobacteriaceae isolated (4 blood, 14 urine) received an FQ. Among these patients, the median LOS was 4 days; one patient was readmitted within 30 days, and 0% mortality was observed. The patient readmitted within 30 days received an FQ for a blood isolate with MIC 0.5. Overall, with the revised breakpoints, we observed a 4.2% decrease in the number of Enterobacteriaceae that would be susceptible to ciprofloxacin (Figure 1). Conclusion The new FQ breakpoints for Enterobacteriaceae will have a marginal impact on overall FQ susceptibility rates at our medical center. In this single-center study, patients that received FQ antibiotics for Enterobacteriaceae with MIC values now considered intermediate or resistant did not appear to experience poor outcomes. Disclosures All authors: No reported disclosures.

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