This study aims to assess whether administering intravenous iron early in pregnancy, compared to standard oral iron treatment, can enhance hemoglobin levels before delivery and reduce the need for blood transfusions in patients with iron deficiency anemia. Patients diagnosed with iron deficiency anemia were randomly assigned to receive either oral or intravenous iron. Before treatment initiation, patients completed a symptom questionnaire baseline hemoglobin, and ferritin levels were measured. Follow-up visits occurred four weeks later and at 24 to 28 weeks gestation, involving reassessment of symptoms, laboratory testing, and monitoring of treatment adherence. Final hemoglobin levels were determined before delivery, and data on the need for blood transfusion at delivery were recorded.

开始日期2023-11-21

申办/合作机构

Arrowhead Regional Medical Center

NCT06543290 / Recruiting临床1期IIT

Azithromycin to Prevent Chorioamnionitis in Women Undergoing Induction of Labor, a Randomized Control Trial

This is a double blinded randomized control trial involving administration of 2 grams prophylactic azithromycin in third trimester patients undergoing induction of labor at our institution to demonstrate reduction in maternal and neonatal infection.

开始日期2023-08-07

申办/合作机构

Arrowhead Regional Medical Center

NCT05400382 / Not yet recruitingN/AIIT

Optimizing Mindfulness to Reduce Post-cesarean Pain and Prevent Postpartum Depression

This study will test the effect of a mobile mindfulness-based intervention on reducing post-cesarean delivery pain and preventing postpartum depression.

开始日期2023-07-01

申办/合作机构

University of Illinois At UrbanaChampaign

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项与 Arrowhead Regional Medical Center 相关的文献（医药）

2024-10-01·The American Surgeon™

The Great Debate: Mesh or No Mesh in Contaminated Hernia Repairs?

Review

作者: You, Yuchen ; Lee, Tommy H. ; Kim, So Un ; Schweitzer, Jeremy

Abdominal hernia surgeries are commonly performed with many different approaches, and mesh utilization has become a cornerstone in hernia repair, ensuring durable outcomes with minimal recurrence risk. However, managing contaminated hernia repairs presents unique challenges due to the heightened risks of mesh infection. Recent advancements in lightweight macroporous polypropylene meshes offer promising solutions. Studies have highlighted the superiority of macroporous polypropylene meshes compared to primary suture repair and other mesh types in terms of reduced surgical site infection rates and lower hernia recurrence rates. Moreover, utilizing macroporous polypropylene mesh in the retrorectus plane is associated with a favorable salvage rate, underscoring its efficacy in contaminated hernia repairs. At the same time, contrary evidence suggests higher postoperative complications with mesh use in settings of clean-contaminated or contaminated fields. Most significant complications are increased infection rates and similar recurrence rates compared to mesh-free repairs. New synthetic mesh that is being marketed as having better outcomes than other types of mesh and potentially primary repair need to be carefully assessed as biologic mesh once used to also be touted as the mesh to use in such fields, but more research is showing higher complication rates. The risk of infection and consequent morbidity might outweigh the benefit of less recurrence risk with mesh use. Further research, including prospective studies with long-term follow-up, is warranted to elucidate optimal hernia repair strategies in contaminated fields and inform evidence-based practice guidelines.

2024-10-01·Vascular and Endovascular Surgery

Re-do Hybrid Deep Venous Arterialization via the Popliteal Venous System: Conversion From a Deep Venous Arterialization to a Superficial Venous Arterialization

Article

作者: Kim, So Un ; Schwartz, Samuel ; Perez, Kevin ; Guan, Angel ; GnanaDev, Raja ; Dua, Anahita ; Lee, Michelle ; Malkoc, Aldin

Deep venous arterialization (DVA) is a final option for limb salvage in patients with end stage arterial anatomy. We report a 66-year-old dialysis dependent male with forefoot gangrene, Rutherford class 6 chronic limb ischemia, who required a redo endovascular DVA. On initial presentation an angiogram was demonstrated a desert foot with absent tibial runoff to his bilateral lower extremities. After discussion, patient elected to trial DVA in hope of avoiding a major amputation. A hybrid DVA was performed using a Pioneer Plus and .018″ Viabahn stents from the peroneal artery into the peroneal venous system; following this, the peroneal vein was anastomosed to the lesser saphenous vein via an open posterior approach at the ankle. 3 months later, a second DVA was performed by exposing the above knee popliteal artery and vein and creating an end-to-side anastomosis. Of note, the great saphenous vein was less than 2 mm in diameter and no arm vein was available due to history of prior fistulas in bilateral arms. Via the popliteal vein, the posterior tibial vein was selected and additional .018″ Viabahn stents were deployed from the malleolus to the P2 segment of the popliteal vein. Three months after the second hybrid DVA, the patient’s forefoot had healed after split thickness skin grafting. Continued patency is noted of the re-do hybrid DVA with minimal calf edema. Newer creative strategies are required for “No Option Chronic Limb Ischemia” which is becoming more relevant in diabetic and dialysis dependent patients. This case illustrates the potential to convert a deep venous arterialization to a superficial venous arterialization for improved venous outflow and wound healing.

2024-09-01·Annals of Vascular Surgery

The Use of Advanced Three-Dimensional Computed Tomography During Simple and Complex Endovascular Aortic Aneurysm Repairs

Article

作者: Tayyarah, Majid ; Andacheh, Iden ; Shoemaker, Hailey B ; Alach, Ahmad ; Hsu, Jeffrey H ; Vo, Trung D ; Gnanadev, Raja ; Behseresht, Jason ; Malkoc, Aldin

BACKGROUNDEndovascular aneurysm repair (EVAR) success depends on imaging technology both in the planning and operative phases. Endovascular repair requires intravenous contrast and radiation exposure to the patient as well as radiation exposure to the operator. Recent developments in imaging technology attempt to merge preoperative imaging with intraoperative imaging to improve the efficiency and accuracy of EVAR. The Cydar 3-dimensional (3D) imaging system combines the preoperative and intraoperative imaging during the operation. We aim to investigate the use of the Cydar 3D imaging system during EVAR compared to conventional methods.METHODSRetrospective review of all patients undergoing an EVAR at a single quaternary vascular center from 2019-2023 was collected. This cohort was divided into 2 groups: (1) repair using Cydar 3D imaging or (2) repair without Cydar 3D imaging. Overall, 138 unique patients were identified with 27 operations using Cydar 3D imaging and 111 operations without Cydar 3D imaging. We performed a 1-to-1 propensity score-matched analysis using nearest-neighbor matching for variables including age, case urgency, and if the case was performed in the operative room or interventional radiology room. A match occurred when a patient in the Cydar 3D imaging group had an estimated score within 0.01 standard deviations of a patient in the control group. From this, we paired 27 from each cohort for a total of 54 patients. Demographic data included length of stay in days, contrast volume (mL), fluoroscopy time (min), procedure length (mins), mortality, and blood loss (mL). Univariate analyses were performed and a P value less than 0.05 was considered statistically significant.RESULTSA total of 54 vascular patients were analyzed: 27 without the Cydar 3D imaging and 27 with the Cydar 3D imaging. In the univariate analysis, there was no statistical difference in the average length of stay (6.4 days ± 11.76 vs. 4.1 ± 6.03, P = 0.372), aneurysm size (5.9 ± 1.4 vs. 5.9 ± 1.2, P = 0.88), contrast volume in mL (91.3 ± 47.0 vs. 91.1-33.49, P = 9.88), fluoroscopy time in mins (20.2 ± 17.2 vs. 19.5 ± 19.4, P = 0.89), procedure length (299.3 ± 177.9 vs. 353 ± 191.98, P = 0.279), and blood loss in mL (513.8 ± 791 vs. 353 ± 191.98, P = 0.594). There was an increase in reintervention for endoleaks in the group with use of Cydar 3D imaging (0 vs. 6, P = 0.043). A subanalysis of patients undergoing physician-modified EVARs did show a 15% reduction in the contrast volume used.CONCLUSIONSThe use of 3D imaging technology has the potential to increase the safety of EVAR to both patients and operators. In our study, we did not find any difference in standard EVARs; however, there was a contrast use decrease in physician-modified EVARs. Further studies will need to be performed to determine the realized benefit from performing EVARs using this new technology.

项与 Arrowhead Regional Medical Center 相关的新闻（医药）

2024-04-11

·PRNewswire

Black Maternal Health Week 2024: U.S. News Recognizes U.S. Hospitals With Excellent Black Patient Outcomes

Twenty-six Maternity Care Hospitals achieved excellent outcomes among Black patients. WASHINGTON, April 11, 2024 /PRNewswire/ -- For Black Maternal Health Week 2024, U.S. News & World Report, the global authority in hospital rankings and consumer advice, today recognized High-Performing Maternity Care Hospitals' success in supporting Black maternal health. U.S. News' analysis of all High-Performing Maternity Care Hospitals in the U.S. identified 26 hospitals in 13 states achieving excellent outcomes for cesarean section and unexpected newborn complications among Black patients. The 26 high-performing hospitals include: Allina Health United Hospital (Saint Paul, MN) Arrowhead Regional Medical Center (Colton, CA) Atrium Health Pineville (Charlotte, NC) Aurora Medical Center-Grafton (Grafton, WI) Bakersfield Memorial Hospital (Bakersfield, CA) Bethesda North Hospital (Cincinnati, OH) Capital Health Medical Center-Hopewell (Pennington, NJ) Carilion Roanoke Memorial Hospital (Roanoke, VA) Henry Ford Wyandotte Hospital (Wyandotte, MI) Kaiser Permanente Westside Medical Center (Hillsboro, OR) Lakeland Regional Health Medical Center (Lakeland, FL) Methodist Hospital of Sacramento (Sacramento, CA) Miami Valley Hospital (Dayton, OH) Novant Health Forsyth Medical Center (Winston-Salem, NC) Novant Health Matthews Medical Center (Matthews, NC) Overlook Medical Center (Summit, NJ) Pomona Valley Hospital Medical Center (Pomona, CA) Saint Francis Hospital-Tulsa (Tulsa, OK) Sentara Martha Jefferson Hospital (Charlottesville, VA) St. Catherine Hospital-East Chicago (East Chicago, IN) Sutter Delta Medical Center (Antioch, CA) UNC REX Hospital (Raleigh, NC) UPMC Magee-Womens Hospital (Pittsburgh, PA) Virtua Our Lady of Lourdes Hospital (Camden, NJ) WakeMed Cary Hospital (Cary, NC) WakeMed Raleigh Campus (Raleigh, NC) Regional highlights include: North Carolina has the most recognized hospitals, with six hospitals achieving excellent outcomes for cesarean section and unexpected newborn complications among Black patients. The following states have only one hospital recognized for achieving excellent outcomes for cesarean section and unexpected newborn complications among Black patients: Florida, Indiana, Michigan, Minnesota, Oklahoma, Oregon, Pennsylvania, Wisconsin. Two states in the West Census Region ( California, Oregon) were recognized. Five states in the Midwest Census Region ( Indiana, Michigan, Minnesota, Ohio, Wisconsin) were recognized. Four states in the South Census Region ( Florida, North Carolina, Oklahoma, Virginia) were recognized. Two states in the Northeast Census Region ( New Jersey, Pennsylvania) were recognized. "For Black Maternal Health Week 2024, we celebrate these hospitals' success in their important work supporting and advancing Black maternal health as part of U.S. News' ongoing commitment to health equity and our support of women's access to maternity care," said Jennifer Winston, Ph.D., health data scientist at U.S. News. U.S. News identified 26 hospitals that were rated High Performing in U.S. News' Best Hospitals for Maternity Care, served at least 20 Black patients per year and had newborn complication rates of less than 2.62% and c-section rates of less than 23.9% (among hospitals providing a higher level of care) or 23.6% (among hospitals not providing a higher level of care) among Black patients. A hospital that has earned a High Performing designation may be a good option for parents, in consultation with their medical provider, to consider. Founded by Black Mamas Matter Alliance (BMMA), Black Maternal Health Week is held every April as part of National Minority Health Month; this year is the seventh annual observation of Black Maternal Health Week. Join the conversation for Black Maternal Health Week 2024 from April 11-17, 2024 using #BMHW24 on Facebook, Instagram, TikTok and X (formerly Twitter). About U.S. News & World Report U.S. News & World Report is the global leader in quality rankings that empower consumers, business leaders and policy officials to make better, more informed decisions about important issues affecting their lives and communities. A multifaceted digital media company with Education, Health, Money, Travel, Cars, News, Real Estate, Careers and 360 Reviews platforms, U.S. News provides rankings, independent reporting, data journalism, consumer advice and U.S. News Live events. More than 40 million people visit USNews.com each month for research and guidance. Founded in 1933, U.S. News is headquartered in Washington, D.C. SOURCE U.S. News & World Report, L.P.

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