The goal of this randomized control trial is to compare outpatient transcervical foley balloon to inpatient vaginal misoprostol in pregnant women for cervical ripening. The main questions it aims to answer are:
1. Does outpatient transcervical foley balloon decreased the time from admission to delivery compared to inpatient vaginal misoprostol
2. Does outpatient transcervical foley balloon will increase risk of c-section during induction of labor compared to inpatient vaginal misoprostol
Participants will be randomized to either the outpatient transcervical foley balloon group or to the inpatient intravaginal misoprostol group. The researchers will compare if outpatient transcervical foley balloon decreases the tie from hospital admission to delivery of the baby.

开始日期2022-06-09

申办/合作机构

Hurley Medical Center, Inc.

NCT05386316

/ Enrolling by invitationN/AIIT

Meeting Women Where They Are: The Maternal Health Multilevel Intervention for Racial Equity (MIRACLE) Project

This community-partnered study will scale a community, provider, and system-level implementation intervention to reduce African American maternal morbidity and mortality disparities in two Michigan counties (Genesee and Kent). This project will test the intervention using data from Medicaid insured women who deliver in Michigan from 2016-2019 and 2022-2025 (approximately 540,000 births, including 162,000 births to African American women).

开始日期2022-01-01

申办/合作机构

Michigan State University

[+3]

NCT04767282

/ CompletedN/AIIT

Innovative Nutrition Practices in Pediatric Health Care: Assessment of a Fruit and Vegetable Prescription Program for Children in Need

The objective of this study is to address gaps in knowledge related to the influence of pediatric fruit and vegetable prescription programs on food security, child dietary patterns, and weight status. To do this, we will compare demographically similar pediatric patient groups from three large clinics in a low-income urban city based on their exposure to a fruit and vegetable prescription program (FVPP) that provides one $15 prescription for fresh fruits and vegetable to every child at every office visit. Three clusters will be identified based on child exposure to the pediatric FVPP at baseline: high exposure (>24 months), moderate exposure (12-24 months), and no previous exposure. We will then introduce the FVPP to never exposed patients and collect, record, and compare changes in dietary intake, food security, and weight status over time. We will test the hypothesis that exposure to the FVPP is associated with higher intake of fruits and vegetables, better food security, and lower rates of obesity among children. The first aim will compare baseline dietary intake, food security, and weight status between high exposure, moderate exposure, no exposure groups. The second aim will measure changes in diet, food security, and weight status at 6-, 12-, 18-, and 24-months among children newly exposed to the FVPP. The third aim will compare follow-up measures of dietary intake, food security, and weight status in the initial no exposure group to baseline measures in the high exposure group.

开始日期2021-02-23

申办/合作机构

Michigan State University

[+3]

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项与 Hurley Medical Center, Inc. 相关的文献（医药）

2026-01-01·NEUROSURGERY

Evaluating the Impact of Frailty on Mortality in Patients With Nonoperative and Operative Type II Odontoid Fracture: An American College of Surgeons Trauma Quality Improvement Program Survival Analysis of 22 440 Patients

Article

作者: Owodunni, Oluwafemi P. ; Courville, Evan N. ; Schmidt, Meic H. ; Norii, Tatsuya ; Crandall, Cameron S. ; Bowers, Christian A.

BACKGROUND AND OBJECTIVES::

Type II odontoid fractures (T2OF) are the most prevalent cervical spine injuries among the elderly. Nonetheless, there are insufficient data regarding the influence of frailty on outcomes for both nonoperative and operative treatment approaches. We sought to evaluate the influence of frailty on outcomes using 5-factor modified frailty index.

METHODS::

We performed a retrospective review of the American College of Surgeons Trauma Quality Improvement Program database from 2015 to 2020. We analyzed nonoperative and operative traumatic T2OF cases. Outcomes included major complications, hospital length of stay (LOS), nonhome discharge (NHD), mortality rates, and survival probabilities. We used unmatched and propensity score–matched risk-adjusted models to assess the association between frailty and all outcomes. Survival probabilities were examined using Kaplan–Meier plots, stratified by frailty strata.

RESULTS::

A total of 22 440 patients comprising 7138 (31.8%) robust, 7913 (35.2%) normal, 5158 (22.9%) frail, and 2231 (9.9%) very frail patients were included. Results from unmatched multivariable analyses revealed a dose-dependent relationship between frailty and all outcomes, in both cohorts ( P < .05). Propensity score–matched resulted in 3942 nonoperative and operative matched pairs. Preoperative characteristics were similar between cohorts, except for age: 75 years (IQR: 60-83) for nonoperative and 70 years (IQR: 56-78) for operative, and male sex: 1799 (55.8%) for nonoperative and 439 (61.1%) for operative cohorts. Significant mortality reductions (43%-77%; P < .05) were observed in the operative cohort compared with the nonoperative cohort across all frailty strata. As expected, the operative cohort had longer LOS and increased NHD risk ranging from 64% to 97%, P < .001. In Kaplan–Meier analyses, survival declined significantly across increasing frailty strata P < .001.

CONCLUSION::

Increasing frailty was independently associated with major complications, LOS, NHD, and decreased survival. Operative patients exhibited improved survival compared with nonoperative patients across all frailty strata. These findings highlight the importance of frailty in T2OF management and care coordination.

2026-01-01·FERTILITY AND STERILITY

The impact of supraphysiologic estradiol levels on placental pathology among in vitro fertilization–conceived singleton livebirths after fresh embryo transfer

Article

作者: Cherouveim, Panagiotis ; Bormann, Charles L ; Fitz, Victoria ; Kavelidou, Marianthi ; James, Kaitlyn ; Dimitriadis, Irene ; Minis, Evelyn ; Jiang, Victoria ; Roberts, Drucilla ; Souter, Irene

OBJECTIVE:

To investigate the effect of supraphysiologic estradiol levels during ovarian stimulation on placental pathology among singleton livebirths conceived with in vitro fertilization (IVF) and fresh embryo transfer.

DESIGN:

Retrospective cohort study.

SUBJECTS:

Six hundred twenty six IVF-conceived singleton livebirths with associated placental pathology.

EXPOSURE:

Two separate analyses were performed, using the ≥75th (2588.75pg/mL), and ≥ 90th (3120.5 pg/mL) estradiol percentile as cut-offs. Livebirths were categorized as below or above the estradiol cut-off at time of trigger, and placental abnormalities were compared between groups.

MAIN OUTCOME MEASURES:

Placental pathology (abnormalities classified as: anatomic, vascular, infectious, and inflammatory).

RESULTS:

Mean (SD) age and body mass index were 35.2 (4.0) years and 24.8 (4.5) kg/m². Most patients were identified as White (n = 482, 77.0%), and the most common infertility diagnosis was male factor (n = 178, 28.9%). Using the 75th percentile as estradiol cut-off, unadjusted rates of placental abnormalities did not differ between the two groups (anatomic: 63.7% vs. 65.9%; vascular: 72.0% vs. 66.1%; infectious:33.1% vs. 32%; and inflammatory: 14.6% vs. 20%, for ≥75th vs. <75th percentile, respectively). Adjusted risk ratio (adjRR) (95% confidence interval [CI]) was calculated to account for possible confounding factors (maternal age, body mass index, infertility diagnosis, stimulation protocol, gestational age at delivery, and infant sex). AdjRR (95% CI) did not show significant differences between groups in risk of anatomic or infectious abnormalities. In patients with estradiol levels ≥75th percentile, the risk of vascular abnormalities was higher vs. patients in the <75th percentile group (adjRR [95% CI] 1.14 [1.00-1.29]). Among patients with estradiol levels ≥75th percentile, the risk of inflammatory abnormalities was lower vs. patients in the <75th percentile group (adjRR [95% CI] 0.62 [0.38-0.99]). When using the 90th percentile as the cut-off, no significant differences were noted between groups in rates of anatomic, vascular, infectious, or inflammatory abnormalities (65.1% vs. 65.4%; 76.2% vs. 66.6%; 34.9% vs. 32%; and 15.9% vs. 19%, for ≥90th vs. <90th percentile, respectively). AdjRR (95% CI) did not show significant differences between groups in risk of anatomic, infectious, or inflammatory abnormalities. However, risk for vascular abnormalities was higher among patients with estradiol ≥90th vs. <90th percentile (adjRR [95% CI]: 1.19 [1.01-1.39]).

CONCLUSION:

Our study did not reveal clinically increased risks of placental abnormalities. Higher serum estradiol during IVF was associated with a marginally higher risk for vascular placental abnormalities.

2025-12-01·JOURNAL OF CLINICAL NEUROSCIENCE

A systematic review on COVID-19 and spinal strokes, the end of an era

Review

作者: Mahdavi, Sadegh Baradaran ; Moisi, Marc ; Arora, Shubham ; Mirza, Sara ; Bowers, Christian ; Zoghi, Sina ; Shah, Smit ; Venero, Carmelo ; Sourani, Arman ; Foroughi, Mina ; Haridas, Abilash ; Vahdat, Noushin

AIM:

To investigate the association of the COVID-19 virus with hemorrhagic and ischemic spinal strokes.

, BACKGROUND:

COVID-19 has extensive extrapulmonary manifestations. Myelitis, demyelinating syndromes, hemorrhagic and ischemic presentations have been reported. To date, there is no comprehensive study to delineate an evidence-based correlation between COVID-19 and spinal strokes comprehensively.

MATERIALS AND METHODS:

A PRISMA-based systematic review.

RESULTS:

In the final review, 8 data sets for ischemia and 11 for hemorrhagic lesions were included. The mean age for ischemia and hemorrhagic lesions was 52 and 47 years old, respectively. Patients with cord ischemia had more severe COVID-19 pneumonia as compared to hemorrhagic (62 % vs 27 %). Lab results showed 75 % coagulation abnormalities in cord ischemia patients while there was no coagulopathy in the hemorrhage group. Somatosensory deficits were the most prevalent neurological presentations in both groups. MRI showed that the anterior spinal artery and central ischemia were the most common patterns of COVID-19 spinal ischemia. MRI images also revealed epidural and intramedullary hematomas were the most common type of hemorrhagic lesions with cervical and thoracic preferences. The most common on-admission neurological status was American Spinal Injury Association (ASIA) impairment scale A-B(ischemia) and ASIA B-D(hemorrhage). All of the ischemic patients received conservative management. In hemorrhagic patients, there were 4 laminectomies, 6 conservative management, and 1 combined approach. Post-intervention clinical outcomes in ischemia were unfavorable but in the hemorrhagic spinal strokes, it had more promising results.

CONCLUSION:

COVID-19 can cause both ischemia and hemorrhagic spinal strokes. Coagulopathy may be a precipitating factor in cord ischemia development while other neuropathogenesis mechanisms may precipitate spinal hemorrhage. Early surgical or conservative management is the key factor in determining long-term outcomes.

项与 Hurley Medical Center, Inc. 相关的新闻（医药）

2023-08-02

·PRNewswire

SENTINEL MEDICAL TECHNOLOGIES ADDRESSES IAP TRANSDUCER SHORTAGE WITH TRAUMAGUARD

JACKSONVILLE, Fla., Aug. 2, 2023 /PRNewswire/ -- In the face of the ongoing supply issues affecting Intra-Abdominal Pressure (IAP) transducer kits, Sentinel Medical Technologies is stepping up to ensure that patient care remains uncompromised. The company's FDA-cleared product, TraumaGuard, is now readily available to fill the gap left by the shortage of CR BARD or Centurion IAP kits. Continue Reading TraumaGuard Continuous Intra-Abdominal Pressure Monitoring System IAP monitoring is a critical component of patient care in OR and ICU settings. It serves as a crucial guide for medical teams in assessing the risk of developing Intra-Abdominal Hypertension (IAH) and Abdominal Compartment Syndrome (ACS), conditions that can have severe consequences if not addressed promptly. Given the critical importance of IAP measurements, the ongoing shortage of transducer kits has created obstacles for healthcare providers, increasing the barriers in delivering essential, life-saving care. TraumaGuard offers a solution to this pressing issue. More than a product, TraumaGuard is a commitment to patient care. It provides continuous, hands-free monitoring of IAP, Core Body Temperature, and bladder drainage in critical care patients of all departments. Once administered, TraumaGuard can be left in place for 30 days, eliminating clinical staff burden and improving workflow. Moreover, TraumaGuard's unique technology is designed with patient safety in mind. It actively detects advancement toward Abdominal Compartment Syndrome (ACS), sending proactive alerts to both bedside and nurses' stations while automatically recording and storing measurements in the existing EMR database. This allows for timely interventions that can prevent the escalation of negative patient conditions. In addition to its clinical benefits, TraumaGuard also offers significant cost savings. When actively deployed, it reduces the overall cost of patient care while requiring no capital equipment and can be connected to existing bedside monitors. This makes TraumaGuard a cost-competitive and equivalent replacement to existing IAP devices. Patrick Beer, DO, Critical Care Surgery Specialist, Hurley Medical Center, commented on the situation: "The availability of TraumaGuard comes at a time when IAP transducer kits are currently unavailable or discontinued. This shortage has been a major challenge for OR and ICU teams, who rely on IAP monitoring to assess the risk of Intra-Abdominal Hypertension (IAH) and Abdominal Compartment Syndrome (ACS)." Sentinel Medical Technologies is committed to ensuring the availability of TraumaGuard now and in the future. The company understands the critical role that IAP monitoring plays in patient care and is dedicated to ensuring that healthcare providers have the tools they need to deliver the best possible outcomes. For more information about TraumaGuard, please visit About Sentinel Medical Technologies: Sentinel Medical Technologies is a focused-leader in health technology, committed to saving lives with pressure monitoring. Founded with the mission to advance the standard of care, Sentinel offers a growing suite of innovative pressure-based monitoring devices that cater to a variety of disease states. By unlocking the power of data at the point of care, Sentinel delivers value-based healthcare solutions that are simple, efficient, and cost-effective. Our cutting-edge technologies are designed to solve unmet clinical needs, instill technological confidence in the workflow, and improve patient outcomes. SOURCE Sentinel Medical Technologies

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