The association between postpartum aspirin use and NT-proBNP levels as a marker for maternal cardiac health: a randomized-controlled trial.

Objective: To compare levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), a marker of cardiac strain, and clinical outcomes in patients at risk of preeclampsia randomized to continuation of low-dose aspirin (LDA) versus placebo for 6 weeks postpartum.

Study Design: This double-blinded randomized-controlled trial included patients at risk of preeclampsia randomized in a 1:1 fashion to LDA (81 mg) versus placebo for 6 weeks postpartum. The primary outcome was NT-proBNP levels at the postpartum visit.

Future reproductive outcomes and contraceptive access in the first year postpartum after non-receipt of postpartum permanent contraception.

Objective: Our objective was to compare pregnancy, contraceptive uptake, and health care utilization in the 365 days following delivery, between those who requested and did not receive permanent contraception and those who requested other types of postpartum contraception.

Study Design: This was a retrospective cohort study of 1412 patients among 5688 delivering in 2018 at one health system. Our primary outcome was pregnancy within 365 days postpartum and we compared 207 individuals who requested and did not receive permanent contraception, with 956 who requested other types of contraception.

Hypersensitivity Reactions to Fibrin Glue during Epidural Blood Patching.

Background And Purpose: Fibrin glue is increasingly incorporated as a component in epidural blood patching (EBP) for the treatment of spinal CSF leaks. Hypersensitivity reactions are a potential complication of its use but are not well studied in the setting of EBP. The purpose of this study was to determine the incidence of hypersensitivity reactions to fibrin glue during EBP and to identify any predisposing factors associated with increased patient risk.

Medicaid Expansion, Uninsurance Rates, and Catastrophic Costs at the Time of Emergency Gynecologic Surgery.

Objective: To estimate the effect of Medicaid expansion on uninsurance rates and catastrophic charges from emergency surgical management of ectopic pregnancy and ovarian torsion using difference-in-difference analysis and to evaluate for racial and ethnic disparities.

Methods: We conducted a retrospective cohort analysis using 2012-2018 State Inpatient Data and State Ambulatory Surgery and Services Databases in four states: Kentucky and Maryland (expansion) and Florida and North Carolina (nonexpansion). Patients undergoing surgical management of ovarian torsion or ectopic pregnancy were included.

Assessment of different intervention models to decrease no-show rates of embedded pharmacy visits.

Background: Clinical pharmacist practitioners (CPPs) are embedded in several Duke Primary Care (DPC) clinic locations. CPPs are able to independently modify medications and order labs within protocol in collaboration with a supervising physician. Patient no-shows for CPP appointments are costly to clinics.

Photon-Counting CT Effects on Sensitivity for Liver Lesion Detection: A Reader Study Using Virtual Imaging.

Background Detection of hepatic metastases at CT is a daily task in radiology departments that influences medical and surgical treatment strategies for oncology patients. Purpose To compare simulated photon-counting CT (PCCT) with energy-integrating detector (EID) CT for the detection of small liver lesions. Materials and Methods In this reader study (July to December 2023), a virtual imaging framework was used with 50 anthropomorphic phantoms and 183 generated liver lesions (one to six lesions per phantom, 0.

Opioid Treatment Is Associated with Recurrent Healthcare Visits, Increased Side Effects, and Pain.

Introduction: Pain is a major driver of visits to the emergency department (ED). Clinicians must consider not only the efficacy of treatment options but also subsequent healthcare utilization and patient-centered outcomes such as side effects from prescribed medications. Our goal in this study was to determine whether there was an association between acute pain treatment regimen (opioids, intranasal non-steroidal anti-inflammatory drugs [NSAIDs], or both) and unscheduled healthcare visits following ED discharge.

Transcutaneous Electric Nerve Stimulation for Analgesia During Outpatient Endometrial Biopsy: A Randomized Controlled Trial.

Objective: To evaluate whether transcutaneous electric nerve stimulation (TENS) decreases pain at the time of outpatient endometrial biopsy.

Methods: We conducted a randomized, double-blind trial of active TENS compared with placebo TENS at the time of endometrial biopsy. The primary outcome was pain measured on a 0- to 100-mm visual analog scale immediately after biopsy, with secondary outcomes including satisfaction and tolerability of TENS and pain scores at other procedural time points.

Incidence of opportunistic viral infections in hepatitis C virus nucleic acid test negative recipients of kidneys from hepatitis C virus nucleic acid test positive donors.

Background: In kidney transplantation, concerns have been raised regarding increased incidence of viral opportunistic infections in hepatitis C virus (HCV) nucleic acid test (NAT)-negative (-) recipients who received HCV NAT-positive (+) donor kidneys, specifically BK polyomavirus (BKPyV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV). The purpose of this study was to determine the incidence of these three viral opportunistic infections in HCV NAT- recipients who have undergone kidney transplantation with HCV NAT+ donor kidneys at our institution.

Methods: This was an Institutional Review Board-approved, single-center, retrospective case-control study of HCV NAT- kidney transplant recipients with HCV NAT+ donors from 2018 to 2021.

Diagnostic Performance of Renal Contrast Excretion on Early-Phase CT Myelography in Spontaneous Intracranial Hypotension.

Background And Purpose: Early opacification of the renal collecting system during CT myelography (CTM) performed for the evaluation of spontaneous intracranial hypotension (SIH) has been demonstrated in prior studies. However, these investigations often included CTMs scanned >30 minutes after intrathecal contrast injection, a longer delay than the myelographic techniques used in current practice. The purpose of this study was to determine whether renal contrast excretion (RCE) measured during this earlier time period (≤30 minutes) can discriminate patients with SIH from patients without SIH.

Assessment of embedded versus remote pharmacist versus remote student pharmacist outreach on statin prescribing.

Background: The Statin Use in Persons with Diabetes (SUPD) measure is a Star measure by the Center for Medicare & Medicaid Services. The Duke Population Health Management Office has a team of pharmacists and pharmacy students who conduct targeted outreach to patients at risk of failing statin quality measures. Pharmacy services are embedded in select primary care clinics and other clinics are supported remotely.

Evaluation of Tacrolimus Concentrations and Clinical Outcomes Between Extended and Immediate Release Formulations in Kidney Transplant.

Tacrolimus remains the mainstay of immunosuppression in kidney transplantation. Understanding the relationship between therapeutic tacrolimus levels and outcomes of acute rejection, patient/graft survival, and tolerability are important. The relationship between time to therapeutic tacrolimus levels and outcomes has not been well established, specifically with the use of extended release tacrolimus formulation (LCP-Tac).

Reported changes in romantic and sexual behavior among college and graduate students during COVID-19.

To understand changes in romantic and sexual behavior among college and graduate students in North Carolina during COVID-19. : Participants were between 18-30 years old and enrolled in a two- or four-year college or graduate program in North Carolina ( = 926). : A cross-sectional web-based survey was administered to college and graduate students to assess romantic and sexual behavioral changes during COVID-19.

Cryocompression to Reduce Peripheral Neuropathy in Gynecologic Cancer: A Randomized Controlled Trial.

Objective: To investigate the efficacy of cryocompression therapy to prevent chemotherapy-induced peripheral neuropathy.

Methods: This single-institution, randomized, self-controlled trial of cryocompression enrolled gynecologic cancer patients planned for five to six cycles neurotoxic chemotherapy. Exclusion criteria were prior neurotoxic chemotherapy or baseline peripheral neuropathy.

Gender and Language in Letters of Recommendation for Obstetrics and Gynecology Fellowship Applications.

Objective: To delineate the use of gender-biased language in letters of recommendation for Obstetrics and Gynecology fellowships and its impact on applicants.

Design: Fellowship letters of recommendation from 4 Obstetrics and Gynecology specialties at a single institution in 2020 were included.

Primary Outcome: frequency of agentic and communal language in letters of recommendation using Linguistics Inquiry Word Count software.

Preemptive immune globulin therapy in sensitized lung transplant recipients.

Background: Sensitized lung transplant recipients are at increased risk of developing donor-specific antibodies, which have been associated with acute and chronic rejection. Perioperative intravenous immune globulin has been used in sensitized individuals to down-regulate antibody production.

Methods: We compared patients with a pre-transplant calculated panel reactive antibody ≥25% who did not receive preemptive immune globulin therapy to a historical control that received preemptive immune globulin therapy.

Patient and Surgery Characteristics of Inpatient Hysterectomies Among Transgender Individuals.

The purpose of this study is to estimate population-based rates of inpatient hysterectomy and accompanying bilateral salpingo-oophorectomy by indication and evaluate surgical patient characteristics by indication, year, patient age, and hospital location. We used 2016 and 2017 cross-sectional data from the Nationwide Inpatient Sample to estimate the hysterectomy rate for individuals aged 18-54 years with a primary indication for gender-affirming care (GAC) compared to other indications. Outcome measures were population-based rates for inpatient hysterectomy and bilateral salpingo-oophorectomy by indication.