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Article ; Online: Preeclampsia and subsequent cardiovascular disease: villain or innocent bystander?

Maynard, Sharon E

Clinical journal of the American Society of Nephrology : CJASN

2013 Volume 8, Issue 7, Page(s) 1061–1063

MeSH term(s)	Albuminuria/epidemiology ; Female ; Humans ; Pre-Eclampsia/epidemiology ; Pregnancy
Language	English
Publishing date	2013-07
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	2226665-3
ISSN	1555-905X ; 1555-9041
ISSN (online)	1555-905X
ISSN	1555-9041
DOI	10.2215/CJN.04830513
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Article ; Online: Acute kidney injury in pregnancy: the thrombotic microangiopathies.

Ganesan, Chitra / Maynard, Sharon E

Journal of nephrology

2011 Volume 24, Issue 5, Page(s) 554–563

Abstract: ... thrombotic thrombocytopenic purpura (TTP) are all frequently complicated by AKI, and share several clinical features which pose ...

Abstract	Acute kidney injury (AKI) is a rare but serious complication of pregnancy. Although prerenal and ischemic causes of AKI are most common, renal insufficiency can complicate several other pregnancy-specific conditions. In particular, severe preeclampsia/HELLP syndrome, acute fatty liver of pregnancy (AFLP) and thrombotic thrombocytopenic purpura (TTP) are all frequently complicated by AKI, and share several clinical features which pose diagnostic challenges to the clinician. In this article, we discuss the clinical and laboratory features, pathophysiology and treatment of these 3 conditions, with particular attention to renal manifestations. It is imperative to distinguish these conditions to make appropriate therapeutic decisions which can be lifesaving for the mother and fetus. Typically AFLP and HELLP improve after delivery of the fetus, whereas plasma exchange is the first-line treatment for TTP.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/etiology ; Acute Kidney Injury/physiopathology ; Acute Kidney Injury/therapy ; Diagnosis, Differential ; Fatty Liver/diagnosis ; Fatty Liver/physiopathology ; Fatty Liver/therapy ; Female ; HELLP Syndrome/diagnosis ; HELLP Syndrome/physiopathology ; HELLP Syndrome/therapy ; Humans ; Pre-Eclampsia/diagnosis ; Pre-Eclampsia/physiopathology ; Pre-Eclampsia/therapy ; Predictive Value of Tests ; Pregnancy ; Pregnancy Complications/diagnosis ; Pregnancy Complications/physiopathology ; Pregnancy Complications/therapy ; Severity of Illness Index ; Thrombotic Microangiopathies/complications ; Thrombotic Microangiopathies/diagnosis ; Thrombotic Microangiopathies/physiopathology ; Thrombotic Microangiopathies/therapy ; Treatment Outcome
Language	English
Publishing date	2011-09
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	1093991-x
ISSN	1724-6059 ; 1120-3625 ; 1121-8428
ISSN (online)	1724-6059
ISSN	1120-3625 ; 1121-8428
DOI	10.5301/JN.2011.6250
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Article ; Online: Angiogenic factors and preeclampsia.

Maynard, Sharon E / Karumanchi, S Ananth

Seminars in nephrology

2010 Volume 31, Issue 1, Page(s) 33–46

Abstract: Preeclampsia, a hypertensive disorder peculiar to pregnancy, is a systemic syndrome that appears to originate in the placenta and is characterized by widespread maternal endothelial dysfunction. Until recently, the molecular pathogenesis of phenotypic ... ...

Abstract	Preeclampsia, a hypertensive disorder peculiar to pregnancy, is a systemic syndrome that appears to originate in the placenta and is characterized by widespread maternal endothelial dysfunction. Until recently, the molecular pathogenesis of phenotypic preeclampsia was largely unknown, but recent observations support the hypothesis that altered expression of placental anti-angiogenic factors are responsible for the clinical manifestations of the disease. Soluble Flt1 and soluble endoglin, secreted by the placenta, are increased in the maternal circulation weeks before the onset of preeclampsia. These anti-angiogenic factors produce systemic endothelial dysfunction, resulting in hypertension, proteinuria, and the other systemic manifestations of preeclampsia. The molecular basis for placental dysregulation of these pathogenic factors remains unknown, and as of 2011 the role of angiogenic proteins in early placental vascular development was starting to be explored. The data linking angiogenic factors to preeclampsia have exciting clinical implications, and likely will transform the detection and treatment of preeclampsia.
MeSH term(s)	Angiogenesis Inhibitors/physiology ; Animals ; Female ; Fetal Growth Retardation/physiopathology ; Humans ; Models, Animal ; Neovascularization, Physiologic ; Placenta/physiology ; Placenta/physiopathology ; Pre-Eclampsia/diagnosis ; Pre-Eclampsia/epidemiology ; Pre-Eclampsia/physiopathology ; Pregnancy ; Signal Transduction
Chemical Substances	Angiogenesis Inhibitors
Language	English
Publishing date	2010-11-24
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	604652-6
ISSN	1558-4488 ; 0270-9295
ISSN (online)	1558-4488
ISSN	0270-9295
DOI	10.1016/j.semnephrol.2010.10.004
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Article ; Online: Pregnancy and the kidney.

Maynard, Sharon E / Thadhani, Ravi

Journal of the American Society of Nephrology : JASN

2009 Volume 20, Issue 1, Page(s) 14–22

Abstract: Nephrologists are frequently called on to diagnose and treat renal disorders in pregnant women. In this review, we update recent literature pertinent to pregnancy and renal disease. We initially begin by describing the application of common clinical ... ...

Abstract	Nephrologists are frequently called on to diagnose and treat renal disorders in pregnant women. In this review, we update recent literature pertinent to pregnancy and renal disease. We initially begin by describing the application of common clinical estimators of GFR and proteinuria in pregnancy and then summarize recent studies regarding pregnancy in women with chronic kidney disease and the latest information on the use of common renal medications in pregnancy. In the final section, we describe advances in our understanding of the pathophysiology of preeclampsia and the potential clinical implications of these discoveries for screening, prevention, and treatment of preeclampsia.
MeSH term(s)	Animals ; Chronic Disease ; Female ; Galectins/blood ; Glomerular Filtration Rate ; Humans ; Immunosuppressive Agents/adverse effects ; Kidney Diseases/diagnosis ; Kidney Transplantation ; Pre-Eclampsia/diagnosis ; Pre-Eclampsia/etiology ; Pre-Eclampsia/prevention & control ; Pregnancy ; Pregnancy Complications/diagnosis ; Pregnancy Proteins/blood ; Proteinuria/diagnosis ; Receptor, Angiotensin, Type 1/physiology ; Renin-Angiotensin System/drug effects ; Renin-Angiotensin System/physiology
Chemical Substances	Galectins ; Immunosuppressive Agents ; LGALS13 protein, human ; Pregnancy Proteins ; Receptor, Angiotensin, Type 1
Language	English
Publishing date	2009-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1085942-1
ISSN	1533-3450 ; 1046-6673
ISSN (online)	1533-3450
ISSN	1046-6673
DOI	10.1681/ASN.2008050493
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Article ; Online: Merging machine learning and patient preference: a novel tool for risk prediction of percutaneous coronary interventions.

Hamilton, David E / Albright, Jeremy / Seth, Milan / Painter, Ian / Maynard, Charles / Hira, Ravi S / Sukul, Devraj / Gurm, Hitinder S

European heart journal

2024 Volume 45, Issue 8, Page(s) 601–609

Abstract: ... enhancing shared decision-making. This study aimed to employ machine learning models using pre-procedural ... to PCI could help inform treatment selection and shared decision-making discussions. ...

Abstract	Background and aims: Predicting personalized risk for adverse events following percutaneous coronary intervention (PCI) remains critical in weighing treatment options, employing risk mitigation strategies, and enhancing shared decision-making. This study aimed to employ machine learning models using pre-procedural variables to accurately predict common post-PCI complications. Methods: A group of 66 adults underwent a semiquantitative survey assessing a preferred list of outcomes and model display. The machine learning cohort included 107 793 patients undergoing PCI procedures performed at 48 hospitals in Michigan between 1 April 2018 and 31 December 2021 in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) registry separated into training and validation cohorts. External validation was conducted in the Cardiac Care Outcomes Assessment Program database of 56 583 procedures in 33 hospitals in Washington. Results: Overall rate of in-hospital mortality was 1.85% (n = 1999), acute kidney injury 2.51% (n = 2519), new-onset dialysis 0.44% (n = 462), stroke 0.41% (n = 447), major bleeding 0.89% (n = 942), and transfusion 2.41% (n = 2592). The model demonstrated robust discrimination and calibration for mortality {area under the receiver-operating characteristic curve [AUC]: 0.930 [95% confidence interval (CI) 0.920-0.940]}, acute kidney injury [AUC: 0.893 (95% CI 0.883-0.903)], dialysis [AUC: 0.951 (95% CI 0.939-0.964)], stroke [AUC: 0.751 (95%CI 0.714-0.787)], transfusion [AUC: 0.917 (95% CI 0.907-0.925)], and major bleeding [AUC: 0.887 (95% CI 0.870-0.905)]. Similar discrimination was noted in the external validation population. Survey subjects preferred a comprehensive list of individually reported post-procedure outcomes. Conclusions: Using common pre-procedural risk factors, the BMC2 machine learning models accurately predict post-PCI outcomes. Utilizing patient feedback, the BMC2 models employ a patient-centred tool to clearly display risks to patients and providers (https://shiny.bmc2.org/pci-prediction/). Enhanced risk prediction prior to PCI could help inform treatment selection and shared decision-making discussions.
MeSH term(s)	Humans ; Percutaneous Coronary Intervention/methods ; Patient Preference ; Treatment Outcome ; Renal Dialysis ; Risk Factors ; Hemorrhage/etiology ; Machine Learning ; Stroke/etiology ; Acute Kidney Injury/etiology ; Risk Assessment/methods
Language	English
Publishing date	2024-01-08
Publishing country	England
Document type	Journal Article
ZDB-ID	603098-1
ISSN	1522-9645 ; 0195-668X
ISSN (online)	1522-9645
ISSN	0195-668X
DOI	10.1093/eurheartj/ehad836
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Zs.A 1563: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Assessing Nephrology Fellows' Skills in Communicating About Kidney Replacement Therapy and Kidney Biopsy: A Multicenter Clinical Simulation Study on Breaking Bad News.

Prince, Lisa K / Howle, Anna M / Mikita, Jeffrey / Y'Barbo, Brian C / Maynard, Sharon E / Sussman, Amy N / Maursetter, Laura J / Lenz, Oliver / Scalese, Ross J / Sozio, Stephen M / Cohen, Scott / Watson, Maura A / Nee, Robert / Yuan, Christina M

American journal of kidney diseases : the official journal of the National Kidney Foundation

2021 Volume 78, Issue 4, Page(s) 541–549

Abstract: Rationale & objective: Interpersonal communication skills and professionalism competencies are difficult to assess among nephrology trainees. We developed a formative "Breaking Bad News" simulation and implemented a study in which nephrology fellows ... ...

Abstract	Rationale & objective: Interpersonal communication skills and professionalism competencies are difficult to assess among nephrology trainees. We developed a formative "Breaking Bad News" simulation and implemented a study in which nephrology fellows were assessed with regard to their skills in providing counseling to simulated patients confronting the need for kidney replacement therapy (KRT) or kidney biopsy. Study design: Observational study of communication competency in the setting of preparing for KRT for kidney failure, for KRT for acute kidney injury (AKI), or for kidney biopsy. Setting & participants: 58 first- and second-year nephrology fellows assessed during 71 clinical evaluation sessions at 8 training programs who participated in an objective structured clinical examination of simulated patients in 2017 and 2018. Predictors: Fellowship training year and clinical scenario. Outcome: Primary outcome was the composite score for the "overall rating" item on the Essential Elements of Communication-Global Rating Scale 2005 (EEC-GRS), as assessed by simulated patients. Secondary outcomes were the score for EEC-GRS "overall rating" item for each scenario, score < 3 for any EEC-GRS item, Mini-Clinical Examination Exercise (Mini-CEX) score < 3 on at least 1 item (as assessed by faculty), and faculty and fellow satisfaction with simulation exercise (via a survey they completed). Analytical approach: Nonparametric tests of hypothesis comparing performance by fellowship year (primary goal) and scenario. Results: Composite scores for EEC-GRS overall rating item were not significantly different between fellowship years (P = 0.2). Only 4 of 71 fellow evaluations had an unsatisfactory score for the EEC-GRS overall rating item on any scenario. On Mini-CEX, 17% scored < 3 on at least 1 item in the kidney failure scenario; 37% and 53% scored < 3 on at least 1 item in the AKI and kidney biopsy scenarios, respectively. In the survey, 96% of fellows and 100% of faculty reported the learning objectives were met and rated the experience good or better in 3 survey rating questions. Limitations: Relatively brief time for interactions; limited familiarity with and training of simulated patients in use of EEC-GRS. Conclusions: The fellows scored highly on the EEC-GRS regardless of their training year, suggesting interpersonal communication competency is achieved early in training. The fellows did better with the kidney failure scenario than with the AKI and kidney biopsy scenarios. Structured simulated clinical examinations may be useful to inform curricular choices and may be a valuable assessment tool for communication and professionalism.
MeSH term(s)	Adult ; Clinical Competence/standards ; Communication ; Computer Simulation/standards ; Fellowships and Scholarships/standards ; Female ; Humans ; Internship and Residency/standards ; Kidney Diseases/psychology ; Kidney Diseases/therapy ; Male ; Nephrology/education ; Nephrology/standards ; Physician-Patient Relations ; Prospective Studies ; Renal Replacement Therapy/psychology ; Renal Replacement Therapy/standards
Language	English
Publishing date	2021-03-16
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Observational Study ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	604539-x
ISSN	1523-6838 ; 0272-6386
ISSN (online)	1523-6838
ISSN	0272-6386
DOI	10.1053/j.ajkd.2021.02.323
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Article ; Online: Light chain cast nephropathy caused by plasmablastic lymphoma of the bladder.

Jafarizade, Mehrian / Goli, Kiran / D'Agati, Vivette / Dulaimi, Essel / Daniel, Krupa / Lash, Bradley / Maynard, Sharon

Clinical nephrology. Case studies

2021 Volume 9, Page(s) 72–80

Abstract: Introduction: Plasmablastic lymphoma (PBL) is a rare form of B-cell lymphoma typically seen in patients with underlying immunosuppression such as HIV, autoimmune disease, and organ transplantation. PBL in HIV-positive patients usually originates from ... ...

Abstract	Introduction: Plasmablastic lymphoma (PBL) is a rare form of B-cell lymphoma typically seen in patients with underlying immunosuppression such as HIV, autoimmune disease, and organ transplantation. PBL in HIV-positive patients usually originates from the gastrointestinal tract, with a predilection for the oral cavity. Bladder involvement by PBL is exceedingly rare, and cast nephropathy due to κ light chain-secreting PBL has not been reported previously. Case report: We report a patient who presented with acute kidney injury (AKI) in the setting of HIV, and was found to have a bladder tumor. Bladder pathology revealed a high-grade PBL with κ light chain restriction. Renal biopsy showed κ light chain cast nephropathy, presumably secondary to κ light chain-secreting PBL. Conclusion: Although the prognosis of PBL is poor, our patient recovered from AKI, achieved complete hematologic remission with chemotherapy, and underwent successful autologous stem cell transplant.
Language	English
Publishing date	2021-07-01
Publishing country	Germany
Document type	Case Reports
ISSN	2196-5293
ISSN (online)	2196-5293
DOI	10.5414/CNCS110339
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Article ; Online: Misapplications of commonly used kidney equations: renal physiology in practice.

Nguyen, Mai T / Maynard, Sharon E / Kimmel, Paul L

Clinical journal of the American Society of Nephrology : CJASN

2009 Volume 4, Issue 3, Page(s) 528–534

Abstract: Equations for estimating GFR, quantifying urinary protein excretion, and assessing renal sodium handling are widely used in routine nephrology and general medical and surgical practice. If these equations are applied in circumstances inconsistent with ... ...

Abstract	Equations for estimating GFR, quantifying urinary protein excretion, and assessing renal sodium handling are widely used in routine nephrology and general medical and surgical practice. If these equations are applied in circumstances inconsistent with the clinical situations for or extrapolated beyond the limits in which they were validated, clinicians can come to erroneous conclusions, which could be detrimental for patient care. This review uses clinical vignettes to demonstrate some of the common pitfalls that clinicians may encounter in the use of these equations and considers the physiologic principles underlying their use. Equations for assessing aspects of renal function should only be used in specific clinical situations, if the underlying assumptions regarding their calculations and values are satisfied.
MeSH term(s)	Acute Disease ; Adult ; Aged ; Female ; Glomerular Filtration Rate ; Humans ; Kidney/physiopathology ; Kidney Diseases/diagnosis ; Kidney Diseases/physiopathology ; Kidney Function Tests/methods ; Male ; Middle Aged ; Models, Biological ; Predictive Value of Tests ; Pregnancy ; Pregnancy Complications/diagnosis ; Pregnancy Complications/physiopathology ; Proteinuria/diagnosis ; Proteinuria/physiopathology ; Reagent Strips ; Reproducibility of Results ; Sodium/metabolism ; Urinalysis
Chemical Substances	Reagent Strips ; Sodium (9NEZ333N27)
Language	English
Publishing date	2009-03-04
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2226665-3
ISSN	1555-905X ; 1555-9041
ISSN (online)	1555-905X
ISSN	1555-9041
DOI	10.2215/CJN.05731108
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Article ; Online: Implementation of the I-PASS handoff program in diverse clinical environments: A multicenter prospective effectiveness implementation study.

Starmer, Amy J / Spector, Nancy D / O'Toole, Jennifer K / Bismilla, Zia / Calaman, Sharon / Campos, Maria-Lucia / Coffey, Maitreya / Destino, Lauren A / Everhart, Jennifer L / Goldstein, Jenna / Graham, Dionne A / Hepps, Jennifer H / Howell, Eric E / Kuzma, Nicholas / Maynard, Greg / Melvin, Patrice / Patel, Shilpa J / Popa, Alina / Rosenbluth, Glenn /

Schnipper, Jeffrey L / Sectish, Theodore C / Srivastava, Rajendu / West, Daniel C / Yu, Clifton E / Landrigan, Christopher P

Journal of hospital medicine

2022 Volume 18, Issue 1, Page(s) 5–14

Abstract: Background: Handoff miscommunications are a leading source of medical errors. Harmful medical errors decreased in pediatric academic hospitals following implementation of the I-PASS handoff improvement program. However, implementation across specialties ...

Abstract	Background: Handoff miscommunications are a leading source of medical errors. Harmful medical errors decreased in pediatric academic hospitals following implementation of the I-PASS handoff improvement program. However, implementation across specialties has not been assessed. Objective: To determine if I-PASS implementation across diverse settings would be associated with improvements in patient safety and communication. Design: Prospective Type 2 Hybrid effectiveness implementation study. Settings and participants: Residents from diverse specialties across 32 hospitals (12 community, 20 academic). Intervention: External teams provided longitudinal coaching over 18 months to facilitate implementation of an enhanced I-PASS program and monthly metric reviews. Main outcome and measures: Systematic surveillance surveys assessed rates of resident-reported adverse events. Validated direct observation tools measured verbal and written handoff quality. Results: 2735 resident physicians and 760 faculty champions from multiple specialties (16 internal medicine, 13 pediatric, 3 other) participated. 1942 error surveillance reports were collected. Major and minor handoff-related reported adverse events decreased 47% following implementation, from 1.7 to 0.9 major events/person-year (p < .05) and 17.5 to 9.3 minor events/person-year (p < .001). Implementation was associated with increased inclusion of all five key handoff data elements in verbal (20% vs. 66%, p < .001, n = 4812) and written (10% vs. 74%, p < .001, n = 1787) handoffs, as well as increased frequency of handoffs with high quality verbal (39% vs. 81% p < .001) and written (29% vs. 78%, p < .001) patient summaries, verbal (29% vs. 78%, p < .001) and written (24% vs. 73%, p < .001) contingency plans, and verbal receiver syntheses (31% vs. 83%, p < .001). Improvement was similar across provider types (adult vs. pediatric) and settings (community vs. academic).
MeSH term(s)	Adult ; Humans ; Child ; Patient Handoff ; Internship and Residency ; Prospective Studies ; Internal Medicine ; Communication
Language	English
Publishing date	2022-11-03
Publishing country	United States
Document type	Multicenter Study ; Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2233783-0
ISSN	1553-5606 ; 1553-5592
ISSN (online)	1553-5606
ISSN	1553-5592
DOI	10.1002/jhm.12979
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Article ; Online: I-PASS Mentored Implementation Handoff Curriculum: Implementation Guide and Resources.

O'Toole, Jennifer K / Starmer, Amy J / Calaman, Sharon / Campos, Maria-Lucia / Goldstein, Jenna / Hepps, Jennifer / Maynard, Gregory A / Owolabi, Mobola / Patel, Shilpa J / Rosenbluth, Glenn / Schnipper, Jeffrey L / Sectish, Theodore C / Srivastava, Rajendu / West, Daniel C / Yu, Clifton E / Landrigan, Christopher P / Spector, Nancy D

MedEdPORTAL : the journal of teaching and learning resources

2018 Volume 14, Page(s) 10736

Abstract: Introduction: Communication failures during shift-to-shift handoffs of patient care have been identified as a leading cause of adverse events in health care institutions. The I-PASS Handoff Program is a comprehensive handoff program that has been shown ... ...

Abstract	Introduction: Communication failures during shift-to-shift handoffs of patient care have been identified as a leading cause of adverse events in health care institutions. The I-PASS Handoff Program is a comprehensive handoff program that has been shown to decrease rates of medical errors and adverse events. As part of the spread and adaptation of this program, a comprehensive implementation guide was created to assist individuals in the implementation process. Methods: The I-PASS Mentored Implementation Guide grew out of materials created for the original I-PASS Study, Society of Hospital Medicine (SHM) mentored implementation programs, and the experience of members of the I-PASS Study Group. The guide provides a comprehensive framework of all elements required to implement the large-scale I-PASS Handoff Program and contains detailed information on generating institutional support, training activities, a campaign, measuring impact, and sustaining the program. Results: Thirty-two sites across North America utilized the guide as part of the SHM program. The guide served as a main reference for 477 hours of mentoring phone calls between site leads and their mentors. Postprogram surveys from wave 2 sites revealed that 85% ( Discussion: The I-PASS Mentored Implementation Guide is an essential resource for those looking to implement the large-scale I-PASS Handoff Program at their institution.
MeSH term(s)	Curriculum/trends ; Humans ; Internship and Residency/methods ; Mentors ; North America ; Patient Handoff ; Patient Safety ; Surveys and Questionnaires ; Teaching/standards ; Teaching/trends
Language	English
Publishing date	2018-08-03
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ISSN	2374-8265
ISSN (online)	2374-8265
DOI	10.15766/mep_2374-8265.10736
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