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Article ; Online: Lessons from Mortality Reviews: Nonbiologic Contributors to Maternal Deaths.

Minkoff, Howard / Chazotte, Cynthia / Nathan, Lisa M

2023

Abstract: Based on years of review and analysis of severe maternal morbidity and maternal mortality cases, it is clear that the high rates of maternal mortality in this country are due to more than obstetrical emergencies gone awry. Many nonmedical factors ... ...

Abstract	Based on years of review and analysis of severe maternal morbidity and maternal mortality cases, it is clear that the high rates of maternal mortality in this country are due to more than obstetrical emergencies gone awry. Many nonmedical factors contribute to these poor outcomes including complex and ineffectual health care systems, poor coordination of care, and structural racism. In this article we discuss what physicians can and cannot accomplish on their own, the role of race and racism, and barriers built into the manner in which health care is delivered. We conclude that while obstetricians must continue to focus on the area where their expertise lies, reducing deaths by educating and training physicians to deal with the downstream consequences of upstream events, they must also focus increased attention on educating themselves and their trainees about the effect of racism, social disadvantage, and poor coordination of care on health, as well as their role in resolving these issues. Physicians must also reach out to their representatives in government to partner with them. Those leaders must recognize that when they hear about disparities in maternal mortality, focusing only on events in hospitals ignores the more dispositive issues that put Black women at risk in the first instance. KEY POINTS: · Structural racism contributes to maternal deaths.. · Coordination of postpartum care is critically important.. · U.S. health care system is complex and not patient friendly..
Language	English
Publishing date	2023-06-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	605671-4
ISSN	1098-8785 ; 0735-1631
ISSN (online)	1098-8785
ISSN	0735-1631
DOI	10.1055/s-0043-1769470
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Article ; Online: An overview of obstetric hemorrhage.

Nathan, Lisa M

Seminars in perinatology

2018 Volume 43, Issue 1, Page(s) 2–4

Abstract: Obstetric hemorrhage is the leading cause of maternal morbidity and mortality in the world. Disparities in the prevalence of obstetric hemorrhage and its related mortality both on a global scale and locally in the United States indicate that a ... ...

Abstract	Obstetric hemorrhage is the leading cause of maternal morbidity and mortality in the world. Disparities in the prevalence of obstetric hemorrhage and its related mortality both on a global scale and locally in the United States indicate that a significant proportion is preventable. In many parts of the world, including the United States, there has also been an unexplainable increase in rates of postpartum hemorrhage. Efforts should focus on implementing comprehensive hemorrhage toolkit/bundles, which research has shown may have the potential to reduce severe maternal morbidity from hemorrhage.
MeSH term(s)	Blood Transfusion/statistics & numerical data ; Clinical Competence ; Developed Countries ; Developing Countries ; Female ; Healthcare Disparities/statistics & numerical data ; Humans ; Interdisciplinary Communication ; Maternal Mortality/trends ; Midwifery/standards ; Obstetric Labor Complications/mortality ; Obstetric Labor Complications/therapy ; Obstetrics/standards ; Patient Care Team/standards ; Patient Safety/standards ; Postpartum Hemorrhage/mortality ; Postpartum Hemorrhage/prevention & control ; Pregnancy ; Quality Improvement
Language	English
Publishing date	2018-11-14
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	752403-1
ISSN	1558-075X ; 0146-0005
ISSN (online)	1558-075X
ISSN	0146-0005
DOI	10.1053/j.semperi.2018.11.001
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Zs.A 1339: Show issues

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Article ; Online: Treat-to-target vs fixed interval retreatment strategy with rituximab in rheumatoid arthritis: a retrospective cohort study.

Schapink, Lisa / den Broeder, Nathan / den Broeder, Alfons A / Verhoef, Lise M

Rheumatology international

2024

Abstract: To compare the effectiveness of retreatment of rheumatoid arthritis (RA) patients with rituximab (RTX) following the treat-to-target retreatment (TTr) or fixed interval retreatment (FIr) strategy. RA patients starting RTX treatment between January 2008 ... ...

Abstract	To compare the effectiveness of retreatment of rheumatoid arthritis (RA) patients with rituximab (RTX) following the treat-to-target retreatment (TTr) or fixed interval retreatment (FIr) strategy. RA patients starting RTX treatment between January 2008 and June 2016, and receiving at least three infusion cycles were grouped by strategy (TTr, FIr or both). Primary outcome (between strategy difference in DAS28-CRP (Disease Activity Score in 28 joints calculated with C-reactive protein)) and secondary outcomes (flares, use of co-medication and mean yearly dose of RTX) were analyzed by group using linear mixed models to account for different strategies within patients. A total of 213 patients, 59 TTr (of whom 32 switched from TTr to FIr) and 186 FIr were included. No between-group difference in mean DAS28-CRP was found (0.10 DAS28-CRP point (95% CI - 0.07 to 0.26)). The TTr strategy did not result in more flares (IRR 1.13, 95%CI 0.87 to 1.47), conventional synthetic disease-modifying antirheumatic drug use (difference - 11.7%, 95%CI - 26.3% to 2.9%), or lower mean yearly RTX dose (difference 172 mg/yr, 95%CI - 355 to 11.7 mg/yr). RTX retreatment with either a TTr or FIr strategy does not seem to lead to better disease control and/or less drug use when used in a DAS28-CRP treat-to-target context. Choice of either strategy can, therefore, be made based on patient and physician preferences and logistical context.
Language	English
Publishing date	2024-01-29
Publishing country	Germany
Document type	Journal Article
ZDB-ID	8286-7
ISSN	1437-160X ; 0172-8172
ISSN (online)	1437-160X
ISSN	0172-8172
DOI	10.1007/s00296-023-05524-x
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Zs.A 1639: Show issues

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Article ; Online: Infection and Sepsis Trends during United States' Delivery Hospitalizations from 2000 to 2020.

Liu, Lilly Y / Friedman, Alexander M / Goffman, Dena / Nathan, Lisa / Sheen, Jean-Ju / Reddy, Uma M / D'Alton, Mary E / Wen, Timothy

American journal of perinatology

2024

Abstract: Objective: This study aimed to evaluate trends, risk factors, and outcomes associated with infections and sepsis during delivery hospitalizations in the United States.: Study design: The 2000-2020 National Inpatient Sample was used for this ... ...

Abstract	Objective: This study aimed to evaluate trends, risk factors, and outcomes associated with infections and sepsis during delivery hospitalizations in the United States. Study design: The 2000-2020 National Inpatient Sample was used for this repeated cross-sectional analysis. Delivery hospitalizations of patients aged 15 to 54 with and without infection and sepsis were identified. Common infection diagnoses during delivery hospitalizations analyzed included (i) pyelonephritis, (ii) pneumonia/influenza, (iii) endometritis, (iv) cholecystitis, (v) chorioamnionitis, and (vi) wound infection. Temporal trends in sepsis and infection during delivery hospitalizations were analyzed. The associations between sepsis and infection and common chronic health conditions including asthma, chronic hypertension, pregestational diabetes, and obesity were analyzed. The associations between clinical, demographic, and hospital characteristics, and infection and sepsis were determined with unadjusted and adjusted logistic regression models with unadjusted odds ratio (OR) and adjusted odds ratios with 95% confidence intervals as measures of association. Results: An estimated 80,158,622 delivery hospitalizations were identified and included in the analysis, of which 2,766,947 (3.5%) had an infection diagnosis and 32,614 had a sepsis diagnosis (4.1 per 10,000). The most common infection diagnosis was chorioamnionitis (2.7% of deliveries) followed by endometritis (0.4%), and wound infections (0.3%). Infection and sepsis were more common in the setting of chronic health conditions. Evaluating trends in individual infection diagnoses, endometritis and wound infection decreased over the study period both for patients with and without chronic conditions, while risk for pyelonephritis and pneumonia/influenza increased. Sepsis increased over the study period for deliveries with and without chronic condition diagnoses. Risks for adverse outcomes including mortality, severe maternal morbidity, the critical care composite, and acute renal failure were all significantly increased in the presence of sepsis and infection. Conclusion: Endometritis and wound infections decreased over the study period while risk for sepsis increased. Infection and sepsis were associated with chronic health conditions and accounted for a significant proportion of adverse obstetric outcomes including severe maternal morbidity. Key points: · Sepsis increased over the study period for deliveries with and without chronic condition diagnoses.. · Endometritis and wound infection decreased over the study period.. · Infection and sepsis accounted for a significant proportion of adverse obstetric outcomes..
Language	English
Publishing date	2024-02-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	605671-4
ISSN	1098-8785 ; 0735-1631
ISSN (online)	1098-8785
ISSN	0735-1631
DOI	10.1055/s-0044-1780538
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Zs.A 1929: Show issues

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Article ; Online: The validity of electronic health data for measuring smoking status: a systematic review and meta-analysis.

Haque, Md Ashiqul / Gedara, Muditha Lakmali Bodawatte / Nickel, Nathan / Turgeon, Maxime / Lix, Lisa M

BMC medical informatics and decision making

2024 Volume 24, Issue 1, Page(s) 33

Abstract: Background: Smoking is a risk factor for many chronic diseases. Multiple smoking status ascertainment algorithms have been developed for population-based electronic health databases such as administrative databases and electronic medical records (EMRs). ...

Abstract	Background: Smoking is a risk factor for many chronic diseases. Multiple smoking status ascertainment algorithms have been developed for population-based electronic health databases such as administrative databases and electronic medical records (EMRs). Evidence syntheses of algorithm validation studies have often focused on chronic diseases rather than risk factors. We conducted a systematic review and meta-analysis of smoking status ascertainment algorithms to describe the characteristics and validity of these algorithms. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. We searched articles published from 1990 to 2022 in EMBASE, MEDLINE, Scopus, and Web of Science with key terms such as validity, administrative data, electronic health records, smoking, and tobacco use. The extracted information, including article characteristics, algorithm characteristics, and validity measures, was descriptively analyzed. Sources of heterogeneity in validity measures were estimated using a meta-regression model. Risk of bias (ROB) in the reviewed articles was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Results: The initial search yielded 2086 articles; 57 were selected for review and 116 algorithms were identified. Almost three-quarters (71.6%) of algorithms were based on EMR data. The algorithms were primarily constructed using diagnosis codes for smoking-related conditions, although prescription medication codes for smoking treatments were also adopted. About half of the algorithms were developed using machine-learning models. The pooled estimates of positive predictive value, sensitivity, and specificity were 0.843, 0.672, and 0.918 respectively. Algorithm sensitivity and specificity were highly variable and ranged from 3 to 100% and 36 to 100%, respectively. Model-based algorithms had significantly greater sensitivity (p = 0.006) than rule-based algorithms. Algorithms for EMR data had higher sensitivity than algorithms for administrative data (p = 0.001). The ROB was low in most of the articles (76.3%) that underwent the assessment. Conclusions: Multiple algorithms using different data sources and methods have been proposed to ascertain smoking status in electronic health data. Many algorithms had low sensitivity and positive predictive value, but the data source influenced their validity. Algorithms based on machine-learning models for multiple linked data sources have improved validity.
MeSH term(s)	Humans ; Electronic Health Records ; Predictive Value of Tests ; Sensitivity and Specificity ; Smoking/epidemiology ; Algorithms ; Chronic Disease
Language	English
Publishing date	2024-02-02
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	2046490-3
ISSN	1472-6947 ; 1472-6947
ISSN (online)	1472-6947
ISSN	1472-6947
DOI	10.1186/s12911-024-02416-3
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Article: Lessons from Mortality Reviews: Nonbiologic Contributors to Maternal Deaths

Minkoff, Howard / Chazotte, Cynthia / Nathan, Lisa M.

American Journal of Perinatology

2023

Abstract	Based on years of review and analysis of severe maternal morbidity and maternal mortality cases, it is clear that the high rates of maternal mortality in this country are due to more than obstetrical emergencies gone awry. Many nonmedical factors contribute to these poor outcomes including complex and ineffectual health care systems, poor coordination of care, and structural racism. In this article we discuss what physicians can and cannot accomplish on their own, the role of race and racism, and barriers built into the manner in which health care is delivered. We conclude that while obstetricians must continue to focus on the area where their expertise lies, reducing deaths by educating and training physicians to deal with the downstream consequences of upstream events, they must also focus increased attention on educating themselves and their trainees about the effect of racism, social disadvantage, and poor coordination of care on health, as well as their role in resolving these issues. Physicians must also reach out to their representatives in government to partner with them. Those leaders must recognize that when they hear about disparities in maternal mortality, focusing only on events in hospitals ignores the more dispositive issues that put Black women at risk in the first instance. Key Points: Structural racism contributes to maternal deaths. Coordination of postpartum care is critically important. U.S. health care system is complex and not patient friendly.
Keywords	maternal mortality ; structural racism ; health care access ; racial disparities
Language	English
Publishing date	2023-06-06
Publisher	Thieme Medical Publishers, Inc.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	605671-4
ISSN	1098-8785 ; 0735-1631
ISSN (online)	1098-8785
ISSN	0735-1631
DOI	10.1055/s-0043-1769470
Database	Thieme publisher's database

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Zs.A 1929: Show issues

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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Coronavirus disease 2019 isolation guidelines change with emerging data.

Nathan, Lisa M / Vega, Marisa / Bernstein, Peter S

American journal of obstetrics & gynecology MFM

2020 Volume 3, Issue 1, Page(s) 100292

MeSH term(s)	Humans ; Asymptomatic Diseases ; Centers for Disease Control and Prevention, U.S. ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19/virology ; COVID-19 Testing ; Patient Isolation/methods ; Quarantine/methods ; SARS-CoV-2 ; United States/epidemiology ; Practice Guidelines as Topic
Language	English
Publishing date	2020-12-04
Publishing country	United States
Document type	Letter
ISSN	2589-9333
ISSN (online)	2589-9333
DOI	10.1016/j.ajogmf.2020.100292
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Article: Acquired Hemophilia A: A Rare, Acquired Coagulopathy in the Postpartum Setting.

Oberlin, Austin / Krenitsky, Nicole M / Gandhi, Christy / Akpan, Imo Joseph / Eisenberger, Andrew / Landau, Ruth / Yurteri-Kaplan, Ladin / Nathan, Lisa / Sheen, Jean-Ju / LaSala, Anita / D'Alton, Mary

AJP reports

2023 Volume 13, Issue 4, Page(s) e85–e88

Abstract: Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity. Pregnancy-associated acquired hemophilia A (AHA) caused by autoantibodies against factor VIII can present with recurrent episodes of postpartum bleeding. ...

Abstract	Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity. Pregnancy-associated acquired hemophilia A (AHA) caused by autoantibodies against factor VIII can present with recurrent episodes of postpartum bleeding.
Language	English
Publishing date	2023-11-28
Publishing country	United States
Document type	Case Reports
ZDB-ID	2628074-7
ISSN	2157-7005 ; 2157-6998
ISSN (online)	2157-7005
ISSN	2157-6998
DOI	10.1055/a-2198-7888
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Zs.A 6934: Show issues

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Article ; Online: Trauma patient heterotopic ossification diagnosis is associated with increased hospital length of stay.

Foster, Nichola / Martin, Lisa / Raby, Edward / Wood, Fiona M / Fear, Mark / Pavlos, Nathan / Edgar, Dale W

Injury

2024 Volume 55, Issue 4, Page(s) 111328

Abstract: Background: Traumatic heterotopic ossification (tHO) refers to the development of extra-skeletal bone in muscle and soft tissues following tissue insult secondary to surgery or trauma. This presents a persistent clinical concern associated with ... ...

Abstract	Background: Traumatic heterotopic ossification (tHO) refers to the development of extra-skeletal bone in muscle and soft tissues following tissue insult secondary to surgery or trauma. This presents a persistent clinical concern associated with significant patient morbidity and expense to diagnose and treat. Traumatic HO is a substantial barrier to rehabilitation for trauma-injured patients. As such, the development of tHO after burn and other trauma is hypothesised to prolong inpatient length of stay (LOS) and thus increase health care costs. Objective: To investigate the association between an inpatient tHO diagnosis and hospital LOS in trauma patients. Methods: A retrospective audit of trauma patients over a 14-year period was completed using data from four WA hospitals. Burn and neurological trauma patients diagnosed with tHO as an inpatient (tHO+) and control subjects (tHO-), matched (1:3) by age, gender, and injury severity factors, were identified using medical diagnostic codes. Data relating to patient and injury-related determinants of LOS from tHO+ and tHO- subjects were analysed to model the association of tHO on total hospital length of stay. Results: 188 identified patients were hospitalised due to traumatic injury; 47 patients with tHO following burn injury (n = 17), spinal cord injury (n = 13) and traumatic brain injury (n = 17), and 141 control patients. Those who developed tHO during hospitalisation had a significantly higher median LOS than matched trauma patients who did not develop tHO (142 days vs. 61 days). Multivariate regression analyses identified the following independent predictive factors of a prolonged hospital LOS: tHO diagnosis, mechanical ventilation hours, injury to the hip region and thigh area, other ossification disorder, pressure injury, admission to intensive care unit and deep vein thrombosis. Trauma patients diagnosed with tHO during their hospital admission stayed 1.6 times longer than trauma patients matched for injury severity without a tHO diagnosis (IRR 1.56, 95% CI 1.35-1.79, p<0.001). Conclusion: Traumatic heterotopic ossification is an independent explanatory factor for increased hospital LOS in patients following burns, spinal cord, and traumatic brain injury. Early diagnosis may assist in reducing the impact of tHO on acute hospital stay after trauma.
MeSH term(s)	Humans ; Length of Stay ; Retrospective Studies ; Brain Injuries, Traumatic ; Hospitals ; Ossification, Heterotopic/diagnosis ; Ossification, Heterotopic/surgery
Language	English
Publishing date	2024-01-21
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2024.111328
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Zs.A 778: 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)
Zs.MO 10: Show issues

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Article: FicD Sensitizes Cellular Response to Glucose Fluctuations in Mouse Embryonic Fibroblasts.

Gulen, Burak / Kinch, Lisa N / Servage, Kelly A / Blevins, Aubrie / Stewart, Nathan M / Gray, Hillery F / Casey, Amanda K / Orth, Kim

bioRxiv : the preprint server for biology

2024

Abstract: During homeostasis, the endoplasmic reticulum (ER) maintains productive transmembrane and secretory protein folding that is vital for proper cellular function. The ER-resident HSP70 chaperone, BiP, plays a pivotal role in sensing ER stress to activate ... ...

Abstract	During homeostasis, the endoplasmic reticulum (ER) maintains productive transmembrane and secretory protein folding that is vital for proper cellular function. The ER-resident HSP70 chaperone, BiP, plays a pivotal role in sensing ER stress to activate the unfolded protein response (UPR). BiP function is regulated by the bifunctional enzyme FicD that mediates AMPylation and deAMPylation of BiP in response to changes in ER stress. AMPylated BiP acts as a molecular rheostat to regulate UPR signaling, yet little is known about the molecular consequences of FicD loss. In this study, we investigate the role of FicD in mouse embryonic fibroblast (MEF) response to pharmacologically and metabolically induced ER stress. We find differential BiP AMPylation signatures when comparing robust chemical ER stress inducers to physiological glucose starvation stress and recovery. Wildtype MEFs respond to pharmacological ER stress by downregulating BiP AMPylation. Conversely, BiP AMPylation in wildtype MEFs increases upon metabolic stress induced by glucose starvation. Deletion of FicD results in widespread gene expression changes under baseline growth conditions. In addition, FicD null MEFs exhibit dampened UPR signaling, altered cell stress recovery response, and unconstrained protein secretion. Taken together, our findings indicate that FicD is important for tampering UPR signaling, stress recovery, and the maintenance of secretory protein homeostasis. Significance statement: The chaperone BiP plays a key quality control role in the endoplasmic reticulum, the cellular location for the production, folding, and transport of secreted proteins. The enzyme FicD regulates BiP's activity through AMPylation and deAMPylation. Our study unveils the importance of FicD in regulating BiP and the unfolded protein response (UPR) during stress. We identify distinct BiP AMPylation signatures for different stressors, highlighting FicD's nuanced control. Deletion of FicD causes widespread gene expression changes, disrupts UPR signaling, alters stress recovery, and perturbs protein secretion in cells. These observations underscore the pivotal contribution of FicD for preserving secretory protein homeostasis. Our findings deepen the understanding of FicD's role in maintaining cellular resilience and open avenues for therapeutic strategies targeting UPR-associated diseases.
Language	English
Publishing date	2024-01-23
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.01.22.576705
Database	MEDical Literature Analysis and Retrieval System OnLINE

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