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  1. Article ; Online: COVID-19 vaccination hesitancy among health care workers, communication, and policy-making.

    Toth-Manikowski, Stephanie M / Swirsky, Eric S / Gandhi, Rupali / Piscitello, Gina

    American journal of infection control

    2021  Volume 50, Issue 1, Page(s) 20–25

    Abstract: Background: Coronavirus disease 2019 (COVID-19) vaccine hesitancy in health care workers (HCWs) contributes to personal and patient risk in contracting COVID-19. Reasons behind hesitancy and how best to improve vaccination rates in HCWs are not clear.!## ...

    Abstract Background: Coronavirus disease 2019 (COVID-19) vaccine hesitancy in health care workers (HCWs) contributes to personal and patient risk in contracting COVID-19. Reasons behind hesitancy and how best to improve vaccination rates in HCWs are not clear.
    Methods: We adapted a survey using the Health Belief Model framework to evaluate HCW vaccine hesitancy and reasons for choosing for or against COVID-19 vaccination. The survey was sent to 3 large academic medical centers in the Chicagoland area between March and May 2021.
    Results: We received 1974 completed responses with 85% of HCWs receiving or anticipating receiving COVID-19 vaccination. Multivariable logistic regression found HCWs were less likely to receive COVID-19 vaccination if they were Black (OR 0.34, 95% CI 0.15-0.80), Republican (OR 0.54, 95% CI 0.31-0.91), or allergic to any vaccine component (OR 0.27, 95% CI 0.10-0.70) and more likely to receive if they believed people close to them thought it was important for them to receive the vaccine (OR 5.2, 95% CI 3-8).
    Conclusions: A sizable number of HCWs remain vaccine hesitant 1 year into the COVID-19 pandemic. As HCWs are positively influenced by colleagues who believe in COVID-19 vaccination, development of improved communication across HCW departments and roles may improve vaccination rates.
    MeSH term(s) COVID-19 ; COVID-19 Vaccines ; Communication ; Health Personnel ; Humans ; Pandemics ; Policy ; SARS-CoV-2 ; Vaccination ; Vaccination Hesitancy
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2021-10-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 392362-9
    ISSN 1527-3296 ; 0196-6553
    ISSN (online) 1527-3296
    ISSN 0196-6553
    DOI 10.1016/j.ajic.2021.10.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Race, Pregnancy, and ESKD.

    Toth-Manikowski, Stephanie M / Crews, Deidra C

    Journal of the American Society of Nephrology : JASN

    2019  Volume 30, Issue 12, Page(s) 2280–2282

    MeSH term(s) Female ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Pregnancy ; Renal Dialysis ; United States
    Language English
    Publishing date 2019-11-04
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.2019101038
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: How Race and Ethnicity Affect the Relationship Between Quality of Life and Mortality in a Hemodialysis Population: "Quality of Life Is More Important Than Life Itself".

    Toth-Manikowski, Stephanie M / Fischer, Michael J / Porter, Anna C

    Kidney medicine

    2019  Volume 1, Issue 5, Page(s) 232–234

    Language English
    Publishing date 2019-09-12
    Publishing country United States
    Document type Journal Article
    ISSN 2590-0595
    ISSN (online) 2590-0595
    DOI 10.1016/j.xkme.2019.06.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Hemodialysis Prescription for Incident Patients: Twice Seems Nice, But Is It Incremental?

    Toth-Manikowski, Stephanie M / Shafi, Tariq

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

    2016  Volume 68, Issue 2, Page(s) 180–183

    MeSH term(s) Humans ; Kidney Failure, Chronic ; Renal Dialysis
    Language English
    Publishing date 2016-04-06
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2016.04.005
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  5. Article: Cooling dialysate during in-center hemodialysis: Beneficial and deleterious effects.

    Toth-Manikowski, Stephanie M / Sozio, Stephen M

    World journal of nephrology

    2016  Volume 5, Issue 2, Page(s) 166–171

    Abstract: The use of cooled dialysate temperatures first came about in the early 1980s as a way to curb the incidence of intradialytic hypotension (IDH). IDH was then, and it remains today, the most common complication affecting chronic hemodialysis patients. It ... ...

    Abstract The use of cooled dialysate temperatures first came about in the early 1980s as a way to curb the incidence of intradialytic hypotension (IDH). IDH was then, and it remains today, the most common complication affecting chronic hemodialysis patients. It decreases quality of life on dialysis and is an independent risk factor for mortality. Cooling dialysate was first employed as a technique to incite peripheral vasoconstriction on dialysis and in turn reduce the incidence of intradialytic hypotension. Although it has become a common practice amongst in-center hemodialysis units, cooled dialysate results in up to 70% of patients feeling cold while on dialysis and some even experience shivering. Over the years, various studies have been performed to evaluate the safety and efficacy of cooled dialysate in comparison to a standard, more thermoneutral dialysate temperature of 37 °C. Although these studies are limited by small sample size, they are promising in many aspects. They demonstrated that cooled dialysis is safe and equally efficacious as thermoneutral dialysis. Although patients report feeling cold on dialysis, they also report increased energy and an improvement in their overall health following cooled dialysis. They established that cooling dialysate temperatures improves hemodynamic tolerability during and after hemodialysis, even in patients prone to IDH, and does so without adversely affecting dialysis adequacy. Cooled dialysis also reduces the incidence of IDH and has a protective effect over major organs including the heart and brain. Finally, it is an inexpensive measure that decreases economic burden by reducing necessary nursing intervention for issues that arise on hemodialysis such as IDH. Before cooled dialysate becomes standard of care for patients on chronic hemodialysis, larger studies with longer follow-up periods will need to take place to confirm the encouraging outcomes mentioned here.
    Language English
    Publishing date 2016-02-21
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2220-6124
    ISSN 2220-6124
    DOI 10.5527/wjn.v5.i2.166
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Incremental short daily home hemodialysis: a case series.

    Toth-Manikowski, Stephanie M / Mullangi, Surekha / Hwang, Seungyoung / Shafi, Tariq

    BMC nephrology

    2017  Volume 18, Issue 1, Page(s) 216

    Abstract: Background: Patients starting dialysis often have substantial residual kidney function. Incremental hemodialysis provides a hemodialysis prescription that supplements patients' residual kidney function while maintaining total (residual + dialysis) urea ... ...

    Abstract Background: Patients starting dialysis often have substantial residual kidney function. Incremental hemodialysis provides a hemodialysis prescription that supplements patients' residual kidney function while maintaining total (residual + dialysis) urea clearance (standard Kt/Vurea) targets. We describe our experience with incremental hemodialysis in patients using NxStage System One for home hemodialysis.
    Case presentation: From 2011 to 2015, we initiated 5 incident hemodialysis patients on an incremental home hemodialysis regimen. The biochemical parameters of all patients remained stable on the incremental hemodialysis regimen and they consistently achieved standard Kt/Vurea targets. Of the two patients with follow-up >6 months, residual kidney function was preserved for ≥2 years. Importantly, the patients were able to transition to home hemodialysis without automatically requiring 5 sessions per week at the outset and gradually increased the number of treatments and/or dialysate volume as the residual kidney function declined.
    Conclusions: An incremental home hemodialysis regimen can be safely prescribed and may improve acceptability of home hemodialysis. Reducing hemodialysis frequency by even one treatment per week can reduce the number of fistula or graft cannulations or catheter connections by >100 per year, an important consideration for patient well-being, access longevity, and access-related infections. The incremental hemodialysis approach, supported by national guidelines, can be considered for all home hemodialysis patients with residual kidney function.
    Language English
    Publishing date 2017-07-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041348-8
    ISSN 1471-2369 ; 1471-2369
    ISSN (online) 1471-2369
    ISSN 1471-2369
    DOI 10.1186/s12882-017-0651-1
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  7. Article ; Online: Hispanic ethnicity and mortality among critically ill patients with COVID-19.

    Ricardo, Ana C / Chen, Jinsong / Toth-Manikowski, Stephanie M / Meza, Natalie / Joo, Min / Gupta, Shruti / Lazarous, Deepa G / Leaf, David E / Lash, James P

    PloS one

    2022  Volume 17, Issue 5, Page(s) e0268022

    Abstract: Background: Hispanic persons living in the United States (U.S.) are at higher risk of infection and death from coronavirus disease 2019 (COVID-19) compared with non-Hispanic persons. Whether this disparity exists among critically ill patients with COVID- ...

    Abstract Background: Hispanic persons living in the United States (U.S.) are at higher risk of infection and death from coronavirus disease 2019 (COVID-19) compared with non-Hispanic persons. Whether this disparity exists among critically ill patients with COVID-19 is unknown.
    Objective: To evaluate ethnic disparities in mortality among critically ill adults with COVID-19 enrolled in the Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID).
    Methods: Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units (ICU) at 67 U.S. hospitals from March 4 to May 9, 2020. Multilevel logistic regression was used to evaluate 28-day mortality across racial/ethnic groups.
    Results: A total of 2153 patients were included (994 [46.2%] Hispanic and 1159 [53.8%] non-Hispanic White). The median (IQR) age was 62 (51-71) years (non-Hispanic White, 66 [57-74] years; Hispanic, 56 [46-67] years), and 1462 (67.9%) were men. Compared with non-Hispanic White patients, Hispanic patients were younger; were less likely to have hypertension, chronic obstructive pulmonary disease, coronary artery disease, or heart failure; and had longer duration of symptoms prior to ICU admission. During median (IQR) follow-up of 14 (7-24) days, 785 patients (36.5%) died. In analyses adjusted for age, sex, clinical characteristics, and hospital size, Hispanic patients had higher odds of death compared with non-Hispanic White patients (OR, 1.44; 95% CI, 1.12-1.84).
    Conclusions: Among critically ill adults with COVID-19, Hispanic patients were more likely to die than non-Hispanic White patients, even though they were younger and had lower comorbidity burden. This finding highlights the need to provide earlier access to care to Hispanic individuals with COVID-19, especially given our finding of longer duration of symptoms prior to ICU admission among Hispanic patients. In addition, there is a critical need to address ongoing disparities in post hospital discharge care for patients with COVID-19.
    MeSH term(s) Adult ; Aged ; COVID-19 ; Cohort Studies ; Critical Illness ; Ethnicity ; Female ; Hospital Mortality ; Humans ; Intensive Care Units ; Male ; Middle Aged ; SARS-CoV-2 ; United States/epidemiology
    Language English
    Publishing date 2022-05-18
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0268022
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  8. Article ; Online: Emergency Department/Urgent Care as Usual Source of Care and Clinical Outcomes in CKD: Findings From the Chronic Renal Insufficiency Cohort Study.

    Toth-Manikowski, Stephanie M / Hsu, Jesse Y / Fischer, Michael J / Cohen, Jordana B / Lora, Claudia M / Tan, Thida C / He, Jiang / Greer, Raquel C / Weir, Matthew R / Zhang, Xiaoming / Schrauben, Sarah J / Saunders, Milda R / Ricardo, Ana C / Lash, James P

    Kidney medicine

    2022  Volume 4, Issue 4, Page(s) 100424

    Abstract: ... Hispanic, mean estimated glomerular filtration rate 50 mL/min/1.73 m: Limitations: Cannot be generalized ...

    Abstract Rationale & objective: Having a usual source of care increases use of preventive services and is associated with improved survival in the general population. We evaluated this association in adults with chronic kidney disease (CKD).
    Study design: Prospective, observational cohort study.
    Setting & participants: Adults with CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study.
    Predictor: Usual source of care was self-reported as: 1) clinic, 2) emergency department (ED)/urgent care, 3) other.
    Outcomes: Primary outcomes included incident end-stage kidney disease (ESKD), atherosclerotic events (myocardial infarction, stroke, or peripheral artery disease), incident heart failure, hospitalization events, and all-cause death.
    Analytical approach: Multivariable regression analyses to evaluate the association between usual source of care (ED/urgent care vs clinic) and primary outcomes.
    Results: Among 3,140 participants, mean age was 65 years, 44% female, 45% non-Hispanic White, 43% non-Hispanic Black, and 9% Hispanic, mean estimated glomerular filtration rate 50 mL/min/1.73 m
    Limitations: Cannot be generalized to all patients with CKD. Causal relationships cannot be established.
    Conclusions: In this large, diverse cohort of adults with moderate-to-severe CKD, those identifying ED/urgent care as usual source of care were at increased risk for death and hospitalizations. These findings highlight the need to develop strategies to improve health care access for this high-risk population.
    Language English
    Publishing date 2022-02-01
    Publishing country United States
    Document type Journal Article
    ISSN 2590-0595
    ISSN (online) 2590-0595
    DOI 10.1016/j.xkme.2022.100424
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  9. Article ; Online: Sex-related differences in mortality, acute kidney injury, and respiratory failure among critically ill patients with COVID-19.

    Toth-Manikowski, Stephanie M / Caldwell, Jillian / Joo, Min / Chen, Jinsong / Meza, Natalie / Bruinius, Jacob / Gupta, Shruti / Hannan, Mary / Kagalwalla, Mustafa / Madrid, Samantha / Melamed, Michal L / Pacheco, Esther / Srivastava, Anand / Viamontes, Christopher / Lash, James P / Leaf, David E / Ricardo, Ana C

    Medicine

    2022  Volume 100, Issue 50, Page(s) e28302

    Abstract: Abstract: Although the number of deaths due to coronavirus disease 2019 (COVID-19) is higher in men than women, prior studies have provided limited sex-stratified clinical data.We evaluated sex-related differences in clinical outcomes among critically ... ...

    Abstract Abstract: Although the number of deaths due to coronavirus disease 2019 (COVID-19) is higher in men than women, prior studies have provided limited sex-stratified clinical data.We evaluated sex-related differences in clinical outcomes among critically ill adults with COVID-19.Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units at 67 U.S. hospitals from March 4 to May 9, 2020. Multilevel logistic regression was used to evaluate 28-day in-hospital mortality, severe acute kidney injury (AKI requiring kidney replacement therapy), and respiratory failure occurring within 14 days of intensive care unit admission.A total of 4407 patients were included (median age, 62 years; 2793 [63.4%] men; 1159 [26.3%] non-Hispanic White; 1220 [27.7%] non-Hispanic Black; 994 [22.6%] Hispanic). Compared with women, men were younger (median age, 61 vs 64 years, less likely to be non-Hispanic Black (684 [24.5%] vs 536 [33.2%]), and more likely to smoke (877 [31.4%] vs 422 [26.2%]). During median follow-up of 14 days, 1072 men (38.4%) and 553 women (34.3%) died. Severe AKI occurred in 590 men (21.8%), and 239 women (15.5%), while respiratory failure occurred in 2255 men (80.7%) and 1234 women (76.5%). After adjusting for age, race/ethnicity and clinical variables, compared with women, men had a higher risk of death (OR, 1.50, 95% CI, 1.26-1.77), severe AKI (OR, 1.92; 95% CI 1.57-2.36), and respiratory failure (OR, 1.42; 95% CI, 1.11-1.80).In this multicenter cohort of critically ill adults with COVID-19, men were more likely to have adverse outcomes compared with women.
    MeSH term(s) Acute Kidney Injury/virology ; Adult ; COVID-19/complications ; COVID-19/mortality ; Critical Illness ; Female ; Hospital Mortality ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Respiratory Insufficiency/virology ; Retrospective Studies ; Risk Factors ; Sex Factors
    Language English
    Publishing date 2022-01-26
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 80184-7
    ISSN 1536-5964 ; 0025-7974
    ISSN (online) 1536-5964
    ISSN 0025-7974
    DOI 10.1097/MD.0000000000028302
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  10. Article ; Online: Periodontal Disease and Incident CKD in US Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos.

    Toth-Manikowski, Stephanie M / Ricardo, Ana C / Salazar, Christian R / Chen, Jinsong / Khambaty, Tasneem / Liu, Jannel / Singer, Richard H / Youngblood, Marston E / Cai, Jianwen / Kaste, Linda M / Daviglus, Martha L / Lash, James P

    Kidney medicine

    2021  Volume 3, Issue 4, Page(s) 528–535.e1

    Abstract: ... mL/min/1.73 m: Analytic approach: Poisson and linear regression.: Results: For the sample (n ...

    Abstract Rationale & objective: Recent studies suggest that periodontal disease may be associated with incident chronic kidney disease (CKD). However, studies have focused on older populations, and US Hispanics/Latinos were not well represented.
    Study design: Observational cohort.
    Setting & participants: We analyzed data from the Hispanic Community Health Study/Study of Latinos who completed a baseline visit with a periodontal examination and a follow-up visit, and did not have CKD at baseline.
    Predictors: Predictors included ≥30% of sites with clinical attachment loss ≥3 mm, ≥30% of sites with probing depth ≥4 mm, percentage of sites with bleeding on probing, and absence of functional dentition (<21 permanent teeth present).
    Outcomes: Outcomes were incident low estimated glomerular filtration rate (eGFR) (eGFR <60 mL/min/1.73 m
    Analytic approach: Poisson and linear regression.
    Results: For the sample (n = 7.732), baseline mean age was 41.5 years, 45.2% were male, 11.7% had ≥30% of sites with clinical attachment loss ≥3 mm, 5.1% had ≥30% of sites with probing depth ≥4 mm, 30.7% had ≥50% of sites with bleeding on probing, and 16.2% had absent functional dentition. During a median follow-up of 5.9 years, 149 patients developed low eGFR and 415 patients developed albuminuria. On multivariable analysis, presence versus absence of ≥30% of sites with probing depth ≥4 mm and absence of functional dentition were each associated with increased risk for incident low eGFR (incident density ratio, 2.31; 95% CI, 1.14-4.65 and 1.65, 95% CI, 1.01-2.70, respectively). None of the other predictors were associated with outcomes.
    Limitations: Only a single kidney function follow-up measure.
    Conclusions: In this cohort of US Hispanics/Latinos, we found that select measures of periodontal disease were associated with incident low eGFR. Future work is needed to assess whether the treatment of periodontal disease may prevent CKD.
    Language English
    Publishing date 2021-07-03
    Publishing country United States
    Document type Journal Article
    ISSN 2590-0595
    ISSN (online) 2590-0595
    DOI 10.1016/j.xkme.2021.02.015
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