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Article ; Online: Heat-resistant aluminium alloys.

Shyam, Amit / Bahl, Sumit

2023 Volume 22, Issue 4, Page(s) 425–426

Language	English
Publishing date	2023-01-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2088679-2
ISSN	1476-4660 ; 1476-1122
ISSN (online)	1476-4660
ISSN	1476-1122
DOI	10.1038/s41563-022-01436-6
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Article: Adenoid Cystic Cancer of the Lacrimal Gland: Management Aspects and Treatment Outcomes.

Bahl, Vishwa Jyoti / Bahl, Amit

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India

2023 Volume 76, Issue 2, Page(s) 2158–2161

Abstract: Adenoid cystic carcinoma (ACC) of the lacrimal gland is the most common malignant epithelial tumor of the lacrimal gland. The biological behavior of these tumors is characterized by a slow growth with frequent nerve invasion but rare invasion of the neck ...

Abstract	Adenoid cystic carcinoma (ACC) of the lacrimal gland is the most common malignant epithelial tumor of the lacrimal gland. The biological behavior of these tumors is characterized by a slow growth with frequent nerve invasion but rare invasion of the neck nodes. Local extension intracranially with bone erosions is seen in locally advanced tumors. Distant metastasis to lungs bone and liver are commonly reported. Treatments using surgery and radiotherapy are generally preferred for adequate tumor control. However there is still no consensus on the best treatment approach. Supplementary information: The online version contains supplementary material available at 10.1007/s12070-023-04426-5.
Language	English
Publishing date	2023-12-21
Publishing country	India
Document type	Journal Article
ZDB-ID	1471137-0
ISSN	0973-7707 ; 2231-3796 ; 0019-5421
ISSN (online)	0973-7707
ISSN	2231-3796 ; 0019-5421
DOI	10.1007/s12070-023-04426-5
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Zs.A 5300: Show issues

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Article ; Online: Pediatric hemolysis in emergency departments: Prevalence, risk factors, and clinical implications.

Mielke, Nicholas / Lee, Ray / Bahl, Amit

PloS one

2024 Volume 19, Issue 3, Page(s) e0299692

Abstract: Objective: This study aimed to analyze the prevalence, risk factors, and clinical implications of hemolyzed laboratory samples in the pediatric emergency department (ED), a subject on which existing data remains scarce.: Methods: We conducted a multi- ...

Abstract	Objective: This study aimed to analyze the prevalence, risk factors, and clinical implications of hemolyzed laboratory samples in the pediatric emergency department (ED), a subject on which existing data remains scarce. Methods: We conducted a multi-site observational cohort analysis of pediatric ED encounters in Metro Detroit, Michigan, United States. The study included participants below 18 years of age who had undergone peripheral intravenous catheter (PIVC) placement and laboratory testing. The primary outcome was the presence of hemolysis, and secondary outcomes included identifying risk factors for hemolysis and assessing the impact of hemolysis on PIVC failure. Results: Between January 2021 and May 2022, 10,462 ED encounters met inclusion criteria, of which 14.0% showed laboratory evidence of hemolysis. The highest proportion of hemolysis occurred in the infant (age 0-1) population (20.1%). Multivariable regression analysis indicated higher odds of hemolysis for PIVCs placed in the hand/wrist in the toddler (age 2-5) and child (age 6-11) subgroups. PIVCs placed in the hand/wrist also demonstrated higher odds of failure in infants. Conclusions: Hemolysis in the pediatric ED population is a frequent complication that occurs at similar rates as in adults. PIVCs placed in the hand/wrist were associated with higher odds of hemolysis compared to those placed in the antecubital fossa. Clinicians should consider alternative locations for PIVC placement if clinically appropriate. Further research is needed to better understand the clinical implications of pediatric hemolysis.
MeSH term(s)	Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Catheterization, Peripheral/adverse effects ; Emergency Service, Hospital ; Hemolysis ; Prevalence ; Risk Factors
Language	English
Publishing date	2024-03-21
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0299692
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Article ; Online: The economic burden of difficult intravenous access in the emergency department from a United States' provider perspective.

Gala, Smeet / Alsbrooks, Kim / Bahl, Amit / Wimmer, Megan

Journal of research in nursing : JRN

2024 Volume 29, Issue 1, Page(s) 6–18

Abstract: Background: Peripheral intravenous catheter placement is one of the most common invasive procedures that nurses will perform, especially in emergency departments.: Aims: This early analysis aimed to quantify the economic burden associated with ... ...

Abstract	Background: Peripheral intravenous catheter placement is one of the most common invasive procedures that nurses will perform, especially in emergency departments. Aims: This early analysis aimed to quantify the economic burden associated with intravenous therapy in patients presenting in emergency departments with difficult intravenous access, receiving traditional peripheral intravenous catheters. This may inform the opportunity for improvement for investment in nursing tools and services regarding difficult venous access burden reduction. Methods: Model parameter data were obtained from published literature where possible via a targeted literature review for the terms including relative variations of 'Difficult Venous Access', 'burden', and 'costs', or elicited from expert clinical opinion. A simple decision tree model was developed in Microsoft® Excel 2016. Results included number of insertion attempts, number of patients requiring escalation, catheter failures due to complications, healthcare professional (e.g. nurse) time, and total costs (including/excluding health care professional time). Sensitivity analyses were performed. Results: The model considers 64,000 individuals presenting in the emergency department annually, of which 75% (48,000) require a peripheral intravenous catheter; of these 22% (10,560) are estimated to have difficult venous access. The total cost burden of difficult venous access is estimated to be $890,095 per year/$84.29 per patient with difficult venous access, including the cost of clinician time. Key total cost drivers include the population size treated in the emergency department annually, the proportion of midlines placed by a specialist IV (intravenous access) nurse and the percentage of patients with difficult venous access. Conclusion: This is the first formal analysis estimating the significant economic burden of difficult venous access in emergency departments via peripheral intravenous catheter placement, a task frequently performed by nurses. Further studies are needed to evaluate nursing-centric strategies for reducing this burden. Additionally, adoption of a concise definition is needed, as is routine use of reliable assessment tools so that future cost analyses can be better contextualised.
Language	English
Publishing date	2024-01-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2173772-1
ISSN	1744-988X ; 1744-9871
ISSN (online)	1744-988X
ISSN	1744-9871
DOI	10.1177/17449871231213025
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Article ; Online: Catheter Length In-Vein Impacts Ultrasound-Guided Peripheral Intravenous Catheter Survival.

Bahl, Amit / Gibson, S Matthew

Journal of emergency nursing

2021 Volume 47, Issue 6, Page(s) 843–845.e2

MeSH term(s)	Catheterization, Peripheral ; Catheters ; Humans ; Ultrasonography, Interventional
Language	English
Publishing date	2021-07-20
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	604632-0
ISSN	1527-2966 ; 0099-1767
ISSN (online)	1527-2966
ISSN	0099-1767
DOI	10.1016/j.jen.2021.06.001
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Zs.B 2509: Show issues

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Article: The use of procedural kits may reduce unscheduled central line dressing changes: A matched pre-post intervention study.

Bahl, Amit / Mielke, Nicholas / Gibson, Steven Matthew / George, Julie

Journal of infection prevention

2024 Volume 25, Issue 3, Page(s) 73–81

Abstract: Background: Unscheduled dressing changes for central venous lines (CVLs) have been shown to increase the risk of bloodstream infections.: Objective: The objective of this study is to determine if the use of an innovative dressing change kit reduces ... ...

Abstract	Background: Unscheduled dressing changes for central venous lines (CVLs) have been shown to increase the risk of bloodstream infections. Objective: The objective of this study is to determine if the use of an innovative dressing change kit reduces the rate of unscheduled dressing changes. Methods: This pre-post interventional study took place at a large, academic, tertiary care center in metro Detroit, Michigan, the United States. We assessed the impact of the interventional dressing change procedure kit on the rate of unscheduled dressing changes for adult patients who underwent placement of a CVL inclusive of a central catheter, peripherally inserted central catheter, or hemodialysis catheter. Data was collected for the pre-intervention cohort through electronic health records (EHRs), while data for the post-intervention cohort were collected by direct observation by trained research staff in combination with EHR data. The primary outcome was the rate of unscheduled dressing changes. Secondary outcomes included rate of unscheduled dressing changes based on admission floor type, etiology of unscheduled dressing changes, and central line-associated bloodstream infections (CLABSIs). Results: The study included a convenience sample of 1548 CVLs placed between May 2018 and June 2022 with a matched analysis including 488 catheters in each of the pre- and post-intervention groups. The results showed that the unadjusted rate of unscheduled dressing evaluations was significantly reduced from the pre-intervention group (0.21 per day) to the post-intervention group (0.13 per day) ( Discussion: Procedural kits for central line dressing changes are effective in reducing unscheduled dressing changes and may have a role in reducing CLABSI. Further studies assessing the impact of dressing change kits on cost, procedural compliance, and the precise impact on CLABSI are needed.
Language	English
Publishing date	2024-02-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2595000-9
ISSN	1757-1782 ; 1757-1774
ISSN (online)	1757-1782
ISSN	1757-1774
DOI	10.1177/17571774241232063
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Article ; Online: Operation STICK: A vascular access specialty program for the generalist emergency medicine clinician.

Bahl, Amit / Mielke, Nicholas / DiLoreto, Emily / Gibson, S Matthew

The journal of vascular access

2024 , Page(s) 11297298231222060

Abstract: Objective: Comprehensive education and training programs are urgently needed to improve vascular access outcomes in the emergency department (ED). This study aimed to demonstrate the success of a formalized vascular access program in developing ... ...

Abstract	Objective: Comprehensive education and training programs are urgently needed to improve vascular access outcomes in the emergency department (ED). This study aimed to demonstrate the success of a formalized vascular access program in developing competent ED clinicians in traditional and ultrasound-guided insertion methods. Methods: This was a retrospective observational study exploring the success of trainees in obtaining competency in peripheral vascular access at an academic suburban ED with 120,000 annual visits. Eligible participants included healthcare workers that enrolled in the Operation STICK vascular access program and perform vascular access procedures as an aspect of their clinical practice. Competency in vascular access included both traditional and ultrasound-guided (US) peripheral intravenous catheter (PIVC) insertions. Competency was defined as demonstration of successful insertion of one traditional and one US PIVC in compliance with checklist. The primary objective was competency. Secondary objectives included trainee time to competency, trainee number of line encounters, and changes in program competency achievements over time. Results: From October 15, 2021, to April 15, 2023, 141 clinicians participated in peripheral vascular access training via the Operation STICK model, which included 72 (51.1%) nurses, 52 (36.9%) ED technicians, and 17 (12.0%) healthcare personnel with other medical training. Clinicians overall reported an average of 5.6 years of experience inserting peripheral intravenous catheters (PIVCs) and 23 (16.3%) had experience with using ultrasound. About 122 (86.5%) clinicians successfully completed the program and demonstrated competency in traditional and ultrasound-guided techniques. Time to competency varied over time, with a median of 124 days in the early phase, 32.5 days middle phase, and 10.6 h over 9.5 days in the later phase of the program ( Conclusions: Achieving competency in PIVC insertion necessitates a focused effort on refining and systematizing education and training approaches. Recognizing the inherent challenges present in ED settings, it is feasible to effectively and efficiently train emergency clinicians to be expert in both basic and advanced PIVC placement techniques through participation in a well-organized vascular access training program.
Language	English
Publishing date	2024-01-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2252820-9
ISSN	1724-6032 ; 1129-7298
ISSN (online)	1724-6032
ISSN	1129-7298
DOI	10.1177/11297298231222060
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Zs.A 6414: Show issues

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Article ; Online: Symptomatic Deep Vein Thrombosis Associated With Peripherally Inserted Central Catheters of Different Diameters: A Systematic Review and Meta-Analysis.

Bahl, Amit / Alsbrooks, Kimberly / Gala, Smeet / Hoerauf, Klaus

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis

2023 Volume 29, Page(s) 10760296221144041

Abstract: We assessed the relationship between peripherally inserted central catheter (PICC) diameters and symptomatic deep vein thrombosis (DVT) rates. We conducted a systematic search for articles published between 2010 and 2021 reporting DVT incidence by ... ...

Abstract	We assessed the relationship between peripherally inserted central catheter (PICC) diameters and symptomatic deep vein thrombosis (DVT) rates. We conducted a systematic search for articles published between 2010 and 2021 reporting DVT incidence by catheter diameter in patients who had a PICC, followed by meta-analyses for DVT risk in each diameter group. Pooled DVT rates were incorporated into an economic model. Of 1627 abstracts screened, 47 studies were included. The primary meta-analysis of 40 studies demonstrated the incidence of DVT was 0.89%, 3.26%, 5.46%, and 10.66% for 3, 4, 5, and 6 French (Fr) PICCs (
MeSH term(s)	Humans ; Catheterization, Central Venous/adverse effects ; Risk Factors ; Catheters/adverse effects ; Catheterization, Peripheral/adverse effects ; Venous Thrombosis/epidemiology ; Venous Thrombosis/etiology ; Retrospective Studies ; Central Venous Catheters/adverse effects
Language	English
Publishing date	2023-06-09
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	1237357-6
ISSN	1938-2723 ; 1076-0296
ISSN (online)	1938-2723
ISSN	1076-0296
DOI	10.1177/10760296221144041
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Zs.A 4370: Show issues

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Article ; Online: ROLE OF ANDROGEN RECEPTOR-TARGETED AGENTS IN LOCALIZED PROSTATE CANCER.

Murgić, Jure / Fröbe, Ana / Challapalli, Amarnath / Bahl, Amit

Acta clinica Croatica

2023 Volume 61, Issue Suppl 3, Page(s) 51–56

Abstract: Anti-androgen therapy continues to be a basic pilar of treatment for both localized and metastatic prostate cancer. The advent of new generation of androgen receptor targeted agents (ARTA) transformed the care of patients with advanced disease. After ... ...

Abstract	Anti-androgen therapy continues to be a basic pilar of treatment for both localized and metastatic prostate cancer. The advent of new generation of androgen receptor targeted agents (ARTA) transformed the care of patients with advanced disease. After such a success, the steps were taken to incorporate a new generation of ARTAs into the treatment landscape of localized prostate cancer. High-risk prostate cancer represents the most aggressive form of localized disease with significant metastatic potential and poor outcome. Here, the impact of novel therapies will likely be profound and transforming. This clinical space has already been a showcase for multidisciplinary treatment where the combination of local therapies with systemic treatment gradually improved patient outcomes and the chances of cure. The most recent step in redefining the treatment of localized disease is the adoption of novel ARTAs moving forward the multidisciplinary platform. In this narrative review, we discuss current clinical evidence supporting the use of novel ARTAs in patients with localized high-risk prostate cancer and cover recent developments in biomarker-driven strategies for treatment individualization in this clinical context.
MeSH term(s)	Male ; Humans ; Receptors, Androgen/therapeutic use ; Prostatic Neoplasms, Castration-Resistant/drug therapy ; Prostatic Neoplasms, Castration-Resistant/pathology ; Androgen Antagonists/therapeutic use ; Antineoplastic Agents ; Prostatic Neoplasms/drug therapy ; Prostatic Neoplasms/pathology
Chemical Substances	Receptors, Androgen ; Androgen Antagonists ; Antineoplastic Agents
Language	English
Publishing date	2023-02-17
Publishing country	Croatia
Document type	Journal Article ; Review
ZDB-ID	1478635-7
ISSN	1333-9451 ; 0353-9466
ISSN (online)	1333-9451
ISSN	0353-9466
DOI	10.20471/acc.2022.61.s3.7
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Zs.A 5057: Show issues

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Article ; Online: Risk of midline catheter-related thrombosis due to catheter diameter: An observational cohort study.

Bahl, Amit / Mielke, Nicholas / Xing, Yuying

Thrombosis research

2023 Volume 228, Page(s) 172–180

Abstract: Objective: Deep vein thrombosis is a common and serious complication associated with midline catheters (MC). The aim of this investigation was to determine if catheter diameter is related to development of thrombosis.: Methods: This was an ... ...

Abstract	Objective: Deep vein thrombosis is a common and serious complication associated with midline catheters (MC). The aim of this investigation was to determine if catheter diameter is related to development of thrombosis. Methods: This was an observational cohort study conducted at a tertiary care academic center in Southeastern Michigan. Hospitalized adults that required a MC were eligible participants. Primary outcome was symptomatic MC associated upper extremity deep vein thrombosis (DVT) comparing three catheter diameters. Secondary outcomes included complications based on size and DVT comparing catheter to vein ratio. Results: Between January 1, 2017, and December 31, 2021, 3088 MCs met inclusion criteria; the distribution of 3 French (Fr), 4 Fr, and 5 Fr MCs was 35.1 %, 57.0 %, and 7.9 %, respectively. The majority of the population was female (61.2 %) and the average age was 64.2 years old. DVT occurred in 4.4 %, 3.9 %, and 11.9 % of 3 Fr, 4 Fr, and 5 Fr MCs, respectively (p < 0.001). In multivariable regression analysis, there was no difference in the odds of developing DVT for the 4 Fr MC compared to the 3 Fr (aOR 0.88; 95 % CI 0.59-1.31; p = 0.5243), however, there was significantly higher odds for the 5 Fr (aOR 2.72; 95 % CI 1.62-4.51; p = 0.001). Additionally, for every additional day the MC was in place, the odds of DVT increased by 3 % (aOR 1.03; 95 % CI 1.01-1.05; p = 0.0039). When comparing accuracy of the size model versus catheter to vein ratio model for predicting DVT, receiver operating characteristic curve analysis demonstrated the area under the curve for size was 73.70 % (95 % CI 68.04 %-79.36 %) compared to 73.01 % (95 % CI: 66.88 %-79.10 %) for catheter-to-vein ratio. Conclusions: Smaller diameter catheters should be preferentially chosen to mitigate the risk of thrombosis when therapy via midline catheters is required. Choosing a catheter based on reduced size or 1:3 catheter to vein ratio threshold has similar accuracy in predicting DVT.
MeSH term(s)	Adult ; Humans ; Female ; Middle Aged ; Risk Factors ; Catheters/adverse effects ; Upper Extremity Deep Vein Thrombosis/etiology ; Cohort Studies ; Veins ; Retrospective Studies
Language	English
Publishing date	2023-06-12
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	121852-9
ISSN	1879-2472 ; 0049-3848
ISSN (online)	1879-2472
ISSN	0049-3848
DOI	10.1016/j.thromres.2023.06.007
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