St Anthony Central Hospital

Central City, CO, United States

St Anthony Central Hospital

Central City, CO, United States
SEARCH FILTERS
Time filter
Source Type

Bar-Or D.,Swedish Medical Center | Bar-Or D.,Ampio Pharmaceuticals | Bar-Or D.,Rocky Vista University | Slone D.S.,Swedish Medical Center | And 4 more authors.
Analytical Biochemistry | Year: 2013

Due to the heterogeneous nature of commercial human serum albumin (cHSA), other components, such as the protease dipeptidyl peptidase IV (DPP-IV), possibly contribute to the therapeutic effect of cHSA. Here, we provide evidence for the first time that DPP-IV activity contributes to the formation of aspartate- alanine diketopiperazine (DA-DKP), a known immunomodulatory molecule from the N terminus of human albumin. cHSA was assayed for DPP-IV activity using a specific DPP-IV substrate and inhibitor. DPP-IV activity was assayed at 37 and 60 C because cHSA solutions are pasteurized at 60 C. DPP-IV activity in cHSA was compared with other sources of albumin such as a recombinant albumin (rHSA). In addition, the production of DA-DKP was measured by negative electrospray ionization/liquid chromatography mass spectrometry (ESI/LCMS). Significant levels of DPP-IV activity were present in cHSA. This activity was abolished using a specific DPP-IV inhibitor. Fully 70 to 80% DPP-IV activity remained at 60 C compared with the 37 C incubate. No DPP-IV activity was present in rHSA, suggesting that DPP-IV activity is present only in HSA produced using the Cohn fractionation process. The formation of DA-DKP at 60 C was observed with the DPP-IV inhibitor significantly decreasing this formation. DPP-IV activity in cHSA results in the production of DA-DKP, which could account for some of the clinical effects of cHSA. © 2013 Elsevier Inc. All rights reserved.


Salottolo K.,Swedish Medical Center | Salottolo K.,St Anthony Central Hospital | Offner P.,St Anthony Central Hospital | Offner P.,Rocky Vista University | And 9 more authors.
Journal of Trauma - Injury, Infection and Critical Care | Year: 2011

Background: Pharmacologic thromboprophylaxis (PTP) is frequently withheld, begun late, or interrupted in patients with traumatic brain injury (TBI). The purpose of this study was to analyze whether late or interrupted PTP increases the risk of venous thromboembolism (VTE) after TBI. Methods: We retrospectively studied patients with blunt TBI and stable head computed tomography (CT) scans who were admitted to two Level I trauma centers. PTP use was analyzed as an independent risk factor for VTE using separate logistic regression models for each definition of PTP use: (1) administration of PTP; (2) timing of PTP (early [<72 hours] vs. late [≥72 hours]); and (3) continuous versus interrupted use of PTP. Results: Four hundred eighty patients with TBI were identified. VTE occurred in 15 patients (3.13%). VTE developed in six patients despite early PTP (5.56%), four patients with late PTP (2.72%), and five with no PTP (2.22%). Neither administration of PTP nor timing of PTP was independent predictor of developing a VTE (PTP vs. none: odds ratio [OR] = 0.36, p = 0.18; early PTP vs. late PTP: OR = 2.00, p = 0.41). PTP was administered continuously in 188 patients (73.7%). Patients with interrupted PTP had a significant increased odds of developing VTE compared with patients with continuous PTP (OR = 7.07, p = 0.04). Walking before discharge significantly decreased the odds of developing a VTE (OR = 0.19, p = 0.02). Conclusions: Interrupted administration of PTP in patients with TBI is associated with significantly increased risk of VTE. These findings underscore the importance of continuous PTP administration, and every effort should be made to avoid interruption if possible. Copyright © 2011 by Lippincott Williams &Wilkins.


Bourg P.,St Anthony Central Hospital
Journal of trauma nursing : the official journal of the Society of Trauma Nurses | Year: 2012

Inconsistent application of trauma service resources and underevaluation of risk and resuscitation status in elderly trauma patients are problematic. We describe a geriatric protocol that includes initial lactate determination and trauma surgery admission. Protocol compliance rates were initial lactate determination, 67.9%; trauma service admission for overt or compensated (elevated lactate) shock, 73.6%; and trauma service consultation for nonshock patients, 67.8%. Implementation of this protocol resulted in a trend toward reduced mortality and reduced potentially preventable deaths.


Pearl A.,Swedish Medical Center | Bar-Or D.,St Anthony Central Hospital
Studies in Health Technology and Informatics | Year: 2012

Ventilator Associated Pneumonia (VAP) is a complication of intubated trauma patients and a leading cause in Intensive Care Unit (ICU) mortality. Since early diagnosis, by specimen culture takes days to complete, an overuse of broad spectrum antibiotics is the usual treatment. As a result there is the risk of developing antibiotic resistant strains. Using an Artificial Neural Network (ANN) derived model to predict those at risk would result in reduced risk of resistant strains, a lowering of mortality rates and considerable savings in treatment costs. Artificial Neural Networks work well on classification problems, using feedforward/ back propagation methodology. Using the National Trauma Data Bank (V6.2) data files, Tiberius Software created the ANN models. Best models were identified by their Gini co-efficient, ability to predict the complication outcome selected, and their RMSE scores. The model ensemble for the complications recorded in the registry were determined, variables ranked and model accuracy recorded. Results show an effective model, able to predict to 85% of those likely to contract VAP and similar figures for those unlikely to contract VAP. This equates to 1 in 10 patients being missed, and 1 in 10 falsely being flagged for treatment. Important variables in model development are not related to physiological factors, but injury status and the treatment received (intubation and expected ICU stay more than 2 days). Application of a predictive model could reduce the number of false positives being treated in an ICU and identify those most at risk, thereby lowering treatment costs and potentially helping improve mortality rates. © 2012 European Federation for Medical Informatics and IOS Press. All rights reserved.


Copeland D.A.,St Anthony Central Hospital | Copeland D.A.,University of California at Los Angeles | Heilemann M.V.,University of California at Los Angeles
Qualitative Health Research | Year: 2011

Family members in the United States-especially mothers-are frequently caregivers, and provide housing for their adult relatives and children with mental illness. They often do so with little support from the mental health system. The purpose of this analysis was to explore mothers' experiences related to housing options available to their adult children with a mental illness and a history of violence (MIHV) toward the mothers. The results of this study reveal a complex mixing of desires, feelings, internal factors, and external forces experienced by mothers of adult children with MIHV when considering whether or not these children can live in their homes. The findings from this study illuminate needs for greater familial involvement in mental health treatment decisions, respite for caregiving families, and housing as a crucial element of a comprehensive mental health treatment plan. © 2011 The Author(s).


Salottolo K.M.,Swedish Medical Center | Salottolo K.M.,St Anthony Central Hospital | Fanale C.V.,Swedish Medical Center | Fanale C.V.,Colorado Neurological Institute | And 5 more authors.
American Journal of Neuroradiology | Year: 2011

BACKGROUND AND PURPOSE: Patients with acute ischemic stroke require immediate medical treatment, and a CT to rule out hemorrhage is required before tPA. We adapted our protocol to include multimodal CT: unenhanced CT, CTA, and PCT. The purpose of this study was to determine whether multimodal CT imaging delays initiation of IV tPA beyond 60 minutes from hospital arrival. MATERIALS AND METHODS: All patients admitted during 3 years through the ED with a stroke alert and time from symptom onset to hospital arrival <2.5 hours were included. We examined 2 subgroups (multimodal CT versus unenhanced CT) to determine whether multimodal CT delayed tPA administration. Logistic regression was used to identify variables that predicted tPA within 60 minutes. RESULTS: There were 123 patients in the analysis, including 108 patients who were examined with multimodal CT. The median time from arrival to tPA was 56 minutes and was shorter for patients examined with multimodal CT (55 versus 78 minutes, P = .02). After adjustment, variables that were associated with tPA administration within 60 minutes included prehospital stroke alert (OR = 3.47, P = .03), time to CT (OR = 0.94, P = .01), and onset-to-arrival time (OR = 1.02, P = .04). There was no statistically significant difference in the odds of receiving timely tPA for multimodal versus unenhanced CT (OR = 3.99, P = .07). CONCLUSIONS: In our single-center experience, the use of multimodal imaging in patients with acute stroke did not delay IV tPA beyond 60 minutes. Further study is needed to assess the feasibility of the routine use of multimodal imaging in the acute stroke setting. Copyright © 2011 by the American Society of Neuroradiology.


Chopra S.,University of California at Irvine | Frank S.J.,St Anthony Central Hospital | Gu M.,University of California at Irvine | Gu M.,Oncotech Inc.
Acta Cytologica | Year: 2010

Background: Chordoma, a distinct malignant neoplasm arising from the remnants of the notochord, occurs mostly in patients in the fifth to seventh decade of life. Metastasis occurs in 20-30% of cases. The most common metastatic sites are lungs and, less commonly, other bones and visceral organs. The cytologic features of chordoma in both primary and metastatic foci have been described for specimens obtained by fine needle aspiration biopsy. A few cases have been reported in the sputum and the cerebrospinal fluid. Case: A 57-year-old man presented with metastatic chordoma diagnosed in a peritoneal effusion. Cytospin slides of the effusion showed numerous individual and clusters of polygonal, round epithelial cells with a background of myxoid chondroid substance, which stained metachromatic on Diff-Quik slides. Many diagnostic physaliphorous cells were present and characterized by abundant intracytoplasmic vacuoles of various sizes. The nuclei were monotonous, with minimal anisonucleosis. The nuclei had evenly dispersed chromatin with occasional small, eosinophilic nucleoli. The nuclear membranes were smooth, with focal indentation. The differential diagnosis included an adenocarcinoma and metastatic chordoma. Immunohistochemistry applied to the cell block showed that the neoplastic cells were positive for cytokeratin and S-100 protein. Conclusion: The clinical history with immunohistochemical profiles helped confirm the diagnosis of metastatic chordoma. © The International Academy of Cytology.


PubMed | St Anthony Central Hospital
Type: Journal Article | Journal: Journal of trauma nursing : the official journal of the Society of Trauma Nurses | Year: 2012

Inconsistent application of trauma service resources and underevaluation of risk and resuscitation status in elderly trauma patients are problematic. We describe a geriatric protocol that includes initial lactate determination and trauma surgery admission. Protocol compliance rates were initial lactate determination, 67.9%; trauma service admission for overt or compensated (elevated lactate) shock, 73.6%; and trauma service consultation for nonshock patients, 67.8%. Implementation of this protocol resulted in a trend toward reduced mortality and reduced potentially preventable deaths.


PubMed | St Anthony Central Hospital
Type: Comparative Study | Journal: The Journal of trauma | Year: 2011

In the setting of mild traumatic brain injury (TBI), the clinical significance of a traumatic subarachnoid hemorrhage (tSAH) has not been sufficiently studied. We examined the impact of an isolated tSAH on patient outcomes in the mild TBI population.We retrospectively identified all mild TBI patients (Glasgow Coma Scale score 13) who presented to a Level I trauma center over a 10-year period. We compared isolated tSAH patients with isolated concussion patients. (2) and logistic regression analyses were used to compare intensive care unit (ICU) admission, ICU length of stay (LOS), hospital LOS, progression of tSAH, in-hospital mortality, and disposition to rehabilitation.There were 1,144 concussion and 117 tSAH patients included in our study. After adjustment, tSAH patients had increased odds of admission to the ICU (odds ratio, [OR] = 8.87; p < 0.0001), yet their ICU LOS was significantly shorter (OR = 0.29; p = 0.01). The overall hospital LOS and mortality rate were not significantly different between the TBI groups. When stratified by age, only the 40-year to 69-year-old tSAH patients had significantly increased adjusted odds of disposition to rehabilitation compared with concussion patients, independent of ICU admission (OR = 7.96; p = 0.004). None of the patients required any neurosurgical interventions.We encourage healthcare facilities to consider revising or creating ICU admission criteria for the mild TBI population to help optimize the utilization of their ICUs. We believe clinicians should place more emphasis on variables such as age, comorbidities, and neurologic condition rather than the presence of a small volume of blood in the subarachnoid space when admitting mild isolated TBI patients to the ICU.


PubMed | St Anthony Central Hospital
Type: Journal Article | Journal: Qualitative health research | Year: 2011

Family members in the United States--especially mothers--are frequently caregivers, and provide housing for their adult relatives and children with mental illness. They often do so with little support from the mental health system. The purpose of this analysis was to explore mothers experiences related to housing options available to their adult children with a mental illness and a history of violence (MIHV) toward the mothers. The results of this study reveal a complex mixing of desires, feelings, internal factors, and external forces experienced by mothers of adult children with MIHV when considering whether or not these children can live in their homes. The findings from this study illuminate needs for greater familial involvement in mental health treatment decisions, respite for caregiving families, and housing as a crucial element of a comprehensive mental health treatment plan.

Loading St Anthony Central Hospital collaborators
Loading St Anthony Central Hospital collaborators