WorldCat Identities

Keaveny, Andrew P.

Works: 4 works in 17 publications in 1 language and 265 library holdings
Roles: Editor, Author, htt
Publication Timeline
Most widely held works by Andrew P Keaveny
Complications of cirrhosis : evaluation and management by Andrew P Keaveny( )

14 editions published between 2015 and 2016 in English and held by 262 WorldCat member libraries worldwide

This volume presents a concise yet comprehensive overview on all facets concerning the complications of cirrhosis. Structured in three sections, the book reviews the natural history of cirrhosis, the diagnostic and predictive tools available to assess the disease, complications, and treatment options such as liver assist devices and transplantation. Topical concerns in the management of patients with cirrhosis are also addressed, including issues pertaining to the delivery of quality care in this patient population. Written by experts in their fields, Complications of Cirrhosis: Evaluation and Management serves as a valuable resource for practitioners and physicians-in-training on the subject of cirrhosis
Educational Intervention in Primary Care Residents' Knowledge and Performance of Hepatitis B Vaccination in Patients with Diabetes Mellitus( )

1 edition published in 2015 in English and held by 1 WorldCat member library worldwide

Abstract : Objectives: Although guidelines recommend hepatitis B virus (HBV) immunization for adults with diabetes mellitus (DM), vaccination rates remain low. Our aim was to evaluate knowledge and practice regarding HBV and to assess the effectiveness of a multifaceted educational program. Methods: Primary care residents (n = 244) at three academic institutions were surveyed about various aspects of HBV. Residents at one training program were then randomly assigned to an educational intervention (E) (n = 20) and control group (C) (n = 19). The E group received a focused didactic lecture and periodic e-mail reminders with immediate feedback. We compared knowledge scores before and after the intervention. Chart audits were conducted to evaluate the residents' behavior. Results: A total of 103 (42%) residents responded to the survey. The survey indicated that residents lacked the necessary knowledge and risk assessment skills concerning HBV in patients with DM. In the controlled trial of the E intervention, both groups had similar baseline knowledge scores. The E group had a significant increase in the immediate postintervention knowledge scores from a mean of 29% at baseline to 70% (P <0.001) that was sustained 6 months postintervention (65%; P <0.001). In the C group, 6-month postintervention scores were not different from baseline (38% vs 29%). No significant differences were observed in documentation skills. Conclusions: A combined educational program was effective in enhancing knowledge about HBV and vaccination in DM but had limited influence on physicians' practice. Further study incorporating system changes along with educational initiatives is required to improve clinical practice. Abstract : This study consisted of two phases: a survey of knowledge of primary care residents at three academic centers and the subsequent development and implementation of a strategy to improve the knowledge deficit of these providers. Physician understanding of disease processes and knowledge of appropriate testing are critical for successful implementation of disease prevention guidelines. The authors demonstrated that improvements in knowledge gaps can be achieved with relatively simple educational efforts. This focused educational intervention offered another way of teaching a complicated topic to medical residents and could be easily incorporated into medical education curricula. Supplemental digital content is available in the text
Intraregional model for end-stage liver disease score variation in liver transplantation: Disparity in our own backyard( )

1 edition published in 2018 in English and held by 1 WorldCat member library worldwide

Abstract : Variation in average Model for End-Stage Liver Disease (MELD) score at liver transplantation (LT) by United Network for Organ Sharing (UNOS) regions is well documented. The present study aimed to investigate MELD variation at the interregional, intraregional, and intra-donation service area (DSA) levels. Patients undergoing LT between 2015 and 2016 were obtained from the UNOS standard analysis and research file. The distribution of allocation MELD score including median, skew, and kurtosis was examined for all transplant programs. Intraregional median allocation MELD varied significantly within all 11 UNOS regions. The largest variation between programs was seen in region 5 (MELD 24.0 versus 38.5) and region 3 (MELD 20.5 versus 32.0). Regions 1, 5, and 9 had the largest proportion of programs with a highly negative skewed MELD score (50%, 57%, and 57%, respectively), whereas regions 3, 6, 10, and 11 did not have any programs with a highly negative skew. MELD score distribution was also examined in programs located in the same DSA, where no barriers exist and theoretically no significant difference in allocation should be observed. The largest DSA variation in median allocation MELD score was seen in NYRT-OP1 LiveOnNY (MELD score variation 11), AZOB-OP1 Donor Network of Arizona (MELD score variation 11), MAOB-OP1 New England Organ Bank (MELD score variation 9), and TXGC-OP1 LifeGift Organ Donation Ctr (MELD score variation 9). In conclusion, the present study demonstrates that this MELD disparity is not only present at the interregional level but can be seen within regions and even within DSAs between programs located as close as several city blocks away. Although organ availability likely accounts for a component of this disparity, the present study suggests that transplant center behavior may also play a significant role. Liver Transplantation 24 488-496 2018 AASLD
What are the outcomes of declining a public health service increased risk liver donor for patients on the liver transplant waiting list?( )

1 edition published in 2018 in English and held by 1 WorldCat member library worldwide

Abstract : The tragedy of the national opioid epidemic has resulted in a significant increase in the number of opioid-related deaths and accordingly an increase in the number of potential donors designated Public Health Service (PHS) increased risk. Previous studies have demonstrated reluctance to use these PHS organs, and as a result, higher discard rates for these organs have been observed. All patients listed for liver transplantation in the United States from January 2005 to December 2016 were investigated. Patients on the waiting list were divided into 2 groups: those in which a PHS liver was used for transplantation (accepted PHS group) and those in which a PHS liver was declined and transplanted into a recipient lower on the match run (declined PHS group). Intention-to-treat patient survival from the time of PHS offer was significantly higher in the accepted PHS compared with the declined PHS group (P <0.001). On Cox multivariate regression, declining a PHS donor liver was associated with a hazard ratio of 2.36 (95% confidence interval, 2.23-2.49; P <0.001). For patients in which a PHS organ offer was declined, 11.6% died or were delisted for being too sick within the subsequent year. Donor liver allografts implanted in the accepted PHS group were of a lower donor risk index (1.28 versus 1.44) compared with the non-PHS organs that patients in the declined PHS group ultimately received if they underwent transplantation. In conclusion, there is a significantly higher survival for patients in which a PHS liver is accepted and used compared with those patients in which a PHS organ is declined. These data will help inform decisions about whether or not to accept a PHS donor liver for both patients and transplant professionals. Liver Transplantation 24 497-504 2018 AASLD
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English (17)