Medicine and Health Sciences Commons^™

Patient Self-Management: Tools And Barriers, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

In his issue introduction, the editor-in-chief of the Journal of Patient-Centered Research and Reviews comments on the theme of patient self-management of chronic diseases and the related articles published therein. Illnesses such as cardiovascular disease, diabetes, epilepsy, arthritis, asthma, and obesity often require patients to administer their own medication daily or adhere to strict dietary restrictions. Progress is being made on the process of implementation and evaluation of patient self-management tools in primary care practices. Barriers to self-management tool implementations in clinics, as well as their use by individual patients, must be understood and addressed.

The Association Between Doppler Measures Of Cardiac Function And Outcomes In Patients With Left Ventricular Ejection Fraction ≤ 40% Undergoing Noncardiovascular Surgeries, Yang Shi, Rachel Pedersen, Matthew Rappelt, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan

Aurora Heart Failure / Transplant Faculty

Background: Preoperative risk assessments of individuals who undergo major noncardiac surgery have focused on ischemic heart disease. Information on how to assess the noncardiac surgical risks for patients with depressed cardiac function, as seen in heart failure, is sparse. Echocardiography is routinely performed in patients with depressed cardiac function and is an accepted standard cardiac assessment. Transthoracic echocardiography (TTE) provides strong independent prognostic implications in a wide range of cardiovascular conditions.

Purpose: To identify the echocardiographic parameters associated with outcomes among patients undergoing major noncardiac surgery.

Methods: A retrospective single-institution investigation identified 1,770 patients who underwent one or more major …

New Paradigms In The Treatment Of Acute Complicated And Uncomplicated Type B Aortic Dissection, Eric S. Weiss

Aurora Heart Failure / Transplant Faculty

The treatment of acute type B aortic dissection is a rapidly evolving field, due in a large part to the advent of thoracic endovascular aortic repair (TEVAR). This review will summarize the current literature on the management of both complicated and uncomplicated type B dissections, with special attention paid to emerging evidence supporting earlier aggressive treatment.

Mechanisms Of Left Ventricular Thrombus Formation In Heart Failure With Reduced Ejection Fraction: Novel Insights From Two-Dimensional Speckle Tracking Echocardiography, Dhruv Chawla, Tracy Hammonds, Tadele Mengesha, Matt Umland, Khawaja Afzal Ammar, Vinay Thohan

Aurora Heart Failure / Transplant Faculty

Background: Patients suffering from heart failure with reduced ejection fraction (HFrEF) are at increased risk for left ventricular (LV) thrombus and subsequent thromboembolism, yet anticoagulation is not routinely recommended for left ventricular ejection fraction (LVEF) alone. We sought to determine the role of two-dimensional speckle tracking echocardiography (2D-STE) to quantify regional changes in cardiac function associated with LV thrombus, which may prospectively guide anticoagulation.

Purpose: Help enable cardiovascular clinicians to use 2D-STE to evaluate regional strain patterns among patients with HFrEF with and without LV thrombus. Our results suggest that statistically lower regional longitudinal strain patterns in a well-matched cohort …

Echocardiographic Predictors Of Admission Among Patients With Heart Failure With Reduced Ejection Fraction, Chi C. Cho, Yang Shi, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan

Aurora Heart Failure / Transplant Faculty

Background: Congestive heart failure afflicts 5.7 million people in the United States with annual incidence of 600,000 and mortality of 280,000. Heart failure accounts for greater than 1 million hospitalizations annually and the single largest inpatient Medicare expense. As the U.S. population ages and greater emphasis is placed on population health as a means to bend projected health care expenditures, large health care organizations will need to develop algorithms to identify patients at high risk with heart failure and possibly preempt hospitalizations. Doppler echocardiography is routinely performed in clinical assessment of severe heart failure.

Purpose: We sought to determine echocardiographic …

Advanced Heart Failure Treatment Options Among The Elderly, German Guzman-Gutierrez, Yang Shi, Matthew Rappelt, Arshad Jahangir, Vinay Thohan

Aurora Heart Failure / Transplant Faculty

The aging human population has emerged as a critically important factor in health care, not only due to the unique physiologic and pathologic processes associated with aging but also because of the evolution of medical and surgical therapies that have increased quality and quantity of life. Heart failure is a disease found most commonly among older populations in whom it is associated with high morbidity and mortality. Heart failure disproportionately affects the elderly, and it stands to reason that the most terminal stage, known as advanced heart failure (AHF), is more common among the elderly. Despite limited data, treatment options …

Proteomic Profiling Of Serum Derived Exosomes From Prostate Cancer Patients, David Turay

David Turay, MD

Touted among the major achievements in the diagnosis and management of Prostate cancer (PCa) in the past few decades has been, the dramatic decline of men with advanced/metastatic PCa at diagnosis coupled with a significant improvement ( >90%) in the five and ten year survival rates of the disease. Non-palpable PCa (potentially clinically treatable disease) now accounts for 70-80% of all newly diagnosed cases of PCa. Preceding these changes by about a decade was the introduction of Prostatic Specific Antigen (PSA) into clinical practice; first as biomarker for monitoring response to therapy and subsequently as a complementary screening tool. It …

Limiting Antibiotic Use In Acute Sinusitis: Partly A Matter Of Vocabulary?, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

In his issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews comments on an included article that describes the successful use of an electronic medical record best practice alert to reduce the rate of antibiotic prescription for acute sinusitis. Various methods previously tried to improve antibiotic stewardship in this illness are briefly reviewed. Borrowing on the model of acute bronchitis, it is suggested that a change in conveyed diagnostic vocabulary to “sinus cold” when describing acute sinusitis may help limit antibiotics for this predominantly viral infection.

Geographic Differences In Obesity Prevalence And Its Risk Factors Among Asian Americans: Findings From The 2013–2014 California Health Interview Survey, Shaoqing Gong, Kesheng Wang, Ying Li, Arsham Alamian

Arsham Alamian

Geography disparities exist in obesity and obesity related conditions. This study aimed to examine the geographic differences in obesity prevalence and its risk factors among Asian Americans in California. Data (n = 4,000) from the 2013–2014 California Health Interview Survey were used. Obesity (≥27.5 kg/m2) was defined according to the World Health Organization Asian body mass index cut points in Asian groups. Results suggest that 66.5% of Asians lived in urban areas. Among Asian adults, obesity prevalence was highest in Filipinos (33.8%) and lowest in Koreans (12.8%). Compared to rural Vietnamese, obesity prevalence was higher for urban Vietnamese (8.3% vs. …

The Adipokine C1q Tnf Related Protein 3 (Ctrp3) Is Elevated In The Breast Milk Of Obese Mothers, Megan R. Kwon, Eileen M. Cress, W. Andrew Clark, Arsham Alamian, Yongke Lu, Jonathan M. Peterson

Arsham Alamian

Background C1q TNF related protein 3 (CTRP3) is a relatively novel hormonal factor primarily derived from adipose tissue and has anti-diabetic properties. To determine if CTRP3 could play a role in early childhood development, the purpose of this study was to establish the presence of CTRP3 in breast milk (BM) and to determine whether CTRP3 levels were correlated with pregravid obesity status of the mother. Methods Breast milk was collected from breast-feeding mothers who had a pregravid body mass index (BMI) classification of normal weight (BMI 18–25 kg/m2, n = 23) or obese (BMI > 30 kg/m2, n = 14). Immunoprecipitation …

Gastritis Induced St Segment Elevation On Electrocardiogram, Obadah Aqtash, Ahmed Amro, Ala Gabi, Amal Sobeih, Dr. Mehiar El-Hamdani, Ellen A. Thompson

Ellen A. Thompson

ST segment elevation on an electrocardiogram (EKG) is an alarming finding that warrants an urgent coronary angiogram. Early diagnosis and intervention is extremely important in the setting of Acute Coronary Syndrome (ACS) to prevent irreversible myocardium damage and reduce the mortality rate. However, it is very important to know that not all ST- Elevations (STE) on EKG are due to myocardial infraction. Etiologies can be divided into cardiac and non-cardiac causes. Cardiac causes can include coronary aneurysm and acute pericarditis while non-cardiac causes can include acute cholecystitis and pulmonary embolism. In this paper, we are presenting a unique case of …

Guidance For Switching From Off-Label Antipsychotics To Pimavanserin For Parkinson’S Disease Psychosis: An Expert Consensus, Kevin J. Black, Henry Nasrallah, Stuart Isaacson, Mark Stacy, Rajesh Pahwa, Charles H. Adler, Gustavo Alva, Jeffrey W. Cooney, Daniel Kremens, Matthew A. Menza, Jonathan M. Meyer, Ashwin A. Patkar, Tanya Simuni, Debbi A. Morrissette, Stephen Stahl

Kevin J. Black, MD

Children With Type 1 Diabetes Who Experienced A Honeymoon Phase Had Significantly Lower Ldl Cholesterol 5 Years After Diagnosis, Benjamin U. Nwosu, Bo Zhang, Sanaa S. Ayyoub, Stephanie Choi, Tony R. Villalobos-Ortiz, Laura C. Alonso, Bruce A. Barton

Benjamin U. Nwosu

IMPORTANCE: Landmark studies showed that partial clinical remission in new-onset type 1 diabetes is associated with reduced prevalence of long-term complications, but early clinical indicators of this favorable outcome are poorly characterized.

AIM: To determine if there were any differences in lipid parameters, especially LDL-cholesterol, between remitters and non-remitters 4 to 5 years after the diagnosis of type 1 diabetes after controlling for hemoglobin A1c, body mass index, and pubertal status.

SUBJECTS AND METHODS: A longitudinal retrospective cohort study of 123 subjects of mean age 11.9 +/- 2.9 years, [male 11.7 +/- 2.9 years, (n = 55); female 12.0 +/- …

Use Of Urine Antigen Testing For Blastomyces In An Integrated Health System, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Purpose: Blastomycosis, an endemic fungal infection, mimics many other diseases. We explored the use of Blastomyces urine antigen (BuAg), reportedly the most sensitive noninvasive test, in clinical practice and compared it to other noninvasive tests.

Methods: A total of 836 BuAg tests performed on unique patients (first test only) at one large integrated health system from June 2013 to May 2016 were retrospectively reviewed to examine test characteristics and demographic features. Of these, 100 cases from 2015, a year containing a large local blastomycosis outbreak, were randomly selected for detailed analysis.

Results: Demographics for the BuAg-tested population: mean age 54.9 …

Review Of Kawasaki Disease, Rani Shah, Hisham Hirzallah, Munes Fares, Ashwini Mallad, Gudjon Karlsson, Mehiar El-Hamdani

Hisham Hirzallah

Abstract

Background: Kawasaki disease is one of the leading causes of acquired heart disease in children. It is an acute self-limited vasculitis that predominantly affects infants and children younger than 5 years of age. These patients present with nonspecific symptoms, such as fever and lymphadenopathy, making the diagnosis challenging. This disease can have serious and potentially fatal outcomes, and prompt recognition of this disease is vital to the patient’s outcome. We present a complete review of the disease, including the epidemiology, pathophysiology, diagnosis and management of acute Kawasaki disease, the natural history of this disease, and follow up of …

Fmt Placed By Colonoscopy: Systematic Review And Meta-Analysis, Nadia Huq, Veena Kumaravel, Aboud Affi, Maharaj Singh

Aurora Gastroenterology Faculty

Background: Fecal transplants are successful in the treatment of recurrent or refractory Clostridium difficile infections (CDI), but there is no consensus on the best method of instillation. Studies have shown greater success with lower gastrointestinal tract placement, but technical aspects of placement are not validated.

Purpose: This review aims to identify common traits and procedural techniques of successful fecal microbiota transplant (FMT) therapy via colonoscopy.

Methods: An electronic search was conducted using OVID Medline and PubMed for articles published from January 2010 to January 2016. The primary outcome of interest was cure by FMT placed via colonoscopy.

Results: Of the …

Magneto-Electric Nano-Particles For Non-Invasive Brain Stimulation, Kun Yue, Rakesh Guduru, Jeongmin Hong, Ping Liang, Madhavan Nair, Sakhrat Khizroev

Sakhrat Khizroev

This paper for the first time discusses a computational study of using magneto-electric (ME) nanoparticles to artificially stimulate the neural activity deep in the brain. The new technology provides a unique way to couple electric signals in the neural network to the magnetic dipoles in the nanoparticles with the purpose to enable a non-invasive approach. Simulations of the effect of ME nanoparticles for non-invasively stimulating the brain of a patient with Parkinson’s Disease to bring the pulsed sequences of the electric field to the levels comparable to those of healthy people show that the optimized values for the concentration of …

Transition Of Care For The Young Adult With Cleft Palate: Stuck Between Goodbye To The Pediatric Team And Hello To Adult-Centered Care, Linda Vallino, Brenda Louw

Brenda Louw

Participants will be able to:

• Describe the characteristics and needs of young adults with CLP.
• Discuss the model of transition of care for the young adult with CLP.
• Extrapolate strategies that teams could use to improve the care of young adults with CLP.

Young Adults With Cleft Lip And Palate: Are They Receiving Team Services?, Sarah Widy, Andrea Bisceglia, Emily Bradley, Sanjana Kumari Vyda Srinivasa Kumar, Andrea Mcdowell, Amanda Murr, Blake Nowicki, Elisha Reed, Alexandria Staples, Brenda Louw

Brenda Louw

It is widely acknowledged that a team approach is preferred practice and contributes to optimizing the surgical, dental, speech and psychosocial outcomes for individuals with CLP. Young adulthood often marks the transition from child-centered interdisciplinary care to adult-centered care. There is a paucity in literature relating to the transition of care for young adults with CLP. The purpose of this survey research is therefore to explore the CLP team practices regarding young adults with CLP.

Transition Of Care For Young Adults With Cleft Lip And Palate: We’Ve Got Some Growing Up To Do, Brenda Louw, Linda Vallino

Brenda Louw

Participants will be able to:

• Describe the characteristics and needs of young adults with CLP.
• Discuss the model of transition of care for the young adult with CLP.
• Extrapolate strategies that teams could use to improve the care of young adults with CLP.

Full abstract available through The Cleft Palate-Craniofacial Journal.

They’Re Not Just Big Kids: A Service Delivery Model For Young Adults With Cleft Lip/Palate, Linda Vallino, Brenda Louw

Brenda Louw

No abstract provided.

Speech-Language Pathologists’ Perceptions Of Collaborating With Registered Dietitians In The Pediatric Population, Brenda Louw, Michelle Lee

Brenda Louw

Survey research was conducted to explore Speech-Language Pathologists’ (SLPs) perceptions and experiences collaborating with Registered Dietitians (RDs) in the pediatric population. 107 SLPs in different settingsparticipated. Findings indicate SLPs were not exposed to RDs or the role of nutrition in their didactic and clinical training. Rather this exposure occurred once they were in the field practicing as an SLP. A clear need was identified regarding graduate and continued education on collaboration between SLPs and RDs.

The Icf-Cy As Framework For International Collaboration To Improve Services For Children With Communication Disorders, Brenda Louw, Juan Bornman

Brenda Louw

The purpose of this presentation is to describe the application of The International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) (WHO, 2007) as a framework for international collaboration with the aim of translating an outcomes measure and to field test the clinical applicability and cultural validity thereof.

See, I’Ve Grown: A Service Delivery Model For Young Adults With Cleft/Lip Palate, Brenda Louw, Linda Vallino

Brenda Louw

We compare the health needs between children and young adults with CL/P. Patient-reported experiences about the impact of a cleft are described. A service delivery model integrating quality of life into the ICF framework is presented. Lastly, transition of care for the young adult with CL/P is highlighted.

Perceptions Of Medical Students Of The Role Of The Speech-Language Pathologist In Hiv/Aids Intervention, Kendal Klein, Emily Wagner, Kristi Moore, Tanvi Amin, Brenda Louw

Brenda Louw

Survey research was utilized to explore Medical students’ perceptions of Speech-Language Pathologists’(SLP) and Medical Practitioner’s roles in meeting the healthcare needs of people living with HIV/AIDS(PLWHA). Results identified participants’ knowledge and perceptions. Recommendations suggest interprofessional education and training for both professions, at the pre-professional and professional levels.

Parental Perspective: Toddlers With Clefts Using Touch Screen Technology, Cortney Vineyard, Alexandra Coup, Chelsey Hazelett, Rachel Janes, Brenda Louw

Brenda Louw

This investigation assessed the parental perspectives of parents of toddlers with cleft lip and palate and their use of touchscreen technology. Findings will highlight parental perspectives on touchscreen technology in early intervention with their toddler.

Nutrition Students’ Perception Of The Role Of The Slps In Treating People Living With Hiv/Aids, Stephanie Bare, Natalie Dubin, Haley Hawks, Kathleen Quinn, Brittany Ratliff, Brenda Louw

Brenda Louw

This project explores nutrition students’ perceptions of SLPs' and Nutritionists’ role in healthcare needs of PLWHA through survey research. The results will describe participants’ perceptions of the SLPs' and Nutritionists’ roles in the healthcare needs of PLWHA. Recommendations are made regarding interprofessional training curricula for SLP and Nutrition students.

Island Voices: Experiences Of Living With Cleft Lip And Or Palate., Rachna Gopal, Brenda Louw

Brenda Louw

To date there is a lack of information on how young adults in Mauritius, a representation of the majority contexts, experience living with CLP. The aim of this study is to give a voice to young Mauritian adults with CLP; in describing their treatment journey and satisfaction with cleft care.

Global Engagement: Problem Solving And Information Exchange, Vinaya Manchaiah, Brenda Louw

Brenda Louw

This interactive session provides opportunities (1) to share ideas for infusing global perspectives and goals into CAPCSD projects, conferences, and the work of committees and task forces; (2) to discuss ways to collaborate in an ongoing global engagement projects and help include content for 2017 conference; and (3) to create how-to guides for ethical and culturally attuned translational research, and clinical education, and service learning.

A New Perspective On The Outcomes Of Children With Cleft Lip And Palate: Application Of The Icf-Cy, Brenda Louw

Brenda Louw

Learner Outcomes:

• Acknowledge the application value of the ICF to individuals with CLP.
• Integrate the ICF framework into the assessment of individuals with CLP.
• Formulate intervention goals that go beyond speech production skills to include functional communication outcomes in a variety of life situations.
• Include improvement and changes in communication participation in everyday functioning in assessment and progress reports.