Medicine and Health Sciences Commons^™

Which Clinical Guidelines Should Be Implemented For Management Of Osteopenia In Primary Care? A Clin-Iq, Turia Hollingsworth

Journal of Patient-Centered Research and Reviews

Literature review was conducted to determine clinical guidelines for osteopenia management of immunocompetent patients in the primary care setting. It was concluded that pharmacological treatment should be offered to patients with osteopenia if they are considered high risk, which can be determined by utilizing the World Health Organization Fracture Risk Assessment Tool (FRAX^®) to evaluate 10-year risk. Patients with a calculated hip fracture probability of at least 3% or those with probability of 20% or more for all osteoporotic fractures may be offered bisphosphonate therapy.

What Is Pfapa And Why Does It Matter?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

PFAPA, the syndrome of periodic fever, aphthous stomatitis, pharyngitis and cervical lymphadentitis, is an uncommon disease of episodic immune dysregulation that usually begins in early childhood. Symptoms occur at regular, predictable intervals, with healthy periods in between, and generally include the namesake signs and various other constitutional symptoms such as fever and fatigue. The etiology is unknown and there is no definitive diagnostic test or treatment. Uncertainty during the period of searching for a diagnosis may be disconcerting to the family and the clinician. Single-dose prednisone is effective for resolving the fever of PFAPA episodes within just a few hours, …

Recurrent Aphthous Stomatitis: Diagnosis And Management In Primary Care, Jillian Hudson

Journal of Patient-Centered Research and Reviews

Recurrent aphthous stomatitis (canker sores) is a very common oral condition that remains incompletely understood. Presentation has been well-classified into minor, major or herpetiform subcategories based on clinical features, but exact etiology is unknown. Because etiology is unclear, treatments are primarily empiric and aimed at symptom reduction rather than prevention or cure. However, there are several methods, both topical and systemic, that can be easily and affordably utilized in the primary care setting.

Erratum (For “In Adult Smokers Unwilling Or Unable To Quit, Does Changing From Tobacco Cigarettes To Electronic Cigarettes Decrease The Incidence Of Negative Health Effects Associated With Smoking Tobacco? A Clin-Iq”)

Journal of Patient-Centered Research and Reviews

In Volume 1, Issue 2, the article “In Adult Smokers Unwilling or Unable to Quit, Does Changing From Tobacco Cigarettes to Electronic Cigarettes Decrease the Incidence of Negative Health Effects Associated With Smoking Tobacco? A Clin-IQ” (J Patient-Centered Res Rev. 2014;1:99-101) mistakenly reported the delivery agent in e-cigarettes as diethylene glycol instead of propylene glycol. Propylene glycol is a relatively benign substance commonly used in concert smoke machines. Diethylene glycol, a highly toxic substance, was reportedly found in only one e-cigarette cartridge studied in the literature, which may have been due to use of a nonpharmaceutical grade propylene …

Autoantibodies To The Ny-Eso-1 Tumor Antigen In Metastatic Melanoma: Sialylation Of The Fc Region Of Immunoglobulin G Induces Differential Expression Signatures Of Inflammatory Molecules During Dendritic Cell Differentiation And Maturation, Martin Oaks, Nathaniel Rein, John O. Richards, James Shaffer

Journal of Patient-Centered Research and Reviews

Purpose: We tested the hypothesis that different glycoforms of antibodies from patients with metastatic melanoma have different functional effects on human dendritic cell differentiation and maturation.

Methods: Antibodies to the cancer antigen NY-ESO-1 were affinity-purified from patients with melanoma and further fractionated into different glycoforms by lectin chromatography. Sialic acid-rich and sialic acid-poor fractions of these immunoglobulin G antibodies (IgG) were added to dendritic cell cultures during both differentiation and maturation, and the resulting cellular messenger RNA (mRNA) and culture supernatants were tested by microarray and enzyme-linked immunoassay for molecules related to inflammatory pathways.

Results: We identified unique mRNA and …

Discordant Documentation Of Obesity Body Mass Index And Obesity Diagnosis In Electronic Medical Records, Jennifer T. Fink, George L. Morris Iii, Maharaj Singh, David A. Nelson, Renee E. Walker, Ron A. Cisler

Journal of Patient-Centered Research and Reviews

Purpose: This study examined concordance between presence of obesity body mass index (BMI), defined as BMI ≥ 30, in the patient’s electronic medical record (EMR) and a documented diagnosis of obesity.

Methods: We conducted a retrospective review of the EMR in a large health care system for a 1-year period (2012). A total of 397,313 patients met the study criteria of having at least one physician visit, being at least 18 years of age, and not being pregnant. Of those, 158,327 (40%) had a recorded BMI ≥ 30. We examined the EMR of these obese patients to determine whether a …

Assessing Technologies For Information-Seeking On Prostate Cancer Screening By Low-Income Men, Susan W. Mcroy, Emily M. Cramer, Hayeon Song

Journal of Patient-Centered Research and Reviews

Purpose: This paper presents a multipart investigation of the benefits and challenges in deploying automated question-answering as an alternative to web-based searching to provide information about prostate cancer screening for low-income men age 40 years and older.

Methods: The study comprised: 1) a survey assessing current use of the Internet, mobile phones and texting; 2) a controlled observational study of both web-based searching and automated question-answering for information about prostate cancer; and 3) a formative field study in which subjects interacted with a health department nurse using text messages.

Results: Survey results suggest the target population has greater access to, …

Diagnosis Of Chemotherapy-Induced Cardiotoxicity, Fausto Pizzino, Giampiero Vizzari, Charles A. Bomzer, Rubina Qamar, Scipione Carerj, Concetta Zito, Bijoy K. Khandheria

Journal of Patient-Centered Research and Reviews

Cardiotoxicity is a rising issue connected to use of chemotherapy and radiotherapy in the treatment of neoplastic diseases. Early diagnosis during follow-up is of paramount importance, and careful surveillance is recommended. Evaluation of left ventricular ejection fraction by echocardiography and nuclear medicine techniques is widely used in clinical practice; however, their sensitivity in detecting early cardiac damage is low. New instruments like speckle-tracking imaging, cardiac magnetic resonance and cardiac circulating biomarkers are available to clinicians to best evaluate the onset and progression of cardiotoxic effects, improving the therapeutic management and final outcome for the patient.

Cardio-Oncology: Success Breeds New Challenges, Opportunities, Charles A. Bomzer, Bijoy K. Khandheria

Journal of Patient-Centered Research and Reviews

N/A

Cardiovascular Toxicity Of Common Chemotherapy Drugs Used To Treat Breast Cancer: An Overview, Charles A. Bomzer

Journal of Patient-Centered Research and Reviews

Treatment of breast cancer often exposes patients to many different drugs. Some of these drugs have toxic effects involving the cardiovascular system. This review provides an overview of the drugs most commonly used to treat breast cancer and their potential adverse impact on the cardiovascular system.

Clinical Outcomes Of Unprotected Left Main Coronary Artery Stenting In Nonsurgical Patients: A Single-Center Experience, John-Paul Pham, Abdelazim Hashim, Naoyo Mori, Mohamed Taha, Mohamed Djelmami-Hani, Joaquin Solis, Suhail Allaqaband, Tanvir Bajwa, Anjan Gupta

Journal of Patient-Centered Research and Reviews

Purpose: Coronary artery bypass graft is the standard treatment for unprotected left main disease; however, some patients are poor surgical candidates due to comorbidities. We assessed the safety and clinical outcome of elective, unprotected left main coronary artery stenting in nonsurgical patients.

Methods: Between October 2004 and June 2006, 50 consecutive patients underwent elective, unprotected left main coronary artery stenting at our institution. Patients were followed for a median of 16 and 96 months and clinical outcomes monitored.

Results: Median logistic euroSCORE was 28.6 (interquartile range: 14.6-43.4). Median baseline left ventricular ejection fraction (LVEF) was 50%. Procedural success rate was …

An Uncommon Presentation For Cardiac Melanoma, Burcu Gul, Michael N. Young, David A. Slosky, Mark A. Lawson, Jeffrey N. Rottman

Journal of Patient-Centered Research and Reviews

A 66-year-old man with locally advanced malignant melanoma, which was surgically resected, presented with a 3-week history of dizziness, recurrent near-syncopal episodes and generalized weakness. He was found to have sustained polymorphic ventricular tachycardia in the setting of cardiac melanoma. We draw attention to an unusual presentation of malignant melanoma with cardiac metastasis and discuss both its etiology and treatment options.

An Overview Of Cancer Rehabilitation And Exercise In The Literature: Promoting Increased Referrals To Improve Oncology Outcomes, Leslie J. Waltke

Journal of Patient-Centered Research and Reviews

Medical management for malignant neoplastic diseases includes surgery, chemotherapy, radiation, and hormonal and biological therapies. Each of these antineoplastic interventions has unique impacts on physiological, musculoskeletal and functional performance. Cancer rehabilitation is the area of physical medicine responsible for addressing impairments associated with cancer treatment and survivorship, advanced disease and end of life. Although it is expected that more than one-half of persons being treated for cancer will suffer moderate pain and physical and functional decline, and that most will describe fatigue, referrals to rehabilitation are traditionally low. Evidence suggests that referrals to rehabilitation before, during and after treatment for …

Proceedings Of 2014 Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

N/A

In Adult Smokers Unwilling Or Unable To Quit, Does Changing From Tobacco Cigarettes To Electronic Cigarettes Decrease The Incidence Of Negative Health Effects Associated With Smoking Tobacco? A Clin-Iq, Jennifer Brown, Brandon Brown, Peter Schwiebert, Kalyanakrishnan Ramakrisnan, Laine H. Mccarthy

Journal of Patient-Centered Research and Reviews

Data from a randomized controlled trial and systematic review support the claim that switching from tobacco cigarettes to electronic cigarettes (e-cigarettes) can reduce the short-term negative health effects of smoking. In adult smokers unwilling or unable to quit, exhaled carbon monoxide levels, total number of cigarettes smoked, and exposure to nitrosamine chemicals were reduced within a 12-month period. While the e-cigarette industry remains largely unregulated thus far, these studies provide encouraging hope in the uphill battle toward helping patients make informed and healthy choices.

From Breast Cancer To Bedbugs -- Really?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

No abstract provided.

Jpcrr Author Instructions

Journal of Patient-Centered Research and Reviews

No abstract provided.

Predictors Of Hospitalization Among Newly Admitted Skilled Nursing Facility Residents: Rethinking The Role Of Functional Decline, Sun J. Kim, Joo H. Lee, Shunichi Nakagawa, Elizabeth Bukowy, Ankoor Biswas, Boram Han, Yeilim Cho, Hyun Phil Shin, Ji Won Yoo

Journal of Patient-Centered Research and Reviews

Purpose: Hospital transfer from a skilled nursing facility (SNF) is costly, and many are potentially preventable. This study examines: 1) whether functional decline is a predictor of hospital transfer, and 2) the magnitude of relationships between predictors (functional impairment and chronic medical illness) and hospital transfer from SNFs.

Methods: We used Minimum Data Set (MDS) Version 2.0 in the state of Michigan between 2007 and 2009. In total, 196,662 new SNF admissions were observed. Multilevel generalized estimating equations and regression models were performed for each functional and clinical domain while adjusting for demographic variables and change in activities of daily …

Application Of The Breastfeeding Personal Efficacy Beliefs Inventory And Acknowledgment Of Barriers For Improving Breastfeeding Initiation Rates In An Urban Population, Diwata Bose, Callie Cox Bauer, Kiley A. Bernhard, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Introduction: Breastfeeding (BF) is recognized as the preferred method of infant nutrition by American Academy of Pediatricians, American College of Obstetricians and Gynecologists, and the World Health Organization. Despite the benefits of BF, in 1998 only 69% of new mothers in the United States initiated BF and 29% continued to breastfeed at 6 months.

Objective: To assess perceived breastfeeding confidence (BFC) and determine barriers in regards to BF in an urban population.

Methods: The Breastfeeding Personal Efficacy Beliefs Inventory (BPEBI) was used to determine perceived BFC. The survey was distributed to 271 women during prenatal appointments at an urban Milwaukee …

Circulating Tumor Cells In Metastatic Breast Cancer: A Prognostic And Predictive Marker, Sayyed Farshid Moussavi-Harami, Kari B. Wisinski, David J. Beebe

Journal of Patient-Centered Research and Reviews

The role of circulating tumor cells (CTCs) as a marker for disease progression in metastatic cancer is controversial. The current review will serve to summarize the evidence on CTCs as a marker of disease progression in patients with metastatic breast cancer. The immunohistochemistry (IHC)-based CellSearch^® is the only FDA-approved isolation technique for quantifying CTCs in patients with metastatic breast cancer. We searched PubMed and Web of Knowledge for clinical studies that assessed the prognostic and predictive value of CTCs using IHC-based isolation.

The patient outcomes reported include median and Cox-proportional hazard ratios for overall survival (OS) and progression-free survival …

Bedbugs Biting Back? A Multifactorial Consideration Of Bedbug Resurgence, Vanessa L. Abejuela-Matt

Journal of Patient-Centered Research and Reviews

Bedbugs, previously thought to be eradicated during the mid-20th century, have reemerged in the new millennium with unforeseen furor. Affected patients and families frequently present in primary care settings, not only with complaints of pruritus or rash, but with anxiety and shame regarding the condition. Changes in eradication techniques and resistance, as well as lack of reporting – from both patients and lodging institutions – have hindered control. The increased mobility of goods and the human population has provided further avenues for bedbug spread. While current literature thoroughly describes the clinical presentation of bedbugs and the increasingly problematic effects on …

The Molecular Biology And Treatment Of Malignant Melanoma With Brafv600 Mutations, Michael P. Mullane

Journal of Patient-Centered Research and Reviews

Since 2011, the treatment options for metastatic malignant melanoma have significantly changed. In that year, ipilimumab, an anti-CTLA4 monoclonal antibody, and vemurafenib, a potent inhibitor of mutated-BRAF (V600E and V600K), were approved by the U.S. Food and Drug Administration (FDA). In 2013, dabrafenib, another inhibitor of mutated-BRAF, and trametinib, a MEK inhibitor, were approved by the FDA. Most recently, combination therapy with dabrafenib and trametinib was approved. This article will describe a patient with metastatic malignant melanoma with BRAF^V600E who has responded very well to vemurafenib monotherapy. We will then explore the molecular basis, pharmacologic development and clinical outcomes …

Sentinel Lymph Node Biopsy In Head And Neck Melanoma: A Review, Martin Corsten, Stephanie Johnson-Obaseki

Journal of Patient-Centered Research and Reviews

The incidence of melanoma in the United States continues to rise. Head and neck melanomas comprise approximately 20% of all primary cutaneous melanomas. Sentinel lymph node (SLN) biopsy (SLNB) has become the standard of care for staging in melanoma. It has a number of advantages, including the addition of prognostic information, accurate staging, and the potential to add completion lymph node dissection (CLND) or adjuvant therapy when indicated. Furthermore, it may allow for the identification of patients who would benefit from inclusion in clinical trials; this advantage may be amplified based on the introduction of novel targeted therapies.

SLNB does …

Proceedings Of 2013 Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

No abstract provided.

Why Patient-Centered?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

No abstract provided.

Melanoma: Attacking On Many Fronts, Michael A. Thompson

Journal of Patient-Centered Research and Reviews

No abstract provided.

Welcome To The Journal Of Patient-Centered Research And Reviews, Nick Turkal, Randall S. Lambrecht

Journal of Patient-Centered Research and Reviews

No abstract provided.

A Rendezvous With An Unexpected Diagnosis, Helen C. Williams, Alexandria Rogers

Journal of Patient-Centered Research and Reviews

A personal account of skin cancer explores a caregiver’s emotional encounter with malignant melanoma, following her podiatrist’s initial diagnosis when she presented for an ingrown toenail.

Targeted Therapy For Cutaneous Melanoma: Beyond Braf..., Michael A. Davies

Journal of Patient-Centered Research and Reviews

The development and regulatory approval of vemurafenib and dabrafenib for metastatic melanoma patients with activating BRAF mutations has demonstrated that personalized targeted therapy strategies can provide significant clinical benefit in this highly aggressive disease. However, these agents are not beneficial in patients who do not have activating BRAF mutations, representing over half of all melanoma patients. Recent studies have demonstrated that melanomas have the highest rate of somatic mutations among the major cancers. Based on this information, additional personalized treatment strategies are now in various stages of clinical development and testing. These efforts are being guided by the lessons learned …

Primary Care For Melanoma: Should We Be Screaming For Screening?, Dennis J. Baumgardner, Alexandria Rogers

Journal of Patient-Centered Research and Reviews

The incidence of cutaneous malignant melanoma continues to rise in the United States. This deadly disease is potentially curable if caught at an early stage, however screening programs remain controversial. The United States Preventive Services Task Force cites insufficient evidence to recommend screening, by total-body skin examination (TBSE), for early detection of cutaneous melanoma. While definitive studies may be cost-prohibitive in the United States, more recent evidence suggests that organized programs to increase TBSE reduce mortality from melanoma. The positive impact of TBSE, and education regarding risk reduction and skin self-examination, is most likely to be cost-effective in high-risk patients …