Medicine and Health Sciences Commons^™

Effects Of A Community Population Health Initiative On Blood Pressure Control In Latinos., James R Langabeer, Timothy D Henry, Carlos Perez Aldana, Larissa Deluna, Nora Silva, Tiffany Champagne-Langabeer

Journal Articles

Background Hypertension remains one of the most important, modifiable cardiovascular risk factors. Yet, the largest minority ethnic group (Hispanics/Latinos) often have different health outcomes and behavior, making hypertension management more difficult. We explored the effects of an American Heart Association-sponsored population health intervention aimed at modifying behavior of Latinos living in Texas. Methods and Results We enrolled 8071 patients, and 5714 (65.7%) completed the 90-day program (58.5 years ±11.7; 59% female) from July 2016 to June 2018. Navigators identified patients with risk factors; initial and final blood pressure ( BP ) readings were performed in the physician's office; and interim …

Exome Sequencing Identifies Gene Variants And Networks Associated With Extreme Respiratory Outcomes Following Preterm Birth, Aaron Hamvas, Rui Feng, Yingtao Bi, Fan Wang, Soumyaroop Bhattacharya, Jared Mereness, Madhurima Kaushal, C Michael Cotten, Philip L Ballard, Thomas J Mariani

Journal Articles

BACKGROUND: Previous studies have identified genetic variants associated with bronchopulmonary dysplasia (BPD) in extremely preterm infants. However, findings with genome-wide significance have been rare, and not replicated. We hypothesized that whole exome sequencing (WES) of premature subjects with extremely divergent phenotypic outcomes could facilitate the identification of genetic variants or gene networks contributing disease risk.

RESULTS: The Prematurity and Respiratory Outcomes Program (PROP) recruited a cohort of > 765 extremely preterm infants for the identification of markers of respiratory morbidity. We completed WES on 146 PROP subjects (85 affected, 61 unaffected) representing extreme phenotypes of early respiratory morbidity. We tested for …

Effect Of Aspirin On Disability-Free Survival In The Healthy Elderly, John J Mcneil, Robyn L Woods, Mark R Nelson, Christopher M Reid, Brenda Kirpach, Rory Wolfe, Elsdon Storey, Raj C Shah, Jessica E Lockery, Andrew M Tonkin, Anne B Newman, Jeff D Williamson, Karen L Margolis, Michael E Ernst, Walter P Abhayaratna, Nigel Stocks, Sharyn M Fitzgerald, Suzanne G Orchard, Ruth E Trevaks, Lawrence J Beilin, Geoffrey A Donnan, Peter Gibbs, Colin I Johnston, Joanne Ryan, Barbara Radziszewska, Richard Grimm, Anne M Murray

Journal Articles

BACKGROUND: Information on the use of aspirin to increase healthy independent life span in older persons is limited. Whether 5 years of daily low-dose aspirin therapy would extend disability-free life in healthy seniors is unclear.

METHODS: From 2010 through 2014, we enrolled community-dwelling persons in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics in the United States) and did not have cardiovascular disease, dementia, or physical disability. Participants were randomly assigned to receive 100 mg per day of enteric-coated aspirin or placebo orally. The primary end …

Effect Of Aspirin On All-Cause Mortality In The Healthy Elderly, John J Mcneil, Mark R Nelson, Robyn L Woods, Jessica E Lockery, Rory Wolfe, Christopher M Reid, Brenda Kirpach, Raj C Shah, Diane G Ives, Elsdon Storey, Joanne Ryan, Andrew M Tonkin, Anne B Newman, Jeff D Williamson, Karen L Margolis, Michael E Ernst, Walter P Abhayaratna, Nigel Stocks, Sharyn M Fitzgerald, Suzanne G Orchard, Ruth E Trevaks, Lawrence J Beilin, Geoffrey A Donnan, Peter Gibbs, Colin I Johnston, Barbara Radziszewska, Richard Grimm, Anne M Murray

Journal Articles

BACKGROUND: In the primary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial, now published in the Journal, we report that the daily use of aspirin did not provide a benefit with regard to the primary end point of disability-free survival among older adults. A numerically higher rate of the secondary end point of death from any cause was observed with aspirin than with placebo.

METHODS: From 2010 through 2014, we enrolled community-dwelling persons in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics …

Effect Of Aspirin On Cardiovascular Events And Bleeding In The Healthy Elderly, John J Mcneil, Rory Wolfe, Robyn L Woods, Andrew M Tonkin, Geoffrey A Donnan, Mark R Nelson, Christopher M Reid, Jessica E Lockery, Brenda Kirpach, Elsdon Storey, Raj C Shah, Jeff D Williamson, Karen L Margolis, Michael E Ernst, Walter P Abhayaratna, Nigel Stocks, Sharyn M Fitzgerald, Suzanne G Orchard, Ruth E Trevaks, Lawrence J Beilin, Colin I Johnston, Joanne Ryan, Barbara Radziszewska, Michael Jelinek, Mobin Malik, Charles B Eaton, Donna Brauer, Geoff Cloud, Erica M Wood, Suzanne E Mahady, Suzanne Satterfield, Richard Grimm, Anne M Murray

Journal Articles

BACKGROUND: Aspirin is a well-established therapy for the secondary prevention of cardiovascular events. However, its role in the primary prevention of cardiovascular disease is unclear, especially in older persons, who have an increased risk.

METHODS: From 2010 through 2014, we enrolled community-dwelling men and women in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics in the United States) and did not have cardiovascular disease, dementia, or disability. Participants were randomly assigned to receive 100 mg of enteric-coated aspirin or placebo. The primary end point was a …

Gsa Members' Experiences With A Structured Program To Promote Well-Being, Alicia A. Lapointe, Claire Crooks

Journal Articles

LGBT2Q+ youth experience significant oppression in schools and there are few evidence-informed programs to promote well-being. This study describes the experiences of youth who participated in a 17-session structured mental health promotion program through their GSAs. Focus groups were conducted with 15 youth. Results indicated that the program helped youth validate and affirm their identities and expressions. The program also afforded youth structured opportunities to identify and process minority stressors, and develop essential coping strategies to bolster their well-being and manage their toxic relationships.

Precision Oncology Decision Support: Current Approaches And Strategies For The Future, Katherine C Kurnit, Ecaterina E Ileana Dumbrava, Beate Litzenburger, Yekaterina B Khotskaya, Amber M Johnson, Timothy A Yap, Jordi Rodon, Jia Zeng, Md Abu Shufean, Ann M Bailey, Nora S Sánchez, Vijaykumar Holla, John Mendelsohn, Kenna Mills Shaw, Elmer V Bernstam, Gordon B Mills, Funda Meric-Bernstam

Journal Articles

With the increasing availability of genomics, routine analysis of advanced cancers is now feasible. Treatment selection is frequently guided by the molecular characteristics of a patient's tumor, and an increasing number of trials are genomically selected. Furthermore, multiple studies have demonstrated the benefit of therapies that are chosen based upon the molecular profile of a tumor. However, the rapid evolution of genomic testing platforms and emergence of new technologies make interpreting molecular testing reports more challenging. More sophisticated precision oncology decision support services are essential. This review outlines existing tools available for health care providers and precision oncology teams and …

Changes In Depression And Positive Mental Health Among Youth In A Healthy Relationships Program, Natalia Lapshina, Claire Crooks, Amanda Kerry

Journal Articles

Mental health promotion programming in schools and community settings is an important part of a comprehensive mental health strategy. The goal of this study was to identify and explore meaningful classes of youth based on their pre- and post-intervention depression symptoms scores with 722 youth involved in a 15-week healthy relationships and mental health promotion program. We utilized latent class growth analysis to identify depression class trajectories, controlling for group clustering effects. A three-class solution identified high decreasing, moderate stable, and low stable trajectories. Gender, age, and reported experience of bullying victimization predicted trajectory class membership. The low stable class …

A Feasibility Trial Of Mental Health First Aid First Nations: Acceptability, Cultural Adaptation, And Preliminary Outcomes, Claire Crooks, Andrea Lapp, Monique Auger, Kim Van Der Woerd, Angela Snowshoe, Billie Jo Rogers, Samantha Tsuruda, Cassidy Caron

Journal Articles

The Mental Health First Aid First Nations course was adapted from Mental Health First Aid Basic to create a community‐based, culturally safe and relevant approach to promoting mental health literacy in First Nations contexts. Over 2.5 days, the course aims to build community capacity by teaching individuals to recognize and respond to mental health crises. This feasibility trial utilized mixed methods to evaluate the acceptability, cultural adaptation, and preliminary effectiveness of MHFAFN. Our approach was grounded in community‐based participatory research principles, emphasizing relationship‐driven procedures to collecting data and choice for how participants shared their voices. Data included participant interviews ( …

Feasibility And Fit Of A Mental Health Promotion Program For Lgbtq+ Youth, Alicia A. Lapointe, Caely I. Dunlop, Claire Crooks

Journal Articles

This study evaluated the feasibility and fit of a mental health promotion and violence prevention program adapted for LGBTQ+ youth (ages 14-18). The pilot program included 16 30-minute sessions and was implemented in 8 gender and sexuality alliances (GSAs) and one community youth group setting. Extensive feedback was collected from 11 facilitators via session tracking sheets, ongoing email communication, an implementation survey, and a focus group; and from 7 youth who participated in a variety of feedback activities during a 2-day post-program workshop. Results indicated a strong interest in formalized programming, challenges related to its delivery in GSAs, and significant …

Biting The Hands That Feed “The Alligators”: A Case Study In Morbid Obesity Extremes, End-Of-Life Care, And Prohibitions On Harming And Accelerating The End Of Life, Michael J. Malinowski

Journal Articles

Obesity, recognized as a disease in the U.S. and at times as a terminal illness due to associated medical complications, is an American epidemic according to the Centers for Disease Control and Prevention (“CDC”), American Heart Association (“AHA”), and other authorities. More than one third of Americans (39.8% of adults and 18.5% of children) are medically obese. This article focuses on cases of “extreme morbid obesity” (“EMO”)—situations in which death is imminent without aggressive medical interventions, and bariatric surgery is the only treatment option with a realistic possibility of success. Bariatric surgeries themselves are very high risk for EMO patients. …

Activation Of Invariant Natural Killer T Cells Redirects The Inflammatory Response In Neonatal Sepsis, A. C. Bolognese, W. Yang, L. W. Hansen, A. Sharma, J. M. Nicastro, G. F. Coppa, P. Wang

Journal Articles

No abstract provided.

Neonatal Intestinal Dysbiosis In Necrotizing Enterocolitis, N. Denning, J. M. Prince

Journal Articles

No abstract provided.

Age And Other Risk Factors Influencing Long-Term Mortality In Patients With Traumatic Cervical Spine Fracture., M. Bank, K. Gibbs, C. Sison, N. Kutub, A. Paptheodorou, S. Lee, A. Stein, O. Bloom

Journal Articles

To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age.Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly who constitute an increasing percentage of the US population.We analyzed data collected for 10 years at a state-designated level I trauma center to identify variables that influenced in-hospital and long-term mortality among elderly patients with traumatic cervical spine fracture with or without SCI. Acute in-hospital mortality was determined from hospital records and long-term mortality within the study period (2003-2013) was determined from the …

Gastric Banding Surgery Versus Continuous Positive Airway Pressure For Obstructive Sleep Apnea: A Randomized Controlled Trial, J. P. Bakker, A. Tavakkoli, M. Rueschman, W. Wang, R. Andrews, A. Malhotra, R. L. Owens, A. Anand, K. A. Dudley, S. R. Patel

Journal Articles

No abstract provided.

Current Options For The Emergency Management Of Diverticular Disease And Options To Reduce The Need For Colostomy, D. Theodoropoulos

Journal Articles

No abstract provided.

B-1a Cells Protect Mice From Sepsis-Induced Acute Lung Injury, M. Aziz, Y. Ode, M. Zhou, M. Ochani, N. E. Holodick, T. L. Rothstein, P. Wang

Journal Articles

No abstract provided.

Merkel Cell Carcinoma Masquerading As Cellulitis: A Case Report And Review Of The Literature, F. Safa, M. Pant, C. Weerasinghe, R. Felix, T. Terjanian

Journal Articles

© 2018 Multimed Inc. Merkel cell carcinoma (MCC) is an uncommon malignancy of the skin arising from cells located in the deeper layers of the epidermis called Merkel cells. This malignancy rarely presents as a metastatic disease, and the field is therefore deficient in regards to management. We report the case of a 49-year-old woman who presented with a presumptive diagnosis of osteomyelitis of the left fifth digit that was resistant to treatment with antibiotics; she underwent debridement of the digit that revealed MCC and was later to have metastatic disease to her lungs, liver, and musculoskeletal system. The management …

Streptococcus Intermedius Brain And Diverticular Abscesses After Dental Manipulation: A Case Report., H. Al Moussawi, M. Krzyzak, Z. Awada, J. M. Chalhoub

Journal Articles

A brain abscess is defined as a focal intracerebral infection consisting of an encapsulated collection of pus, which can be a life-threatening complication of infections, trauma, or surgery. While immunocompromised patients can have a wide array of causative organisms, bacterial species represent the most common etiology in immunocompetent individuals. The incidence of brain abscesses ranges from 0.4 to 0.9 per 100,000, with a high predisposition among immunocompromised patients and in those with disruption of the blood-brain barrier. The most common causative organisms found were Streptococcus species, particularly S. viridians and S. pneumonia, Enterococcus, and Staphylococcus species, mainly S. aurieus and …

Delayed Pneumothorax: A Potential Complication Of Transbronchial Lung Biopsy, N. Narula, F. Siddiqui, A. H. Siddiqui, W. C. Man, M. Chalhoub

Journal Articles

© 2018 The purpose of this article is to report a case of secondary tension pneumothorax presenting seven weeks post Transbronchial Lung biopsy. A 62 year old male with a known history of germ cell tumor was found to have a left-sided pneumothorax which later complicated to a tension pneumothorax.To the best of our knowledge this is the second case being reported for a delayed pneumothorax post a Transbronchial Lung Biopsy.The purpose of this case report is to create awareness among physicians to consider this diagnosis even at a later stage and the importance of patient education regarding the signs …

Initial Experience With A Novel Resection And Plication (Rap) Method For Acid Reflux: A Pilot Study., P. C. Benias, L. D'Souza, G. Lan, C. Gluckman, S. Inamdar, A. J. Trindade, L. S. Miller, D. L. Carr-Locke

Journal Articles

Current endoscopic therapies for gastroesophageal reflux disorder (GERD) are limited by technical complexity, and/or cost. We sought to evaluate the success of a novel resection and plication (RAP) anti-reflux procedure. RAP was performed on 10 patients with GERD refractory to proton pump inhibitor (PPI) therapy. RAP consists of semi-circumferential mucosectomy along with full-thickness plication of the lower esophageal sphincter (LES) and cardia. We assessed the technical success and safety as well as followed GERD-Health Related Quality of Life (GERD-HRQL) scores and medication usage.All patients underwent RAP without adverse events and were discharged on the same day. Only half of the …

Adult Onset Immunoglobulin A Vasculitis (Henoch-Schonlein Purpura) With Alveolar Hemorrhage, N. Niknam, L. Ha, P. Gautam-Goyal

Journal Articles

© 2018 The Authors S. pyogenes is the cause of many important human diseases, ranging from mild superficial skin infections to life-threatening systemic diseases. The post streptococcal syndromes are immune mediated phenomena including Immunoglobulin A Vasculitis (Henoch-Schönlein purpura). HSP is more common in children and usually self limited but it can cause skin, joint, renal, gastrointestinal and rarely respiratory involvement. We present a case with Streptococcus pyogenes pneumonia that presented with respiratory failure, pulmonary hemorrhage, extensive rash and renal failure.

Same-Session Placement Of Multiple Lumen-Apposing Metal Stents To Provide Effective Drainage Of Extensive Walled-Off Pancreatic Necrosis, D. V. Sejpal, G. M. Grimaldi, P. C. Benias, A. J. Trindade, C. W. Lee

Journal Articles

No abstract provided.

Mutation Patterns Identify Adult Patients With De Novo Acute Myeloid Leukemia Aged 60 Years Or Older Who Respond Favorably To Standard Chemotherapy: An Analysis Of Alliance Studies, A. K. Eisfeld, J. Kohlschmidt, K. Mrózek, J. S. Blachly, C. J. Walker, D. Nicolet, S. Orwick, S. E. Maharry, J. E. Kolitz, C. D. Bloomfield, +6 Additional Authors

Journal Articles

© 2018 Macmillan Publishers Limited, part of Springer Nature. Thus far, only 5-15% of AML patients aged ≥60 years are cured with chemotherapy. Identification of patients who are less (more) likely to respond to standard chemotherapy might enable early risk stratification toward alternative treatment regimens. We used a next-generation sequencing panel of 80 cancer- and/or leukemia-associated genes to profile molecularly 423 older patients with de novo AML. Using variables identified in multivariable models and co-occurring mutations in NPM1-mutated AML, we classified the patients into good-, intermediate-, and poor-risk groups for complete remission (CR) attainment, disease-free (DFS), and overall survival (OS). …

Potentially Avoidable Readmissions In United States Hemodialysis Patients, A. T. Mathew, L. Rosen, R. Pekmezaris, A. Kozikowski, D. W. Ross, T. Mcginn, K. Kalantar-Zadeh, S. Fishbane

Journal Articles

© 2017 International Society of Nephrology Introduction: Patients with end-stage kidney disease have a high risk of 30-day readmission to hospital. These readmissions are financially costly to health care systems and are associated with poor health-related quality of life. The objective of this study was to describe and analyze the frequency, causes, and predictors of 30-day potentially avoidable readmission to hospital in patients on hemodialysis. Methods: We conducted a retrospective cohort study using the US Renal Data System data from January 1, 2008, to December 31, 2008. A total of 107,940 prevalent United States hemodialysis patients with 248,680 index hospital …

Nephropathology Education During Nephrology Fellowship Training In The United States, V. Mechery, T. Hernandez, A. T. Mathew, R. Wanchoo, S. V. Seshan, K. D. Jhaveri, H. H. Shah

Journal Articles

No abstract provided.

Oral Curcumin For Radiation Dermatitis: A Urcc Ncorp Study Of 686 Breast Cancer Patients, J. R. Wolf, C. E. Heckler, J. J. Guido, A. R. Peoples, J. S. Gewandter, M. Ling, V. P. Vinciguerra, T. Anderson, L. Evans, G. R. Morrow, +2 Additional Authors

Journal Articles

No abstract provided.

Effects Of Vedolizumab Therapy On Extraintestinal Manifestations In Inflammatory Bowel Disease, M. Fleisher, J. Marsal, S. D. Lee, L. E. Frado, A. Parian, B. I. Korelitz, B. G. Feagan

Journal Articles

No abstract provided.

Glecaprevir/Pibrentasvir In Patients With Hepatitis C Virus Genotype 1 Or 4 And Past Direct-Acting Antiviral Treatment Failure, F. Poordad, S. Pol, A. Asatryan, M. Buti, D. Shaw, C. Hezode, F. Felizarta, R. W. Reindollar, D. E. Bernstein, F. J. Mensa, +10 Additional Authors

Journal Articles

No abstract provided.

The Comb Sign In Crohn's Ileocolitis, N. Adlakha, A. Swaminath

Journal Articles

No abstract provided.