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Full-Text Articles in Medicine and Health Sciences

A Retrospective Review Of The Safety And Efficacy Of Direct Oral Anticoagulants (Doacs) In Obese Patients Who Underwent Electrical Cardioversion, Matt Cox, Brian Carlone, Jaclynne Gowen, Amber Rollins, Wes Zemrak Apr 2020

A Retrospective Review Of The Safety And Efficacy Of Direct Oral Anticoagulants (Doacs) In Obese Patients Who Underwent Electrical Cardioversion, Matt Cox, Brian Carlone, Jaclynne Gowen, Amber Rollins, Wes Zemrak

Costas T. Lambrew Research Retreat 2020

Purpose: Abnormal atrial rhythms, including atrial fibrillation (AF) and atrial flutter, are the most common cardiac arrhythmias. Patients often undergo direct current cardioversion (DCCV) to restore normal sinus rhythm (NSR). Previous studies demonstrate that anticoagulation during DCCV decreases the risk of stroke from 6.8% to 1%. Additionally, obese patients are at a heightened risk of developing atrial arrhythmias, and previous pharmacokinetic studies suggest that recommended doses of DOACs may not provide therapeutic anticoagulation in these patients. Landmark trials investigating the use of DOACs during DCCV included a small percentage of patients with a body mass index (BMI) > 40 kg ...


A Pilot Study On The Feasibility Of A Smartphone Application For Identifying Living Donors For Kidney Transplant Waitlisted Candidates, Shelby Mcdonnell, Theresa Boulos, Juan Palma, Ana Rossi Apr 2020

A Pilot Study On The Feasibility Of A Smartphone Application For Identifying Living Donors For Kidney Transplant Waitlisted Candidates, Shelby Mcdonnell, Theresa Boulos, Juan Palma, Ana Rossi

Costas T. Lambrew Research Retreat 2020

Purpose: To assess the feasibility of using a smartphone application for potential living donor outreach in patients waitlisted for a kidney transplant in Maine.

Background: More than 100,000 individuals are awaiting organ transplant in the US. For patients needing a kidney transplant, living donation is a way to help meet this need. Barriers to identifying a potential donor include lack of education and hesitance to initiate a conversation about live donation. Social media has been used to assist candidates in finding living donors for over twenty years and can provide a free platform for outreach that can reduce disparities ...


Testosterone (T) And Estradiol (E2) Therapy Alone Can Suppress Gonadal Function In Transgender Patients., India I. Pappas, Wendy Y. Craig, Lindsey V. Spratt, Daniel I. Spratt Apr 2020

Testosterone (T) And Estradiol (E2) Therapy Alone Can Suppress Gonadal Function In Transgender Patients., India I. Pappas, Wendy Y. Craig, Lindsey V. Spratt, Daniel I. Spratt

Costas T. Lambrew Research Retreat 2020

Suppression of endogenous gonadal function is an important goal of transgender hormone therapy in both female-to-male (FTM) and male-to-female (MTF) patients. Current recommendations include exogenous hormone therapy in the form of testosterone (T) for FTM or estradiol (E2) for MTF, in addition to a GnRH agonist or progestin to effectively suppress endogenous gonadal activity. It has been claimed, however, that routine use of a GnRH agonist is not justified in terms of a cost-benefit analysis and there is no clear evidence that progestins add to the feminization of MTF patients. To determine how often T or E2 therapy alone is ...


Does Your Patient Know If They Have Prediabetes?, Sophia Adams, Christina Holt, Amy Haskins Apr 2020

Does Your Patient Know If They Have Prediabetes?, Sophia Adams, Christina Holt, Amy Haskins

Costas T. Lambrew Research Retreat 2020

BACKGROUND: Prediabetes is common; 1 in 3 people have prediabetes, but 9 out of 10 people with prediabetes do not know that they have it. Among those with prediabetes, 25% will progress to diabetes in 3-5 years. MaineHealth has now implemented Diabetes Prevention Program classes, based on a major multicenter clinical research study that showed structured lifestyle interventions can cut the risk of developing type 2 diabetes in half for pre-diabetic participants. This program is available to all patients, free of charge, but in order for patients to participate, they first need to know if they have prediabetes and be ...


Meditative And Mind-Body Practice Among Patients With Genitourinary Malignancy, William Daly, Paul Han, Stephen Ryan, Moritz Hansen, Joshua Linscott, Quoc-Dien Trinh, Jesse Sammon Apr 2020

Meditative And Mind-Body Practice Among Patients With Genitourinary Malignancy, William Daly, Paul Han, Stephen Ryan, Moritz Hansen, Joshua Linscott, Quoc-Dien Trinh, Jesse Sammon

Costas T. Lambrew Research Retreat 2020

Patients with genitourinary (GU) malignancies like prostate, kidney, and bladder cancer are exposed to many psychosocial stressors associated with cancer diagnosis, treatment and survivorship. The prevalence of anxiety and depression amongst kidney and bladder cancer patients is on par with, and in some studies exceeds, that seen in breast cancer patients. While prostate cancer patients tend to exhibit lower levels of stress when compared to other malignancies, subsets of those patients, especially those with preexisting tendencies towards anxiety, are at higher risk for psychological morbidity than the general population.

Two tools proposed to help patients manage disease specific stressors are ...


A Retrospective Study Of Acute Post-Operative Pain Following Cesarean Section In Patients On Opioid Agonist Pharmacotherapy, Johanna Cobb, Elizabeth Snow, Heather Turcotte, Aurora Quaye, Wendy Craig, Robert Warters Apr 2020

A Retrospective Study Of Acute Post-Operative Pain Following Cesarean Section In Patients On Opioid Agonist Pharmacotherapy, Johanna Cobb, Elizabeth Snow, Heather Turcotte, Aurora Quaye, Wendy Craig, Robert Warters

Costas T. Lambrew Research Retreat 2020

Background: Opioid agonist pharmacotherapy, most commonly methadone or buprenorphine, is strongly recommended for patients with opioid use disorder during pregnancy and peripartum to reduce the risk of relapse and obstetric complications. Patients on opioid agonist pharmacotherapy can have difficulty achieving adequate pain relief following cesarean section and often require higher doses of opioids; however small retrospective studies have been conflicting.

Methods: We generated a comprehensive dataset of all patients who underwent cesarean section at our institution between January 2016 and December 2018. We compared 24 hour postoperative opioid consumption for patients receiving methadone or buprenorphine at the time of surgery ...


Feasibility And Safety Of Uninterrupted And Nearly Uninterrupted Doac Use In Patients Undergoing Radiofrequency Ablation For Atrial Fibrillation In A Tertiary Community Medical Center, William Adam Janes, Wendy Craig, Kyle Cunningham, Jill Knutson, Amanda Haskell, Henry Sesselberg Apr 2020

Feasibility And Safety Of Uninterrupted And Nearly Uninterrupted Doac Use In Patients Undergoing Radiofrequency Ablation For Atrial Fibrillation In A Tertiary Community Medical Center, William Adam Janes, Wendy Craig, Kyle Cunningham, Jill Knutson, Amanda Haskell, Henry Sesselberg

Costas T. Lambrew Research Retreat 2020

Background: Atrial fibrillation (AF) ablation in the setting of uninterrupted anticoagulation (AC) has been studied by large university based medical centers in randomized controlled trials. This strategy has not been looked at in a clinical based Electrophysiology (EP) program at a tertiary hospital.

Methods: Patients aged 18 years or older who presented to Maine Medical Center and captured in the American Heart Association (AHA) Get With The Guidelines: Afib database between 1/1/2015 and 6/1/2019 were eligible. Inclusion criteria were any patient with a left side AF procedure (Pulmonary vein isolation [PVI] or other lesions). Patients were ...


Documentation Of Obesity On The Problem List And Referral Rates Among Obese Children And Adults, Heidi Walls, Christina Holt, Amy Haskins, William Dexter Apr 2020

Documentation Of Obesity On The Problem List And Referral Rates Among Obese Children And Adults, Heidi Walls, Christina Holt, Amy Haskins, William Dexter

Costas T. Lambrew Research Retreat 2020

Purpose/Background: Obesity is a serious public health concern that is overwhelming primary care doctors. The 15 minute office visit model leaves little time for counseling in regards to nutrition and physical activity, and many providers may not have enough expertise in nutrition and exercise to confidently counsel their patients. Despite the time constraints placed on primary care doctors, there are things that can be done. Studies have shown that simply documenting obesity on the problem list promotes action about obesity. The purpose of this study was to determine the rate of obesity documentation on the problem list and referrals ...


Evaluation Of A Resident-Driven Trauma-Sensitive Yoga Program For Female Immigrant Primary Care Patients, Katherine Rizzolo, Maha Jaber, Jessica Schaumburg, Kiana Vakil-Gilani, Nicole Rebusi Apr 2020

Evaluation Of A Resident-Driven Trauma-Sensitive Yoga Program For Female Immigrant Primary Care Patients, Katherine Rizzolo, Maha Jaber, Jessica Schaumburg, Kiana Vakil-Gilani, Nicole Rebusi

Costas T. Lambrew Research Retreat 2020

Purpose/ Background Maine Medical Center’s immigrant population has a high need for mental health care and resources. Our program is a referral-based community trauma-informed yoga class for immigrant women. We sought to eliminate common barriers such as cost, childcare, and transportation, as well as providing group-based wellness options that differ from the traditional referral-based model to limit social isolation and build community.

Methods The yoga program is a weekly trauma-sensitive yoga program at the YMCA taught by Sea Change Yoga. Cost is free with transportation included. Women are self- referred from the primary care clinics. Criteria for referral include ...


Bmi And Post-Operative Quality Of Life Outcomes In Women Receiving Tension-Free Vaginal Tape (Tvt) Slings For Isolated Stress Urinary Incontinence, Margaret Wilkes, Mary Brandes, Caroline Foust-Wright Apr 2020

Bmi And Post-Operative Quality Of Life Outcomes In Women Receiving Tension-Free Vaginal Tape (Tvt) Slings For Isolated Stress Urinary Incontinence, Margaret Wilkes, Mary Brandes, Caroline Foust-Wright

Costas T. Lambrew Research Retreat 2020

Objective: Stress urinary incontinence (SUI) is a prevalent subtype of urinary incontinence among women, reported by as many as 44-57% of middle-aged and postmenopausal women. Obesity is a known risk factor for SUI; however, literature investigating the impact of mid-urethral sling placement on quality of life (QoL) among women of varying BMI is limited and inconsistent. Validated questionnaires, including the abbreviated Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7) are widely used in practice and research to assess symptoms, with high scores in both questionnaires indicating a greater symptom burden. This study analyzes pre- and post-operative QoL scores stratified ...


Sleep And Gastrointestinal Problems In Hospitalized Children With Autism Spectrum Disorder (Asd), Briana J. Taylor, Kahsi Pedersen, Matthew Siegel, Autism And Developmental Disorders Inpatient Research Collaborative Apr 2020

Sleep And Gastrointestinal Problems In Hospitalized Children With Autism Spectrum Disorder (Asd), Briana J. Taylor, Kahsi Pedersen, Matthew Siegel, Autism And Developmental Disorders Inpatient Research Collaborative

Costas T. Lambrew Research Retreat 2020

Background: Sleep and gastrointestinal (GI) problems are prevalent medical comorbidities in children with autism spectrum disorder (ASD). Sleep and GI problems are correlated with one another in both ASD and non-ASD children; however, mechanisms underlying this association are unclear. Anxiety is also highly prevalent in ASD and has been identified as a potential mediator of the sleep-GI association in non-ASD individuals. The role of anxiety in the sleep-GI association in ASD is unclear.

Objectives: To determine if anxiety symptoms statistically mediate associations between sleep problems and GI problems in a sample of psychiatrically hospitalized children with ASD.

Methods: Data from ...


Current Practice Of Trauma Informed Care In Pregnancy Among Obstetric Providers, Morgan R. Abbey, Rebecca Hunt Apr 2020

Current Practice Of Trauma Informed Care In Pregnancy Among Obstetric Providers, Morgan R. Abbey, Rebecca Hunt

Costas T. Lambrew Research Retreat 2020

Purpose: In women with a history of trauma routine events of pregnancy, labor, and delivery can be re-traumatizing. This study will explore how obstetric providers screening for and manage a history of trauma in patients during pregnancy.

Background: A traumatic event can be directly experienced or indirectly. Post traumatic stress disorder (PTSD) is characterized by exposure to a traumatic event and symptoms of re-experiencing, avoidance behavior, negative mood/cognition, alterations in arousal, and dissociation relating to the trauma. Trauma-informed care recognizes the prevalence of trauma, and acknowledges the role trauma may have played in an individual’s life. Trauma and ...


“I Only Want To See The Doctor” Comparison Of Patient Satisfaction Between Urology Physicians And Advanced Practice Providers, Erin Santos, Kelly Ernst, Lisa Beaule, Moritz Hansen, Matthew Hayn, Jesse D. Sammon Apr 2020

“I Only Want To See The Doctor” Comparison Of Patient Satisfaction Between Urology Physicians And Advanced Practice Providers, Erin Santos, Kelly Ernst, Lisa Beaule, Moritz Hansen, Matthew Hayn, Jesse D. Sammon

Costas T. Lambrew Research Retreat 2020

Introduction There is a projected national shortage of urologists in the coming decade. The American Urological Association supports the incorporation of advanced practice providers (APPs) into urologic practices. However, there has been limited research addressing the effect of increased utilization of APPs in the urologic setting and available research about patient satisfaction with APPs is mostly limited to primary care and non-surgical specialties. We are seeking to understand patient satisfaction with APPs in a urologic setting. The subspecialty nature of urologic practice leads us to believe that there may be measurable and meaningful differences in patient satisfaction.

Materials & Methods We ...


Empathy In Individuals Who Experience Psychosis: An Empathetic Perspective, Kristen Woodberry, Katherine Elacqua Apr 2020

Empathy In Individuals Who Experience Psychosis: An Empathetic Perspective, Kristen Woodberry, Katherine Elacqua

Costas T. Lambrew Research Retreat 2020

Purpose/Background: There is a large amount of literature exploring how individuals with psychotic spectrum symptoms or disorders experience empathy. The findings are often presented through a deficit-oriented frame, suggesting that these individuals are impaired in their ability to experience empathy. Unfortunately, claims of empathy deficits have the potential to contribute to the already high stigma faced by this population. This review, therefore, aims to contextualize the deficit-oriented discussion based on the following three questions: how is empathy defined, what methods are being used to understand it, and to what degree does the discussion around empathy in psychosis accurately reflect ...


Evaluation Of Serial Biomarkers In Intermediate Risk Acute Pulmonary Embolism Patients, Hilamber Subba, Ariel Mckenna, Joel Wirth Apr 2020

Evaluation Of Serial Biomarkers In Intermediate Risk Acute Pulmonary Embolism Patients, Hilamber Subba, Ariel Mckenna, Joel Wirth

Costas T. Lambrew Research Retreat 2020

Purpose/Background Pulmonary embolism (PE) is a major cause of morbidity and mortality. The rate of hospitalization for PE has doubled in the past decade, and it is now the third most common cause of cardiovascular disease after MI and stroke. Early, accurate risk stratification can guide appropriate management and has the potential to improve clinical outcomes. Patients with PE are stratified as being low, intermediate, or high risk for early mortality based on the European classification system which takes into account clinical, imaging, and laboratory parameters. This strategy is recommended to reduce use of potentially harmful therapies, such as ...


Osteopathic Manipulative Medicine May Help Hospitalized Patients With Substance Use Disorder., Alisa Cleary, E. Katherine Nenninger, David Keller, Kinna Thakarar Apr 2020

Osteopathic Manipulative Medicine May Help Hospitalized Patients With Substance Use Disorder., Alisa Cleary, E. Katherine Nenninger, David Keller, Kinna Thakarar

Costas T. Lambrew Research Retreat 2020

OBJECTIVES: Inpatient hospitalization can often offer an opportunity to initiate treatment and preventive care that otherwise would be lost. At our hospital, which is a tertiary care teaching hospital in a region where injection drug use is rising, a multidisciplinary “IMAT” (integrated medication assisted treatment) team is available to facilitate substance use disorder treatment and services. In addition, consultation services for osteopathic manipulative medicine (OMM) are available. Osteopathic manipulative treatment (OMT) can play an important role in the overall healing and well-being of an individual. This non-invasive, hands on approach can improve patient comfort, promote recovery, and potentially reduce length ...


Effect Of 3d Lung Nodule Educational Tool On Patient Distress Following Ldct Incidental Finding Of Lung Nodule, Theresa Roelke, Ivette Emery Apr 2020

Effect Of 3d Lung Nodule Educational Tool On Patient Distress Following Ldct Incidental Finding Of Lung Nodule, Theresa Roelke, Ivette Emery

Costas T. Lambrew Research Retreat 2020

Summary: Annually, thousands of Americans learn they have pulmonary nodules found on low dose computed tomography (LDCT) within the context of lung cancer screening. These patients experience distress regarding these nodule findings, in part, due to a limited understanding of what a lung nodule is and misconceptions about the risk of cancer that they pose. This study is designed to explore the utility of a 3D printed nodule educational tool to support providers in educating patients during the lung screening shared-decision making (SDM)conversation about this commonly reported lung lesion.

Specific aims: The aim of this study is to assess ...


Evidence Based Estimation Of Energy And Protein Needs In Adults With Major Burn Injuries, Ashley Lazarz, Samantha Buttarazzi Waller Apr 2020

Evidence Based Estimation Of Energy And Protein Needs In Adults With Major Burn Injuries, Ashley Lazarz, Samantha Buttarazzi Waller

Costas T. Lambrew Research Retreat 2020

Background: It is estimated that more than 2 million people suffer burn injuries in the United States annually, resulting in approximately 3400 deaths. Burns cause pathological alterations in nearly every system of the body and changes in both metabolism and immunity in burned patients contribute to adverse outcomes. Hypermetabolism leads to severe catabolism and loss of lean body mass in the severely burned patient making nutrition intervention critical. Literature indicates that enteral nutrition alone does not prevent hypermetabolism after a major burn injury, but nutrition intervention can improve outcomes. Although nutrition supplementation is widely regarded as beneficial, controversy regarding a ...


Insights From Immuno-Oncology: The Society For Immunotherapy Of Cancer Statement On Access To Il-6-Targeting Therapies For Covid-19., Paolo Antonio Ascierto, Bernard Fox, Walter Urba, Ana Carrizosa Anderson, Michael B Atkins, Ernest C Borden, Julie Brahmer, Lisa H Butterfield, Alessandra Cesano, Daniel Chen, Tanja De Gruijl, Robert O Dillman, Charles G Drake, Leisha A Emens, Thomas F Gajewski, James L Gulley, F Stephen Hodi, Patrick Hwu, David Kaufman, Howard Kaufman, Michael Lotze, Douglas G Mcneel, Kim Margolin, Francesco Marincola, Michael J Mastrangelo, Marcela V Maus, David R Parkinson, Pedro J Romero, Paul M Sondel, Stefani Spranger, Mario Sznol, George J Weiner, Jon M Wiggington, Jeffrey S Weber Apr 2020

Insights From Immuno-Oncology: The Society For Immunotherapy Of Cancer Statement On Access To Il-6-Targeting Therapies For Covid-19., Paolo Antonio Ascierto, Bernard Fox, Walter Urba, Ana Carrizosa Anderson, Michael B Atkins, Ernest C Borden, Julie Brahmer, Lisa H Butterfield, Alessandra Cesano, Daniel Chen, Tanja De Gruijl, Robert O Dillman, Charles G Drake, Leisha A Emens, Thomas F Gajewski, James L Gulley, F Stephen Hodi, Patrick Hwu, David Kaufman, Howard Kaufman, Michael Lotze, Douglas G Mcneel, Kim Margolin, Francesco Marincola, Michael J Mastrangelo, Marcela V Maus, David R Parkinson, Pedro J Romero, Paul M Sondel, Stefani Spranger, Mario Sznol, George J Weiner, Jon M Wiggington, Jeffrey S Weber

Department of Microbiology and Immunology Faculty Papers

No abstract provided.


Simulation-Based Mastery Learning Compared To Standard Education For Discussing Diagnostic Uncertainty With Patients In The Emergency Department: A Randomized Controlled Trial., Danielle M. Mccarthy, Rhea E. Powell, Kenzie A. Cameron, David H. Salzman, Dimitrios Papanagnou, Amanda Doty, Benjamin E. Leiby, Katherine Piserchia, Matthew R. Klein, Xiao C. Zhang, William C. Mcgaghie, Kristin L. Rising Feb 2020

Simulation-Based Mastery Learning Compared To Standard Education For Discussing Diagnostic Uncertainty With Patients In The Emergency Department: A Randomized Controlled Trial., Danielle M. Mccarthy, Rhea E. Powell, Kenzie A. Cameron, David H. Salzman, Dimitrios Papanagnou, Amanda Doty, Benjamin E. Leiby, Katherine Piserchia, Matthew R. Klein, Xiao C. Zhang, William C. Mcgaghie, Kristin L. Rising

Department of Pharmacology and Experimental Therapeutics Faculty Papers

BACKGROUND: Diagnostic uncertainty occurs frequently in emergency medical care, with more than one-third of patients leaving the emergency department (ED) without a clear diagnosis. Despite this frequency, ED providers are not adequately trained on how to discuss diagnostic uncertainty with these patients, who often leave the ED confused and concerned. To address this training need, we developed the Uncertainty Communication Education Module (UCEM) to teach physicians how to discuss diagnostic uncertainty. The purpose of the study is to evaluate the effectiveness of the UCEM in improving physician communications.

METHODS: The trial is a multicenter, two-arm randomized controlled trial designed to ...


Immune Checkpoint Modulation Enhances Hiv-1 Antibody Induction., Todd Bradley, Masayuki Kuraoka, Chen-Hao Yeh, Ming Tian, Huan Chen, Derek W Cain, Xuejun Chen, Cheng Cheng, Ali H Ellebedy, Robert Parks, Maggie Barr, Laura L. Sutherland, Richard M. Scearce, Cindy M. Bowman, Hilary Bouton-Verville, Sampa Santra, Kevin Wiehe, Mark G. Lewis, Ane Ogbe, Persephone Borrow, David Montefiori, Mattia Bonsignori, M Anthony Moody, Laurent Verkoczy, Kevin O. Saunders, Rafi Ahmed, John R. Mascola, Garnett Kelsoe, Frederick W. Alt, Barton F. Haynes Feb 2020

Immune Checkpoint Modulation Enhances Hiv-1 Antibody Induction., Todd Bradley, Masayuki Kuraoka, Chen-Hao Yeh, Ming Tian, Huan Chen, Derek W Cain, Xuejun Chen, Cheng Cheng, Ali H Ellebedy, Robert Parks, Maggie Barr, Laura L. Sutherland, Richard M. Scearce, Cindy M. Bowman, Hilary Bouton-Verville, Sampa Santra, Kevin Wiehe, Mark G. Lewis, Ane Ogbe, Persephone Borrow, David Montefiori, Mattia Bonsignori, M Anthony Moody, Laurent Verkoczy, Kevin O. Saunders, Rafi Ahmed, John R. Mascola, Garnett Kelsoe, Frederick W. Alt, Barton F. Haynes

Manuscripts, Articles, Book Chapters and Other Papers

Eliciting protective titers of HIV-1 broadly neutralizing antibodies (bnAbs) is a goal of HIV-1 vaccine development, but current vaccine strategies have yet to induce bnAbs in humans. Many bnAbs isolated from HIV-1-infected individuals are encoded by immunoglobulin gene rearrangments with infrequent naive B cell precursors and with unusual genetic features that may be subject to host regulatory control. Here, we administer antibodies targeting immune cell regulatory receptors CTLA-4, PD-1 or OX40 along with HIV envelope (Env) vaccines to rhesus macaques and bnAb immunoglobulin knock-in (KI) mice expressing diverse precursors of CD4 binding site HIV-1 bnAbs. CTLA-4 blockade augments HIV-1 Env ...


Contemporary Nstemi Management: The Role Of The Hospitalist., Charles V Pollack, Alpesh Amin, Tracy Wang, Steven Deitelzweig, Marc Cohen, David Slattery, John Fanikos, Christopher Dilascia, Regan Tuder, Scott Kaatz Feb 2020

Contemporary Nstemi Management: The Role Of The Hospitalist., Charles V Pollack, Alpesh Amin, Tracy Wang, Steven Deitelzweig, Marc Cohen, David Slattery, John Fanikos, Christopher Dilascia, Regan Tuder, Scott Kaatz

Department of Emergency Medicine Faculty Papers

Non-ST-segment elevation myocardial infarction (NSTEMI) is defined as elevated cardiac biomarkers of necrosis in the absence of persistent ST-segment elevation in the setting of anginal symptoms or other acute event. It carries a poorer prognosis than most ST-segment elevation events, owing to the typical comorbidity burden of the older NSTEMI patients as well as diverse etiologies that add complexity to therapeutic decision-making. It may result from an acute atherothrombotic event ('Type 1') or as the result of other causes of mismatch of myocardial oxygen supply and demand ('Type 2'). Regardless of type and other clinical factors, the hospital medicine specialist ...


A Head-To-Head Comparison Of The Efficacy And Safety Of Ixekizumab And Adalimumab In Biological-Naïve Patients With Active Psoriatic Arthritis: 24-Week Results Of A Randomised, Open-Label, Blinded-Assessor Trial., Philip Mease, Josef S Smolen, Frank Behrens, Peter Nash, Soyi Liu Leage, Lingnan Li, Hasan Tahir, Melinda Gooderham, Eswar Krishnan, Hong Liu-Seifert, Paul Emery, Sreekumar G Pillai, Philip S Helliwell Jan 2020

A Head-To-Head Comparison Of The Efficacy And Safety Of Ixekizumab And Adalimumab In Biological-Naïve Patients With Active Psoriatic Arthritis: 24-Week Results Of A Randomised, Open-Label, Blinded-Assessor Trial., Philip Mease, Josef S Smolen, Frank Behrens, Peter Nash, Soyi Liu Leage, Lingnan Li, Hasan Tahir, Melinda Gooderham, Eswar Krishnan, Hong Liu-Seifert, Paul Emery, Sreekumar G Pillai, Philip S Helliwell

Articles, Abstracts, and Reports

OBJECTIVES: To compare efficacy and safety of ixekizumab (IXE) to adalimumab (ADA) in biological disease-modifying antirheumatic drug-naïve patients with both active psoriatic arthritis (PsA) and skin disease and inadequate response to conventional synthetic disease-modifying antirheumatic drug (csDMARDs).

METHODS: Patients with active PsA were randomised (1:1) to approved dosing of IXE or ADA in an open-label, head-to-head, blinded assessor clinical trial. The primary objective was to evaluate whether IXE was superior to ADA at week 24 for simultaneous achievement of a ≥50% improvement from baseline in the American College of Rheumatology criteria (ACR50) and a 100% improvement from baseline in ...


Unmet Need In Rheumatology: Reports From The Targeted Therapies Meeting 2019., Kevin L Winthrop, Michael E Weinblatt, Joan Bathon, Gerd R Burmester, Philip Mease, Leslie Crofford, Vivian Bykerk, Maxime Dougados, James Todd Rosenbaum, Xavier Mariette, Joachim Sieper, Fritz Melchers, Bruce N Cronstein, Ferry C Breedveld, Joachim Kalden, Josef S Smolen, Daniel Furst Jan 2020

Unmet Need In Rheumatology: Reports From The Targeted Therapies Meeting 2019., Kevin L Winthrop, Michael E Weinblatt, Joan Bathon, Gerd R Burmester, Philip Mease, Leslie Crofford, Vivian Bykerk, Maxime Dougados, James Todd Rosenbaum, Xavier Mariette, Joachim Sieper, Fritz Melchers, Bruce N Cronstein, Ferry C Breedveld, Joachim Kalden, Josef S Smolen, Daniel Furst

Articles, Abstracts, and Reports

OBJECTIVES: To detail the greatest areas of unmet scientific and clinical needs in rheumatology.

METHODS: The 21st annual international Advances in Targeted Therapies meeting brought together more than 100 leading basic scientists and clinical researchers in rheumatology, immunology, epidemiology, molecular biology and other specialties. During the meeting, breakout sessions were convened, consisting of 5 disease-specific groups with 20-30 experts assigned to each group based on expertise. Specific groups included: rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, systemic lupus erythematosus and other systemic autoimmune rheumatic diseases. In each group, experts were asked to identify unmet clinical and translational research needs in general ...


Case Study: Efficacy Of Physical Therapy On A Patient With Cva In Normalizing Gait And Shoulder Mechanics, Jane Mongkolvipakul, Amanda Orr, Queenie Lim, Rajbir Basati, Faris Alshammari Dec 2019

Case Study: Efficacy Of Physical Therapy On A Patient With Cva In Normalizing Gait And Shoulder Mechanics, Jane Mongkolvipakul, Amanda Orr, Queenie Lim, Rajbir Basati, Faris Alshammari

San Marcos, Fall 2019

Background & Purpose: Cerebrovascular Accident (CVA) is known as Stroke. It is a damage to the brain due to an interruption of blood supply. Two main types of stroke are ischemic stroke and hemorrhagic stroke. Ischemic stroke, the most common type of stroke, is due to a blocked artery and a hemorrhagic stroke is due to a leak or burst of a blood vessel. Signs and symptoms of stroke are presented contralaterally. The purpose of this case report is to demonstrate the use of PT interventions to improve shoulder function and gait mechanics in a post CVA patient.

Case Description: Patient ...


Memantine: Can It Be Used To Treat Children With Autism Spectrum Disorder?, Austin Brown, Katherine Liu, Pul Lee, Rachel Muhlenkamp, Manoranjan D'Souza Dec 2019

Memantine: Can It Be Used To Treat Children With Autism Spectrum Disorder?, Austin Brown, Katherine Liu, Pul Lee, Rachel Muhlenkamp, Manoranjan D'Souza

Pharmacy and Wellness Review

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social, behavior and communicative skills. The current therapy for ASD only targets the associated symptoms such as aggression, self-harming acts or temper tantrums but not the core symptoms of social dysfunction. The pathology of ASD is not fully understood. Interestingly, imaging studies in ASD patients have reported abnormal high levels of glutamate in certain brain regions that play an important role in social interaction and communication. Thus, it has been hypothesized that medications attenuating glutamate transmission may be used as treatment for some of the core symptoms of ...


Outbreak Of Ebola Virus Disease, Alexandra Dimit, Tiffany Kneuss, Joelle Farano, Haley Armstrong, Jodi Otte, Andrew M. Roecker Dec 2019

Outbreak Of Ebola Virus Disease, Alexandra Dimit, Tiffany Kneuss, Joelle Farano, Haley Armstrong, Jodi Otte, Andrew M. Roecker

Pharmacy and Wellness Review

Ebola virus disease (EVD) has existed as a major health concern with devastating and, many times, fatal symptoms. The recent outbreaks of EVD in West Africa and the Democratic Republic of the Congo (DRC) have incited international concern. In this article, the implications of EVD will be discussed including the etiology, transmission, signs and symptoms, diagnosis and treatment of the disease. In addition to this discussion, the manner in which major health care organizations, including the World Health Organization (WHO), are dealing with treating infected patients and containing spread of the disease will be covered.


Cannabinoids For The Treatment Of Chronic Headaches, Kevin Krivanek, Lucy K. Wagala, Brian Heilbronner, Kimberly Loughlin, David Kinder Dec 2019

Cannabinoids For The Treatment Of Chronic Headaches, Kevin Krivanek, Lucy K. Wagala, Brian Heilbronner, Kimberly Loughlin, David Kinder

Pharmacy and Wellness Review

Species of the Cannabis plant genus were among the earliest medicinal plants cultivated by man, with historical accounts of their medicinal uses dating back before the Common Era. Despite its current legal status, Cannabis has garnered nationwide attention as a therapeutic agent for various disease states, including chronic headaches, due to its medical indications as an antispastic, analgesic, antiemetic, neuroprotective and anti-inflammatory agent. Since headaches have a high prevalence in the American population and greatly impair simple daily aspects of living, chronic headaches have become a particular point of interest in regard to the therapeutic potential of Cannabis. Clinical trials ...


Marijuana And Its Cardiovascular Implications, Albert Bui, Daniel Powell, Victoria Cho, Kelsey Lindsley, Lindsey Peters Dec 2019

Marijuana And Its Cardiovascular Implications, Albert Bui, Daniel Powell, Victoria Cho, Kelsey Lindsley, Lindsey Peters

Pharmacy and Wellness Review

As marijuana becomes legalized for medical use, it is important for prescribers and pharmacists to be knowledgeable about the important aspects of marijuana such as mechanism of action, indications and abuse potential. Although marijuana's medicinal benefits are frequently reported, the risks, namely cardiovascular risks, associated with its utilization are often overlooked. Use of marijuana has been reported to increase the risk of myocardial infarction, tachycardia and hypotension, among others. Health care providers must determine if marijuana's benefits outweigh such risks when marijuana therapy is an option. It is also important for pharmacists to understand how to successfully counsel ...


Fda Approves New Inhaled Insulin: Afrezza® (Technosphere® Insulin), Benjamin Finley, Christina Ciccone, Kimberly Loughlin, Michelle Musser Dec 2019

Fda Approves New Inhaled Insulin: Afrezza® (Technosphere® Insulin), Benjamin Finley, Christina Ciccone, Kimberly Loughlin, Michelle Musser

Pharmacy and Wellness Review

Diabetes is an endocrine disease caused by deficiency or malfunction of insulin that results in high blood glucose levels and places patients at higher risk for a number of complications. This chronic disease is difficult to manage and affects millions of people in the United States, costing the health care system billions of dollars a year. Of a variety of antidiabetic agents used to control blood glucose, insulin is perhaps the most effective, but until recently it was only available in injectable form. As of June 27, 2014, a new inhaled insulin called Afrezza® (Technosphere® insulin) was approved by the ...