Translational Medical Research Commons^™

Detection Of Diabetic Foot Ulcers Using Svm Based Classification, Lei Wang, Peder Pedersen, Diane Strong, Bengisu Tulu, Emmanuel Agu, Qian He, Ronald Ignotz, Raymond Dunn, David Harlan, Sherry Pagoto

Emmanuel O. Agu

Diabetic foot ulcers represent a significant health issue, for both patients’ quality of life and healthcare system costs. Currently, wound care is mainly based on visual assessment of wound size, which suffers from lack of accuracy and consistency. Hence, a more quantitative and computer-based method is needed. Supervised machine learning based object recognition is an attractive option, using training sample images with boundaries labeled by experienced clinicians. We use forty sample images collected from the UMASS Wound Clinic by tracking 8 subjects over 6 months with a smartphone camera. To maintain a consistent imaging environment and facilitate the capture process …

Perceiving One's Heart Condition To Be Cured Following Hospitalization For Acute Coronary Syndromes: Implications For Patient-Provider Communication, Molly Waring, David Mcmanus, Stephenie Lemon, Joel Gore, Milena Anatchkova, Richard Mcmanus, Arlene Ash, Robert Goldberg, Catarina Kiefe, Jane Saczynski

Richard H. McManus

OBJECTIVE: We examined the proportion of patients perceiving their heart condition to be cured following hospitalization for ACS and identified characteristics associated with these perceptions.

METHODS: We conducted a prospective cohort study of adults hospitalized with ACS (N=396). Patient interviews during hospitalization and one week post-discharge provided demographic and psychosocial characteristics. Medical records provided clinical characteristics. At one week, patients who rated "My heart condition is cured" as "definitely true" or "mostly true" were considered to perceive their heart condition cured.

RESULTS: Participants were aged 60.7 (SD:11.0) years, 26.5% female, and 89.0% non-Hispanic white; 16.7% had unstable angina, 59.6% NSTEMI, …

Working Therapeutically With Deaf People Recovering From Trauma And Addiction, Melissa Anderson, Neil Glickman, Lisa Mistler, Marco Gonzalez

Melissa L. Anderson

OBJECTIVE: This article reviews what is known about behavioral health treatment of deaf persons with comorbid trauma and addiction.

METHOD: We discuss how to work therapeutically with deaf people with comorbid trauma and addiction, both through a review of the literature and through clinical observations of the authors. The article also includes the personal stories of two people-a Deaf peer specialist and a hearing psychiatrist-who share their humbling stories about the recovery process for deaf people and the challenges of learning to become an effective Deaf mental health care provider.

FINDINGS: Deaf people report higher rates of mental health problems …

Characteristics Of Contemporary Patients Discharged From The Hospital After An Acute Coronary Syndrome, Robert Goldberg, Jane Saczynski, David Mcmanus, Molly Waring, Richard Mcmanus, Jeroan Allison, David Parish, Darleen Lessard, Sharina Person, Joel Gore, Catarina Kiefe

Richard H. McManus

BACKGROUND: Limited contemporary data compare the clinical and psychosocial characteristics and acute management of patients hospitalized with an initial vs a recurrent episode of acute coronary disease. We describe these factors in a cohort of patients recruited from 6 hospitals in Massachusetts and Georgia after an acute coronary syndrome. MATERIALS AND METHODS: We performed structured baseline in-person interviews and medical record abstractions for 2174 eligible and consenting patients surviving hospitalization for an acute coronary syndrome between April 2011 and May 2013. RESULTS: The average patient age was 61 years, 64% were men, and 47% had a high school education or …

Severity Of Pre-Existing Cerebral Small Vessel Disease Is Associated With Outcome After Traumatic Brain Injury, Nils Heninger, Saef Izzy, Raphael Carandang, Wiley Hall, Susanne Muehlschlegel

Nils Henninger

Background and purpose: It is now well accepted that traumatic white matter injury constitutes a critical determinant of post-traumatic functional impairment. However, the contribution of pre-existing white matter rarefaction on outcome following traumatic brain injury (TBI) is unknown. Hence, we sought to determine whether the burden of pre-existing cerebral small vessel disease related white matter rarefaction (leukoaraiosis) is independently associated with outcome after TBI. Methods: We retrospectively analyzed consecutive, prospectively enrolled patients of ≥50 years (n=136) that were admitted to a single neurological-trauma intensive care unit. Supratentorial white matter hypoattenuation on head CT was graded on a 5-point scale (range …

Traumatic Brain Injury: Translation From Animal Models And Genetics To Improving Outcomes, Susanne Muehlschlegel, Nils Henninger, Raphael Carandang, Constance Moore

Nils Henninger

This presentation offers background information on traumatic brain injury (TBI), a public health problem which affects approximately 1.7 million Americans each year. The presentation is part of a mini-symposium highlighting the interdisciplinary and translational nature of TBI research at the University of Massachusetts Medical School.

In-Hospital Depression Predicts Early Hospital Readmission After An Acute Coronary Syndrome: Preliminary Data From Trace-Core, David Mcmanus, Jane Saczynski, Molly Waring, Milena Anatchkova, Richard Mcmanus, Robert Goldberg, Jeroan Allison, David Parish, Hamza Awad, Jerry Gurwitz, Arlene Ash, Catarina Kiefe

Richard H. McManus

Background: Hospital systems, patients and providers seek to avert rehospitalizations within 30 days for patients admitted with an acute coronary syndrome (ACS). Rehospitalizations within 30 days of discharge are often considered preventable and to reflect poor in-hospital management or discharge practices. However, independent associations of psychosocial factors with early rehospitalization in patients admitted with an ACS have not been examined. Methods: A multi-racial cohort of 1,540 patients admitted with an ACS reported psychosocial factors via standardized questionnaires in an in-hospital interview. One month following discharge, patients were interviewed via phone and reported hospital readmissions. We used logistic regression models to …

Long-Term Survival For Patients With Acute Decompensated Heart Failure According To Ejection Fraction Findings, Andrew Coles, Kimberly Fisher, Chad Darling, Jorge Yarzebski, David Mcmanus, Joel Gore, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

Limited data exist about the long-term prognosis of patients with acute decompensated heart failure (ADHF) further stratified according to ejection fraction (EF) findings. The primary objective of this population-based observational study was to characterize and compare trends in long-term prognosis after an episode of ADHF across 3 EF strata. Hospital medical records were reviewed for 3,604 residents of the Worcester, Massachusetts, metropolitan area who were discharged after ADHF from all 11 medical centers in central Massachusetts during 1995, 2000, 2002, and 2004 and had EF measurements during their index hospitalizations. The average age of this population was 75 years, most …

Diabetes Care Trends In The Ma Patient Centered Medical Home Initiative (Ma Pcmhi) At Mid-Point, Sai Cherala, Judith Steinberg, Stephen Baker

Sai Cherala

Background: The MA PCMHI is a multi-payer demonstration involving 45 primary care practices. Thirty-one (31) practices receive additional financial support; all receive technical assistance.

Objectives: To assess data trends in diabetes quality measures from participating adult practices.

Study Design: Quality improvement study utilizing practices’ self-reported data on clinical quality measures. Diabetes measures included blood pressure, LDL cholesterol and hemoglobin A1C control and depression screening.

Methods: Monthly quality data from 38 practices reported June 2011 (baseline) through November 2012 were evaluated. Using a general linear mixed model Analysis of Variance (ANOVA), an overall comparison across time and pair-wise comparisons between times …

Pressure Pain Threshold Testing Demonstrates Predictive Ability In People With Acute Whiplash., David Walton

David Walton

No abstract provided.

Risk Factors For Persistent Problems Following Whiplash Injury: Results Of A Systematic Review And Meta-Analysis, David Walton

David Walton

No abstract provided.