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Cec Newsletter (Spring 2017), Mary Lloyd Moore, Executive Director 2017 Western Kentucky University

Cec Newsletter (Spring 2017), Mary Lloyd Moore, Executive Director

CEC Publications

No abstract provided.


Venoarterial Extracorporeal Membrane Oxygenation For Cardiogenic Shock: A Retrospective Analysis Based On The Etiology Of Shock, Andrew Burchett, Thomas Tribble, Richard Charnigo, Susan Smyth, Maya Guglin 2017 University of Kentucky

Venoarterial Extracorporeal Membrane Oxygenation For Cardiogenic Shock: A Retrospective Analysis Based On The Etiology Of Shock, Andrew Burchett, Thomas Tribble, Richard Charnigo, Susan Smyth, Maya Guglin

The VAD Journal

Abstract:

Background: We performed a retrospective analysis to evaluate the efficacy of VA-ECMO support in cardiogenic shock based on various etiologies.

Methods: We retrospectively analyzed 99 patients supported with VA-ECMO from January 1, 2012 to January 1, 2015. Outcomes included survival to discontinuation of VA-ECMO support and survival to hospital discharge. The etiologies of cardiogenic shock included cardiac arrest (CPR), acute myocardial infarction (AMI), decompensated congestive heart failure (CHF), pulmonary embolism (PE), right ventricular failure (RVF) not secondary to an acute pulmonary embolism, and post-cardiotomy syndrome (PCS). The PCS group was used as a reference group; odds ratios were estimated ...


P30. Optimizing Current Steering In Deep Brain Stimulation For Treating Parkinsonian Axial Motor Symptoms, Daphne Hui 2017 Western University

P30. Optimizing Current Steering In Deep Brain Stimulation For Treating Parkinsonian Axial Motor Symptoms, Daphne Hui

Western Research Forum

Background: The proposed study will investigate deep brain stimulation (DBS), of the subthalamic nucleus (STN) to improve gait dysfunctions in advanced Parkinson’s Disease (PD). DBS requires implantation of electrodes into the brain that contain contacts where current traverses to stimulate neurons. Imprecise electrode implantations are inherent in surgical implantation; thus, contributing to the elusiveness of DBS on gait.

Methods: The proposed investigation will divide current between two contacts to receive 0, 30, 50, 70, or 100% of current, to find the best combination to improve gait. Gait changes associated with fractional combinations will be visually assessed with clinical scales ...


A Novel Hybrid Imaging System To Aid In Surgical Decision Making, Lawrence Yip, Madeleine Van De Kleut, Ivan Kosik, Astrid Chamson-Reig, Jeffrey JL Carson 2017 Western University

A Novel Hybrid Imaging System To Aid In Surgical Decision Making, Lawrence Yip, Madeleine Van De Kleut, Ivan Kosik, Astrid Chamson-Reig, Jeffrey Jl Carson

Western Research Forum

Background:

Breast cancer accounts for 25% of all cancer cases among women. In breast-conserving surgery, a common treatment, the tumour is excised with a healthy tissue margin. However, detection of the margin can be difficult. Current techniques to guide excision are often insufficient, and re-excision can occur up to 25% of the time.

Methods:

Photoacoustic imaging is a hybrid imaging modality that combines the advantages of optical imaging and ultrasound while using safe non-ionizing light. This project involves the development of a novel imaging system with a new scanner design to overcome common limitations and provide images to aid in ...


Outcomes Of Early Transition From Intravenous To Oral Antimicrobial Treatment In Pediatric Osteomyelitis, Sofia Rahmanzai 2017 University of Nebraska at Omaha

Outcomes Of Early Transition From Intravenous To Oral Antimicrobial Treatment In Pediatric Osteomyelitis, Sofia Rahmanzai

Student Research and Creative Activity Fair

The purpose of this clinical study is to determine the effectiveness of the updated treatment for acute osteomyelitis. This treatment plan consists of early transition from intravenous to oral antimicrobial therapy. The efficaciousness of these therapies were compared with post-discharge outcomes and complication rates. This study will utilize patient records during 2011 to 2016 from the University of Nebraska Medical Center and Children’s Hospital and Medical Center. The study includes patients aged from 1 month to 18 years for acute or unspecified osteomyelitis. Excluded patients are children with chronic osteomyelitis, hospitalization of ten or more days, patients with comorbid ...


Engineering Fret Biosensors For Microrna Presence/Absence Analysis, Nicholas E. Larkey, Sean M. Burrows 2017 Oregon State University

Engineering Fret Biosensors For Microrna Presence/Absence Analysis, Nicholas E. Larkey, Sean M. Burrows

Biomedical Engineering Western Regional Conference

No abstract provided.


Difference Image Ultra-Short Echo Time T2* Mapping Using A 3d Cones Trajectory, Amin Nazaran, Grayson Tarbox, Randy Hartley, Neal Bangerter 2017 University of California - San Diego

Difference Image Ultra-Short Echo Time T2* Mapping Using A 3d Cones Trajectory, Amin Nazaran, Grayson Tarbox, Randy Hartley, Neal Bangerter

Biomedical Engineering Western Regional Conference

This study introduces a methodology for detecting subtle variations in tissues with very rapid T2* decay through a difference image ultra-short T2* mapping technique using a 3D cones k-space trajectory. The new method is demonstrated in both a normal and surgically repaired Achilles tendon. The resulting UTE images are differenced and T2* values were calculated using a mono-exponential least squares fit on a voxel by voxel basis. The ultrashort T2* maps yield very consistent short T2* values in healthy tendon of 0.3-0.5 ms, while notable variations and elevations of T2* values are observed in surgically repaired tendon.


Complexity And Chaos In Surgical Start Times, Dennis J. Baumgardner 2017 Aurora UW Medical Group, Aurora Health Care

Complexity And Chaos In Surgical Start Times, Dennis J. Baumgardner

Dennis J. Baumgardner. MD

In discussing an article investigating the causes for delay of first-case operating room start times included in this issue of the Journal of Patient-Centered Research and Reviews, the editor uses elements of complexity science and chaos theory to explain that such stubborn problems rarely stem from one of a few isolated causes. Taking a whole systems approach that utilizes flexibility, cross training, enhanced communication, common sense and perhaps mathematical models is suggested to effect positive change.


Zero-Fluoroscopy Cavotricuspid Isthmus Ablation Using Carto Mapping System As Sole Guiding Method, Wassim Ballany, Indrajit Choudhuri, Mohamed Djelmami-Hani, Ryan L. Cooley 2017 Aurora Health Care

Zero-Fluoroscopy Cavotricuspid Isthmus Ablation Using Carto Mapping System As Sole Guiding Method, Wassim Ballany, Indrajit Choudhuri, Mohamed Djelmami-Hani, Ryan L. Cooley

Aurora Electrophysiology Fellows

Background: Catheter ablation of the cavotricuspid isthmus (CTI) is traditionally performed using fluoroscopy and electroanatomical mapping systems. Zero-fluoroscopy approaches have recently been studied, mostly using the EnSite® mapping system (St. Jude Medical Inc., St. Paul, MN). We studied the feasibility and efficacy of zero-fluoroscopic mapping and ablation of the CTI using the Carto® 3 system (Biosense Webster Inc., South Diamond Bar, CA).

Purpose: To evaluate the efficacy and safety of a zero-fluoroscopic approach to CTI ablation.

Methods: We included 9 patients with typical atrial flutter for whom mapping and ablation of the CTI was done using Carto mapping as the ...


Penetrance Estimates For Incidental Genomic Findings In Acmg-59, James A. Diao 2017 Yale University

Penetrance Estimates For Incidental Genomic Findings In Acmg-59, James A. Diao

Yale Day of Data

The dropping costs and rising popularity of next-generation sequencing has introduced the possibility of personalizing medical treatments and screening for genetic diseases. Still, the clinical community’s understanding remains incomplete, with limited consensus on the proper interpretation for many genetic variants. Thus, the standard procedure when returning sequencing results has been to report findings only in genes related to the diagnostic indication, and not incidental findings in other genes. To balance the threat of false positives with the medical benefits of true findings, the American College on Medical Genetics and Genomics (ACMG) recommends an exception: that clinical sequencing laboratories seek ...


It Is Reasonable To Recommended Intrapleural Alteplase For Loculated Pleural Effusions, Tricia Fernandez 2017 Wayne State University School of Medicine

It Is Reasonable To Recommended Intrapleural Alteplase For Loculated Pleural Effusions, Tricia Fernandez

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Thommi G, Shehan J, Robison K, Christensen M, Backemeyer L, McLeay M. A double blind randomized cross over trial comparing rate of decortication and efficacy of intrapleural instillation of alteplase vs placebo in patients with empyemas and complicated parapneumonic effusions. Respir Med. 2012;17(2):716-723. doi: 10.1016/j.rmed.2012.02.005


Manage Terminal Ileum Diverticulitis Comparably To Diverticulitis Elsewhere, James Yip 2017 Wayne State University School of Medicine

Manage Terminal Ileum Diverticulitis Comparably To Diverticulitis Elsewhere, James Yip

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Park HC, Lee BH. The management of terminal ileum diverticulitis. Am Surg. 2009 Dec;75(12):1199-202.


The Crux Of The Heart –– The Closest Approach Of The Right Atrium To The Left Ventricle, Lynn Erickson, David Krum, Hannah Samuel, Anwer Dhala, Jasbir Sra 2017 Aurora Research Institute

The Crux Of The Heart –– The Closest Approach Of The Right Atrium To The Left Ventricle, Lynn Erickson, David Krum, Hannah Samuel, Anwer Dhala, Jasbir Sra

Jasbir Sra, MD, FACC, Program Director

Background: Accessory pathways, the source of atrioventricular reentry tachycardia, occasionally connect the left ventricle to the right atrium. This is possible because, in some patients, a portion of the right atrium abuts the left ventricle on the posterior wall of the heart, near the mid-coronary sinus. This anatomic region is known as the “crux” of the heart. These accessory pathways can be difficult to ablate because of the unusual and unexpected substrate. While the presence of these accessory pathways is described in the literature, the prevalence of the underlying anatomic substrate is not currently known.

Purpose: To measure the closest ...


Predicting Outcomes In Patients With Atrial Fibrillation And Acute Mesenteric Ischemia, Sanjay Bhandari, Geetanjali Dang, Muhammad Shahreyar, Ahmad Hanif, Vijayadershan Muppidi, Atul Bhatia, Jasbir Sra, A. Jamil Tajik, Arshad Jahangir 2017 Medical College of Wisconsin

Predicting Outcomes In Patients With Atrial Fibrillation And Acute Mesenteric Ischemia, Sanjay Bhandari, Geetanjali Dang, Muhammad Shahreyar, Ahmad Hanif, Vijayadershan Muppidi, Atul Bhatia, Jasbir Sra, A. Jamil Tajik, Arshad Jahangir

Jasbir Sra, MD, FACC, Program Director

Purpose Outcomes in patients with atrial fibrillation who develop acute mesenteric ischemia, and the impact of anticoagulation on complications, are not defined. Methods Patients admitted with acute mesenteric ischemia in the National Inpatient Sample from 2007, with and without atrial fibrillation, were compared for in-hospital outcomes using multivariate regression, and the impact of prior anticoagulation determined. Results Of 48,872 patients with acute mesenteric ischemia, 8,306 had atrial fibrillation, with 680 patients also on anticoagulation. Atrial fibrillation patients were more likely to be older and have hypertension, heart failure, or chronic lung or renal disease. After adjusting for potential ...


Atrial Fibrillation And Stroke In Elderly Patients, Geetanjali Dang, Imaan Jahangir, Jasbir Sra, A. Jamil Tajik, Arshad Jahangir 2017 Medical College of Wisconsin; Aurora Research Institute

Atrial Fibrillation And Stroke In Elderly Patients, Geetanjali Dang, Imaan Jahangir, Jasbir Sra, A. Jamil Tajik, Arshad Jahangir

Jasbir Sra, MD, FACC, Program Director

The increasing prevalence of stroke, with an estimated annual cost of $71.5 billion, has made it a major health problem that increases disability and death, particularly in patients with atrial fibrillation. Although advanced age and atrial fibrillation are recognized as strong risk factors for stroke, the basis for this susceptibility are not well defined. Aging or associated diseases are accompanied by changes in rheostatic, humoral, metabolic and hemodynamic factors that may contribute more to stroke predisposition than rhythm abnormality alone. Several thromboembolism-predisposing clinical characteristics and serum biomarkers with prognostic significance have been identified in patients with atrial fibrillation. Although ...


Atrial Fibrillation And Stroke In Elderly Patients, Geetanjali Dang, Imaan Jahangir, Jasbir Sra, A. Jamil Tajik, Arshad Jahangir 2017 Medical College of Wisconsin; Aurora Research Institute

Atrial Fibrillation And Stroke In Elderly Patients, Geetanjali Dang, Imaan Jahangir, Jasbir Sra, A. Jamil Tajik, Arshad Jahangir

Jasbir Sra, MD, FACC, Program Director

The increasing prevalence of stroke, with an estimated annual cost of $71.5 billion, has made it a major health problem that increases disability and death, particularly in patients with atrial fibrillation. Although advanced age and atrial fibrillation are recognized as strong risk factors for stroke, the basis for this susceptibility are not well defined. Aging or associated diseases are accompanied by changes in rheostatic, humoral, metabolic and hemodynamic factors that may contribute more to stroke predisposition than rhythm abnormality alone. Several thromboembolism-predisposing clinical characteristics and serum biomarkers with prognostic significance have been identified in patients with atrial fibrillation. Although ...


Design Of Radio-Frequency Arrays For Ultra-High Field Mri, Ian R O Connell 2017 The University of Western Ontario

Design Of Radio-Frequency Arrays For Ultra-High Field Mri, Ian R O Connell

Electronic Thesis and Dissertation Repository

Magnetic Resonance Imaging (MRI) is an indispensable, non-invasive diagnostic tool for the assessment of disease and function. As an investigational device, MRI has found routine use in both basic science research and medicine for both human and non-human subjects.

Due to the potential increase in spatial resolution, signal-to-noise ratio (SNR), and the ability to exploit novel tissue contrasts, the main magnetic field strength of human MRI scanners has steadily increased since inception. Beginning in the early 1980’s, 0.15 T human MRI scanners have steadily risen in main magnetic field strength with ultra-high field (UHF) 8 T MRI systems ...


Lead Burden As A Factor For Higher Complication Rate In Patients With Implantable Cardiac Devices, Christopher Kolibash, Naoyo Mori, Jasbir Sra, Masood Akhtar, M. Eyman Mortada 2017 Aurora Sinai/Aurora St. Luke’s Medical Centers, Aurora Health Care

Lead Burden As A Factor For Higher Complication Rate In Patients With Implantable Cardiac Devices, Christopher Kolibash, Naoyo Mori, Jasbir Sra, Masood Akhtar, M. Eyman Mortada

Mohammad Mortada, MD, FACC, FHRS

Purpose Lead revisions have increased over the last decade. Patients who do not undergo lead extraction face an increased lead burden. Consequences of increased lead burden have not been fully defined. We sought to characterize the complication rate and outcomes in patients with sterile redundant leads. Methods We retrospectively reviewed 242 consecutive patients [mean age 74 ± 12 years; 66.9% male] who underwent lead revision that resulted in an abandoned lead from January 2005 to June 2010. Patients were placed in a cohort based on number of leads after last recorded procedure (Group A: ≤2 [n=58]; Group B: 3-4 ...


Evaluating Medical Students’ Proficiency With A Handheld Ophthalmoscope: A Pilot Study, Gregory Gilmour, James M. McKivigan 2017 Touro University Nevada

Evaluating Medical Students’ Proficiency With A Handheld Ophthalmoscope: A Pilot Study, Gregory Gilmour, James M. Mckivigan

College of Health & Human Services (TUN) Publications and Research

Introduction: Historically, testing medical students’ skills using a handheld ophthalmoscope has been difficult to do objectively. Many programs train students using plastic models of the eye which are a very limited fidelity simulator of a real human eye. This makes it difficult to be sure that actual proficiency is attained given the differences between the various models and actual patients. The purpose of this article is to introduce a method of testing where a medical student must match a patient with his/her fundus photo, ensuring objective evaluation as well as developing skills on real patients which are more likely ...


Assessment With Children Who Need Augmentative And Alternative Communication (Aac): Clinical Decisions Of Aac Specialists., Shelley Lund, Quach Wendy, Kristy S.E. Weissling, Miechelle L. McKelvey, Aimee R. Dietz 2017 University of Wisconsin - Milwaukee

Assessment With Children Who Need Augmentative And Alternative Communication (Aac): Clinical Decisions Of Aac Specialists., Shelley Lund, Quach Wendy, Kristy S.E. Weissling, Miechelle L. Mckelvey, Aimee R. Dietz

Special Education and Communication Disorders Faculty Publications

Purpose The purpose of this study was to explore how speech-language pathologists (SLPs) who are augmentative and alternative communication (AAC) specialists approach the assessment process for 2 case studies, 1 child with cerebral palsy and 1 with autism spectrum disorder. The aim of the study was to answer the following questions: (a) How do clinicians with expertise approach the AAC assessment process for children with developmental disabilities? (b) Can any initial hypothesis be drawn about how SLPs approach the assessment of children with motor versus social interactive deficits?

Method This study used a phenomenological qualitative design. The researchers conducted 2 ...


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