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Surveillance, Prevention And Surgical Treatments For Hepatocellular Carcinoma, Kerui Xu 2018 University of Nebraska Medical Center

Surveillance, Prevention And Surgical Treatments For Hepatocellular Carcinoma, Kerui Xu

Theses & Dissertations

Liver cancer is the second-leading cause of cancer death, representing roughly 9.1% of all cancer mortality. Of all primary cancers of the liver, hepatocellular carcinoma (HCC) accounts for roughly 85%. HCC has been increasing in the U.S. and other countries. In particular, HCC places a huge burden on the Chinese population, as China alone consists of approximately 50% of the total HCC cases and deaths. In China, chronic hepatitis B virus (HBV) infection is the leading cause for developing HCC. The two challenges in prevention and control of HCC experienced in China are low rates of HCC screening ...


Magnitude And Impact Of Multiple Chronic Conditions With Advancing Age In Older Adults Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, Hoa L. Nguyen, Jerry H. Gurwitz, David D. McManus, Joel M. Gore, Sonal Singh, Jorge L. Yarzebski, Robert J. Goldberg 2018 University of Massachusetts Medical School

Magnitude And Impact Of Multiple Chronic Conditions With Advancing Age In Older Adults Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, Hoa L. Nguyen, Jerry H. Gurwitz, David D. Mcmanus, Joel M. Gore, Sonal Singh, Jorge L. Yarzebski, Robert J. Goldberg

Open Access Articles

BACKGROUND: To examine age-specific differences in the frequency and impact of cardiac and non-cardiac conditions among patients aged 65years and older hospitalized with acute myocardial infarction (AMI).

METHODS: Study population consisted of 3863 adults hospitalized with AMI at 11 medical centers in central Massachusetts on a biennial basis between 2001 and 2011. The presence of 11 chronic conditions (five cardiac and six non-cardiac) was based on the review of hospital medical records.

RESULTS: Participants' median age was 79years, 49% were men, and had an average of three chronic conditions (average of cardiac conditions: 2.6 and average of non-cardiac conditions ...


Nortex Fall 2018 Newsletter, North Texas Primary Care Practice-Based Research Network 2018 University of North Texas Health Science Center

Nortex Fall 2018 Newsletter, North Texas Primary Care Practice-Based Research Network

North Texas Primary Care Practice-Based Research Network (NorTex) Newsletter

No abstract provided.


Predictors Of Patient Activation At Acs Hospital Discharge And Health Care Utilization In The Subsequent Year, Rebecca L. Kinney 2018 University of Massachusetts Medical School

Predictors Of Patient Activation At Acs Hospital Discharge And Health Care Utilization In The Subsequent Year, Rebecca L. Kinney

GSBS Dissertations and Theses

Background. AHA guidelines have been established to reduce Acute Coronary Syndrome (ACS)-related morbidity, mortality and recurrent events post-discharge. These recommendations emphasize the patient as an engaged member of the health care team in secondary prevention efforts. Patients with high levels of activation are more likely to perform activities that will promote their own health and are more likely to have their health care needs met. Despite evidence and strong expert consensus supporting patients as active collaborators in their own ACS care, the complexity and unexpected realities of self-managing one’s care at home are often underestimated. This study seeks ...


Prediction Of Preterm Birth With And Without Preeclampsia Using Mid-Pregnancy Immune And Growth-Related Molecular Factors And Maternal Characteristics, Laura L. Jelliffe-Pawlowski, Larry Rand, Bruce Bedell, Rebecca J. Baer, Scott P. Oltman, Mary E. Norton, Gary M. Shaw, David K. Stevenson, Jeffrey C. Murray, Kelli K. Ryckman 2018 University of Iowa

Prediction Of Preterm Birth With And Without Preeclampsia Using Mid-Pregnancy Immune And Growth-Related Molecular Factors And Maternal Characteristics, Laura L. Jelliffe-Pawlowski, Larry Rand, Bruce Bedell, Rebecca J. Baer, Scott P. Oltman, Mary E. Norton, Gary M. Shaw, David K. Stevenson, Jeffrey C. Murray, Kelli K. Ryckman

Stead Family Department of Pediatrics Publications

OBJECTIVE: To evaluate if mid-pregnancy immune and growth-related molecular factors predict preterm birth (PTB) with and without (±) preeclampsia.

STUDY DESIGN: Included were 400 women with singleton deliveries in California in 2009-2010 (200 PTB and 200 term) divided into training and testing samples at a 2:1 ratio. Sixty-three markers were tested in 15-20 serum samples using multiplex technology. Linear discriminate analysis was used to create a discriminate function. Model performance was assessed using area under the receiver operating characteristic curve (AUC).

RESULTS: Twenty-five serum biomarkers along with maternal age80% of women with PTB ± preeclampsia with best performance in women with ...


Knowledge And Risk Factors For Stroke Among Undergraduates In Southwestern Nigeria, Wasiu Olalekan Adebimpe 2018 University of Medical Sciences Ondo Nigeria

Knowledge And Risk Factors For Stroke Among Undergraduates In Southwestern Nigeria, Wasiu Olalekan Adebimpe

Marshall Journal of Medicine

The burden of non-communicable diseases due to stroke is increasing. Despite this, community based studies that could stimulate stroke primordial prevention among the population at risk are sparse. This study assessed community knowledge and risk factors to stroke among University undergraduates in Osogbo, southwestern Nigeria. A descriptive cross sectional study was conducted among 420 male undergraduates selected through multi-stage sampling method. Research instruments were self-administered semi structured questionnaire. Data was analyzed using the SPSS software version 17.0. Four hundred and seven (96.9%) have heard about stroke. Good mean knowledge score of causes, symptoms, warning signs and risk factors ...


Racial Disparity Among Women Diagnosed With Invasive Breast Cancer In A Large Integrated Health System, Maharaj Singh, Santhi D. Konduri, George C. Bobustuc, Amin B. Kassam, Richard A. Rovin 2018 Aurora Research Institute, Aurora Health Care

Racial Disparity Among Women Diagnosed With Invasive Breast Cancer In A Large Integrated Health System, Maharaj Singh, Santhi D. Konduri, George C. Bobustuc, Amin B. Kassam, Richard A. Rovin

Journal of Patient-Centered Research and Reviews

Purpose: Reasons for the well-described disparity in outcomes between African American (AA) and non-Hispanic white (NHW) women with invasive breast cancer are unclear, making it difficult to identify solutions. This study examined the effects of demographics, biomarkers, tumor characteristics, cancer stage, morphology, and treatment variables on overall and cancer-free survival in these patient populations.

Methods: We retrospectively reviewed data for 6231 patients diagnosed with invasive breast cancer throughout an integrated health system from January 2006 through March 2015. Included for analysis were 5023 NHW and 413 AA women. All category and continuous variables in the study were described in the ...


Improving Health And Well-Being: Connecting Research And Practice. The 24th Annual Conference Of The Health Care Systems Research Network, Karen L. Margolis, Nico Pronk, Jane E. Duncan, Sarah M. Greene 2018 HealthPartners Institute

Improving Health And Well-Being: Connecting Research And Practice. The 24th Annual Conference Of The Health Care Systems Research Network, Karen L. Margolis, Nico Pronk, Jane E. Duncan, Sarah M. Greene

Journal of Patient-Centered Research and Reviews

The 24th annual conference of the Health Care Systems Research Network (HCSRN, formerly the HMO Research Network), held April 11–13, 2018, in Minneapolis, Minnesota, attracted 357 attendees. The HCSRN is a consortium of 18 community-based research organizations embedded in or affiliated with large health care delivery systems. Its annual research conference, held since 1994, is a unique venue that brings diverse stakeholders (eg, research teams, clinicians, patients, funders) together to explore a range of health research topics and scientific findings, with a unifying goal of connecting applied research to real-world care delivery for the betterment of individual and community ...


Pre-Diagnosis Plasma Immune Markers And Risk Of Non-Hodgkin Lymphoma In Two Prospective Cohort Studies, Mara M. Epstein, Bernard Rosner, Elizabeth C. Breen, Julie L. Batista, Edward L. Giovannucci, Larry Magpantay, Jon C. Aster, Scott J. Rodig, Kimberly A. Bertrand, Francine Laden, Otoniel Martinez-Maza, Brenda M. Birmann 2018 University of Massachusetts

Pre-Diagnosis Plasma Immune Markers And Risk Of Non-Hodgkin Lymphoma In Two Prospective Cohort Studies, Mara M. Epstein, Bernard Rosner, Elizabeth C. Breen, Julie L. Batista, Edward L. Giovannucci, Larry Magpantay, Jon C. Aster, Scott J. Rodig, Kimberly A. Bertrand, Francine Laden, Otoniel Martinez-Maza, Brenda M. Birmann

Open Access Articles

Inflammation and B-cell hyperactivation have been associated with non-Hodgkin lymphoma development. This prospective analysis aimed to further elucidate pre-diagnosis plasma immune marker profiles associated with non-Hodgkin lymphoma risk. We identified 598 incident lymphoma cases and 601 matched controls in Nurses' Health Study and Health Professionals Follow-up Study participants with archived pre-diagnosis plasma samples and measured 13 immune marker levels with multiplexed immunoassays. Using multivariable logistic regression we calculated odds ratios and 95% confidence intervals per standard deviation unit increase in biomarker concentration for risk of non-Hodgkin lymphoma and major histologic subtype, stratifying additional models by years ( < 5, 5 to < 10, > /=10) after blood draw ...


Efficacy And Safety Of Direct Oral Anticoagulants Approved For Cardiovascular Indications: Systematic Review And Meta-Analysis, Raghavendra Charan Makam, David C. Hoaglin, David D. McManus, Victoria Wang, Joel M. Gore, Frederick A. Spencer, Richeek Pradhan, Hoang Tran, Hong Yu, Robert J. Goldberg 2018 University of Massachusetts Medical School

Efficacy And Safety Of Direct Oral Anticoagulants Approved For Cardiovascular Indications: Systematic Review And Meta-Analysis, Raghavendra Charan Makam, David C. Hoaglin, David D. Mcmanus, Victoria Wang, Joel M. Gore, Frederick A. Spencer, Richeek Pradhan, Hoang Tran, Hong Yu, Robert J. Goldberg

Quantitative Health Sciences Publications and Presentations

BACKGROUND: Direct oral anticoagulants (DOACs) have emerged as promising alternatives to vitamin K antagonists (VKAs) for patients with non-valvular atrial fibrillation (NVAF) or venous thromboembolism (VTE). Few meta-analyses have included all DOACs that have received FDA approval for these cardiovascular indications, and their overall comparisons against VKAs have shortcomings in data and methods. We provide an updated overall assessment of the efficacy and safety of those DOACs at dosages currently approved for NVAF or VTE, in comparison with VKAs.

METHODS: We used data from Phase 3 randomized trials that compared an FDA-approved DOAC with VKA for primary prevention of stroke ...


The Role Of Race And Economic Characteristics In The Presentation And Survival Of Patients With Surgically Resected Non-Small Cell Lung Cancer, John M. Varlotto, Kerrie McKie, Rickie P. Voland, John C. Flickinger, Malcolm M. DeCamp, Debra Maddox, Paul Rava, Thomas J. Fitzgerald, William Walsh, Paulo Oliveira, Negar Rassaei, Jennifer Baima, Karl Uy 2018 University of Massachusetts Medical School

The Role Of Race And Economic Characteristics In The Presentation And Survival Of Patients With Surgically Resected Non-Small Cell Lung Cancer, John M. Varlotto, Kerrie Mckie, Rickie P. Voland, John C. Flickinger, Malcolm M. Decamp, Debra Maddox, Paul Rava, Thomas J. Fitzgerald, William Walsh, Paulo Oliveira, Negar Rassaei, Jennifer Baima, Karl Uy

Open Access Articles

Background: Little is understood regarding the inter-relation between economic, marital, and racial/ethnic differences in presentation and survival of surgically resected lung cancer patients. Our investigation will assess these differences in addition to known therapeutic, patient, and histopathologic factors.

Methods: A retrospective review of the Surveillance Epidemiology and End Reporting database was conducted through the years 2007-2012. The population was split into nine different ethnic groups. Population differences were assessed via chi-square testing. Multivariable analysis (MVA) were used to detect overall survival (OS) differences in the total surgical population (TS, N = 35,689) in an ear (T1-T2 < 4 cm N0) surgical population [early-stage resectable (ESR), N = 17,931]. Lung cancer-specific survival (LCSS) was assessed in the ESR.

Results: In the ...


Aggressive Diuresis And Severity-Adjusted Length Of Hospital Stay In Acute Congestive Heart Failure Patients., Muhammad U. Butt M.D. 2018 Selected Works

Aggressive Diuresis And Severity-Adjusted Length Of Hospital Stay In Acute Congestive Heart Failure Patients., Muhammad U. Butt M.D.

Muhammad Umer Butt M.D., MSCRD

To see if aggressive diuresis in 1st 24 hours is associated with a comparable number of total days in the hospital as compared to non-aggressive diuresis.  In this retrospective cohort study, we compared the length of hospital stay of consecutive patients admitted in one year based on their diuresis during the first twenty-four hours of hospitalization: aggressive diuresis (group 1) i.e. >2400mL versus non-aggressive diuresis (group 2) i.e. ≤ 2400mL urine output. Patients were excluded if in cardiogenic shock, had creatinine level above 3 mg/dL on admission, or on dialysis. A total of 194 patients were enrolled (29 ...


Lifetime Risk Of Atrial Fibrillation According To Optimal, Borderline, Or Elevated Levels Of Risk Factors: Cohort Study Based On Longitudinal Data From The Framingham Heart Study, Laila Staerk, Biqi Wang, Sarah R. Preis, Martin G. Larson, Steven A. Lubitz, Patrick T. Ellinor, David D. McManus, Darae Ko, Lu-Chen Weng, Kathryn L. Lunetta, Lars Frost, Emelia J. Benjamin, Ludovic Trinquart 2018 National Heart, Lung, and Blood Institute

Lifetime Risk Of Atrial Fibrillation According To Optimal, Borderline, Or Elevated Levels Of Risk Factors: Cohort Study Based On Longitudinal Data From The Framingham Heart Study, Laila Staerk, Biqi Wang, Sarah R. Preis, Martin G. Larson, Steven A. Lubitz, Patrick T. Ellinor, David D. Mcmanus, Darae Ko, Lu-Chen Weng, Kathryn L. Lunetta, Lars Frost, Emelia J. Benjamin, Ludovic Trinquart

Open Access Articles

OBJECTIVE: To examine the association between risk factor burdens-categorized as optimal, borderline, or elevated-and the lifetime risk of atrial fibrillation.

DESIGN: Community based cohort study.

SETTING: Longitudinal data from the Framingham Heart Study.

PARTICIPANTS: Individuals free of atrial fibrillation at index ages 55, 65, and 75 years were assessed. Smoking, alcohol consumption, body mass index, blood pressure, diabetes, and history of heart failure or myocardial infarction were assessed as being optimal (that is, all risk factors were optimal), borderline (presence of borderline risk factors and absence of any elevated risk factor), or elevated (presence of at least one elevated risk ...


Under One Roof: Identification, Evaluation, And Treatment Of Chronic Hepatitis C In Addiction Care, Stephen A. Martin, Jordon Bosse, Amanda Wilson, Phyllis Losikoff, Lisa Chiodo 2018 University of Massachusetts Medical School

Under One Roof: Identification, Evaluation, And Treatment Of Chronic Hepatitis C In Addiction Care, Stephen A. Martin, Jordon Bosse, Amanda Wilson, Phyllis Losikoff, Lisa Chiodo

Open Access Articles

For over a decade, the vast majority of new hepatitis C virus (HCV) infections have been among young people who inject drugs (PWID). Well-characterized gaps in chronic HCV diagnosis, evaluation, and treatment have resulted in fewer than 5% of PWID receiving HCV treatment. While interferon-based treatment may have intentionally been foregone during part of this time in anticipation of improved oral therapies, the overall pattern points to deficiencies and treatment exclusions in the health care system. Treatment for HCV with all-oral, highly effective direct-acting antiviral medication for 12 weeks or less is now the standard of care, putting renewed focus ...


Lagged Influence Of Fine Particulate Matter And Geographic Disparities On Clinic Visits For Children’S Asthma In Taiwan, Lung-Chang Chien, Yu-An Chen, Hwa-Lung Yu 2018 University of Nevada, Las Vegas

Lagged Influence Of Fine Particulate Matter And Geographic Disparities On Clinic Visits For Children’S Asthma In Taiwan, Lung-Chang Chien, Yu-An Chen, Hwa-Lung Yu

Community Health Sciences Faculty Publications

Recent studies have revealed the influence of fine particulate matter (PM2.5) on increased medication use, hospital admission, and emergency room visits for asthma attack in children, but the lagged influence of PM2.5 on children’s asthma and geographic disparities of children’s asthma have rarely been discussed simultaneously. This study investigated the documented diagnosis of children’s asthma in clinic visits for children aged less than 15 years old that were associated with PM2.5 in two counties located in west-central Taiwan during 2005–2010. The result shows that PM2.5 had a significant lagged effect on children ...


The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer 2018 Brandman University

The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer

Dissertations

Purpose: The purpose of this descriptive, qualitative study was to identify and describe the importance of the predictors of juvenile recidivism and the effectiveness of efforts to prevent/avoid juvenile recidivism as perceived by previously detained, arrested, convicted, and/or incarcerated adult students 18 years of age and older exiting from alternative education in Northern California. A second purpose was to explore the types of support provided by alternative schools and the perceived importance of the support to avoid recidivism according to adult students 18 years of age and older exiting from alternative education.

Methodology: This qualitative, descriptive research design ...


Anxiety, Depression, And Adverse Clinical Outcomes In Patients With Atrial Fibrillation Starting Warfarin: Cardiovascular Research Network Wave Study, Christine Baumgartner, Dongjie Fan, Margaret C. Fang, Daniel E. Singer, Daniel M. Witt, John R. Schmelzer, Marc S. Williams, Jerry H. Gurwitz, Sue Hee Sung, Alan S. Go 2018 University of California, San Francisco

Anxiety, Depression, And Adverse Clinical Outcomes In Patients With Atrial Fibrillation Starting Warfarin: Cardiovascular Research Network Wave Study, Christine Baumgartner, Dongjie Fan, Margaret C. Fang, Daniel E. Singer, Daniel M. Witt, John R. Schmelzer, Marc S. Williams, Jerry H. Gurwitz, Sue Hee Sung, Alan S. Go

Open Access Articles

BACKGROUND: Anxiety and depression are associated with worse outcomes in several cardiovascular conditions, but it is unclear whether they affect outcomes in atrial fibrillation (AF). In a large diverse population of adults with AF, we evaluated the association of diagnosed anxiety and/or depression with stroke and bleeding outcomes.

METHODS AND RESULTS: The Cardiovascular Research Network WAVE (Community-Based Control and Persistence of Warfarin Therapy and Associated Rates and Predictors of Adverse Clinical Events in Atrial Fibrillation and Venous Thromboembolism) Study included adults with AF newly starting warfarin between 2004 and 2007 within 5 health delivery systems in the United States ...


Association Between Smoking And Functional Outcome In Acute Ischemic Stroke Population Treated With Tissue Plasminogen Activator, iretioluwa ajani, Oluyemi R. Rotimi, Olubunmi Kuku, Ndukwe Kalu, Olakunle Oni, Christian Nwabueze, Thomas Nathaniel, Shimin Zheng 2018 East Tennessee State University

Association Between Smoking And Functional Outcome In Acute Ischemic Stroke Population Treated With Tissue Plasminogen Activator, Iretioluwa Ajani, Oluyemi R. Rotimi, Olubunmi Kuku, Ndukwe Kalu, Olakunle Oni, Christian Nwabueze, Thomas Nathaniel, Shimin Zheng

Appalachian Student Research Forum

Association between Smoking and Functional Outcome in Acute Ischemic Stroke Population Treated with Tissue Plasminogen Activator

Iretioluwa Ajani1, Oluyemi Rotimi1, Olubunmi Kuku1, Ndukwe Kalu1, Olakunle Oni1, Nwabueze Christian1,Thomas Nathaniel2, Shimin Zheng1*

1Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614

2Department of Neurology, Department of Pharmacology, Physiology & Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208

*Sponsoring faculty

Background

The effect of smoking on outcome in acute ischemic stroke patients treated with tissue plasminogen activator (TPA) is debatable. Based on the hypothesis that smokers may have more effective thrombolysis with TPA. Some clinical studies have demonstrated a favorable outcome while others have seen worse prognosis or no effect at all. This study seeks to determine the association between smoking and functional improvement in TPA treated and non-treated patients.

Methods

We analyzed data from the Greenville Health System (GHS) stroke registry on stroke patients between January 2010 and December 2013. Patients were divided into two groups: those treated with TPA and those not treated with TPA but presenting within 4.5 hours. Logistic regression analysis was conducted to assess if smoking was associated with improvement in ambulation.

Results

Of 1,446 patients, 595 (41.15 %) were treated with TPA (181 smokers (30.42%), 414 non-smokers (69.58 %) and 851 (58.85%) not treated with TPA (198 smokers (23.27 %), 653 non-smokers (76.73 %). In the multiple logistic models, smoking was not independently associated with favorable outcome in patients treated with TPA (OR = 0.84; 95% CI = 0.54 – 1.33; P = 0.46) and those not treated with TPA (OR = 0.96; 95% CI = 0.64 – 1.44; P-value = 0.85) though the bivariate models showed significant association ...


Nortex Spring 2018 Newsletter, North Texas Primary Care Practice-Based Research Network 2018 University of North Texas Health Science Center

Nortex Spring 2018 Newsletter, North Texas Primary Care Practice-Based Research Network

North Texas Primary Care Practice-Based Research Network (NorTex) Newsletter

No abstract provided.


Impressions Of Participants In A Chemical Mass Casualty Exercise, Ethan J. Start, Joan M. Culley, Abbas Tavakoli 2018 University of South Carolina - Columbia

Impressions Of Participants In A Chemical Mass Casualty Exercise, Ethan J. Start, Joan M. Culley, Abbas Tavakoli

Senior Theses

A mass casualty exercise was performed to investigate triage and decontamination of patients exposed to an irritant gas. Nursing students participated in two groups: emergency department triage (ED) and decontamination (DECON). While participants felt overall that the experience was valuable, DECON participants had a greater interest in emergency response and were more likely to volunteer again.


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