Medicine and Health Sciences Commons^™

Reactive Hyperemia Occurs Via Activation Of Inwardly-Rectifying Potassium Channels And Na+/K+-Atpase In Humans, Anne R. Crecelius, Jennifer C. Richards, Gary J. Luckasen, Dennis G. Larson, Frank A. Dinenno

Anne R. Crecelius

Rationale: Reactive hyperemia (RH) in the forearm circulation is an important marker of cardiovascular health, yet the underlying vasodilator signaling pathways are controversial and thus remain unclear. Objective: We hypothesized that RH occurs via activation of inwardly rectifying potassium (KIR) channels and Na+/K+-ATPase and is largely independent of the combined production of the endothelial autocoids nitric oxide (NO) and prostaglandins in young healthy humans. Methods and Results: In 24 (23±1 years) subjects, we performed RH trials by measuring forearm blood flow (FBF; venous occlusion plethysmography) after 5 minutes of arterial occlusion. In protocol 1, we studied 2 groups of 8 …

The Science Of Prevention Strategies, Rachel Abrishami, Jeffery A. Goad

Jeff Goad

"From newborn screening for Phenylkentonurea (PKU) and the birth dose of Hepatitis B vaccine to prostate and breast cancer screening and pneumococcal immunization for older adults, the science of health maintenance is multi-tiered and spans the lifetime of an individual. Primary, secondary, and tertiary prevention strategies are used in concert with each other to enable healthcare professionals and their patients to sustain and improve the quality of life."

Immunization Update, Karl M. Hess, Jeffery A. Goad

Jeff Goad

"Immunization represents a very effective primary prevention strategy to curb the rate of vaccine preventable diseases...Pharmacists can play a leading role in vaccination by serving as an advocate, facilitator, and active immunizer. As an advocate, pharmacists provide vaccine education while motivating people to get immunized. As a facilitator, pharmacy’s can host other groups, such as the visiting nurses association, to come into the pharmacy and vaccinate. As an active immunizer, however, pharmacists serve their greatest role by giving immunizations to adolescents and adults."

Association Of Antipsychotic Use With Hospital Events And Mortality Among Medicare Beneficiaries Residing In Long-Term Care Facilities, Linda Simoni-Wastila, Priscilla T. Ryder, Jingjing Qian, Ilene H. Zuckermann, Thomas Shaffer, Lirong Zhao

Priscilla T. Ryder

Objective—Antipsychotic (AP) utilization has grown significantly in long-term care (LTC) settings. Although a growing literature associates AP use with higher mortality in elderly with dementia, the association of APs with hospital events is unclear. The authors examine prevalence and trends in AP use by Medicare beneficiaries residing in LTC and the association of APs and other drug use variables with hospital events and mortality. Design—Retrospective analysis using sequential multivariate Cox proportional hazards models. Setting—Medicare Current Beneficiary Survey linked to Institutional Drug Administration and Minimum Data Set files. Participants—A total of 2,363 LTC Medicare beneficiaries, 1999–2002. Measurements—Trends in LTC AP use …

Administrators’ Perceptions Of Medication Management In Assisted Living Facilities: Results From Focus Groups, Priscilla T. Ryder, Melanie Joseph, Marnie Zuckermann, Ilene H. Zuckermann

Priscilla T. Ryder

Objective: Assisted living (AL) residents are vulnerable to adverse events as a result of using numerous medications and frequently need assistance in administering medications. Very little is known, however, about the ways in which medications are managed within this level of care. Design: AL administrators from the metropolitan Baltimore, Maryland area were invited to participate in focus groups to explore issues involved in medication management. Setting and Participants: Four administrators from smaller (15 beds or fewer) and six larger (more than 15 beds) certified AL facilities serving primarily older residents participated. Administrators must have served in their position at least …

Real-Time Mri-Guided Catheter Tracking Using Hyperpolarized Silicon Particles, Nicholas Whiting, Jingzhe Hu, Jay V. Shah, Maja C. Cassidy, Erik Cressman, Niki Zacharias Millward, David G. Menter, Charles M. Marcus, Pratip K. Bhattacharya

Nicholas Whiting

Ptsd/Sud In Individuals With Physical Disabilities: Identifying Problems And Promising Interventions, Melissa L. Anderson, Douglas M. Ziedonis, Lisa M. Najavits

Melissa L. Anderson

Co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) is common, affects multiple domains of functioning, and presents complex challenges to recovery. Initial research indicates that individuals with physical disabilities experience higher rates of lifetime trauma and PTSD, and exhibit more severe SUD compared to non-disabled individuals. To expand upon these initial findings, we conducted a series of two studies on PTSD and SUD among individuals with physical disabilities.

Morphological Knowledge And Decoding Skills Of Deaf Readers, M. Diane Clark, Gizelle L. Gilbert, Melissa L. Anderson

Melissa L. Anderson

Many studies have reported the necessity of phonological awareness to become a skilled reader, citing barriers to phonological information as the cause for reading difficulties experienced by deaf individuals. In contrast, other research suggests that phonological awareness is not necessary for reading acquisition, citing the importance of higher levels of syntactic and semantic knowledge. To determine if deaf students with higher language skills have better word decoding strategies, students responded to a morphological test, where monomorphemic words and multimorphemic words were matched to their definitions. Two studies are reported, one focusing on English placement levels and a second with formal …

Supporting Recovery In The Deaf Community: Creating Continuum Of Behavioral Health Care In Central Massachusetts, Melissa L. Anderson, Neil S. Glickman, Lisa Mistler, Susan Jones, Monika E. Kolodziej, Douglas M. Ziedonis

Melissa L. Anderson

Across the U.S., there is a paucity of mental health and substance abuse services for Deaf individuals. Without the availability of communication accommodations and specialized clinical expertise, Deaf individuals seeking behavioral health services contend with access limitations, misdiagnoses, and superficial treatments. Moreover, while the assessment and treatment of co-occurring disorders and the infusion of trauma-informed care are key components of effective treatment in the mainstream literature, the investigation and application of these initiatives to the Deaf population has not yet occurred. The proposed poster will outline the current state of specialized behavioral health services for Deaf individuals in Central Massachusetts, …

Hyperphosphatemia In Pediatric Oncology Patients Receiving Liposomal Amphotericin B, Chad A. Knoderer, Holly M. Knoderer

Chad A. Knoderer

OBJECTIVE: After transitioning our front-line amphotericin product to the liposomal formulation, we observed an increased incidence of hyperphosphatemia. We aimed to determine the incidence of hyperphosphatemia in children with oncologic disorders receiving an amphotericin B product and to establish whether the incidence varies depending on amphotericin formulation. METHODS: This retrospective review of the medical record was conducted at a tertiary, free standing children’s hospital. Pharmacy data revealed 159 patients receiving an amphotericin product between November 2006 and December 2008. Doses of amphotericin, serum phosphorous, calcium and creatinine concentrations were recorded at daily time points during the 10 days following both …

Continuous Infusion Of Nafcillin For Sternal Osteomyelitis In An Infant After Cardiac Surgery, Chad A. Knoderer, Jennifer L. Morris, Elaine G. Cox

Chad A. Knoderer

We report the use of the continuous infusion of nafcillin for the treatment of an infant who had methicillinsusceptible Staphylococcus aureus sternal osteomyelitis not responsive to traditional nafcillin dosing. The patient was successfully treated with surgical debridement and the continuous infusion of nafcillin. To our knowledge, this is the first report describing the successful use of the continuous infusion of nafcillin to treat an infant who had sternal osteomyelitis after cardiac surgery.

Vancomycin And Gentamicin Pharmacokinetic Alterations In An Adolescent Amputee, Kristen R. Nichols, Kari M. Edison, Michelle D. Rosenbaum, Chad A. Knoderer

Chad A. Knoderer

A 14-year-old male with bilateral above-the-knee amputations presented to our hospital for treatment of a skin and soft-tissue infection. We report the experience of vancomycin and gentamicin therapy in this patient. Because these medications require weight-based dosages and pharmacokinetic monitoring of serum levels, it was necessary to obtain peak and trough levels of the two drugs in order to determine the pharmacokinetic differences in this patient compared to those in an adolescent male without amputations. To our knowledge, this is the first report describing pharmacokinetic differences in an adolescent amputee.

Cinacalcet Administration By Gastrostomy Tube In A Child Receiving Peritoneal Dialysis, Kristen R. Nichols, Chad A. Knoderer, Bethanne Johnston, Amy C. Wilson

Chad A. Knoderer

A 2-year-old male with chronic kidney disease with secondary hyperparathyroidism developed hypercalcemia while receiving calcitriol, without achieving a serum parathyroid hormone concentration within the goal range. Cinacalcet 15 mg (1.2 mg/kg), crushed and administered via gastrostomy tube, was added to the patient’s therapy. This therapy was effective in achieving targeted laboratory parameters in our patient despite instructions in the prescribing information that cinacalcet should always be taken whole.

Outcomes Of Extended-Infusion Piperacillin/Tazobactam In Pediatric Patients., Kristen R. Nichols, Katie Andricopulos, Ashley S. Crumby, Elaine G. Cox, Chad A. Knoderer

Kristen R. Nichols

Poster presented at: ID Week 2013, October 2013, San Francisco, California.

Vancomycin And Gentamicin Pharmacokinetic Alterations In An Adolescent Amputee, Kristen R. Nichols, Kari M. Edison, Michelle D. Rosenbaum, Chad A. Knoderer

Kristen R. Nichols

A 14-year-old male with bilateral above-the-knee amputations presented to our hospital for treatment of a skin and soft-tissue infection. We report the experience of vancomycin and gentamicin therapy in this patient. Because these medications require weight-based dosages and pharmacokinetic monitoring of serum levels, it was necessary to obtain peak and trough levels of the two drugs in order to determine the pharmacokinetic differences in this patient compared to those in an adolescent male without amputations. To our knowledge, this is the first report describing pharmacokinetic differences in an adolescent amputee.

Linezolid-Associated Thrombocytopenia In Children With Renal Impairment, Chad A. Knoderer, Kristen R. Nichols, Heather L. Deyoung, Sara J. Jones, Elaine G. Cox

Kristen R. Nichols

Poster presented at ID Week, October 2013, San Francisco, California.

From Survival To Survivorship: Late Side Effects Become An Issue In High-Grade Glioma., Yaacov R Lawrence, Wenyin Shi, Adam P Dicker

Yaacov R. Lawrence

“For many patients, controlling neurological symptoms, preventing cognitive dysfunction and maintaining functional independence are just as important as prolonging survival.”

Chart Rounds In The Digital Age: A Survey Of North American Institutions, M. A. Whiton, A. P. Dicker, E. J. Wuthrick, L. Doyle, A. S. Harrison, Y. R. Lawrence

Yaacov R. Lawrence

Purpose: Recent reports of medical errors in radiaKon treatment delivery have emphasized the importance of quality assurance (QA) pracKces. Strict guidelines exist for medical physics QA, but not for QA procedures as applied to clinicians. We sought to document how clinical quality assurance (QA) meeKngs or “chart rounds” are performed across academic North American RadiaKon Oncology departments.

Early Toxicity Predicts Long-Term Survival In High-Grade Glioma., Y. R. Lawrence, M Wang, Adam Dicker, David W Andrews, Walter J Curran, J M Michalski, L Souhami, W-Ka Yung, M Mehta

Yaacov R. Lawrence

BACKGROUND: Patients with high-grade gliomas are treated with surgery followed by chemoradiation. The risk factors and implications of neurological side effects are not known.

METHODS: Acute and late ≥ grade 3 neurological toxicities (NTs) were analysed among 2761 patients from 14 RTOG trials accrued from 1983 to 2003. The association between acute and late toxicity was analysed using a stepwise logistic regression model. The association between the occurrence of acute NT and survival was analysed as an independent variable.

RESULTS: There were 2610 analysable patients (86% glioblastoma, 10% anaplastic astrocytoma). All received a systemic agent during radiation (83% chemotherapy, 17% …

Splenic Infarction: An Update On William Osler's Observations., Yaacov R Lawrence, Ma Mbbs Mrcp, Russell Pokroy, Mb Bch, Daniel Berlowitz, Mb Bch, Dvora Aharoni, Md, Daniel Hain, Md, Gabriel S Breuer, Md

Yaacov R. Lawrence

BACKGROUND: Osler taught that splenic infarction presents with left upper abdominal quadrant pain, tenderness and swelling accompanied by a peritoneal friction rub. Splenic infarction is classically associated with bacterial endocarditis and sickle cell disease. OBJECTIVES: To describe the contemporary experience of splenic infarction. METHODS: We conducted a chart review of inpatients diagnosed with splenic infarction in a Jerusalem hospital between 1990 and 2003. RESULTS: We identified 26 cases with a mean age of 52 years. Common causes were hematologic malignancy (six cases) and intracardiac thrombus (five cases). Only three cases were associated with bacterial endocarditis. In 21 cases the splenic …

The Effect Of Il-6 On Satellite Cell Activity In Tumor Bearing Mice

samuel.lambert@uconn.edu

Cancer cachexia results in severe muscle atrophy and can greatly hinder the quality of life and chances of survival for the afflicted individual. In studies where cachexia-induced muscle atrophy is inhibited, survival is prolonged. The activity of satellite cells, the muscle progenitor cells that incorporate into muscle fibers to cause hypertrophy, is the focus of this study. It was hypothesized that mRNA expression of Pax7, MyoD, FoxO1, FoxO3a, and FoxO4 would be altered in injured muscle in TB animals, and this would be attenuated by inhibition of interleukin (IL)-6 signaling. To test this hypothesis, tumor bearing (TB) and control mice …

Parkinson’S Disease Psychosis: A Roundtable Discussion, Jennifer G. Goldman, Rajesh Pahwa, Stuart H. Isaacson, Kevin J. Black

Kevin J. Black, MD

Case Studies In Evaluating Time Series Prediction Models Using The Relative Mean Absolute Error, Nicholas G. Reich, Justin Lessler, Krzysztof Sakrejda, Stephen A. Lauer, Sopon Iamsirithaworn, Derek A T Cummings

Nicholas G Reich

Statistical prediction models inform decision-making processes in many real-world settings. Prior to using predictions in practice, one must rigorously test and validate candidate models to ensure that the proposed predictions have sufficient accuracy to be used in practice. In this paper, we present a framework for evaluating time series predictions that emphasizes computational simplicity and an intuitive interpretation using the relative mean absolute error metric. For a single time series, this metric enables comparisons of candidate model predictions against naive reference models, a method that can provide useful and standardized performance benchmarks. Additionally, in applications with multiple time series, this …

Hyperpolarization Methods For Mrs, Boyd M. Goodson, Nicholas Whiting, Aaron M. Coffey, Panayiotis Nikolaou, Fan Shi, Brogan M. Gust, Maxwell E. Gemeinhardt, Roman Shchepin, Jason G. Skinner, Jonathan R. Birchall, Michael J. Barlow, Eduard Y. Chekmenev

Nicholas Whiting

Implementation Of A Quick Admit Order Process To Improve Emergency Department Throughput, Griselle Pastor

Griselle Pastor

No abstract provided.

Human Umbilical Cord Blood-Derived Mononuclear Cells Improve Murine Ventricular Function Upon Intramyocardial Delivery In Right Ventricular Chronic Pressure Overload, Saji Oommen, Satsuki Yamada, Susana Cantero Peral, Katherine A. Campbell, Elizabeth S. Bruinsma, Andre Terzic, Timothy J. Nelson

Katherine Campbell, PhD

No abstract provided.