Medicine and Health Sciences Commons^™

Tightening Our Belts In The New Healthcare Economy, Laura Pizzi Pharmd,Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Santa Clara, 2013-02-21, Santa Clara University

The Santa Clara

No abstract provided.

Acute Aortic Valve Rupture From Infective Endocarditis After Transrectal Prostate Biopsy: A Call To Revise The Aha Guidelines For Prevention Of Infective Endocarditis, Julia Ansari, Gurkaran Singh Garcha, Henry Huang, Faisal G. Bakaeen, Salim S. Virani, Hani Jneid

Office of the Provost

We describe the case of a 63-year-old man with a known murmur who presented with a 4-month history of intermittent fever and a progressive reduction in energy level after a transrectal prostate biopsy (TRPB). He subsequently presented with acute heart failure secondary to aortic valve cusp rupture caused by endocarditis and underwent urgent aortic valve surgery. The 2008 American College of Cardiology/American Heart Association Guideline update on infective endocarditis has narrowed the use of antibiotic prophylaxis before most accepted dental procedures and continues to recommend against prophylaxis before genitourinary or gastrointestinal procedures. In contrast, the American Urological Association recommends the …

Observational Intensity Bias Associated With Illness Adjustment: Cross Sectional Analysis Of Insurance Claims, J. E. Wennberg, D. O. Staiger, S. M. Sharp, D. J. Gottlieb

Dartmouth Scholarship

Objective: To determine the bias associated with frequency of visits by physicians in adjusting for illness, using diagnoses recorded in administrative databases.

Setting: Claims data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions.

Design: Cross sectional analysis. Participants 20% sample of fee for service Medicare beneficiaries residing in the United States in 2007 (n=5 153 877).

Hearing Loss In The Dental Office: The Effects Of High Speed Dental Drills On Dentists' Hearing, Krisztina Johnson, Jacek Smurzynski, Saravanan Elangovan, Marc Fagelson

ETSU Faculty Works

Hearing test results of 23 dentists obtained before and after working hours are compared to determine if dentists experience any temporary hearing loss. The aim of the project is to determine whether dental drills cause hearing loss and to document the consequences of the loss. Hearing evaluations include pure-tone audiometry, middle-ear testing, and measurements of otoacoustic emissions. The results are expected to convince dentists of the danger of noise exposure and the need for hearing protection

Developing A Clinical Nurse Leader Practice Model: An Interpretive Synthesis, Miriam Bender Phd

Dissertations

Objective: The Institute of Medicine's Future of Nursing report identifies the Clinical Nurse Leader (CNL) as an innovative and necessary new role for meeting higher healthcare quality standards. The American Association of Colleges of Nursing CNL White Paper defines core competencies necessary for practice. The literature documents preliminary evidence of improved outcomes associated with CNL integration into clinical microsystems. However, the CNL role is not yet clearly defined in terms of fundamental activities and responsibilities necessary to produce outcomes. Lack of practice clarity limits the ability to articulate, implement, and measure CNL-specific practice and outcomes. The purpose of this study …

Treatment Options For Seizures: Practical Points In Epilepsy Management, Soraya E. Jiménez Md

Neurology Update for the Non-Neurologist

No abstract provided.

Diagnosis, Assessment And Evaluation For Seizures, John W. Margraf Md

Neurology Update for the Non-Neurologist

No abstract provided.

Special Populations And Considerations In Migraine Therapy, Gary Clauser Md

Neurology Update for the Non-Neurologist

No abstract provided.

Migraine Diagnosis And Treatment, Vitaliy Koss Md

Neurology Update for the Non-Neurologist

No abstract provided.

Defining The Need For Specific Neurological Studies, John E. Castaldo Md

Neurology Update for the Non-Neurologist

No abstract provided.

How To Think Like A Neurologist – Review Of Exam Process And Assessment Findings, Gary Clauser Md

Neurology Update for the Non-Neurologist

No abstract provided.

Using Learning Collaboratives To Improve Public Health Emergency Preparedness Systems, Michael A. Stoto, Harold Cox, Melissa Higdon, Kerry Dunnell, Donald Goldmann

Frontiers in Public Health Services and Systems Research

The U.S. National Health Security Strategy calls for the development and wide-spread implementation of quality improvement (QI) tools in public health emergency preparedness (PHEP), including the development of “learning collaboratives,” a structured way for organizations with common interests to close the gap between potential and practice by learning from each other. To test this approach, we developed and assessed separate learning collaboratives focused on PHEP emergency communications and on the use of Medical Reserve Corps (MRC) volunteers. Although participants carried out improvement projects that they felt were useful, each collaborative struggled to identify a common theme, participation was limited, and …

Evidence-Based Decision Making To Improve Public Health Practice, Ross C. Brownson, Jonathan E. Fielding, Christopher M. Maylahn

Frontiers in Public Health Services and Systems Research

Despite the many accomplishments of public health, greater attention on evidence-based approaches is warranted. This article reviews the concepts of evidence-based public health (EBPH), on which formal discourse originated about 15 years ago. Key components of EBPH include: making decisions based on the best available scientific evidence, using data and information systems systematically, applying program planning frameworks, engaging the community in decision making, conducting sound evaluation, and disseminating what is learned. Core competencies for EBPH are emerging, including not only technical skills but also attention to administrative practices in public health agencies. To better bridge evidence and practice, the concepts …

Commentary: A Public Health And Hospital System Collaboration For Conducting Community Health Assessments And Community Health Improvement Plans: Seven Hospital Systems In Oregon And Washington And Four County Public Health Departments In Oregon And One In Washington, Lillian Shirley, Andrew S. Davidson, Marti Franc, Kathleen O'Leary, Priscilla Lewis, Marni Storey, Christine Sorvari

Frontiers in Public Health Services and Systems Research

The following narrative describes the innovative partnership and approach to create comprehensive, meaningful, and coordinated community health assessments and community health improvement plans that fulfill the specific needs of hospital systems, local public health, and coordinated care organizations (Oregon’s version of Accountable Care Organizations).

Progress Realized: Trends In Hiv-1 Viral Load And Cd4 Cell Count In A Tertiary-Care Center From 1999 Through 2011, Howard B. Gale, Manuel D. Rodriguez, Heather J. Hoffman, Debra A. Benator, Fred M. Gordin, Ann M. Labriola, Virginia L. Kan

Epidemiology Faculty Publications

Abstract

Accumulating evidence suggests that alterations in immune function may be important in the etiology of papillary thyroid cancer (PTC). To identify genetic markers in immune-related pathways, we evaluated 3,985 tag single nucleotide polymorphisms (SNPs) in 230 candidate gene regions (adhesion-extravasation-migration, arachidonic acid metabolism/eicosanoid signaling, complement and coagulation cascade, cytokine signaling, innate pathogen detection and antimicrobials, leukocyte signaling, TNF/NF-kB pathway or other) in a case-control study of 344 PTC cases and 452 controls. We used logistic regression models to estimate odds ratios (OR) and calculate one degree of freedom P values of linear trend (PSNP-trend) for the association …

Role Of An Iron-Dependent Transcriptional Regulator In The Pathogenesis And Host Response To Infection With Streptococcus Pneumoniae., Radha Gupta, Minny Bhatty, Edwin Swiatlo, Bindu Nanduri

CVM Publications

Iron is a critical cofactor for many enzymes and is known to regulate gene expression in many bacterial pathogens. Streptococcus pneumoniae normally inhabits the upper respiratory mucosa but can also invade and replicate in lungs and blood. These anatomic sites vary considerably in both the quantity and form of available iron. The genome of serotype 4 pneumococcal strain TIGR4 encodes a putative iron-dependent transcriptional regulator (IDTR). A mutant deleted at idtr (?idtr) exhibited growth kinetics similar to parent strain TIGR4 in vitro and in mouse blood for up to 48 hours following infection. However, ?idtr was significantly attenuated in a …

Roles And Mechanism Of Mir-199a And Mir-125b In Tumor Angiogenesis., Jun He, Yi Jing, Wei Li, Xu Qian, Qing Xu, Feng-Shan Li, Ling-Zhi Liu, Bing-Hua Jiang, Yue Jiang

Computational Medicine Center Faculty Papers

MicroRNAs (miRNAs) have been shown to be involved in different aspects of cancer biology including tumor angiogenesis. In this study, we identified that two miRNAs, miR-199a and miR-125b were downregulated in ovarian cancer tissues and cell lines. Overexpression of miR-199a and miR-125b inhibited tumor-induced angiogenesis associated with the decrease of HIF-1α and VEGF expression in ovarian cancer cells. Moreover, the levels of miR-199a and miR-125b were negatively correlated with VEGF mRNA levels in ovarian tissues. We further showed that direct targets of miR-199a and miR-125b HER2 and HER3 were functionally relevant. Forced expression of HER2 and HER3 rescued miR-199a- and …

Promoting Collaboration In Health Care Teams Through Interprofessional Education: A Simulation Case Study, Ozgur Ekmekci

Clinical Research and Leadership Faculty Publications

This simulation study explores how the integration of interprofessional components into health care curriculum may impact professional stereotyping and collaborative behavior in care delivery teams comprised of a physician, a registered nurse, a physician’s assistant, a physical therapist, and a radiation therapist. As part of the agent-based modeling simulation, 500 students completed a curriculum with no IPE component and another 500 completed the same curriculum in which 25% of the courses being offered had IPE components embedded. The 500 students completing the non-IPE curriculum were asked to randomly form 100 health care delivery teams consisting of a member from each …

Phospholipid Scramblase-1-Induced Lipid Reorganization Regulates Compensatory Endocytosis In Neuroendocrine Cells, Stéphane Ory, Mara Ceridono, Fanny Momboisse, Sébastien Houy, Sylvette Chasserot-Golaz, Dimitri Heintz, Valérie Calco, Anna-Marie Haeberlé, Flor A. Espinoza, Peter J. Sims, Yannick Bailly, Marie-France Bader, Stéphane Gasman

Faculty Articles

Calcium-regulated exocytosis in neuroendocrine cells and neurons is accompanied by the redistribution of phosphatidylserine (PS) to the extracellular space, leading to a disruption of plasma membrane asymmetry. How and why outward translocation of PS occurs during secretion are currently unknown. Immunogold labeling on plasma membrane sheets coupled with hierarchical clustering analysis demonstrate that PS translocation occurs at the vicinity of the secretory granule fusion sites. We found that altering the function of the phospholipid scramblase-1 (PLSCR-1) by expressing a PLSCR-1 calcium-insensitive mutant or by using chromaffin cells from PLSCR-1^−/−mice prevents outward translocation of PS in cells stimulated for …

2013 February 19 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

Curatedovariandata: Clinically Annotated Data For The Ovarian Cancer Transcriptome, Benjamin Frederick Ganzfried, Markus Riester, Benjamin Haibe-Kains, Thomas Risch, Svitlana Tyekucheva, Ina Jazic, Xin Victoria Wang, Mahnaz Ahmadifar, Michael J. Birrer, Giovanni Parmigiani, Curtis Huttenhower, Levi Waldron

Publications and Research

This article introduces a manually curated data collection for gene expression meta-analysis of patients with ovarian cancer and software for reproducible preparation of similar databases. This resource provides uniformly prepared microarray data for 2970 patients from 23 studies with curated and documented clinical metadata. It allows users to efficiently identify studies and patient subgroups of interest for analysis and to perform meta-analysis immediately without the challenges posed by harmonizing heterogeneous microarray technologies, study designs, expression data processing methods and clinical data formats. We confirm that the recently proposed biomarker CXCL12 is associated with patient survival, independently of stage and optimal …

The "Coopetition" Model: Caring For San Diego's Low-Income Population, Lisa Sprague, Jessamyn Taylor

National Health Policy Forum

This site visit explored aspects of health care delivery for Medicaid beneficiaries and the uninsured in a California county marked by a diverse population, dominant managed care, and stakeholder dedication to solving problems in a spirit of "coopetition." The program looked at the impact of California's Bridge to Reform (the state's Medicaid section 1115 waiver) on federally qualified health centers and the people they serve. Eligibility and enrollment expansions in the Low Income Health Program and Medi-Cal, health information technology adoption and its use to improve care delivery and health, and patient-centered medical homes and care coordination were discussed. The …

Training Verb Argument Structure Production In Agrammatic Aphasia: Behavioral And Neural Recovery Patterns, Cynthia K. Thompson, Ellyn A. Riley, Dirk B. Den Ouden, Aya Meltzer-Asscher, Sladjana Lukic

Communication Sciences and Disorders Faculty Articles and Research

Introduction

Impact Of The Tohoku Earthquake And Tsunami On Pneumonia Hospitalisations And Mortality Among Adults In Northern Miyagi, Japan: A Multicentre Observational Study, Hisayoshi Daito, Motoi Suzuki, Jun Shiihara, Paul E. Kilgore, Hitoshi Ohtomo, Konosuke Morimoto, Masayuki Ishida, Taro Kamigaki, Hitoshi Oshitani, Masahiro Hashizume, Wataru Endo, Koichi Hagiwara, Koya Ariyoshi, Shoji Okinaga

Department of Pharmacy Practice

Background On 11 March 2011, the Tohoku earthquake and tsunami struck off the coast of northeastern Japan. Within 3 weeks, an increased number of pneumonia admissions and deaths occurred in local hospitals.

Methods A multicentre survey was conducted at three hospitals in Kesennuma City (population 74000), northern Miyagi Prefecture. All adults aged ≥18 years hospitalised between March 2010 and June 2011 with community-acquired pneumonia were identified using hospital databases and medical records. Segmented regression analyses were used to quantify changes in the incidence of pneumonia.

Results A total of 550 pneumonia hospitalisations were identified, including 325 during the pre-disaster period …

Ada News - 02/18/2013, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

Multifactor Dimensionality Reduction Reveals A Three-Locus Epistatic Interaction Associated With Susceptibility To Pulmonary Tuberculosis, Ryan L. Collins, Ting Hu, Christian Wejse, Giorgio Sirugo, Scott M. Williams, Jason H. Moore

Dartmouth Scholarship

Background:

Identifying high-order genetics associations with non-additive (i.e. epistatic) effects in population-based studies of common human diseases is a computational challenge. Multifactor dimensionality reduction (MDR) is a machine learning method that was designed specifically for this problem. The goal of the present study was to apply MDR to mining high-order epistatic interactions in a population-based genetic study of tuberculosis (TB).

Results:

The study used a previously published data set consisting of 19 candidate single-nucleotide polymorphisms (SNPs) in 321 pulmonary TB cases and 347 healthy controls from Guniea-Bissau in Africa. The ReliefF algorithm was applied first to generate a smaller set …

A 2-Step Approach To Myeloablative Haploidentical Stem Cell Transplantation With Optimized T-Cell Dosing: Early Immune Reconstitution Leads To Better Outcomes, Sameh Gaballa, Onder Alpdogan, Matthew Carabasi, Joanne Filicko, Margaret Kasner, Ubaldo E. Martinez-Outshoorn, Md, John L Wagner, Mark Weiss, Neal Flomenberg, Delores Grosso

Department of Medical Oncology Faculty Papers

We developed a 2-step approach to myeloablative haploidentical HSCT in which patients receive a large fixed dose of cyclophosphamide (CY)-tolerized T cells separately frm the HSC infusion in the hopes of accelerating post HSCT immune reconstitution (IR). The uniformity of the T cell dosing facilitates comparison of patients without (low risk) and with (high risk) active malignancy at HSCT to ascertain the impact of disease status at HSCT on IR with fewer confounding effects from conditioning or T cell dosing.

Pope Benedict Xvi’S Resignation: A Witness To Aging, A Signal For A New Bioethics, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Inhibition Of Cholinergic Signaling Causes Apoptosis In Human Bronchioalveolar Carcinoma, Jamie K. Lau, Kathleen C. Brown, Brent A. Thornhill, Clayton M. Crabtree, Aaron M. Dom, Theodore R. Witte, W. Elaine Hardman, Christopher A. Mcnees, Cody A. Stover, A. Betts Carpenter, Haitao Luo, Yi C. Chen, Brandon S. Shiflett, Piyali Dasgupta

Biochemistry and Microbiology

Recent case-controlled clinical studies show that bronchioalveolar carcinomas (BAC) are correlated with smoking. Nicotine, the addictive component of cigarettes, accelerates cell proliferation through nicotinic acetylcholine receptors (nAChR). In this study, we show that human BACs produce acetylcholine (ACh) and contain several cholinergic factors including acetylcholinesterase (AChE), choline acetyltransferase (ChAT), choline transporter 1 (CHT1, SLC5A7), vesicular acetylcholine transporter (VAChT, SLC18A3), and nACh receptors (AChRs, CHRNAs). Nicotine increased the production of ACh in human BACs, and ACh acts as a growth factor for these cells. Nicotine-induced ACh production was mediated by α7-, α3β2-, and β3-nAChRs, ChAT and VAChT pathways. We observed that …