Medicine and Health Sciences Commons^™

Barriers And Facilitators For Colorectal Cancer Screening Practices In The Latino Community: Perspectives From Community Leaders, Ana Natale-Pereira, Jonnie Marks, Marielos Vega, Dawne Mouzon, Shawna Hudson, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

BACKGROUND: Colorectal cancer (CRC) is the second-leading cause of cancer-related death in the United States and the third most commonly diagnosed cancer among Latinos. While Latinos represent one of the fastest-growing ethnic groups in the United States, their participation in cancer prevention and treatment trials is low. METHODS: Thirty-six Latino community leaders participated in five focus groups that examined factors affecting CRC screening practices among Latinos. RESULTS: The top four barriers identified were low knowledge and awareness of CRC, language barriers, lack of insurance, and undocumented legal status. Additional barriers included seeking health care only when sick, fatalism, fear, denial …

Pulmonary Ventilation Defects In Older Never-Smokers, Khadija Sheikh, Gregory A Paulin, Sarah Svenningsen, Miranda Kirby, Nigel A M Paterson, David G Mccormack, Grace Parraga

Medical Biophysics Publications

Hyperpolarized (3)He MRI previously revealed spatially persistent ventilation defects in healthy, older compared with healthy, younger never-smokers. To understand better the physiological consequences and potential relevance of (3)He MRI ventilation defects, we evaluated (3)He-MRI ventilation-defect percent (VDP) and the effect of deep inspiration (DI) and salbutamol on VDP in older never-smokers. To identify the potential determinants of ventilation defects in these subjects, we evaluated dyspnea, pulmonary function, and cardiopulmonary exercise test (CPET) measurements, as well as occupational and second-hand smoke exposure. Fifty-two never-smokers (71 ± 6 yr) with no history of chronic respiratory disease were evaluated. During a single visit, …

Three-Dimensional Carotid Ultrasound Plaque Texture Predicts Vascular Events, Arna Van Engelen, Thapat Wannarong, Grace Parraga, Wiro J Niessen, Aaron Fenster, J David Spence, Marleen De Bruijne

Medical Biophysics Publications

BACKGROUND AND PURPOSE: Carotid ultrasound atherosclerosis measurements, including those of the arterial wall and plaque, provide a way to monitor patients at risk of vascular events. Our objective was to examine carotid ultrasound plaque texture measurements and the change in carotid plaque texture during 1 year in patients at risk of events and to compare these with measurements of plaque volume and other risk factors as predictors of vascular events.

METHODS: We evaluated 298 patients with carotid atherosclerosis using 3-dimensional (3D) ultrasound at baseline and after 1 year and measured carotid plaque volume and 376 measures of plaque texture. Patients …

Comparison Of Insulin Infusion Protocols Targeting 110-140 Mg/Dl In Patients After Cardiac Surgery., Vasudev Magaji, Shriddha Nayak, Amy Donihi, Lauren Willard, Srinivasa Jampana, Parachur Nivedita, Raymond Eder, Jann Johnston, Mary Korytkowski

Vasudev G Magaji MD, MS

BACKGROUND: Continuous intravenous insulin infusion (CII) following coronary artery bypass graft (CABG) surgery reduces postoperative complications and hospitalization duration. Because of limited data evaluating outcomes of CII with revised glycemic targets (110-140 mg/dL) in cardiac surgery, this study compared efficacy and safety of two different CII protocols having revised targets. SUBJECTS AND METHODS: This is a retrospective study comparing two different protocols between August 2009 and March 2010. Protocol 1 consists of four algorithms, and Protocol 2 is a table to adjust CII. Blood glucose (BG) and CII rates were recorded for 48 h postoperatively or CII discontinuation. Efficacy was …

Volume Of Carotid Artery Ulceration As A Predictor Of Cardiovascular Events, Mariya Kuk, Thapat Wannarong, Vadim Beletsky, Grace Parraga, Aaron Fenster, J David Spence

Medical Biophysics Publications

BACKGROUND AND PURPOSE: Previous studies have shown the presence of ulceration in atherosclerotic plaque either by categorizing the plaque as complex (irregular morphology with ulcers) or smooth or by quantifying the number of ulcers observed in a specific region of interest. The aim of this study was to quantify carotid total ulcer volume by 3-dimensional ultrasound to investigate the relationship of total ulcer volume to vascular events (strokes, transient ischemic attack, myocardial infarction, revascularization, or death because of cardiovascular reasons).

METHODS: In total, 349 at-risk subjects provided written informed consent to carotid 3-dimensional ultrasound and were analyzed for ulcerations. Ulcer …

Angiographic Recognition Of Ostial Left Main Coronary Artery Stenosis: Case Report., R M Macmillan, Bruce Feldman, V Maranhao

Bruce A. Feldman DO

Ostial left main coronary stenosis has a poor prognosis and increased mortality rate with coronary arteriography. Due to its anatomic location, visualization of the stenosis may be difficult. A high index of suspicion based upon only a few signs should prompt the physician to perform certain maneuvers to obtain the correct diagnosis. Four illustrative cases are presented and discussed.

Addressing The Controversy Of Rate-Versus-Rhythm Control In Atrial Fibrillation, Tahmeed Contractor, Vadim Levin, Ravi Desai, Francis E Marchlinski

Vadim A Levin MD

Atrial fibrillation is the most common sustained cardiac arrhythmia and significantly increases patient risk of stroke, cardiomyopathy, and mortality. Rate versus rhythm control as the "best" treatment strategy remains an issue of considerable, ongoing debate. A multitude of clinical trials have compared the 2 strategies and have not shown any benefit of one approach over the other. However, the trials were conducted in specific subgroups of patients and demonstrated low success rates with antiarrhythmic drug (AAD) therapy and a high incidence of adverse AAD effects. Sub-analyses of the trials have confirmed that successful rhythm control with sinus rhythm restoration is …

Addressing The Controversy Of Rate-Versus-Rhythm Control In Atrial Fibrillation, Tahmeed Contractor, Vadim Levin, Ravi Desai, Francis E Marchlinski

Ravi V Desai MD

Atrial fibrillation is the most common sustained cardiac arrhythmia and significantly increases patient risk of stroke, cardiomyopathy, and mortality. Rate versus rhythm control as the "best" treatment strategy remains an issue of considerable, ongoing debate. A multitude of clinical trials have compared the 2 strategies and have not shown any benefit of one approach over the other. However, the trials were conducted in specific subgroups of patients and demonstrated low success rates with antiarrhythmic drug (AAD) therapy and a high incidence of adverse AAD effects. Sub-analyses of the trials have confirmed that successful rhythm control with sinus rhythm restoration is …

Human And Helicobacter Pylori Coevolution Shapes The Risk Of Gastric Disease, Nuri Kodaman, Alvaro Pazos, Barbara G. Schneider, M. Blanca Piazuelo, Robertino Mera, Rafal S. Sobota

Dartmouth Scholarship

Helicobacter pylori is the principal cause of gastric cancer, the second leading cause of cancer mortality worldwide. However, H. pylori prevalence generally does not predict cancer incidence. To determine whether coevolution between host and pathogen influences disease risk, we examined the association between the severity of gastric lesions and patterns of genomic variation in matched human and H. pylori samples. Patients were recruited from two geographically distinct Colombian populations with significantly different incidences of gastric cancer, but virtually identical prevalence of H. pylori infection. All H. pylori isolates contained the genetic signatures of multiple ancestries, with an ancestral African cluster …

Extending The Indications Of Flow Diversion To Small, Unruptured, Saccular Aneurysms Of The Anterior Circulation., Nohra Chalouhi, Md, Robert M Starke, Steven Yang, Cory D Bovenzi, Stavropoula Tjoumakaris, David Hasan, L. Fernando Gonzalez, Robert H. Rosenwasswer Md, Pascal Jabbour Md

Department of Neurosurgery Faculty Papers

BACKGROUND AND PURPOSE: Flow diverters are currently indicated for treatment of large and complex intracranial aneurysms. The purpose of this study was to determine whether the indications of flow diversion can be safely extended to unruptured, small, saccular aneurysms (<10 >mm) of the anterior circulation.

METHODS: Forty patients treated with the pipeline embolization device (PED) were matched in a 1:4 fashion with 160 patients treated with stent-assisted coiling based on patient age, sex, aneurysm location, and aneurysm size. Procedural complications, angiographic results, and clinical outcomes were analyzed and compared.

RESULTS: The rate of periprocedural complications was 5% in the PED …

Risk Factors For Cerebrovascular Disease Mortality Among The Elderly In Beijing: A Competing Risk Analysis, Zhe Tang, Tao Zhou, Yanxia Luo, Changchun Xie, Da Huo, Lixin Tao, Lei Pan, Fei Sun, Huiping Zhu, Xinghua Yang, Wei Wang, Aoshuang Yan, Xia Li, Xiuhua Guo

Research outputs 2014 to 2021

Objective: To examine the associations of combined lifestyle factors and physical conditions with cerebrovascular diseases (CBVD) mortality, after accounting for competing risk events, including death from cardiovascular diseases, cancers and other diseases. Methods: Data on 2010 subjects aged over 55 years were finally analyzed using competing risk models. All the subjects were interviewed by the Beijing Longitudinal Study of Aging (BLSA), in China, between 1 January 1992 and 30 August 2009. Results: Elderly females were at a lower risk of death from CBVD than elderly males (HR = 0.639, 95% CI = 0.457-0.895). Increasing age (HR = 1.543, 95% CI …