Medicine and Health Sciences Commons^™

Cigarette Smoking And Cardio-Renal Events In Patients With Atherosclerotic Renal Artery Stenosis., Christopher A Drummond, Pamela S Brewster, Wencan He, Kaili Ren, Yanmei Xie, Katherine Tuttle, Steven T Haller, Kenneth Jamerson, Lance D Dworkin, Donald E Cutlip, Timothy P Murphy, Ralph B D'Agostino, William L Henrich, Jiang Tian, Joseph I Shapiro, Christopher J Cooper

Articles, Abstracts, and Reports

Cigarette smoking causes cardiovascular disease and is associated with poor kidney function in individuals with diabetes mellitus and primary kidney diseases. However, the association of smoking on patients with atherosclerotic renal artery stenosis has not been studied. The current study utilized data from the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL, NCT00081731) clinical trial to evaluate the effects of smoking on the risk of cardio-renal events and kidney function in this population. Baseline data showed that smokers (n = 277 out of 931) were significantly younger at enrollment than non-smokers (63.3±9.1 years vs 72.4±7.8 years; p

Mutational Landscapes Of Smoking-Related Cancers In Caucasians And African Americans: Precision Oncology Perspectives At Wake Forest Baptist Comprehensive Cancer Center., Ville Kytola, Umit Topaloglu, Lance D Miller, Rhonda L Bitting, Michael M Goodman, Ralph B D Agostino, Rodwige J Desnoyers, Carol Albright, George Yacoub, Shadi A Qasem, Barry Deyoung, Vesteinn Thorsson, Ilya Shmulevich, Meng Yang, Anastasia Shcherban, Matthew Pagni, Liang Liu, Matti Nykter, Kexin Chen, Gregory A Hawkins, Stefan C Grant, W Jeffrey Petty, Angela Tatiana Alistar, Edward A Levine, Edgar D Staren, Carl D Langefeld, Vincent Miller, Gaurav Singal, Robin M Petro, Mac Robinson, William Blackstock, Bayard L Powell, Lynne I Wagner, Kristie L Foley, Edward Abraham, Boris Pasche, Wei Zhang

Articles, Abstracts, and Reports

Background: Cancers related to tobacco use and African-American ancestry are under-characterized by genomics. This gap in precision oncology research represents a major challenge in the health disparities in the United States. Methods: The Precision Oncology trial at the Wake Forest Baptist Comprehensive Cancer Center enrolled 431 cancer patients from March 2015 to May 2016. The composition of these patients consists of a high representation of tobacco-related cancers (e.g., lung, colorectal, and bladder) and African-American ancestry (13.5%). Tumors were sequenced to identify mutations to gain insight into genetic alterations associated with smoking and/or African-American ancestry. Results: Tobacco-related cancers exhibit a high …

Setting The Stage: Success In Performance Excellence, Providence St. Joseph Health

Articles, Abstracts, and Reports

No abstract provided.

Implementing A Discharge Checklist In The Emergency Department, Angela Hahn, Rose Delarosa

All Nursing Boot Camp Posters

No abstract provided.

Aromatherapy: Using Essential Oils To Decrease Nausea And Vomiting In Patients In The Acute Care Setting, Amanda Hanley, Sofia Costas, Ma Fe Chase

All Nursing Boot Camp Posters

No abstract provided.

The Effects Of Centralized Vs. Decentralized Nursing Station On Patient Falls, Ann Sarvent, Nancy Hart, Lynette Savage

All Nursing Boot Camp Posters

No abstract provided.

Mindfulness Decreases Nurse Burnout, Sherry Hutton, Cindy Kenyon

All Nursing Boot Camp Posters

No abstract provided.

The Providence St. Vincent Emergency Department Implementation Of A Standardized Communication Tool In Patient’S Rooms, Amy Engstrom, Fay Johnson, Anita Ott-Hendrickson, Debbie Sanchez

All Nursing Boot Camp Posters

No abstract provided.

Supporting The Discharge Transition From Nicu To Home, Shawna Blix, Lisa Fellin, Beth Yanamura

All Nursing Boot Camp Posters

No abstract provided.

Health Literacy: Improving Patient Comprehension Of Dialysis Treatment Using A Low-Literacy Consent Form, Ava Cavanagh, Julie Moffitt

All Nursing Boot Camp Posters

No abstract provided.

Alzheimer’S Disease And Other Dementias Workgroup: Alzheimer’S Disease And Other Dementias Report And Recommendations, V Weir (Ed), K Rhoads (Chair), Nancy B. Isenberg, See All Group Members In Comments

Articles, Abstracts, and Reports

Rates of Alzheimer’s disease and other dementias are expected to increase greatly over the next decades. Many practices lack guidelines on how to increase quality of diagnosing, treating, and supporting people with dementia and their family members and other caregivers. This workgroup met from January to November 2017, aligned with and built off the Alzheimer’s State Plan, and organized recommendations with the following focus areas:

• Early detection and appropriate diagnosis
• Ongoing care and support or management including for family members and caregivers
• Advance care planning and palliative care
• Assessment and planning for need for increased support and/or higher levels …

Insights Into Local Tumor Microenvironment Immune Factors Associated With Regression Of Cutaneous Melanoma Metastases By, Junbao Yang, Maris S Jones, Romela Irene Ramos, Alfred A Chan, Agnes F Lee, Leland J Foshag, Peter A Sieling, Mark Faries, Delphine J Lee

Articles, Abstracts, and Reports

No abstract provided.

Peripheral Huntingtin Silencing Does Not Ameliorate Central Signs Of Disease In The B6.Httq111/+ Mouse Model Of Huntington's Disease., Sydney R Coffey, Robert M Bragg, Shawn Minnig, Seth A Ament, Jeffrey P Cantle, Anne Glickenhaus, Daniel Shelnut, José M Carrillo, Dominic D Shuttleworth, Julie-Anne Rodier, Kimihiro Noguchi, C Frank Bennett, Nathan D Price, Holly B Kordasiewicz, Jeffrey B Carroll

Articles, Abstracts, and Reports

Huntington's disease (HD) is an autosomal dominant neurodegenerative disease whose predominant neuropathological signature is the selective loss of medium spiny neurons in the striatum. Despite this selective neuropathology, the mutant protein (huntingtin) is found in virtually every cell so far studied, and, consequently, phenotypes are observed in a wide range of organ systems both inside and outside the central nervous system. We, and others, have suggested that peripheral dysfunction could contribute to the rate of progression of striatal phenotypes of HD. To test this hypothesis, we lowered levels of huntingtin by treating mice with antisense oligonucleotides (ASOs) targeting the murine …

Assessing Survival And Grading The Severity Of Complications In Octogenarians Undergoing Pulmonary Lobectomy., Andrew Feczko, Elizabeth Mckeown, Jennifer L Wilson, Brian E Louie, Ralph W Aye, Jed A Gorden, Eric Vallières, Alexander S Farivar

Articles, Abstracts, and Reports

No abstract provided.

Histopathology And Enhanced Detection Of Tumor Invasion Of Peritoneal Membranes., Jey-Hsin Chen, Melissa Borges

Articles, Abstracts, and Reports

Tumor invasion of the peritoneal membrane may have an adverse prognostic significance, but its histopathologic features can be diagnostically difficult to recognize. We observed that local peritoneal injury associated with tumor invasion is characterized by activation and proliferation of serosal stromal cells that express cytokeratin, a characteristic property of injured serosal membranes that may have diagnostic utility. To explore this, we examined 120 primary tumors of the gastrointestinal tract and pancreaticobiliary system using cytokeratin and elastic stains to assess for tumor invasion of peritoneal membranes. Peritoneal invasion by tumor was associated with retraction, splaying, and destruction of the elastic lamina …

Risk Of Glucose Intolerance And Gestational Diabetes Mellitus In Relation To Maternal Habitual Snoring During Early Pregnancy., Chunfang Qiu, Wayne Lawrence, Bizu Gelaye, Lee Stoner, Ihunnaya O Frederick, Daniel A Enquobahrie, Tanya K Sorensen, Michelle A Williams

Articles, Abstracts, and Reports

BACKGROUND: Obstructive sleep apnea (OSA) or habitual snoring is known to be associated with impaired glucose tolerance and type 2 diabetes among both men and non-pregnant women. We examined the association of habitual snoring during early pregnancy with risk of impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM).

METHODS: A cohort of 1,579 women was interviewed during early pregnancy. We collected information about snoring frequency during early pregnancy. Results from screening and diagnostic tests for IGT and GDM were abstracted from medical records. Multivariate logistic regression models were fitted to estimate odds ratios (OR) and 95% confidence intervals (95% …

Journey To Preventing Hospital Onset Clostridium Difficile Infection On Our Patients, Rowena Chin, Lynne Orlins

Articles, Abstracts, and Reports

No abstract provided.

The Feasibility Of Implementing The Ichom Standard Set For Hip And Knee Osteoarthritis: A Mixed-Methods Evaluation In Public And Private Hospital Settings., Ilana N Ackerman, Bernarda Cavka, Jacob Lippa, Andrew Bucknill

Articles, Abstracts, and Reports

Background: There is growing international momentum for standardising patient outcome assessment and using patient-reported outcome measures (PROMs) to capture outcomes that matter to patients. The International Consortium for Health Outcomes Measurement (ICHOM) Standard Sets were developed to capture the outcomes of care for costly conditions including osteoarthritis. This study evaluated the feasibility of implementing the ICHOM Standard Set for Hip and Knee Osteoarthritis in 'real world' public and private hospital settings.

Methods: A mixed-methods design was used to capture comprehensive data on patient outcomes, implementation costs, and the implementation experiences of patients, clinicians and administrative staff. The ICHOM Standard Set …

Prevalence And Correlates Of Cannabis Use In Outpatients With Serious Mental Illness Receiving Treatment For Alcohol Use Disorders., Jordan Skalisky, Emily Leickly, Oladunni Oluwoye, Sterling M Mcpherson, Debra Srebnik, John M Roll, Richard K Ries, Michael G Mcdonell

Articles, Abstracts, and Reports

Introduction: People with serious mental illness (SMI) use cannabis more than any other illicit drug. Cannabis use is associated with increased psychotic symptoms and is highly comorbid with alcohol use disorders (AUDs). Despite the national trend toward decriminalization, little is known about the prevalence, correlates, and impact of cannabis use on those with SMI receiving treatment for substance use disorders, a group at high risk for the negative effects of cannabis use. Methods: In this secondary data analysis, cannabis use prevalence, correlates, and impact on treatment outcomes were examined in 121 adults with cooccurring SMI and AUDs receiving outpatient addiction …

Early Mutation Bursts In Colorectal Tumors., Junsong Zhao, Matthew P Salomon, Darryl Shibata, Christina Curtis, Kimberly Siegmund, Paul Marjoram

Articles, Abstracts, and Reports

Tumor growth is an evolutionary process involving accumulation of mutations, copy number alterations, and cancer stem cell (CSC) division and differentiation. As direct observation of this process is impossible, inference regarding when mutations occur and how stem cells divide is difficult. However, this ancestral information is encoded within the tumor itself, in the form of intratumoral heterogeneity of the tumor cell genomes. Here we present a framework that allows simulation of these processes and estimation of mutation rates at the various stages of tumor development and CSC division patterns for single-gland sequencing data from colorectal tumors. We parameterize the mutation …

Does Gated Beam Delivery Impact Delivery Accuracy On An Elekta Linac?, Mohammed Jermoumi, Roger Xie, Daliang Cao, David J Housley, David M Shepard

Articles, Abstracts, and Reports

In this study, we evaluated the performance of an Elekta linac in the delivery of gated radiotherapy. Delivery accuracy was examined with an emphasis on the impact of using short gating windows (low monitor unit beam-on segments) or long beam hold times. The performance was assessed using a 20cm by 20cm open field with the radiation delivered using a range of beam-on and beam-off time periods. Gated delivery measurements were also performed for two SBRT plans delivered using volumetric modulated arc therapy (VMAT). Tests included both free-breathing based gating (covering a variety of gating windows) and simulated breath-hold based gating. …

Brief Cognitive Screening Tools For Primary Care Practice, K Rhoads, Nancy B. Isenberg, L Korte

Articles, Abstracts, and Reports

Early detection and diagnosis of Alzheimer’s disease and other cognitive impairment presents as a critical issue facing primary and specialty care providers in Washington State. In order to address the gaps and challenges faced by providers, the Dementia Action Collaborative offers the current paper to provide information and guidance around early detection and diagnosis of memory loss and dementia, including Alzheimer’s disease. At the conclusion of this paper, providers should be able to identify indications and opportunities for detection, appropriate tools, and care pathways for individuals and families affected by cognitive impairment and dementia.

Persuasive Interventions For Controversial Cancer Screening Recommendations: Testing A Novel Approach To Help Patients Make Evidence-Based Decisions., Barry Saver, Kathleen M Mazor, Roger Luckmann, Sarah L Cutrona, Marcela Hayes, Tatyana Gorodetsky, Nancy Esparza, Gonzalo Bacigalupe

Articles, Abstracts, and Reports

PURPOSE: We wanted to evaluate novel decision aids designed to help patients trust and accept the controversial, evidence-based, US Preventive Services Task Force recommendations about prostate cancer screening (from 2012) and mammography screening for women aged 40 to 49 years (from 2009).

METHODS: We created recorded vignettes of physician-patient discussions about prostate cancer screening and mammography, accompanied by illustrative slides, based on principles derived from preceding qualitative work and behavioral science literature. We conducted a randomized crossover study with repeated measures with 27 men aged 50 to 74 years and 35 women aged 40 to 49 years. All participants saw …

A Randomized Study Comparing Digital Imaging To Traditional Glass Slide Microscopy For Breast Biopsy And Cancer Diagnosis., Joann G Elmore, Gary M Longton, Margaret S Pepe, Patricia A Carney, Heidi D Nelson, Kimberly H Allison, Berta M Geller, Tracy Onega, Anna N A Tosteson, Ezgi Mercan, Linda G Shapiro, Tad T Brunyé, Thomas R Morgan, Donald L Weaver

Articles, Abstracts, and Reports

BACKGROUND: Digital whole slide imaging may be useful for obtaining second opinions and is used in many countries. However, the U.S. Food and Drug Administration requires verification studies.

METHODS: Pathologists were randomized to interpret one of four sets of breast biopsy cases during two phases, separated by ≥9 months, using glass slides or digital format (sixty cases per set, one slide per case,

RESULTS: Sixty-five percent of responding pathologists were eligible, and 252 consented to randomization; 208 completed Phase I (115 glass, 93 digital); and 172 completed Phase II (86 glass, 86 digital). Accuracy was slightly higher using glass compared …

Differential Phenotypes Of Memory Cd4 And Cd8 T Cells In The Spleen And Peripheral Tissues Following Immunostimulatory Therapy., Gail D Sckisel, Annie Mirsoian, Christine M Minnar, Marka R Crittenden, Brendan Curti, Jane Q Chen, Bruce R Blazar, Alexander D Borowsky, Arta M Monjazeb, William J Murphy

Articles, Abstracts, and Reports

BACKGROUND: Studies assessing immune parameters typically utilize human PBMCs or murine splenocytes to generate data that is interpreted as representative of immune status. Using splenocytes, we have shown memory CD4-T cells that expand following systemic immunostimulatory therapies undergo rapid IFNg-mediated activation induced cell death (AICD) resulting in a net loss of total CD4-T cells which correlates with elevated PD-1 expression. This is in contrast to CD8-T cells which expand with minimal PD-1 upregulation and apoptosis. In this study we expand upon our previous work by evaluating CD4 and CD8-T cell phenotype and distribution in peripheral organs which are more representative …

Catastrophes And Complicated Intraoperative Events During Robotic Lung Resection., Brian E Louie

Articles, Abstracts, and Reports

Intraoperative complications and catastrophes are an accepted and perhaps inevitable aspect of all surgeries. Anatomic pulmonary resection puts in close proximity the tracheal-bronchial tree, pulmonary vasculature, heart and great vessels within the small volume area of the chest. Fortunately, major complications and catastrophes are uncommon regardless of surgical approach. Pulmonary arterial injury is the most frequently reported. Most injuries necessitate a thoracotomy for definitive management though novel techniques are emerging for minimally invasive management. This section focuses on intraoperative pulmonary artery and vein injuries, major airway injuries and transections, injuries to major abdominal organs and effects of carbon dioxide insufflation …

A Journey Of Educational Transformation And Organizational Improvement Through Development Of An Institutional Patient Blood Management Program, Robert Raggi, Karen Klein, Marci Swearingen, Mark Domantay

Articles, Abstracts, and Reports

Providence Holy Cross Medical Center (PHCMC) has embarked on this journey to improve outcomes by reducing the number of unnecessary transfusions through the development of a PBM program. Transfusion-related health risks and increasing economic pressures have driven hospitals to recognize development of blood management programs as an important strategy to improve patient outcomes and reduce costs.