Medical Specialties Commons^™

Heart Failure Follow Up Phone Calls, Melissa Lampert, Anne Major

Nursing Posters

Increase the number of 72-hour post-discharge follow-up phone calls for patients hospitalized with a primary diagnosis of heart failure.

This is a quality measure required for Joint Commission Heart Failure Certification and also to maintain American Heart Association Gold Plus Status.

I.D.E.A.L. Transition Plan, Colleen Porwoll

Nursing Posters

The purpose of this evidence-based practice project is to increase the number of discharges prior to noon by using the IDEAL discharge planning tool with noncomplex total joint replacement patients and maintaining score of discharge phone call follow up. "Were you aware of the discharge plans and felt prepared?"

Decreasing Unnecessary Pharmacy Cost In The Cath Lab, Scott M. Scepaniak, Kristi Patterson

Nursing Posters

AngioMax is a single dose heparin alternative introduced in 2002 that is used in cardiac patients undergoing percutaneous intervention (PCI). Bivalirudin costs $377 per dose; heparin is less than $15 per dose. Noting practice variations, the Cath Lab set out to eliminate unnecessary pharmacy cost for PCI patients by:

• Using current literature to inform clinical care
• Standardizing practice
• Using data to track and guide implementation

The Impact Of Schizophrenia On Copd Readmission Rate Among Hospitalized South Carolinians, Emilienne Y. Watonsi

DNP Research Projects

Due to elevated readmission costs, the Affordable Care Act established the Hospital Readmission Reduction Program in 2012 to curb the 30-day readmission rates. COPD and schizophrenia are two very expensive diseases, COPD national medical costs is projected to be $49.0 billion in 2020; the cost of schizophrenia was 155.7 billion in 2013. The main objective of this study was to determine if schizophrenia is a significant predictor of 30-day readmission following hospitalization for acute exacerbation of COPD after adjusting for age, gender, anxiety, smoking status, T2DM, chronic ischemic heart disease, and GERD. Methods: A retrospective cohort design was used to …

A Chromosomal Deletion And New Frameshift Mutation Cause Arsacs In An African-American, Sean C. Dougherty, Amy Harper, Hind Al Saif, Gregory Vorona, Scott R. Haines

Neurology Publications

Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS) is a rare, progressive, neurodegenerative disease characterized by ataxia, spasticity and polyneuropathy. First described in the French-Canadian population of Quebec in 1978, ARSACS has since been identified in multiple patients worldwide. In this clinical case report, we describe the evaluation of an 11-years-old African-American male who presented to neuromuscular clinic for assessment of a gait abnormality. He had a history of gross motor delay since early childhood, frequent falls and a below average IQ. Chromosomal microarray revealed a 1.422 megabase loss in the 13q12.12 region, which includes the SACS gene. Next Generation Sequencing …

Reducing Stigma Among Healthcare Providers To Improve Mental Health Services (Reshape): Protocol For A Pilot Cluster Randomized Controlled Trial Of A Stigma Reduction Intervention For Training Primary Healthcare Workers In Nepal., Brandon A Kohrt, Mark J D Jordans, Elizabeth L Turner, Kathleen J Sikkema, Nagendra P Luitel, Sauharda Rai, Daisy R Singla, Jagannath Lamichhane, Crick Lund, Vikram Patel

Psychiatry and Behavioral Sciences Faculty Publications

Background

Non-specialist healthcare providers, including primary and community healthcare workers, in low- and middle-income countries can effectively treat mental illness. However, scaling-up mental health services within existing health systems has been limited by barriers such as stigma against people with mental illness. Therefore, interventions are needed to address attitudes and behaviors among non-specialists. Aimed at addressing this gap, REducing Stigma among HealthcAre Providers to ImprovE mental health services (RESHAPE) is an intervention in which social contact with mental health service users is added to training for non-specialist healthcare workers integrating mental health services …

Interpersonal Violence And Suicidality Among Former Child Soldiers And War-Exposed Civilian Children In Nepal., Anvita Bhardwaj, Christine Bourey, Sauharda Rai, Ramesh Prasad Adhikari, Carol M Worthman, Brandon A Kohrt

Psychiatry and Behavioral Sciences Faculty Publications

Background: Suicide risk reduction is crucial for 15-29-year-old youth, who account for 46% of suicide deaths in low- and middle-income countries. Suicide predictors in high-resource settings, specifically depression, do not adequately predict suicidality in these settings. We explored if interpersonal violence (IPV) was associated with suicidality, independent of depression, in Nepal.

Methods: A longitudinal cohort of child soldiers and matched civilian children, enrolled in 2007 after the People's War in Nepal, were re-interviewed in 2012. The Depression Self-Rating Scale and Composite International Diagnostic Interview assessed depression and suicidality, respectively. Non-verbal response cards were used to capture experiences of sexual and …

Neural Correlates Of Taste Reactivity In Autism Spectrum Disorder., Jason A Avery, John E Ingeholm, Sophie Wohltjen, Meghan Collins, Cameron D Riddell, Stephen J Gotts, Lauren Kenworthy, Gregory L Wallace, W Kyle Simmons, Alex Martin

Psychiatry and Behavioral Sciences Faculty Publications

Selective or 'picky' eating habits are common among those with autism spectrum disorder (ASD). These behaviors are often related to aberrant sensory experience in individuals with ASD, including heightened reactivity to food taste and texture. However, very little is known about the neural mechanisms that underlie taste reactivity in ASD. In the present study, food-related neural responses were evaluated in 21 young adult and adolescent males diagnosed with ASD without intellectual disability, and 21 typically-developing (TD) controls. Taste reactivity was assessed using the Adolescent/Adult Sensory Profile, a clinical self-report measure. Functional magnetic resonance imaging was used to evaluate hemodynamic responses …

An Overview Of Perinatal Health And Childhood Development In Honduras, Rose Margaret Carlson, Abigail D. Conrad, Alexandra Nicole Lothe, Caitlin M. O'Donnell, Cameron Svihla

All Electronic Theses and Dissertations

Honduras is a country with great healthcare needs. Within health care, the largest percentage of mortality is due to conditions occurring in the perinatal period, including prenatal and maternal health, delivery and postnatal care (PAHO, 2017a). Additionally, malnutrition continues to affect infants as they growth throughout their childhood (Gray, Cossman, & Powers, 2006). Education is shown to produce positive outcomes in low-income populations (Perkins, et al, 2011). The purpose of this project was to identify Honduran healthcare needs and provide effective and sustainable intervention. A needs assessment with a Honduran-Canadian health organization reiterated evidence found in the literature, illustrating the …

Contraceptive Utilization Among New Exotic Dancers: A Cross-Sectional Study, Mishka Terplan, Caitlin E. Martin, Jennifer Nail, Susan G. Sherman

Obstetrics and Gynecology Publications

Background
Female exotic dancers are a population at high risk of unintended pregnancy. The objective of this study is to describe the reproductive health needs and contraceptive utilization of exotic dancers.

Methods
New exotic dancers (< 6 months dancing) from 26 clubs in Baltimore City/County completed a one-time survey.

Results
Of 117 participants, 96 (82%) had current contraceptive need. The mean age was 24 years, and 55% were black. Sex work (45%), alcohol use disorder (73%), illicit (44%; e.g., heroin, crack, cocaine), and injection drug use (8%) were common. The majority (66%) reported contraception use in the prior 6 months. Condoms were reported by 46% whereas 45% reported non-barrier methods, most commonly hormonal …

Economic Evaluation Of Patient Navigation Programs In Colorectal Cancer Care, A Systematic Review., C Gervès-Pinquié, A Girault, S Phillips, S Raskin, Mandi Pratt-Chapman

GW Cancer Institute

Patient navigation has expanded as a promising approach to improve cancer care coordination and patient adherence. This paper addresses the need to identify the evidence on the economic impact of patient navigation in colorectal cancer, following the Health Economic Evaluation Publication Guidelines. Articles indexed in Medline, Cochrane, CINAHL, and Web of Science between January 2000 and March 2017 were analyzed. We conducted a systematic review of the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality assessment of the included studies was based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Inclusion criteria …

Why West? Comparisons Of Clinical, Genetic And Molecular Features Of Infants With And Without Spasms., Anne T Berg, Samya Chakravorty, Sookyong Koh, Zachary M Grinspan, Renée A Shellhaas, William D Gaillard, +Several Additional Authors

Neurology Faculty Publications

Infantile spasms are the defining seizures of West syndrome, a severe form of early life epilepsy with poorly-understood pathophysiology. We present a novel comparative analysis of infants with spasms versus other seizure-types and identify clinical, etiological, and molecular-genetic factors preferentially predisposing to spasms. We compared ages, clinical etiologies, and associated-genes between spasms and non-spasms groups in a multicenter cohort of 509 infants (

Com Outlook Winter 2018, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Adult Onset Immunoglobulin A Vasculitis (Henoch-Schonlein Purpura) With Alveolar Hemorrhage, N. Niknam, L. Ha, P. Gautam-Goyal

Journal Articles

© 2018 The Authors S. pyogenes is the cause of many important human diseases, ranging from mild superficial skin infections to life-threatening systemic diseases. The post streptococcal syndromes are immune mediated phenomena including Immunoglobulin A Vasculitis (Henoch-Schönlein purpura). HSP is more common in children and usually self limited but it can cause skin, joint, renal, gastrointestinal and rarely respiratory involvement. We present a case with Streptococcus pyogenes pneumonia that presented with respiratory failure, pulmonary hemorrhage, extensive rash and renal failure.

Mutation Patterns Identify Adult Patients With De Novo Acute Myeloid Leukemia Aged 60 Years Or Older Who Respond Favorably To Standard Chemotherapy: An Analysis Of Alliance Studies, A. K. Eisfeld, J. Kohlschmidt, K. Mrózek, J. S. Blachly, C. J. Walker, D. Nicolet, S. Orwick, S. E. Maharry, J. E. Kolitz, C. D. Bloomfield, +6 Additional Authors

Journal Articles

© 2018 Macmillan Publishers Limited, part of Springer Nature. Thus far, only 5-15% of AML patients aged ≥60 years are cured with chemotherapy. Identification of patients who are less (more) likely to respond to standard chemotherapy might enable early risk stratification toward alternative treatment regimens. We used a next-generation sequencing panel of 80 cancer- and/or leukemia-associated genes to profile molecularly 423 older patients with de novo AML. Using variables identified in multivariable models and co-occurring mutations in NPM1-mutated AML, we classified the patients into good-, intermediate-, and poor-risk groups for complete remission (CR) attainment, disease-free (DFS), and overall survival (OS). …

Oral Curcumin For Radiation Dermatitis: A Urcc Ncorp Study Of 686 Breast Cancer Patients, J. R. Wolf, C. E. Heckler, J. J. Guido, A. R. Peoples, J. S. Gewandter, M. Ling, V. P. Vinciguerra, T. Anderson, L. Evans, G. R. Morrow, +2 Additional Authors

Journal Articles

No abstract provided.

Structure And Distribution Of An Unrecognized Interstitium In Human Tissues, P. C. Benias, R. G. Wells, B. Sackey-Aboagye, H. Klavan, J. Reidy, D. Buonocore, M. Miranda, S. Kornacki, M. Wayne, N. D. Theise, +1 Additional Author

Journal Articles

© 2018 The Author(s). Confocal laser endomicroscopy (pCLE) provides real-time histologic imaging of human tissues at a depth of 60-70 μm during endoscopy. pCLE of the extrahepatic bile duct after fluorescein injection demonstrated a reticular pattern within fluorescein-filled sinuses that had no known anatomical correlate. Freezing biopsy tissue before fixation preserved the anatomy of this structure, demonstrating that it is part of the submucosa and a previously unappreciated fluid-filled interstitial space, draining to lymph nodes and supported by a complex network of thick collagen bundles. These bundles are intermittently lined on one side by fibroblast-like cells that stain with endothelial …

Author Correction To: Structure And Distribution Of An Unrecognized Interstitium In Human Tissues, P. C. Benias, R. G. Wells, B. Sackey-Aboagye, H. Klavan, J. Reidy, D. Buonocore, M. Miranda, S. Kornacki, M. Wayne, N. D. Theise, +1 Additional Author

Journal Articles

© 2018 The Author(s). The Supplementary Figure file that accompanies this Article contains an error in Supplementary Figure S1, where the Small Intestine CD34 panel was duplicated from the Gallbladder CD34 panel. The correct Figure S1 appears below as Figure 1. (Figure Presented).

Racial/Ethnic Disparities Among Asian Americans In Inpatient Acute Myocardial Infarction Mortality In The United States, E. J. Kim, N. R. Kressin, M. K. Paasche-Orlow, L. Lopez, J. E. Rosens, M. Lin, A. D. Hanchate

Journal Articles

No abstract provided.

Understanding The Digital Gap Among Us Adults With Disability: Cross-Sectional Analysis Of The Health Information National Trends Survey 2013, E. J. Kim, Y. Yuan, J. Liebschutz, H. Cabral, L. Kazis

Journal Articles

©Eun Ji Kim, Yiyang Yuan, Jane Liebschutz, Howard Cabral, Lewis Kazis. Background: Disabilities affect more than 1 in 5 US adults, and those with disabilities face multiple barriers in accessing health care. A digital gap, defined as the disparity caused by differences in the ability to use advanced technologies, is assumed to be prevalent among individuals with disabilities. Objective: This study examined the associations between disability and use of information technology (IT) in obtaining health information and between trust factors and IT use. We hypothesized that compared to US adults without disabilities, those with disabilities are less likely to refer …

Nf1 Mutations Are Recurrent In Adult Acute Myeloid Leukemia And Confer Poor Outcome, A. K. Eisfeld, J. Kohlschmidt, K. Mrózek, A. Mims, C. J. Walker, J. S. Blachly, D. Nicolet, S. Orwick, J. E. Kolitz, C. D. Bloomfield, +7 Additional Authors

Journal Articles

© 2018 Macmillan Publishers Limited, part of Springer Nature Targeted mutation assessment of 81 genes in 1021 adults with de novo acute myeloid leukemia (AML) identified recurrent mutations in the neurofibromin 1 (NF1) gene in 52 (5.1%) patients, including 36 (5.2%) younger and 16 (4.8%) older patients, which suggests NF1 belongs to the 20 most frequently mutated genes in adult AML. NF1 mutations were found throughout the gene, and comprised missense, frameshift, and nonsense mutations. One mutation hotspot, at amino acid threonine 676 (Thr676), was found in 27% of AML patients with NF1 mutations. NF1-mutated patients belonged more often to …

Phyto-Polyphenols As Potential Inhibitors Of Breast Cancer Metastasis, D. Avtanski, L. Poretsky

Journal Articles

No abstract provided.

Fertility Information Needs And Concerns Post-Treatment Contribute To Lowered Quality Of Life Among Young Adult Female Cancer Survivors, C. Benedict, B. Thom, D. N. Friedman, E. Pottenger, N. Raghunathan, J. F. Kelvin

Journal Articles

No abstract provided.

Hemoglobin Response To Ferric Citrate In Patients With Nondialysis-Dependent Chronic Kidney Disease And Iron Deficiency Anemia, P. E. Pergola, S. Fishbane, R. D. Lewinter, J. F. Neylan, K. Uhlig, G. A. Block, G. M. Chertow

Journal Articles

No abstract provided.

Practice Patterns In Transitioning Patients From Chronic Kidney Disease To Dialysis: A Survey Of United States Nephrologists, M. C. Mallappallil, S. Fishbane, R. Wanchoo, E. Lerma, A. Roche-Recinos, M. Salifu

Journal Articles

No abstract provided.

Risk Factors Associated With Post-Kidney Transplant Malignancies: An Article From The Cancer-Kidney International Network, B. Sprangers, V. Nair, V. Launay-Vacher, L. V. Riella, K. D. Jhaveri

Journal Articles

© The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA.. In kidney transplant recipients, cancer is one of the leading causes of death with a functioning graft beyond the first year of kidney transplantation, and malignancies account for 8-10% of all deaths in the USA (2.6 deaths/1000 patient-years) and exceed 30% of deaths in Australia (5/1000 patient-years) in kidney transplant recipients. Patient-, transplant- and medication-related factors contribute to the increased cancer risk following kidney transplantation. While it is well established that the overall immunosuppressive dose is associated with an increased risk for cancer following transplantation, the contributive …

Ribavirin Dose Management In Hcv Patients Receiving Ombitasvir/Paritaprevir/Ritonavir And Dasabuvir With Ribavirin, J. J. Feld, D. E. Bernstein, Z. Younes, H. Van Vlierberghe, L. Larsen, F. Tatsch, P. Ferenci

Journal Articles

No abstract provided.

Development Of A Molecular Signature To Monitor Pharmacodynamic Responses Mediated By In Vivo Administration Of Glucocorticoids, Y. Hu, J. A. Carman, D. Holloway, S. Kansal, L. Fan, C. Goldstine, D. Lee, J. E. Somerville, R. Furie, S. G. Nadler, +7 Additional Authors

Journal Articles

© 2018 American College of Rheumatology. Objective: To develop an objective, readily measurable pharmacodynamic biomarker of glucocorticoid (GC) activity. Methods: Genes modulated by prednisolone were identified from in vitro studies using peripheral blood mononuclear cells from normal healthy volunteers. Using the criteria of a >2-fold change relative to vehicle controls and an adjusted P value cutoff of less than 0.05, 64 up-regulated and 18 down-regulated genes were identified. A composite score of the up-regulated genes was generated using a single-sample gene set enrichment analysis algorithm. Results: GC gene signature expression was significantly elevated in peripheral blood leukocytes from normal healthy …

The Intersection Of Financial Toxicity And Family Building In Young Adult Cancer Survivors, B. Thom, C. Benedict, D. N. Friedman, J. F. Kelvin

Journal Articles

No abstract provided.

Disparities In Potentially Preventable Hospitalizations: Near-National Estimates For Hispanics, C. Feng, M. K. Paasche-Orlow, N. R. Kressin, J. E. Rosen, L. López, E. J. Kim, M. Y. Lin, A. D. Hanchate

Journal Articles

© Health Research and Educational Trust Objective: To obtain near-national rates of potentially preventable hospitalization (PPH)—a marker of barriers to outpatient care access—for Hispanics; to examine their differences from other race-ethnic groups and by Hispanic national origin; and to identify key mediating factors. Data Sources/Study Setting: Data from all-payer inpatient discharge databases for 15 states accounting for 85 percent of Hispanics nationally. Study Design: Combining counts of inpatient discharges with census population for adults aged 18 and older, we estimated age-sex-adjusted PPH rates. We examined county-level variation in race-ethnic disparities in these rates to identify the mediating role of area-level …