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Integration Of Non-Communicable Diseases Into Primary Health Care: A Snapshot From Eastern Mediterranean Region, Shehla Zaidi, Abdul Latif Khan, Aftab Ali Mukhi, Yousuf Memon, Slim Slama, Samer Jabbour 2014 Aga Khan University

Integration Of Non-Communicable Diseases Into Primary Health Care: A Snapshot From Eastern Mediterranean Region, Shehla Zaidi, Abdul Latif Khan, Aftab Ali Mukhi, Yousuf Memon, Slim Slama, Samer Jabbour

Community Health Sciences

No abstract provided.


In-Hospital Depression Predicts Early Hospital Readmission After An Acute Coronary Syndrome: Preliminary Data From Trace-Core, David McManus, Jane Saczynski, Molly Waring, Milena Anatchkova, Richard McManus, Robert Goldberg, Jeroan Allison, David Parish, Hamza Awad, Jerry Gurwitz, Arlene Ash, Catarina Kiefe 2014 University of Massachusetts Medical School

In-Hospital Depression Predicts Early Hospital Readmission After An Acute Coronary Syndrome: Preliminary Data From Trace-Core, David Mcmanus, Jane Saczynski, Molly Waring, Milena Anatchkova, Richard Mcmanus, Robert Goldberg, Jeroan Allison, David Parish, Hamza Awad, Jerry Gurwitz, Arlene Ash, Catarina Kiefe

Richard H. McManus

Background: Hospital systems, patients and providers seek to avert rehospitalizations within 30 days for patients admitted with an acute coronary syndrome (ACS). Rehospitalizations within 30 days of discharge are often considered preventable and to reflect poor in-hospital management or discharge practices. However, independent associations of psychosocial factors with early rehospitalization in patients admitted with an ACS have not been examined. Methods: A multi-racial cohort of 1,540 patients admitted with an ACS reported psychosocial factors via standardized questionnaires in an in-hospital interview. One month following discharge, patients were interviewed via phone and reported hospital readmissions. We used logistic regression models to …


Septal Myectomy In Obstructive Hypertrophic Cardiomyopathy High Risk Patients, Heather Geist, Matthew W. Martinez MD, James K. Wu MD 2014 Dickinson College

Septal Myectomy In Obstructive Hypertrophic Cardiomyopathy High Risk Patients, Heather Geist, Matthew W. Martinez Md, James K. Wu Md

Department of Medicine

No abstract provided.


Therapeutic Hypothermia Following Cardiac Arrest, Cassandra Patrick 2014 Otterbein University

Therapeutic Hypothermia Following Cardiac Arrest, Cassandra Patrick

Nursing Student Class Projects (Formerly MSN)

According to the Sudden Cardiac Arrest Foundation (2014), each year, 424,000 people in the U.S. (more than 1,000/day) experience EMS-assessed out-of-hospital non-traumatic sudden cardiac arrest. This is roughly equivalent to the number of people who die from Alzheimers’ disease, assault with firearms, breast cancer, cervical cancer, colorectal cancer, diabetes, HIV, house fires, motor vehicle accidents, prostate cancer and suicides combined (Sudden Cardiac Arrest Foundation, 2014). It is estimated that the likelihood of surviving an out-of-hospital cardiac arrest (OHCA) to hospital discharge can be as low as 6% to 8% (Williams, Calder, Cocchi & Donnino, 2013). Additionally an estimated 200,000 hospitalized …


Takotsubo Cardiomyopathy, Kari Patterson 2014 Otterbein University

Takotsubo Cardiomyopathy, Kari Patterson

Nursing Student Class Projects (Formerly MSN)

Term Takotsubo was introduced in 1991 to describe the shape of the left ventricle during an episode of cardiomyopathy. Takotsubo is a Japanese term for a narrow-necked fishing pot used to catch octopus. The left ventricle assumes the shape of the octopus pot during Takotsubo cardiomyopathy. Takotsubo cardiomyopathy is commonly known as Broken Heart Syndrome due to its association with an emotional stressor. Mimics acute coronary syndrome without coronary artery blockage/stenosis. Affects more women than men. Occurs mainly in postmenopausal women (women over the age of 50) Believe a hormonal effect on catecholamine release plays a role.


Atrial Fibrillation Post-Lung Lobectomy, Laura Adorni 2014 Otterbein University

Atrial Fibrillation Post-Lung Lobectomy, Laura Adorni

Nursing Student Class Projects (Formerly MSN)

According to the American Heart Association, atrial fibrillation affected 2.66 million individuals in the United States in 2010 and is expected to double by year 2050 (Sanoski, 2010, p. S11). Post-operative atrial fibrillation (POAF), a classification of atrial fibrillation (AF), can occur after thoracic surgery and is an ongoing source of morbidity and mortality (Imperatori et al., 2012). There is a 10-20% occurrence rate of POAF after non-cardiac surgery, such as a lung lobectomy, and a 40% incidence rate after a pneumonectomy (Omae & Kanmura, 2012, p. 429). Cardiovascular events such as heart failure, cerebral infarction, renal failure, and infection …


Cerebral Venous Sinus Thrombosis (Cvst), Meghan N. DeLong 2014 Otterbein University

Cerebral Venous Sinus Thrombosis (Cvst), Meghan N. Delong

Nursing Student Class Projects (Formerly MSN)

Cerebral venous sinus thrombosis (CVST) is an uncommon condition with incidence resulting in approximately 1-3 % of all strokes. Cerebral venous sinus thrombosis remains often unrecognized initially due to its vague manifestations of symptoms which range from isolated headaches to focal neurological signs and symptoms. CVST is slightly more common in women, particularly in the age group of 20 to 35, due to pregnancy, puerperium and oral contraceptive use (Stam, 2005).


Accurate Intervention In Visceral Aneurysms, Megan Hoying 2014 Otterbein University

Accurate Intervention In Visceral Aneurysms, Megan Hoying

Nursing Student Class Projects (Formerly MSN)

A 30 year old male presented to the ED with a one week history of fever, abdominal pain, and poor PO intake due to nausea and emesis. He was given a GI cocktail and sent home for a presumed diagnosis of gastritis. After having persistent pain the patient returned to the ER the following day and was admitted for further testing. The patient died 3 days later. This is an interesting case presentation, and was in no way straightforward.


Cardiomems Heart Failure System: Keeping Patients Out Of The Hospital, Michelle Leyland 2014 Otterbein University

Cardiomems Heart Failure System: Keeping Patients Out Of The Hospital, Michelle Leyland

Nursing Student Class Projects (Formerly MSN)

It is well known that heart disease is the leading cause of death in the United States, with about 670,000 new diagnoses of congestive heart failure (CHF) each year (Suh et al., 2011). CHF results from a number of different causes, produces many different symptoms and occurs when the heart muscle cannot efficiently pump blood to the rest of the body (Suh et al., 2011). In the United States, heart failure (HF) and associated hospitalizations are leading contributors to high health care costs (Feltner et al., 2014). Up to one fourth of patients hospitalized with HF are readmitted within 30 …


Myocardial Infarction (Mi) In Women, Samuel Agyenim Boateng 2014 Otterbein University

Myocardial Infarction (Mi) In Women, Samuel Agyenim Boateng

Nursing Student Class Projects (Formerly MSN)

Cardiovascular disease (CAD) is the most common cause of death for men and women in the US. The disease has been extensively studied in males (Gulati & Bairey Merz, 2012, p. 141). CVD poses an obvious challenge to the health of women. Coronary heart disease (CHD) is described as a "modern epidemic" (Banner, 2010, p. 3123). Although, the prevalence of CVD has prompted many studies for prevention and treatment, little is known about CVD in women. It Is now known that the mortality rates In women have surpassed that of men. Recent reports Indicate that CVD killed more women in …


Spontaneous Coronary Artery Dissection Among Women, Stacy Hudepohl 2014 Otterbein University

Spontaneous Coronary Artery Dissection Among Women, Stacy Hudepohl

Nursing Student Class Projects (Formerly MSN)

It has been noted that women often place their own health care on the bottom of their priority lists. Many times, they ignore simple pain and dismiss symptoms that may be troubling to health care providers. Health care providers especially to young women may dismiss complaints of chest pain as heartburn or anxiety. Changes seen in pregnancy and with menses can mimic some of these same complaints. As both an female professional in health care and as a patient it is very easy to get busy with the day and not recognize simple signs and symptoms that may lead to …


Enterococcus Faecalis Endocarditis: A Case Study, Torri Curtis 2014 Otterbein University

Enterococcus Faecalis Endocarditis: A Case Study, Torri Curtis

Nursing Student Class Projects (Formerly MSN)

Infectious endocarditis is an uncommon disease of the heart stemming from a bacterial or fungal infection on the endocardial surface of the heart or heart valve (Pierce, Calkins, & Thornton, 2012). From review of the literature, infective endocarditis is fairly uncommon and may be difficult to initially diagnose. Per Sabe, Shrestha, and Menon, occurrence of infective endocarditis (IE) is nearly 0.9-6.2 per 100,000 persons per year (2013). Several preexisting conditions such as aging, heart valve disease, implantable cardiac devices, a history of heart disease such as rheumatic fever, and invasive procedures can put a patient at higher risk for IE …


Hypertrophic Obstructive Cardiomyopathy, Tiffany Branson 2014 Otterbein University

Hypertrophic Obstructive Cardiomyopathy, Tiffany Branson

Nursing Student Class Projects (Formerly MSN)

Hypertrophic obstructive cardiomyopathy or HOCM, is a genetic disease that is described as hypertrophy or enlargement of the left ventricle which obstructs the blood flow to the body (Yue-Cheng et al., 2012). HOCM is a disease that cannot be cure, but can be treated. One of the main goals of treatment is to focus on treating the symptoms. HOCM can be asymptomatic or symptomatic and can cause some major complications. Some of the complications of HOCM are arrhythmias and sudden cardiac death, “which is defined as natural death to due cardiac causes, heralded by abrupt loss of consciousness within one …


Dvt And Economy Class Syndrome, Troy Perkins 2014 Otterbein University

Dvt And Economy Class Syndrome, Troy Perkins

Nursing Student Class Projects (Formerly MSN)

Traveling long distances can be very stressful on the body. Deep vein thrombosis (DVT) has often been linked to long air flights or long distance travel in a vehicle. DVT is a blood clot usually formed in the legs. Economy Class Syndrome (ECS) has been referred to as the formation of a DVT occurring during (or just after) a long airplane flight, especially in economy class where there is the least space allotted per passenger and one’s legs especially tend to be immobilized for lack of leg room (MedicineNet, 2012). Developing a DVT can lead to other life-threatening illnesses such …


Diagnosis, Pathophysiology, And Clinical Treatment Of A Patient With A Pheochromocytoma, Tricia L. Hale 2014 Otterbein University

Diagnosis, Pathophysiology, And Clinical Treatment Of A Patient With A Pheochromocytoma, Tricia L. Hale

Nursing Student Class Projects (Formerly MSN)

Hypertension is an extremely common diagnosis today. This condition can be caused by a multitude of factors, and can inversely cause numerous unfavorable processes in the body. One rare but significant source of hypertension is a tumor known as a pheochromocytoma, or PCC. This usually benign tumor is most often located on an adrenal gland, and can have a grave impact on the cardiovascular system. The tumor intermittently secretes an excess of the catecholamine norepinephrine, and if large enough, also secretes epinephrine [9]. These episodic bursts can cause extreme hypertension and tachycardia, leading to, at times fatal results. By understanding …


Impact Of Pre-Stage Ii Hemodynamics And Pulmonary Artery Anatomy On 12-Month Outcomes In The Pediatric Heart Network Single Ventricle Reconstruction Trial., Ranjit Aiyagari, John F. Rhodes, Peter Shrader, Wolfgang A. Radtke, Varsha M. Bandisode, Lisa Bergersen, Matthew J. Gillespie, Robert G. Gray, Lin T. Guey, Kevin D. Hill, Russel Hirsch, Dennis W. Kim, Kyong-Jin Lee, Andrew N. Pelech, Jeremy Ringewald, Cheryl Takao, Julie A. Vincent, Richard G. Ohye, Pediatric Heart Network Investigators, Girish S. Shirali 2014 Children's Mercy Hospital

Impact Of Pre-Stage Ii Hemodynamics And Pulmonary Artery Anatomy On 12-Month Outcomes In The Pediatric Heart Network Single Ventricle Reconstruction Trial., Ranjit Aiyagari, John F. Rhodes, Peter Shrader, Wolfgang A. Radtke, Varsha M. Bandisode, Lisa Bergersen, Matthew J. Gillespie, Robert G. Gray, Lin T. Guey, Kevin D. Hill, Russel Hirsch, Dennis W. Kim, Kyong-Jin Lee, Andrew N. Pelech, Jeremy Ringewald, Cheryl Takao, Julie A. Vincent, Richard G. Ohye, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To compare the interstage cardiac catheterization hemodynamic and angiographic findings between shunt types for the Pediatric Heart Network Single Ventricle Reconstruction trial. The trial, which randomized subjects to a modified Blalock-Taussig shunt (MBTS) or right ventricle-to-pulmonary artery shunt (RVPAS) for the Norwood procedure, demonstrated the RVPAS was associated with a smaller pulmonary artery diameter but superior 12-month transplant-free survival.

METHODS: We analyzed the pre-stage II catheterization data for the trial subjects. The hemodynamic variables and shunt and pulmonary angiographic data were compared between shunt types; their association with 12-month transplant-free survival was also evaluated.

RESULTS: Of 549 randomized subjects, …


Long-Term Survival For Patients With Acute Decompensated Heart Failure According To Ejection Fraction Findings, Andrew Coles, Kimberly Fisher, Chad Darling, Jorge Yarzebski, David McManus, Joel Gore, Darleen Lessard, Robert Goldberg 2014 University of Massachusetts Medical School

Long-Term Survival For Patients With Acute Decompensated Heart Failure According To Ejection Fraction Findings, Andrew Coles, Kimberly Fisher, Chad Darling, Jorge Yarzebski, David Mcmanus, Joel Gore, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

Limited data exist about the long-term prognosis of patients with acute decompensated heart failure (ADHF) further stratified according to ejection fraction (EF) findings. The primary objective of this population-based observational study was to characterize and compare trends in long-term prognosis after an episode of ADHF across 3 EF strata. Hospital medical records were reviewed for 3,604 residents of the Worcester, Massachusetts, metropolitan area who were discharged after ADHF from all 11 medical centers in central Massachusetts during 1995, 2000, 2002, and 2004 and had EF measurements during their index hospitalizations. The average age of this population was 75 years, most …


Applying Novel Tree-Based Frameworks To Big Data For Classification Of Heart Failure Patients And Prediction Of Clinical Responses, Yan Zhang, Nicholas Downing, Emily Bucholz, Suganthi Balasubramanian, Shu-Xia Li, Tara Liptak, Harlan Krumholz, Mark Gerstein 2014 Yale University

Applying Novel Tree-Based Frameworks To Big Data For Classification Of Heart Failure Patients And Prediction Of Clinical Responses, Yan Zhang, Nicholas Downing, Emily Bucholz, Suganthi Balasubramanian, Shu-Xia Li, Tara Liptak, Harlan Krumholz, Mark Gerstein

Yale Day of Data

Over 5 million Americans suffer from heart failure, a condition with a 5-year survival that eclipses all cancers apart from that of lung cancer. Conventional understanding of heart failure is simplistic: it is viewed as a single syndrome, despite real heterogeneity. In addition, models predicting outcomes focus on dichotomous results, like 30-day readmission. A novel approach to classification of heart failure may improve our ability to target interventions, improve patient experiences, and predict outcomes.

The Healthcare Cost and Utilization Project is a family of administrative claims databases that describes patient demographics, comorbidities, procedures, acute care utilization and outcomes, such as …


Vitamin D Status Is Associated With Early Markers Of Cardiovascular Disease In Prepubertal Children, Benjamin U. Nwosu, Louise Maranda, Karen Cullen, Carol A. Ciccarelli, Mary M. Lee 2014 University of Massachusetts Medical School

Vitamin D Status Is Associated With Early Markers Of Cardiovascular Disease In Prepubertal Children, Benjamin U. Nwosu, Louise Maranda, Karen Cullen, Carol A. Ciccarelli, Mary M. Lee

Mary M. Lee

Background: The associations of 25-hydroxyvitamin D [25(OH)D], non-high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL), and related markers of early cardiovascular disease (CVD) are unclear in prepubertal children. Objective: To investigate the association of 25(OH)D with markers of CVD. The hypothesis was that 25(OH)D would vary inversely with non-HDL-C. Subjects and methods: A prospective cross-sectional study of children (n=45; 26 males, 19 females) of mean age 8.3 ± 2.5 years to investigate the relationships between 25(OH)D and glucose, insulin, high-sensitivity C-reactive protein, and lipids. Vitamin D deficiency was defined as 25(OH)D/mL; overweight as body mass index (BMI) ≥ 85 th but …


Factors Associated With Neurodevelopment For Children With Single Ventricle Lesions., Caren S. Goldberg, Minmin Lu, Lynn A. Sleeper, William T. Mahle, J William Gaynor, Ismee A. Williams, Kathleen A. Mussatto, Richard G. Ohye, Eric M. Graham, Deborah U. Frank, Jeffrey P. Jacobs, Catherine Krawczeski, Linda Lambert, Alan Lewis, Victoria L. Pemberton, Renee Sananes, Erica Sood, Stephanie B. Wechsler, David C. Bellinger, Jane W. Newburger, Pediatric Heart Network Investigators, Girish S. Shirali 2014 Children's Mercy Hospital

Factors Associated With Neurodevelopment For Children With Single Ventricle Lesions., Caren S. Goldberg, Minmin Lu, Lynn A. Sleeper, William T. Mahle, J William Gaynor, Ismee A. Williams, Kathleen A. Mussatto, Richard G. Ohye, Eric M. Graham, Deborah U. Frank, Jeffrey P. Jacobs, Catherine Krawczeski, Linda Lambert, Alan Lewis, Victoria L. Pemberton, Renee Sananes, Erica Sood, Stephanie B. Wechsler, David C. Bellinger, Jane W. Newburger, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To measure neurodevelopment at 3 years of age in children with single right-ventricle anomalies and to assess its relationship to Norwood shunt type, neurodevelopment at 14 months of age, and patient and medical factors.

STUDY DESIGN: All subjects in the Single Ventricle Reconstruction Trial who were alive without cardiac transplant were eligible for inclusion. The Ages and Stages Questionnaire (ASQ, n = 203) and other measures of behavior and quality of life were completed at age 3 years. Medical history, including measures of growth, feeding, and complications, was assessed through annual review of the records and phone interviews. The …


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