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H Berhane, B S Gill, M Bernard, A Olawaiye, S Paniti, J L Kelley, S Beriwal
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Alyce J M Anderson, Benjamin Click, Claudia Ramos-Rivers, Dmitriy Babichenko, Ioannis E Koutroubakis, Douglas J Hartman, Jana G Hashash, Marc Schwartz, Jason Swoger, Arthur M Barrie, Michael A Dunn, Miguel Regueiro, David G Binion
BACKGROUND: Inflammatory bowel disease (IBD) is a heterogeneous collection of chronic inflammatory disorders of the digestive tract. Clinical, genetic, and pathological heterogeneity makes it increasingly difficult to translate efficacy studies into real-world practice. Our objective was to develop a comprehensive natural history registry derived from multi-year observational data to facilitate effectiveness and clinical phenotypic research in IBD. METHODS: A longitudinal, consented registry with prospectively collected data was developed at UPMC...
November 2016: Digestive Diseases and Sciences
Parthasarathy D Thirumala, Samyuktha R Melachuri, Jaspreet Kaur, David Ninaci, Manasa K Melachuri, Miguel E Habeych, Donald J Crammond, Jeffrey R Balzer
STUDY DESIGN: This study examined the diagnostic accuracy of significant changes of somatosensory evoked potentials (SSEPs) to evaluate and predict post-operative neurological deficits after posterior cervical fusions (PCF). 846 eligible patients underwent PCF at the University of Pittsburgh Medical Center (UPMC), from 2010 to 2012. OBJECTIVE: to assess the specificity and sensitivity of intraoperative monitoring in predicting post-operative neurological deficits during PCF...
August 24, 2016: Spine
Juliana Bernardes, Gerson Zaverucha, Catherine Vaquero, Alessandra Carbone
Traditional protein annotation methods describe known domains with probabilistic models representing consensus among homologous domain sequences. However, when relevant signals become too weak to be identified by a global consensus, attempts for annotation fail. Here we address the fundamental question of domain identification for highly divergent proteins. By using high performance computing, we demonstrate that the limits of state-of-the-art annotation methods can be bypassed. We design a new strategy based on the observation that many structural and functional protein constraints are not globally conserved through all species but might be locally conserved in separate clades...
July 2016: PLoS Computational Biology
Rohit Das, Bridger Clarke, Gong Tang, Georgios I Papachristou, David C Whitcomb, Adam Slivka, Dhiraj Yadav
BACKGROUND: The role of endoscopic sphincterotomy (ES) in idiopathic recurrent acute pancreatitis (IRAP) is unclear. We hypothesized that ES will alter the natural history of IRAP. METHODS: We retrospectively studied the course of 50 IRAP patients from the NAPS2 study from UPMC based on whether they underwent ES or were managed medically. Data included age at first AP, rate of attacks, and history of severe AP. Primary outcomes were any subsequent AP and rate of attacks; secondary outcome was chronic pancreatitis (CP) diagnosis during follow-up...
September 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Michelle Julien, Jeffrey L Wild, Joseph Blansfield, Mohsen Shabahang, Kristen Halm, Paul Meade, James Dove, Marcus Fluck, Marie Hunsinger, Diane Leonard
INTRODUCTION: Clostridium difficile infection (CDI) is one of the most common health care-associated infections, and it continues to have significant morbidity and mortality. The onset of fulminant colitis often requires total abdominal colectomy with ileostomy, which has a mortality rate of 35% to 57%. University of Pittsburgh Medical Center (UPMC) developed a scoring system for severity and recommended surgical consultation for severe complicated disease. The aim of this study was to evaluate if the UPMC-proposed scoring system for severe complicated CDI can predict the need for surgical intervention...
August 2016: Journal of Trauma and Acute Care Surgery
Peter G Ellis, Adam M Brufsky, Sushil Beriwal, Kathleen G Lokay, Hans O Benson, Stephanie B McCutcheon, Melinda Krebs
PURPOSE: Breast cancer diagnostics have the ability to predict disease recurrence and the benefit of chemotherapy. This study measures the use of a diagnostic assay, Oncotype DX, when embedded in a breast cancer decision support algorithm and, on the basis of the assay results, the use of chemotherapy in the adjuvant setting. METHODS: UPMC CancerCenter retrospectively reviewed patients with estrogen receptor-positive, human epidermal growth factor receptor 2 (HER2)Neu-negative disease with zero to three positive nodes navigated in the Via Pathways decision support portal during a 12-month period...
June 2016: Journal of Oncology Practice
Suketu M Mansuria, John Comerci, Robert Edwards, Amin Sanei Moghaddam, Tianzhou Ma, Faina Linkov
INTRODUCTION: The goal of this project is to describe the development and implementation of an evidence-based hysterectomy clinical pathway to reduce unnecessary variations in care and to promote improved patient outcomes at a reduced cost. This study characterized the longitudinal impact of hysterectomy pathway implementation on the number of total abdominal hysterectomy (TAH) procedures performed between fiscal years (FY) 2012 to 2014. METHODS: All noncancerous hysterectomy surgeries performed at University of Pittsburgh Medical Center (UPMC) hospitals from FY 2012 to FY 2014 were identified through various systems including Medipac and EpicCare...
May 2016: Obstetrics and Gynecology
Anne E Penner, Wynne Lundblad, Pierre N Azzam, Priya Gopalan, Sansea L Jacobson, Michael J Travis
OBJECTIVE: This study reports the academic outcomes, including scholarly productivity, of the graduates of one residency training track for future clinician educators and academic administrators. Since its implementation in 2008, the Academic Administrator, Clinician Educator (AACE) track at Western Psychiatric Institute and Clinic - UPMC has grown in popularity with reports of participants achieving post-graduate academic success; however, there has been no prior assessment of outcomes...
May 3, 2016: Academic Psychiatry
Rahul Uppal, Gunasheil Mandava, Katrina M Romagnoli, Andrew J King, Amie J Draper, Adam L Handen, Arielle M Fisher, Michael J Becich, Joyeeta Dutta-Moscato
The Computer Science, Biology, and Biomedical Informatics (CoSBBI) program was initiated in 2011 to expose the critical role of informatics in biomedicine to talented high school students.[1] By involving them in Science, Technology, Engineering, and Math (STEM) training at the high school level and providing mentorship and research opportunities throughout the formative years of their education, CoSBBI creates a research infrastructure designed to develop young informaticians. Our central premise is that the trajectory necessary to be an expert in the emerging fields of biomedical informatics and pathology informatics requires accelerated learning at an early age...
2016: Journal of Pathology Informatics
Manu Shankar-Hari, Gary S Phillips, Mitchell L Levy, Christopher W Seymour, Vincent X Liu, Clifford S Deutschman, Derek C Angus, Gordon D Rubenfeld, Mervyn Singer
IMPORTANCE: Septic shock currently refers to a state of acute circulatory failure associated with infection. Emerging biological insights and reported variation in epidemiology challenge the validity of this definition. OBJECTIVE: To develop a new definition and clinical criteria for identifying septic shock in adults. DESIGN, SETTING, AND PARTICIPANTS: The Society of Critical Care Medicine and the European Society of Intensive Care Medicine convened a task force (19 participants) to revise current sepsis/septic shock definitions...
February 23, 2016: JAMA: the Journal of the American Medical Association
Corinna C Franklin, Patrick P Bosch, Jan S Grudziak, Ozgur Dede, Rey N Ramirez, Steven A Mendelson, W Timothy Ward, Maria Brooks, Tanya Kenkre, John D Lubahn, Vincent F Deeney, James W Roach
BACKGROUND: Performance on the Orthopaedic In-training Examination (OITE) has been correlated with performance on the written portion of the American Board of Orthopaedic Surgery examination. Herein we sought to discover whether adding a regular pediatric didactic lecture improved residents' performance on the OITE's pediatric domain. METHODS: In 2012, a didactic lecture series was started in the University of Pittsburgh Medical Center (UPMC) Hamot Orthopaedic Residency Program (Hamot)...
February 10, 2016: Journal of Pediatric Orthopedics
Yasaman Karami, Elodie Laine, Alessandra Carbone
BACKGROUND: Proteins adapt to environmental conditions by changing their shape and motions. Characterising protein conformational dynamics is increasingly recognised as necessary to understand how proteins function. Given a conformational ensemble, computational tools are needed to extract in a systematic way pertinent and comprehensive biological information. RESULTS: Here, we present a method, Communication Mapping (COMMA), to decipher the dynamical architecture of a protein...
2016: BMC Bioinformatics
Elodie Laine, Alessandra Carbone
Protein-protein interactions (PPIs) are essential to all biological processes and they represent increasingly important therapeutic targets. Here, we present a new method for accurately predicting protein-protein interfaces, understanding their properties, origins and binding to multiple partners. Contrary to machine learning approaches, our method combines in a rational and very straightforward way three sequence- and structure-based descriptors of protein residues: evolutionary conservation, physico-chemical properties and local geometry...
December 2015: PLoS Computational Biology
J S Bernardes, F R J Vieira, G Zaverucha, A Carbone
MOTIVATION: Given a protein sequence and a number of potential domains matching it, what are the domain content and the most likely domain architecture for the sequence? This problem is of fundamental importance in protein annotation, constituting one of the main steps of all predictive annotation strategies. On the other hand, when potential domains are several and in conflict because of overlapping domain boundaries, finding a solution for the problem might become difficult. An accurate prediction of the domain architecture of a multi-domain protein provides important information for function prediction, comparative genomics and molecular evolution...
February 1, 2016: Bioinformatics
Eric J Lenze, Benoit H Mulsant, Daniel M Blumberger, Jordan F Karp, John W Newcomer, Stewart J Anderson, Mary Amanda Dew, Meryl A Butters, Jacqueline A Stack, Amy E Begley, Charles F Reynolds
BACKGROUND: Treatment-resistant major depression is common and potentially life-threatening in elderly people, in whom little is known about the benefits and risks of augmentation pharmacotherapy. We aimed to assess whether aripiprazole is associated with a higher probability of remission than is placebo. METHODS: We did a randomised, double-blind, placebo-controlled trial at three centres in the USA and Canada to test the efficacy and safety of aripiprazole augmentation for adults aged older than 60 years with treatment-resistant depression (Montgomery Asberg Depression Rating Scale [MADRS] score of ≥15)...
December 12, 2015: Lancet
Johanna E Bellon, Joel M Stevans, Susan M Cohen, A Everette James, Benjamin Reynolds, Yuting Zhang
BACKGROUND: Although electronic delivery (electronic visits [e-visits]) of healthcare services by advanced practice providers (APPs) is growing, literature defining the roles of different providers and comparing outcomes is lacking. We analyzed two e-visit models at the University of Pittsburgh Medical Center (UPMC) to compare their providers (physicians and APPs) and associated outcomes. MATERIALS AND METHODS: We identified all e-visits for the UPMC AnywhereCare Continuity (physician providers for existing patients) and Convenience (physician and APP providers for Pennsylvania residents) services (n=2,184) using Epic Systems (Verona, WI) MyChart data (November 2013-August 2014)...
December 2015: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Nada Ali Alshaikh, Anna Eleftheriadou
Staging of tumors is very important in treatment and surgical decision making, as well as in predicting disease recurrence and prognosis. This review focuses on the different available classifications of juvenile nasopharyngeal angiofibroma (JNA) and their impact on the evaluation, management, and prognosis of JNA. The literature was reviewed, and publications on JNA staging were examined. Our MEDLINE search of the entire English-language literature found no review article on the current available staging systems for JNA...
June 2015: Ear, Nose, & Throat Journal
Maria Cristina Longo
PURPOSE: The research analyzes good practices in health care "management experimentation models," which fall within the broader range of the integrative public-private partnerships (PPPs). Introduced by the Italian National Healthcare System in 1991, the "management experimentation models" are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality, and cost-savings...
2015: Advances in Health Care Management
(no author information available yet)
A case management team at UPMC Presbyterian Shadyside Hospital in Pittsburgh has developed an initiative to improve communication between the hospital and skilled nursing facilities in an effort to reduce readmissions. The team interviewed readmitted patients, analyzed trends in readmissions and what caused them, and researched readmission prevention tools. They developed a risk tool that assesses a variety of issues and use it to help identify patients who are at risk for readmission. The tool covers comorbidities, psychiatric issues, polypharmacy issues, emergency department visits and hospitalization, and other issues...
April 2015: Hospital Case Management: the Monthly Update on Hospital-based Care Planning and Critical Paths
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