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https://www.readbyqxmd.com/read/28916403/a-case-of-severe-acquired-hypertriglyceridemia-in-a-7-year-old-girl
#1
Jessica S Lilley, MacRae F Linton, Jennifer C Kelley, T Brent Graham, Sergio Fazio, Hagai Tavori
We report a case of severe type I hyperlipoproteinemia caused by autoimmunity against lipoprotein lipase (LPL) in the context of presymptomatic Sjögren's syndrome. A 7-year-old mixed race (Caucasian/African American) girl was admitted to the intensive care unit at Vanderbilt Children's Hospital with acute pancreatitis and shock. She was previously healthy aside from asthma and history of Hashimoto's thyroiditis. Admission triglycerides (TGs) were 2191 mg/dL but returned to normal during the hospital stay and in the absence of food intake...
August 12, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28892449/emergency-preparedness-in-the-workplace-the-flulapalooza-model-for-mass-vaccination
#2
Melanie D Swift, Muktar H Aliyu, Daniel W Byrne, Keqin Qian, Paula McGown, Patricia O Kinman, Katherine Louise Hanson, Demoyne Culpepper, Tamara J Cooley, Mary I Yarbrough
OBJECTIVES: To explore whether an emergency preparedness structure is a feasible, efficient, and sustainable way for health care organizations to manage mass vaccination events. METHODS: We used the Hospital Incident Command System to conduct a 1-day annual mass influenza vaccination event at Vanderbilt University Medical Center over 5 successive years (2011-2015). Using continuous quality improvement principles, we assessed whether changes in layout, supply management, staffing, and documentation systems improved efficiency...
September 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28882701/diagnostic-value-of-histone-3-mutations-in-osteoclast-rich-bone-tumors
#3
Erik Nohr, Lik Hang Lee, Justin M Cates, Marco Perizzolo, Doha Itani
Differentiating osteoclast-rich lesions of bone (giant cell tumor of bone [GCTB], chondroblastoma [CBA], and aneurysmal bone cyst [ABC]) can be challenging, especially in small biopsies or fine needle aspirations. Mutations affecting codons 34 and 36 of either H3 Histone Family Member 3A (H3F3A) and/or 3B (H3F3B) are characteristically seen in GCTB and CBAs. We devised a simple assay to identify these mutations and evaluated its applicability for routine clinical diagnosis. 124 tissue specimens from 108 patients (43 GCTBs, 38 CBAs and 27 ABCs) were collected from the archives of the Calgary Laboratory Services/University of Calgary and Vanderbilt University Medical Center...
September 4, 2017: Human Pathology
https://www.readbyqxmd.com/read/28880943/non-pulmonary-vein-mediated-atrial-fibrillation-a-novel-sub-phenotype
#4
Maureen Farrell, Zachary Yoneda, Jay Montgomery, Diane Crawford, Lauren Lee Wray, Meng Xu, Matthew J Kolek, Travis Richardson, Ricardo Lugo, Mohamed Metawee, Greg Michaud, Juan Carlos Estrada, Pablo Saavedra, Sharon Shen, Arvindh Kanagasundram, Christopher R Ellis, George Crossley, Dan Roden, M Benjamin Shoemaker
BACKGROUND: Atrial fibrillation (AF) is a mechanistically heterogeneous disorder, and the ability to identify sub-phenotypes ("endophenotypes") of AF would assist in the delivery of personalized medicine. We used the clinical response to pulmonary vein isolation (PVI) to identify a sub-group of patients with non-PV mediated AF and sought to define the clinical associations. METHODS: Subjects enrolled in the Vanderbilt AF Ablation Registry who underwent a repeat AF ablation due to arrhythmia recurrence were analyzed on the basis of PV reconnection...
2017: PloS One
https://www.readbyqxmd.com/read/28877293/thermodilution-vs-estimated-fick-cardiac-output-measurement-in-clinical-practice-an-analysis-of-mortality-from-the-veterans-affairs-clinical-assessment-reporting-and-tracking-va-cart-program-and-vanderbilt-university
#5
Alexander R Opotowsky, Edward Hess, Bradley A Maron, Evan L Brittain, Anna E Barón, Thomas M Maddox, Laith I Alshawabkeh, Bradley M Wertheim, Meng Xu, Tufik R Assad, Jonathan D Rich, Gaurav Choudhary, Ryan J Tedford
Importance: Thermodilution (Td) and estimated oxygen uptake Fick (eFick) methods are widely used to measure cardiac output (CO). They are often used interchangeably to make critical clinical decisions, yet few studies have compared these approaches as applied in medical practice. Objectives: To assess agreement between Td and eFick CO and to compare how well these methods predict mortality. Design, Setting, and Participants: This investigation was a retrospective cohort study with up to 1 year of follow-up...
September 6, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28874317/generalized-paroxysmal-fast-activity-in-eeg-an-unrecognized-finding-in-genetic-generalized-epilepsy
#6
Vishwanath Sagi, Inyup Kim, Amar B Bhatt, Hasan Sonmezturk, Bassel W Abou-Khalil, Amir M Arain
OBJECTIVE: To study generalized paroxysmal fast activity (GPFA) in patients with genetic generalized epilepsy (GGE). INTRODUCTION: GPFA is an electroencephalographic (EEG) finding in patients with symptomatic generalized epilepsy consisting of 15-25Hz bifrontally predominant generalized fast activity seen predominantly in sleep. Historically GPFA is linked to epileptic encephalopathy with drug resistant epilepsy and intellectual disability. However, GPFA has been rarely described as an atypical finding in patients with GGE without negative prognostic implication...
September 2, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28858900/trends-in-the-prevalence-of-intraoperative-adverse-events-at-2-academic-hospitals-after-implementation-of-a-mandatory-reporting-system
#7
Jonathan P Wanderer, David M Gratch, Paul St Jacques, Luis I Rodriquez, Richard H Epstein
BACKGROUND: Anesthesia information management systems (AIMSs) have been effectively used to improve quality in anesthesia care, and have enabled the development of mandatory quality assurance (QA) reporting systems for adverse events (AEs). While this approach has been shown to increase event reporting over time, the long-term effect of such a system on quality is unknown. We investigated the trends in AE reporting over time after implementing AIMS-based mandatory reporting systems at 2 academic medical centers...
August 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28858032/group-enrollment-and-open-gym-format-decreases-cardiac-rehabilitation-wait-times
#8
Justin M Bachmann, Zachary W Klint, Allison M Jagoda, Jeremy K McNatt, Lesa R Abney, Shi Huang, David G Liddle, Walter R Frontera, Matthew S Freiberg
PURPOSE: Wait times for the first cardiac rehabilitation (CR) session are inversely related to CR participation rates. We hypothesized that changing from individually scheduled appointments to a group enrollment and open gym format, in which patients were enrolled during group intake sessions and could arrive for subsequent CR sessions any time during open gym periods, would decrease wait times. METHODS: A total of 603 patients enrolled in CR at Vanderbilt University Medical Center from July 2012 to December 2014 were included in the study...
September 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28835143/neonatal-cerebral-lesions-predict-2-year-neurodevelopmental-impairment-in-children-treated-with-laser-surgery-for-twin-twin-transfusion-syndrome
#9
Ramen H Chmait, Andrew H Chon, Sheree M Schrager, Arlyn Llanes, Anita H Hamilton, Douglas L Vanderbilt
OBJECTIVE: To assess whether postnatally detected cerebral abnormalities are predictive of neurodevelopmental impairment (NDI) in survivors of twin-twin transfusion syndrome (TTTS) that underwent laser surgery. MATERIALS AND METHODS: 99 children treated for TTTS had neurodevelopmental assessment at age 2-years (± 6 weeks). "High-risk survivors" had cerebral imaging in the neonatal period. "High-risk survivors" were defined as: 1) delivered at < 32 weeks; or 2) cerebral imaging clinically indicated...
August 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28826895/effect-of-preoperative-beta-blocker-use-on-outcomes-following-cardiac-surgery
#10
Jason B O'Neal, Frederic T Billings, Xulei Liu, Matthew S Shotwell, Yafen Liang, Ashish S Shah, Jesse M Ehrenfeld, Jonathan P Wanderer, Andrew D Shaw
Recent studies suggest that the use of preoperative β blockers in cardiac surgery may not provide improved mortality rates and may even contribute to negative clinical outcomes. We therefore assessed the role of β blockers on several outcomes after cardiac surgery (delirium, acute kidney injury [AKI], stroke, atrial fibrillation (AF), mortality, and hospital length of stay) in 4,076 patients who underwent elective coronary artery bypass grafting, coronary artery bypass grafting + valve, or valve cardiac surgery from November 1, 2009, to September 30, 2015, at Vanderbilt Medical Center...
July 24, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28815116/reducing-clinical-noise-for-body-mass-index-measures-due-to-unit-and-transcription-errors-in-the-electronic-health-record
#11
Robert Goodloe, Eric Farber-Eger, Jonathan Boston, Dana C Crawford, William S Bush
Body mass index (BMI) is an important outcome and covariate adjustment for many clinical association studies. Accurate assessment of BMI, therefore, is a critical part of many study designs. Electronic health records (EHRs) are a growing source of clinical data for research purposes, and have proven useful for identifying and replicating genetic associations. EHR-based data collected for clinical and billing purposes have several unique properties, including a high degree of heterogeneity or "clinical noise...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28814038/design-and-preliminary-assessment-of-vanderbilt-hand-exoskeleton
#12
Benjamin W Gasser, Daniel A Bennett, Christina M Durrough, Michael Goldfarb
This paper presents the design of a hand exoskeleton intended to enable or facilitate bimanual activities of daily living (ADLs) for individuals with chronic upper extremity hemiparesis resulting from stroke. The paper describes design of the battery-powered, self-contained exoskeleton and presents the results of initial testing with a single subject with hemiparesis from stroke. Specifically, an experiment was conducted requiring the subject to repeatedly remove the lid from a water bottle both with and without the hand exoskeleton...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28807740/outcomes-of-hiv-positive-patients-with-cryptococcal-meningitis-in-the-americas
#13
B Crabtree Ramírez, Y Caro Vega, B E Shepherd, C Le, M Turner, C Frola, B Grinsztejn, C Cortes, D Padgett, T R Sterling, C C McGowan, A Person
BACKGROUND: Cryptococcal meningitis (CM) is associated with substantial mortality in HIV-infected patients. Optimal timing of antiretroviral therapy (ART) in persons with CM represents a clinical challenge, and the burden of CM in Latin America has not been well described. Studies suggest that early ART initiation is associated with higher mortality, but data from the Americas are scarce. METHODS: HIV-infected adults in care between 1985-2014 at participating sites in the Latin America (the Caribbean, Central and South America network (CCASAnet)) and the Vanderbilt Comprehensive Care Clinic (VCCC) and who had CM were included...
August 12, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28806206/chronic-pain-and-associated-factors-in-india-and-nepal-a-pilot-study-of-the-vanderbilt-global-pain-survey
#14
Jenna L Walters, Kelly Baxter, Hannah Chapman, Tracy Jackson, Adinarayanan Sethuramachandran, Marcus Couldridge, Hem Raj Joshi, Pankaj Kundra, Xulei Liu, Divya Nair, Bonnie Sullivan, Matthew S Shotwell, Ryan J Jense, Nicholas J Kassebaum, K A Kelly McQueen
BACKGROUND: Evaluation and treatment of chronic pain worldwide are limited by the lack of standardized assessment tools incorporating consistent definitions of pain chronicity and specific queries of known social and psychological risk factors for chronic pain. The Vanderbilt Global Pain Survey (VGPS) was developed as a tool to address these concerns, specifically in the low- and middle-income countries where global burden is highest. METHODS: The VGPS was developed using standardized and cross-culturally validated metrics, including the Brief Pain Inventory and World Health Organization Disability Assessment Scale, as well as the Pain Catastrophizing Scale, the Fibromyalgia Survey Questionnaire along with queries about pain attitudes to assess the prevalence of chronic pain and disability along with its psychosocial and emotional associations...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28792263/implementing-and-evaluating-a-community-based-inter-institutional-interprofessional-education-pilot-programme
#15
Chante Stubbs, Mavis N Schorn, Jacinta P Leavell, Elena Wong Espiritu, Gerald Davis, Chad K Gentry, Elisa Friedman, Traci Patton, Ali Graham, Ron Crowder, Consuelo H Wilkins
Many health professions programmes have begun integrating interprofessional learning into their curricula; however, community-based interprofessional education (IPE) initiatives are relatively scarce. The Meharry-Vanderbilt Alliance IPE Faculty Collaborative, comprised of faculty from five institutions, developed a community-based IPE programme that allowed students to engage in meaningful interprofessional activities while exposing them to social determinants of health. Thirty students from ten professions were divided into six teams and paired with three community organisations...
August 9, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28777633/antiferroelectric-topological-insulators-in-orthorhombic-amgbi-compounds-a-li-na-k
#16
Bartomeu Monserrat, Joseph W Bennett, Karin M Rabe, David Vanderbilt
We introduce antiferroelectric topological insulators as a new class of functional materials in which an electric field can be used to control topological order and induce topological phase transitions. Using first principles methods, we predict that several alkali-MgBi orthorhombic members of an ABC family of compounds are antiferroelectric topological insulators. We also show that epitaxial strain and hydrostatic pressure can be used to tune the topological order and the band gap of these ABC compounds. Antiferroelectric topological insulators could enable precise control of topology using electric fields, enhancing the applicability of topological materials in electronics and spintronics...
July 21, 2017: Physical Review Letters
https://www.readbyqxmd.com/read/28760726/triaging-patient-complaints-monte-carlo-cross-validation-of-six-machine-learning-classifiers
#17
Adel Elmessiry, William O Cooper, Thomas F Catron, Jan Karrass, Zhe Zhang, Munindar P Singh
BACKGROUND: Unsolicited patient complaints can be a useful service recovery tool for health care organizations. Some patient complaints contain information that may necessitate further action on the part of the health care organization and/or the health care professional. Current approaches depend on the manual processing of patient complaints, which can be costly, slow, and challenging in terms of scalability. OBJECTIVE: The aim of this study was to evaluate automatic patient triage, which can potentially improve response time and provide much-needed scale, thereby enhancing opportunities to encourage physicians to self-regulate...
July 31, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28748511/unique-histologic-features-of-tonsils-from-patients-with-periodic-fever-aphthous-stomatitis-pharyngitis-and-cervical-adenitis-pfapa-syndrome
#18
Kalpana Manthiram, Hernan Correa, Kelli Boyd, Joseph Roland, Kathryn Edwards
The objective of this study is to compare the histology and immune cell composition of tonsils from patients with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome to those from patients with obstructive sleep apnea (OSA). Patients with PFAPA and age-matched controls with OSA who had undergone tonsillectomy at Vanderbilt Children's Hospital were recruited. After informed consent, archival paraffin-embedded, formalin-fixed tonsil tissues were obtained. Sizes of major histologic regions were measured...
July 26, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28746134/the-md-med-joint-degree-program-at-vanderbilt-university-training-future-expert-medical-educators
#19
William M Sullivan, Jacob DeVolder, Monica Bhutiani, Kristen W Neal, Bonnie M Miller
PROBLEM: Some medical students are drawn to medical education as an area of academic specialization. However, few options exist for medical students who wish to build a scholarly foundation for future careers in medical education. APPROACH: In 2011, Vanderbilt University School of Medicine (VUSM) and Peabody College of Education and Human Development at Vanderbilt University partnered to establish a novel dual-degree program that, through transfer of credit, allows students to graduate with both an MD and a master of education (MEd) degree in five years...
August 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28737983/advancing-patient-care-through-specialty-pharmacy-services-in-an-academic-health-system
#20
Autumn Bagwell, Tara Kelley, Alicia Carver, Jennifer B Lee, Brandon Newman
BACKGROUND: With the rapid growth of specialty pharmacies, including those within academic health systems, pharmacists have the opportunity to improve patient care through the management of specialty medications. Specialty pharmacists within academic health systems are uniquely positioned to overcome restrictions to medication access, financial constraints, and provider burdens that often lead to obstacles for patients to start and maintain necessary treatments. The Vanderbilt Specialty Pharmacy (VSP) model at Vanderbilt University Medical Center (VUMC) provides an example of a patient-centered, collaborative care prototype that places pharmacists directly into specialty clinics to assist with comprehensive management of patients on specialty medications...
August 2017: Journal of Managed Care & Specialty Pharmacy
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