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https://www.readbyqxmd.com/read/28335839/apolipoprotein-l1-variants%C3%A2-and-blood-pressure-traits-in%C3%A2-african-americans
#1
Girish N Nadkarni, Geneviève Galarneau, Stephen B Ellis, Rajiv Nadukuru, Jinglan Zhang, Stuart A Scott, Claudia Schurmann, Rongling Li, Laura J Rasmussen-Torvik, Abel N Kho, M Geoffrey Hayes, Jennifer A Pacheco, Teri A Manolio, Rex L Chisholm, Dan M Roden, Joshua C Denny, Eimear E Kenny, Erwin P Bottinger
BACKGROUND: African Americans (AA) are disproportionately affected by hypertension-related health disparities. Apolipoprotein L1 (APOL1) risk variants are associated with kidney disease in hypertensive AAs. OBJECTIVES: This study assessed the APOL1 risk alleles' association with blood pressure traits in AAs. METHODS: The discovery cohort included 5,204 AA participants from Mount Sinai's BioMe biobank. Replication cohorts included additional BioMe (n = 1,623), Vanderbilt BioVU (n = 1,809), and Northwestern NUgene (n = 567) AA biobank participants...
March 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28302179/balanced-crystalloids-versus-saline-in-the-intensive-care-unit-study-protocol-for-a-cluster-randomized-multiple-crossover-trial
#2
Matthew W Semler, Wesley H Self, Li Wang, Daniel W Byrne, Jonathan P Wanderer, Jesse M Ehrenfeld, Joanna L Stollings, Avinash B Kumar, Antonio Hernandez, Oscar D Guillamondegui, Addison K May, Edward D Siew, Andrew D Shaw, Gordon R Bernard, Todd W Rice
BACKGROUND: Saline, the intravenous fluid most commonly administered to critically ill adults, contains a high chloride content, which may be associated with acute kidney injury and death. Whether using balanced crystalloids rather than saline decreases the risk of acute kidney injury and death among critically ill adults remains unknown. METHODS: The Isotonic Solutions and Major Adverse Renal Events Trial (SMART) is a pragmatic, cluster-level allocation, cluster-level crossover trial being conducted between 1 June 2015 and 30 April 2017 in five intensive care units at Vanderbilt University Medical Center in Nashville, TN, USA...
March 16, 2017: Trials
https://www.readbyqxmd.com/read/28277261/building-a-palliative-radiation-oncology-program-from-bedside-to-b-e-d
#3
Mark J Stavas, Jonathan D Pagan, Sumeeta Varma, Benjamin Li, Lisa A Kachnic
A growing body of evidence supports the integration of palliative care with standard cancer treatments. In these situations, patients often experience a better quality of life, better quality of care, decreased cost, and, in some cases, improved survival with the addition of palliative care services to traditional treatment pathways. In this manuscript, we explore the integration of radiation oncology at palliative care. First, we discuss the impetus for change at Vanderbilt University and the inception of Vanderbilt's inpatient Palliative Radiation Oncology Service at Vanderbilt...
September 13, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28266038/using-direct-antiglobulin-test-results-to-reduce-unnecessary-cold-agglutinin-testing
#4
Craig B Wilen, Garrett S Booth, Brenda J Grossman, William J Lane, Penny C Szklarski, Ronald Jackups
BACKGROUND: Cold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia mediated by autoantibodies that preferentially react at 4°C. Laboratory testing for cold-reactive autoantibodies is laborious and may not be ordered judiciously, particularly in patients with a negative direct antiglobulin test (DAT). We sought to determine whether a negative DAT using anti-human complement (anti-C3) rules out elevated cold agglutinin (CA) titers and the diagnosis of CAD. STUDY DESIGN AND METHODS: We performed a retrospective study of patients with a CA test performed at three major academic medical centers: Barnes-Jewish Hospital (2003-2014), Vanderbilt University Medical Center (2007-2009), and Massachusetts General Hospital (2009-2014)...
March 7, 2017: Transfusion
https://www.readbyqxmd.com/read/28263642/observer-youth-and-therapist-perspectives-on-the-alliance-in-cognitive-behavioral-treatment-for-youth-anxiety
#5
Bryce D McLeod, Michael A Southam-Gerow, Philip C Kendall
This study examined the score reliability and validity of observer- (Therapy Process Observational Coding System for Child Psychotherapy-Alliance scale [TPOCS-A]; Vanderbilt Therapeutic Alliance Scale Revised, Short Form [VTAS-R-SF]), therapist- (Therapeutic Alliance Scale for Children Therapist Version [TASC-T]), and youth-rated (Therapeutic Alliance Scale for Children Child Version [TASC-C]) alliance instruments. Youths (N = 50) aged 7-15 (Mage = 10.28 years, SD = 1.84; 88.0% Caucasian; 60.0% male) diagnosed with a principal anxiety disorder received manual-based cognitive-behavioral treatment...
March 6, 2017: Psychological Assessment
https://www.readbyqxmd.com/read/28252537/daily-lowest-hemoglobin-and-risk-of-organ-dysfunctions-in-critically-ill-patients
#6
Sarah J Hemauer, Adam J Kingeter, Xue Han, Matthew S Shotwell, Pratik P Pandharipande, Liza M Weavind
OBJECTIVES: To determine the association between hemoglobin levels and the daily risk of individual organ dysfunctions in critically ill patients. DESIGN: Post hoc analysis of prospectively collected data. SETTING: Vanderbilt University Medical Center and Saint Thomas Hospital Medical and Surgical ICUs. PATIENTS: Medical and surgical ICU patients admitted with respiratory failure or shock. INTERVENTIONS: Baseline demographic data, and detailed in-ICU and hospital data, including daily lowest hemoglobin, were collected up to hospital day 30...
March 1, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28248564/patient-and-therapist-perspectives-during-the-psychotherapy-termination-process-the-role-of-participation-and-exploration
#7
Margot P Weil, Michael Katz, Mark J Hilsenroth
OBJECTIVE: This study was the first to examine psychotherapy termination from both therapists' and patients' perspectives by using standardized psychotherapy process measures. Our aim was to examine whether patient participation and therapist exploration during the termination phase of treatment are related to how good and productive the session was. METHOD: The sample consisted of 30 outpatient adults who had completed the Vanderbilt Psychotherapy Process Scale-Short form (VPPS-S; Smith, Hilsenroth, Baity, & Knowles, 2003) and the Session Evaluation Questionnaire (SEQ; Stiles, 1980) during a termination-phase session...
2017: Psychodynamic Psychiatry
https://www.readbyqxmd.com/read/28245487/mitochondrial-haplogroups-affect-severity-but-not-prevalence-of-diabetic-retinopathy
#8
Jana A Bregman, David J Herren, Christopher B Estopinal, Isaac M Chocron, Paula A Harlow, Cassandra Warden, Milam A Brantley, David C Samuels
Purpose: We previously reported European mitochondrial haplogroup H to be a risk factor for and haplogroup UK to be protective against proliferative diabetic retinopathy (PDR) among Caucasian patients with diabetic retinopathy (DR). The purpose of this study was to determine whether these haplogroups are also associated with the risk of having DR among Caucasian patients with diabetes. Methods: Deidentified medical records for 637 Caucasian patients with diabetes (223 with DR) were obtained from BioVU, Vanderbilt University's electronic, deidentified DNA databank...
February 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28225732/integrating-and-assessing-structural-competency-in-an-innovative-prehealth-curriculum-at-vanderbilt-university
#9
Jonathan M Metzl, JuLeigh Petty
PROBLEM: Structural competency is a framework for conceptualizing and addressing health-related social justice issues that emphasizes diagnostic recognition of economic and political conditions producing and racializing inequalities in health. Strategies are needed to teach prehealth undergraduate students concepts central to structural competency (e.g., structural inequity, structural racism, structural stigma) and to evaluate their impact. APPROACH: The curriculum for Vanderbilt University's innovative prehealth major in medicine, health, and society (MHS) was reshaped in 2013 to incorporate structural competency concepts and skills into undergraduate courses...
March 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28219462/the-use-of-a-computerized-provider-order-entry-alert-to-decrease-rates-of-clostridium-difficile-testing-in-young-pediatric-patients
#10
Maribeth R Nicholson, Peter N Freswick, M Cecilia Di Pentima, Li Wang, Kathryn M Edwards, Gregory J Wilson, Thomas R Talbot
BACKGROUND Infants and young children are frequently colonized with C. difficile but rarely have symptomatic disease. However, C. difficile testing remains prevalent in this age group. OBJECTIVE To design a computerized provider order entry (CPOE) alert to decrease testing for C. difficile in young children and infants. DESIGN An interventional age-targeted before-after trial with comparison group SETTING Monroe Carell Jr. Children's Hospital at Vanderbilt University, Nashville, Tennessee. PATIENTS All children seen in the inpatient or emergency room settings from July 2012 through July 2013 (pre-CPOE alert) and September 2013 through September 2014 (post-CPOE alert) INTERVENTION In August of 2013, we implemented a CPOE alert advising against testing in infants and young children based on the American Academy of Pediatrics recommendations with an optional override...
February 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28215817/free-dermal-fat-graft-reconstruction-of-the-head-and-neck-an-alternate-reconstructive-option
#11
Adam Honeybrook, Sanjay M Athavale, Sanjeet V Rangarajan, Sarah L Rohde, James L Netterville
OBJECTIVES: Ablative procedures of the head and neck often result in significant facial and cervical irregularities and cosmetic asymmetry. The deformity resulting from ablative procedures of the head and neck is a significant source of cosmetic morbidity and postoperative dissatisfaction. Reconstruction of post-ablative defects in the head and neck can employ a broad range of techniques, ranging from primary closure to free tissue transfer. The free dermal fat graft (FDFG) is one such option and has been used to repair volume defects of varying sizes after common head and neck procedures such as parotidectomy...
January 27, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28199477/use-of-unsolicited-patient-observations-to-identify-surgeons-with-increased-risk-for-postoperative-complications
#12
William O Cooper, Oscar Guillamondegui, O Joe Hines, C Scott Hultman, Rachel R Kelz, Perry Shen, David A Spain, John F Sweeney, Ilene N Moore, Joseph Hopkins, Ira R Horowitz, Russell M Howerton, J Wayne Meredith, Nathan O Spell, Patricia Sullivan, Henry J Domenico, James W Pichert, Thomas F Catron, Lynn E Webb, Roger R Dmochowski, Jan Karrass, Gerald B Hickson
Importance: Unsolicited patient observations are associated with risk of medical malpractice claims. Because lawsuits may be triggered by an unexpected adverse outcome superimposed on a strained patient-physician relationship, a question remains as to whether behaviors that generate patient dissatisfaction might also contribute to the genesis of adverse outcomes themselves. Objective: To examine whether patients of surgeons with a history of higher numbers of unsolicited patient observations are at greater risk for postoperative complications than patients whose surgeons generate fewer such unsolicited patient observations...
February 15, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28191589/assessment-of-musculoskeletal-impairment-in-head-and-neck-cancer-patients
#13
Michael K Ghiam, Kyle Mannion, Mary S Dietrich, Kristen L Stevens, Jill Gilbert, Barbara A Murphy
PURPOSE: This study aims to describe the types of musculoskeletal impairment in head and neck cancer survivors and to evaluate objective and subjective measures of musculoskeletal impairment and identify areas of need in future studies. METHODS: This is a cross-sectional pilot study of 29 head and neck cancer patients who were treated with resection and reconstruction. Subjective measures of musculoskeletal impairment (Neck Disability Index, Shoulder Pain and Disability Index, Vanderbilt Head and Neck Symptom Survey, General Symptom Survey) were collected and compared to objective measures (Cervical Range of Motion Device, Inter-incisal Distance)...
February 13, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28164727/psychometric-properties-of-the-vanderbilt-adhd-diagnostic-rating-scale-completed-by-juvenile-corrections-staff
#14
Regina Bussing, Joseph C Gagnon, Cynthia W Garvan, Cecelia Ribuffo-Duggan, David Houchins
OBJECTIVE: This research tests the psychometric performance of the Vanderbilt ADHD Diagnostic Teacher Rating Scale (VADTRS) completed by juvenile corrections (JC) staff. METHOD: With institutional review board (IRB) approval and appropriate consents/assents, data were collected from case managers ( n = 18), teachers ( n = 9), youth ( n = 261), and an administrative database. Separate psychometric analyses were conducted for case managers and teachers. RESULTS: For both respondent groups, 2-week retest reliability and internal consistency were high for all four VADTRS subscales, and confirmatory factor analysis suggested fit with previously reported VADTRS subscale structure...
February 1, 2017: Journal of Attention Disorders
https://www.readbyqxmd.com/read/28141730/-footprints-in-the-bathroom-the-role-of-spirituality-in-patient-diagnosis
#15
Veronica Meneses, Douglas Vanderbilt, Linda Barnes, Marilyn Augustyn
Lucy is a 12-year-old Latina whose mother brought her to the pediatric clinic for help with her anxiety symptoms, "hearing voices," and episodes of "spacing out." Lucy did not cry at birth secondary to vocal cord paralysis and still has the tracheostomy performed at a few days of life. In addition to her neonatal intensive care unit stay, she has been hospitalized for pneumonia. Her mother says she is "sickly" and has a weak immune system due to her asthma symptoms. Lucy also experiences somatic complaints related to gastroesophageal reflux and constipation...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28141716/apraxia-autism-attention-deficit-hyperactivity-disorder-do-we-have-a-new-spectrum
#16
Jayna Schumacher, Kristine E Strand, Marilyn Augustyn
Gio is a bilingual 6-year 10-month-old boy new to your practice who presents for an unscheduled visit with concerns for speech and language delay. He was born in Portugal, and his native language is Portuguese. When he was 21 months old, his family moved to Italy and then moved to the United States 3 years later. He had very little contact with other children while living in Italy, but his parents report that he has made friends quickly in the United States. His family speaks Portuguese at home, although his father is fluent in English...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28141715/-when-the-prescription-pad-is-not-enough-attention-deficit-hyperactivity-disorder-management-2-0
#17
Jenny Radesky, Arathi Reddy, Naomi Steiner, Marilyn Augustyn
Jose is a 13-year-old boy who presents to his primary care provider after struggling in school for many years. When he was in the first grade, he was diagnosed at a tertiary center with attention-deficit hyperactivity disorder. Multiple medication trials have produced few benefits and many side effects including poor sleep, morbid thoughts, lack of motivation, and, according to his parents, "he seemed like a robot."He comes now for his annual physical in April, and the parents tell you that the school is threatening that he be retained in the seventh grade...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28141707/bullying-and-adhd-which-came-first-and-does-it-matter
#18
Robert Keder, Robert Sege, Peter C Raffalli, Marilyn Augustyn
Aiden, a 13-year-old boy in the sixth grade who is relatively new to your practice, is seen for follow-up after his routine physical last month when you noted concerns for possible attention-deficit hyperactivity disorder (ADHD) and gave the family Vanderbilt Scales to complete. Aiden has a family history of ADHD, specific learning disabilities, and mood disorder.His mother reports that she is concerned about how Aiden is doing at school; his teachers are complaining that he is not doing his work, and she is worried that he may be kept back in school...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28132018/proportion-of-never-smoker-non-small-cell-lung-cancer-patients-at-three-diverse-institutions
#19
Lorraine Pelosof, Chul Ahn, Ang Gao, Leora Horn, Alejandra Madrigales, Joan Cox, Dauphne McGavic, John D Minna, Adi F Gazdar, Joan Schiller
BACKGROUND: Approximately 10% to 15% of lung cancer cases in the United States occur in never smokers, but there has been much debate about whether this rate is increasing. To determine whether the proportion of never smokers among lung cancer cases is increasing, we conducted a retrospective study using registries from The University of Texas Southwestern Medical Center, Parkland Hospital, and Vanderbilt University. METHODS: Registries were queried for demographic information from 1990 to 2013 including sex, age, stage, and self-reported smoking history...
January 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28129252/optimal-diagnostic-thresholds-for-diagnosis-of-orthostatic-hypotension-with-a-sit-to-stand-test
#20
Brett H Shaw, Emily M Garland, Bonnie K Black, Sachin Y Paranjape, Cyndya A Shibao, Luis E Okamoto, Alfredo Gamboa, André Diedrich, W Dale Plummer, William D Dupont, Italo Biaggioni, David Robertson, Satish R Raj
OBJECTIVE: This study aimed to identify optimal blood pressure cut-offs to diagnose orthostatic hypotension during a sit-to-stand manoeuvre. METHODS: This was a cross-sectional study of patients and healthy controls from the Vanderbilt Autonomic Dysfunction Center. Blood pressure was measured while supine, seated and standing. Blood pressure changes were calculated from supine-to-standing and seated-to-standing. Orthostatic hypotension was diagnosed on the basis of a supine-to-standing SBP drop at least 20 mmHg or a DBP drop at least 10 mmHg...
January 27, 2017: Journal of Hypertension
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