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https://www.readbyqxmd.com/read/27897005/strategies-for-equitable-pharmacogenomic-guided-warfarin-dosing-among-european-and-african-american-individuals-in-a-clinical-population
#1
Laura K Wiley, Jacob P Vanhouten, David C Samuels, Melinda C Aldrich, Dan M Roden, Josh F Peterson, Joshua C Denny
The blood thinner warfarin has a narrow therapeutic range and high inter- and intra-patient variability in therapeutic doses. Several studies have shown that pharmacogenomic variants help predict stable warfarin dosing. However, retrospective and randomized controlled trials that employ dosing algorithms incorporating pharmacogenomic variants under perform in African Americans. This study sought to determine if: 1) including additional variants associated with warfarin dose in African Americans, 2) predicting within single ancestry groups rather than a combined population, or 3) using percentage African ancestry rather than observed race, would improve warfarin dosing algorithms in African Americans...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896978/development-and-performance-of-text-mining-algorithms-to-extract-socioeconomic-status-from-de-identified-electronic-health-records
#2
Brittany M Hollister, Nicole A Restrepo, Eric Farber-Eger, Dana C Crawford, Melinda C Aldrich, Amy Non
Socioeconomic status (SES) is a fundamental contributor to health, and a key factor underlying racial disparities in disease. However, SES data are rarely included in genetic studies due in part to the difficultly of collecting these data when studies were not originally designed for that purpose. The emergence of large clinic-based biobanks linked to electronic health records (EHRs) provides research access to large patient populations with longitudinal phenotype data captured in structured fields as billing codes, procedure codes, and prescriptions...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27876580/management-of-dry-mouth-assessment-of-oral-symptoms-after-use-of-a-polysaccharide-based-oral-rinse
#3
Joel B Epstein, Dana C Villines, Mabi Singh, Athena Papas
OBJECTIVE: Salivary dysfunction is associated with a range of oral/dental issues, and management of oral symptoms may improve oral function and overall quality of life. The purpose of this pilot study was to evaluate oral symptoms and function in a xerostomic population after use of a proprietary topical for dry mouth, Moisyn (Synedgen Inc., Claremont, CA), which is a polysaccharide-based product. STUDY DESIGN: A pre- and post-test survey was completed by 57 patients with xerostomia...
September 28, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/27876163/process-control-charts-in-infection-prevention-make-it-simple-to-make-it-happen
#4
Timothy L Wiemken, Stephen P Furmanek, Ruth M Carrico, William A Mattingly, Annuradha K Persaud, Brian E Guinn, Robert R Kelley, Julio A Ramirez
BACKGROUND: Quality improvement is central to Infection Prevention and Control (IPC) programs. Challenges may occur when applying quality improvement methodologies like process control charts, often due to the limited exposure of typical IPs. Because of this, our team created an open-source database with a process control chart generator for IPC programs. The objectives of this report are to outline the development of the application and demonstrate application using simulated data. METHODS: We used Research Electronic Data Capture (REDCap Consortium, Vanderbilt University, Nashville, TN), R (R Foundation for Statistical Computing, Vienna, Austria), and R Studio Shiny (R Foundation for Statistical Computing) to create an open source data collection system with automated process control chart generation...
November 18, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27809600/plasma-hepatocyte-growth-factor-is-a-novel-marker-of-al-cardiac-amyloidosis
#5
Kristopher J Swiger, Eitan A Friedman, Evan L Brittain, Kelsey A Tomasek, Shi Huang, Yan R Su, Douglas B Sawyer, Daniel J Lenihan
BACKGROUND: Cardiac amyloidosis is an infiltrative cardiomyopathy that is challenging to diagnose. We hypothesized that the novel biomarkers hepatocyte growth factor (HGF), galectin-3 (GAL-3), interleukin-6 (IL-6), and vascular endothelial growth factor (VEGF) would be elevated in cardiac amyloidosis and may be able to discriminate from non-cardiac systemic amyloidosis or other cardiomyopathies with similar clinical or morphologic characteristics. METHODS: Patients were selected from the Vanderbilt Main Heart Registry according to the following groups: (1) amyloid light-chain (AL) cardiac amyloidosis (n = 26); (2) transthyretin (ATTR) cardiac amyloidosis (n = 7); (3) left ventricular hypertrophy (LVH) (n = 45); (4) systolic heart failure (n = 42); and (5) non-cardiac systemic amyloidosis (n = 7)...
December 2016: Amyloid: the International Journal of Experimental and Clinical Investigation
https://www.readbyqxmd.com/read/27807590/mitochondrial-haplogroups-as-a-risk-factor-for-herpes-zoster
#6
Rebecca T Levinson, Todd Hulgan, Spyros A Kalams, Joshua P Fessel, David C Samuels
Background.  Herpes zoster, or shingles, is a common, painful reactivation of latent varicella zoster virus infection. Understanding host factors that predispose to herpes zoster may permit development of more effective prevention strategies. Our objective was to examine mitochondrial haplogroups as a potential host factor related to herpes zoster incidence. Methods.  Study participants were drawn from BioVU, a deoxyribonucleic acid (DNA) biobank connected to deidentified electronic medical records (EMRs) from Vanderbilt University Medical Center...
October 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27806233/fulminant-myocarditis-with-combination-immune-checkpoint-blockade
#7
Douglas B Johnson, Justin M Balko, Margaret L Compton, Spyridon Chalkias, Joshua Gorham, Yaomin Xu, Mellissa Hicks, Igor Puzanov, Matthew R Alexander, Tyler L Bloomer, Jason R Becker, David A Slosky, Elizabeth J Phillips, Mark A Pilkinton, Laura Craig-Owens, Nina Kola, Gregory Plautz, Daniel S Reshef, Jonathan S Deutsch, Raquel P Deering, Benjamin A Olenchock, Andrew H Lichtman, Dan M Roden, Christine E Seidman, Igor J Koralnik, Jonathan G Seidman, Robert D Hoffman, Janis M Taube, Luis A Diaz, Robert A Anders, Jeffrey A Sosman, Javid J Moslehi
Immune checkpoint inhibitors have improved clinical outcomes associated with numerous cancers, but high-grade, immune-related adverse events can occur, particularly with combination immunotherapy. We report the cases of two patients with melanoma in whom fatal myocarditis developed after treatment with ipilimumab and nivolumab. In both patients, there was development of myositis with rhabdomyolysis, early progressive and refractory cardiac electrical instability, and myocarditis with a robust presence of T-cell and macrophage infiltrates...
November 3, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27797769/cancer-driver-gene-discovery-through-an-integrative-genomics-approach-in-a-non-parametric-bayesian-framework
#8
Hai Yang, Qiang Wei, Xue Zhong, Hushan Yang, Bingshan Li
MOTIVATION: Comprehensive catalogue of genes that drive tumor initiation and progression in cancer is key to advancing diagnostics, therapeutics, and treatment. Given the complexity of cancer, the catalogue is far from complete yet. Increasing evidence shows that driver genes exhibit consistent aberration patterns across multiple-omics in tumors. In this study, we aim to leverage complementary information encoded in each of the omics data to identify novel driver genes through an integrative framework...
October 22, 2016: Bioinformatics
https://www.readbyqxmd.com/read/27760836/preclinical-efficacy-of-an-antibody-drug-conjugate-targeting-mesothelin-correlates-with-quantitative-89zr-immunopet
#9
Anton G T Terwisscha van Scheltinga, Annie Ogasawara, Glenn Pacheco, Alexander Vanderbilt, Jeff Tinianow, Nidhi Gupta, Dongwei Li, Ron Firestein, Jan Marik, Suzie J Scales, Simon-Peter Williams
Antibody-drug conjugates (ADCs) use monoclonal antibodies (mAb) as vehicles to deliver potent cytotoxic drugs selectively to tumor cells expressing the target. Molecular imaging with zirconium-89 (89Zr) labeled mAbs recapitulates similar targeting biology and might help predict the efficacy of these ADCs. An anti-mesothelin antibody (AMA, MMOT0530A) was used to make comparisons between its efficacy as an ADC and its tumor uptake as measured by 89Zr immunoPET imaging. Mesothelin-targeted tumor growth inhibition by monomethyl auristatin E (MMAE), ADC AMA-MMAE (DMOT4039A), was measured in mice bearing xenografts of ovarian cancer OVCAR-3 X2...
October 19, 2016: Molecular Cancer Therapeutics
https://www.readbyqxmd.com/read/27740819/magnetoelectric-coupling-through-the-spin-flop-transition-in-ni_-3-teo_-6
#10
M O Yokosuk, Amal Al-Wahish, Sergey Artyukhin, K R O'Neal, D Mazumdar, P Chen, Junjie Yang, Yoon Seok Oh, Stephen A McGill, K Haule, Sang-Wook Cheong, David Vanderbilt, J L Musfeldt
We combined high field optical spectroscopy and first principles calculations to analyze the electronic structure of Ni_{3}TeO_{6} across the 53 K and 9 T magnetic transitions, both of which are accompanied by large changes in electric polarization. The color properties are sensitive to magnetic order due to field-induced changes in the crystal field environment, with those around Ni1 and Ni2 most affected. These findings advance the understanding of magnetoelectric coupling in materials in which magnetic 3d centers coexist with nonmagnetic heavy chalcogenide cations...
September 30, 2016: Physical Review Letters
https://www.readbyqxmd.com/read/27732699/evaluation-of-a-prediction-model-for-the-development-of-atrial-fibrillation-in-a-repository-of-electronic-medical-records
#11
Matthew J Kolek, Amy J Graves, Meng Xu, Aihua Bian, Pedro Luis Teixeira, M Benjamin Shoemaker, Babar Parvez, Hua Xu, Susan R Heckbert, Patrick T Ellinor, Emelia J Benjamin, Alvaro Alonso, Joshua C Denny, Karel G M Moons, Ayumi K Shintani, Frank E Harrell, Dan M Roden, Dawood Darbar
Importance: Atrial fibrillation (AF) contributes to substantial morbidity, mortality, and health care expenditures. Accurate prediction of incident AF would enhance AF management and potentially improve patient outcomes. Objective: To validate the AF risk prediction model originally developed by the Cohorts for Heart and Aging Research in Genomic Epidemiology-Atrial Fibrillation (CHARGE-AF) investigators using a large repository of electronic medical records (EMRs)...
October 12, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27687351/new-technique-targeting-the-c5-nerve-root-proximal-to-the-traditional-interscalene-sonoanatomical-approach-is-analgesic-for-outpatient-arthroscopic-shoulder-surgery
#12
Katherine H Dobie, Yaping Shi, Matthew S Shotwell, Warren S Sandberg
STUDY OBJECTIVE: Regional anesthesia and analgesia for shoulder surgery is most commonly performed via interscalene nerve block. We developed an ultrasound-guided technique that specifically targets the C5 nerve root proximal to the traditional interscalene block and assessed its efficacy for shoulder analgesia. DESIGN: Prospective case series. SETTING: Vanderbilt Bone and Joint Surgery Center. PATIENTS: Patients undergoing shoulder arthroscopy at an ambulatory surgery center...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27676698/aggression-in-autism-spectrum-disorder-supporting-the-entire-family
#13
Thusa Sabapathy, Douglas L Vanderbilt, Irina Zamora, Marilyn Augustyn
Juanita is a 13-year-old non-verbal Latina girl with autism spectrum disorder, moderate intellectual disability, and a seizure disorder whose aggressive behaviors toward her parents have significantly worsened over the past few months.Juanita's monolingual Spanish-speaking parents are here today for medication management at her primary care clinic. The parents report that Juanita pinches them, pulls their hair, and hits her head with her fists. Her aggression toward them is usually triggered by feelings of frustrations, leaving her parents feeling like they have to walk on eggshells around her and have led to differing parenting styles...
October 2016: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/27668543/what-patient-characteristics-influence-nurses-assessment-of-health-literacy
#14
Kathryn Goggins, Kenneth A Wallston, Lorraine Mion, Courtney Cawthon, Sunil Kripalani
Overestimation of patients' health literacy skills is common among nurses and physicians. At Vanderbilt University Hospital, nurses routinely ask patients the 3 Brief Health Literacy Screen (BHLS) questions. Data from 2 studies that recruited patients at Vanderbilt University Hospital-the Health Literacy Screening (HEALS) study and the Vanderbilt Inpatient Cohort Study (VICS)-were analyzed to compare the BHLS score recorded by nurses during clinical care with the score recorded by trained research assistants during the same hospitalization...
2016: Journal of Health Communication
https://www.readbyqxmd.com/read/27642209/school-based-screening-to-identify-children-at-risk-for-attention-deficit-hyperactivity-disorder-barriers-and-implications
#15
Tammy D Barry, Raymond A Sturner, Karen Seymour, Barbara H Howard, Lucy McGoron, Paul Bergmann, Ronald Kent, Casey Sullivan, Theodore S Tomeny, Jessica S Pierce, Kristen L Coin, James K Goodlad, Nichole Werle
This report describes a school-based screening project to improve early identification of children at risk for attention-deficit/hyperactivity disorder (ADHD) and communicate these concerns to parents, recommending that they contact their child's primary care provider (PCP). Of 17,440 eligible children in first through fifth grades in five school districts, 47.0% of parents provided required written consent, and teachers completed 70.4% of the online screeners (using the Vanderbilt AD/HD Diagnostic Teacher Rating Scale)...
2016: Children's Health Care: Journal of the Association for the Care of Children's Health
https://www.readbyqxmd.com/read/27630192/efficacy-and-outcomes-after-vasopressin-guideline-implementation-in-septic-shock
#16
Janet Y Wu, Joanna L Stollings, Arthur P Wheeler, Matthew W Semler, Todd W Rice
BACKGROUND: In septic shock, the dose of norepinephrine (NE) at which vasopressin (AVP) should be added is unknown. Following an increase in AVP price, our medical intensive care unit (MICU) revised its vasopressor guidelines to reserve AVP for patients requiring greater than 50 µg/min of NE. OBJECTIVE: The purpose of this study is to compare efficacy and safety outcomes for patients admitted before the guideline revision with those for patients admitted after the revision...
September 14, 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27617516/tumor-stage-mycosis-fungoides-a-single-center-study-on-clinicopathologic-features-treatments-and-patient-outcome
#17
Samit A Patrawala, Karen C Broussard, Li Wang, John A Zic
BACKGROUND: Tumor stage mycosis fungoides (MF) is a subtype of cutaneous T-cell lymphoma (CTCL). Tumor stage MF is rarely curable. Treatment is aimed towards controlling the disease and minimizing side effects from therapy. OBJECTIVE: To characterize clinicopathologic features of tumor stage MF and the impact of clinical characteristics and treatment modalities on patient outcome. METHODS: A retrospective chart review was conducted on 39 patients with tumor stage MF followed at Vanderbilt University between July 1995 and July 2010...
2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/27614815/an-intervention-to-promote-sleep-and-reduce-adhd-symptoms
#18
Katherine H Peppers, Shelly Eisbach, Sarah Atkins, James M Poole, Anne Derouin
OBJECTIVE: To determine the effect of a sleep hygiene education module and prescriptive sleep routine for children ages 5 through 11 years with attention deficit hyperactivity disorder (ADHD). METHODS: The 20-week pilot project used a pre-/posttest design to assess sleep and ADHD symptoms. The Child Sleep Habits Questionnaire (CHSQ) and Vanderbilt Assessment Scale-Parent Form survey were provided to assess sleep and ADHD behaviors of participants at baseline and 6 weeks after implementation of the sleep hygiene routine...
November 2016: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/27601915/patient-centeredness-and-empathy-in-a-bilingual-interprofessional-primary-care-teaching-clinic-a-pilot-study
#19
Sallie D Mayer, Erika Peterfy, Steven H Crossman, Lisa Burroughs Phipps, Allison A Vanderbilt
Utilizing the Consultation and Relational Empathy survey, this project examined the perceptions of care team empathy and patient-centeredness between English- and Spanish-speaking patients. From fall through spring semesters, patient surveys from a primary care, interprofessional student-led teaching clinic were collected and analyzed. Overall, mean scores for both English- and Spanish-speaking patients were above the reported normative average for general practitioners. While, overall, patients expressed satisfaction with the student-led teaching clinic in terms of empathy and patient-centeredness, English-speaking patients had higher median scores than Spanish-speaking patients...
2016: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/27594764/respirator-use-in-a-hospital-setting-establishing-surveillance-metrics
#20
Mary I Yarbrough, Meredith E Ficken, Christoph U Lehmann, Thomas R Talbot, Melanie D Swift, Paula W McGown, Robert F Wheaton, Michele Bruer, Steven W Little, Charles A Oke
: Information that details use and supply of respirators in acute care hospitals is vital to prevent disease transmission, assure the safety of health care personnel, and inform national guidelines and regulations. OBJECTIVE: To develop measures of respirator use and supply in the acute care hospital setting to aid evaluation of respirator programs, allow benchmarking among hospitals, and serve as a foundation for national surveillance to enhance effective Personal Protective Equipment (PPE) use and management...
2016: Journal of the International Society for Respiratory Protection
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