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Faculty Publication: O'Neal, Weisz, et al.

Mon, 08/31/2015 - 3:03pm -- kcrotty

Blog Teaser

Downes, J. M., O'Neal, K. S., Miller, M. J., Johnson, J. L., Gildon, B. L., & Weisz, M. A. (2015). Identifying opportunities to improve medication management in transitions of care. [Article]. American Journal of Health-System Pharmacy, 72, S58-S69. doi: 10.2146/ajhp150059^

Purpose. The types and causes of medication discrepancies during the transition from inpatient to ambulatory care were investigated. Methods. A descriptive study was conducted at an academic outpatient group practice affiliated with a private nonacademic hospital to (1) describe discrepancies between inpatient discharge summaries and patient-reported medication lists, (2) identify patient and system factors related to breakdowns in medication documentation, and (3) determine reasons for medication discrepancies. During a four-month period, 17 patients at high risk for medication misadventures while transitioning from hospital care to outpatient follow-up were contacted by telephone soon after discharge and asked to provide information on all medications they were taking. Patient-reported medication lists were compared with the corresponding discharge summaries, and medication discrepancies were categorized by patient-and system-level factors using a validated instrument. Results. Of the total of 96 discrepancies identified, more than two thirds (n = 67, 68%) involved the omission of a prescribed medication from either the patient-reported list or the discharge summary. Cardiovascular medications, including antihypertensives, antilipemics, diuretics, and antiarrhythmics, accounted for almost one quarter of all medication discrepancies. About 15% (n = 14) and 16% (n = 15) of identified discrepancies related to medication dose and frequency, respectively. Conclusion. Among 17 patients transitioning from inpatient to outpatient care, nearly 100 discrepancies between patient-reported medication lists and discharge summaries were identified. Most discrepancies were attributed to nonintentional nonadherence and resumption of home medications without instructions to do so. All 17 patients had at least 1 medication discrepancy categorized as involving a system-level factor.

Link to journal record in Schusterman Library catalog and possible full-text.

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Faculty Publication: Munoz, Fox, et al.

Sun, 08/30/2015 - 3:00pm -- kcrotty

Blog Teaser

Munoz, R. T., Aragon, J. S., & Fox, M. D. (2015). Community-engaged research and homeless adolescents: Capturing perceptions of health care and building lasting relationships with the community. International Public Health Journal, 7(1), 155-161.

 

Faculty Publication: Kathuria et al.

Tue, 08/25/2015 - 3:29pm -- kcrotty

Blog Teaser

Akonur, A., Firanek, C., Gellens, M. E., Hutchcraft, A. M., Kathuria, P., & Sloand, J. A. (2015). VOLUME-BASED PERITONEAL DIALYSIS PRESCRIPTION GUIDE TO ACHIEVE ADEQUACY TARGETS. Peritoneal Dialysis International: Journal Of The International Society For Peritoneal Dialysis.

♦ Background: The use of automated and continuous ambulatory peritoneal dialysis (APD and CAPD) prescriptions (Rxs) to achieve adequate uremic toxin and fluid removal targets is important for attaining optimal patient outcomes. One approach for predicting such Rxs is the use of kinetic modeling. ♦ Methods: Demographic data and peritoneal membrane characteristics derived from a peritoneal equilibration test (PET) were available from 1,005 patients in North American centers who participated in a national adequacy initiative in 1999. Twelve patient subgroups were identified according to peritoneal membrane transport type and tertiles of total body water, assumed equal to urea distribution volume (Vurea). Each patient was then modeled using PD Adequest 2.0 to be treated by 12 CAPD and 34 APD Rxs using both glucose and icodextrin solutions to achieve adequacy targets of weekly urea Kt/V of 1.7 and 1 L of daily ultrafiltration (UF). Residual kidney function (RKF) was assumed to be 0, 2, 4, and 6 mL/min. Feasible peritoneal dialysis (PD) Rxs were identified where: 1) the 95% confidence limit achieved the goal of meeting the targets for urea Kt/V, daily UF, and both in 85%, 75%, and 70% of patients, respectively; 2) average PD solution dextrose concentration was <2.5%; and 3) the number of daytime exchanges was minimized. ♦ Results: Feasible PD Rxs were similar when RKF was ≥ 2 mL/min, allowing condensed recommendations based on RKF ≥ 2 mL/min or < 2 mL/min. Individuals with lower or slower membrane transport required relatively greater 24-h solution volumes to achieve adequacy targets when RKF fell below 2 mL/min. With increasing Vurea, there was disproportionately greater dependence on RKF to achieve targets. While multiple Rxs achieving urea Kt/V and daily UF goals were identified for all membrane transport types, use of icodextrin in the long dwell reduced the need for a midday exchange in APD, glucose exposure, required fill and 24-h dwell volumes, irrespective of RKF and Vurea. While these benefits were most notable in high and high-average transporters, similar results were also seen in low and low-average transporters. ♦ Conclusions: Kinetic modeling identified multiple APD and CAPD Rxs that achieved adequate uremic solute and fluid removal for patients, irrespective of RKF and Vurea. Use of icodextrin rather than glucose in the long dwell reduced the complexity of the PD regimen, total glucose exposure, and 24-h total treatment solution volumes. Irrespective of modeling, adequacy of any PD prescription should be based upon individual.


 

Faculty Publication: O'Neal, Murray, Carter, et al.

Tue, 08/25/2015 - 3:05pm -- kcrotty

Blog Teaser

O'Neal, K. S., Murray, K. A., Skomo, M. L., Carter, S. M., & McConaha, J. (2015). Validation of a survey tool assessing effectiveness of an educational intervention on the caring behaviors and referral activities of community pharmacists for migraineurs. Research in Social and Administrative Pharmacy, 11(3), 352-363. doi: http://dx.doi.org/10.1016/j.sapharm.2014.08.012^

Abstract: Background Community pharmacists are in an ideal position to ameliorate migraineur under-consulting, under-diagnosis, and under-treatment. Contemporary education/training on developing therapeutic alliances with patients and in advanced pharmacotherapy may further motivate pharmacists to impact the care of migraineurs. Objectives The objectives of this study were to assess pharmacists' perceptions of a migraine training program and their self-assessment of subsequent impact on patient care and to develop and assess a tool evaluating the impact of the training program from the patients' perspectives: (1) for patients diagnosed with migraines – identify perceptions of care by pharmacists who have undergone specialty training in migraine vs. pharmacists who have not; and (2) for patients with recurrent headaches and not diagnosed with migraines – identify perceptions of pharmacist effectiveness and thoroughness, after specialty training, to identify a potential migraine diagnosis and referral for advanced care vs. pharmacists that have not undergone specialty training. Methods This study employed a mixed method survey design using community pharmacies from the Tulsa, Oklahoma and Pittsburgh, Pennsylvania greater metropolitan areas. Pharmacists from intervention pharmacies received specialty training on migraine and were surveyed on their current practices and about the education program. Approximately 1 month after the training, control and intervention pharmacists were surveyed on current practices. Additionally, patients from both pharmacies were surveyed to assess Migraine Disability Assessment (MIDAS) and pharmacists' delivery of care derived from the Pharmacists' Care of Migraineurs Scale (PCMS). Surveys were handed out for a period of 3-months. Results There were 16 pharmacists and 61 patients recruited. There was no difference in patient perceptions of pharmacists' care or in patient self-perceptions between migraineurs and recurrent headache sufferers. Ninety-two percent of pharmacists agreed that the program could be transferred to an internet-based educational program. The 14-item patient survey, however, demonstrated good internal consistency reliability, with each question having a Cronbach's alpha 0.80 or higher. Conclusions There are few studies evaluating the role and potential impact community pharmacists can have on patients suffering from migraines or recurrent headaches. While no difference was found between the groups, the internal reliability of the survey questions and the need to address needs of migraineurs warrants tool dissemination and a larger-scale study.

 

Faculty Publication: Mushtaq, et al.

Tue, 08/18/2015 - 5:56pm -- kcrotty

Blog Teaser

Siddiqi, K., Jawad, M., Mushtaq, N., Ali, S., & Khan, J. A. (2015). Tobacco and Health Disparities. Biomed Research International, 2015, 570173-570173. doi: 10.1155/2015/570173^

 

Faculty Publication: O'Neal, Gildon, Weisz, et al.

Tue, 08/18/2015 - 4:15pm -- kcrotty

Blog Teaser

Downes, J. M., O'Neal, K. S., Miller, M. J., Johnson, J. L., Gildon, B. L., & Weisz, M. A. (2015). Identifying opportunities to improve medication management in transitions of care. American Journal Of Health-System Pharmacy: AJHP: Official Journal Of The American Society Of Health-System Pharmacists, 72(17 Suppl 2), S58-S69. doi: 10.2146/ajhp150059^

Purpose: The types and causes of medication discrepancies during the transition from inpatient to ambulatory care were investigated.; Methods: A descriptive study was conducted at an academic outpatient group practice affiliated with a private nonacademic hospital to (1) describe discrepancies between inpatient discharge summaries and patient-reported medication lists, (2) identify patient and system factors related to breakdowns in medication documentation, and (3) determine reasons for medication discrepancies. During a four-month period, 17 patients at high risk for medication misadventures while transitioning from hospital care to outpatient follow-up were contacted by telephone soon after discharge and asked to provide information on all medications they were taking. Patient-reported medication lists were compared with the corresponding discharge summaries, and medication discrepancies were categorized by patient- and system-level factors using a validated instrument.; Results: Of the total of 96 discrepancies identified, more than two thirds (n = 67, 68%) involved the omission of a prescribed medication from either the patient-reported list or the discharge summary. Cardiovascular medications, including antihypertensives, antilipemics, diuretics, and antiarrhythmics, accounted for almost one quarter of all medication discrepancies. About 15% (n = 14) and 16% (n = 15) of identified discrepancies related to medication dose and frequency, respectively.; Conclusion: Among 17 patients transitioning from inpatient to outpatient care, nearly 100 discrepancies between patient-reported medication lists and discharge summaries were identified. Most discrepancies were attributed to nonintentional nonadherence and resumption of home medications without instructions to do so. All 17 patients had at least 1 medication discrepancy categorized as involving a system-level factor.

 

Faculty Publication: Savitz, Teague, etc al.

Tue, 08/18/2015 - 4:07pm -- kcrotty

Blog Teaser

Singh, R., Savitz, J., Teague, T. K., Polanski, D. W., Mayer, A. R., Bellgowan, P. S. F., & Meier, T. B. (2015). Mood symptoms correlate with kynurenine pathway metabolites following sports-related concussion. Journal Of Neurology, Neurosurgery, And Psychiatry. doi: 10.1136/jnnp-2015-311369^

Objective: An imbalance of neuroactive kynurenine pathway metabolites has been proposed as one mechanism behind the neuropsychiatric sequelae of certain neurological disorders. We hypothesized that concussed football players would have elevated plasma levels of neurotoxic kynurenine metabolites and reduced levels of neuroprotective metabolites relative to healthy football players and that altered kynurenine levels would correlate with post-concussion mood symptoms.; Methods: Mood scales and plasma concentrations of kynurenine metabolites were assessed in concussed (N=18; 1.61 days post-injury) and healthy football players (N=18). A subset of football players returned at 1-week (N=14; 9.29 days) and 1-month post-concussion (N=14, 30.93 days).; Results: Concussed athletes had significantly elevated levels of quinolinic acid (QUIN) and significantly lower ratios of kynurenic acid (KYNA) to QUIN at all time points compared with healthy athletes (p's<0.05), with no longitudinal evidence of normalization of KYNA or KYNA/QUIN. At 1-day post-injury, concussed athletes with lower levels of the putatively neuroprotective KYNA/QUIN ratio reported significantly worse depressive symptoms (p=0.04), and a trend toward worse anxiety symptoms (p=0.06), while at 1-month higher QUIN levels were associated with worse mood symptoms (p's<0.01). Finally, concussed athletes with worse concussion outcome, defined as number of days until return-to-play, had higher QUIN and lower KYNA/QUIN at 1-month post-injury (p's<0.05).; Conclusions: These results converge with existing kynurenine literature on psychiatric patients and provide the first evidence of altered peripheral levels of kynurenine metabolites following sports-related concussion.; Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

 

Faculty Publication: Clancy

Mon, 08/17/2015 - 3:11pm -- kcrotty

Blog Teaser

Clancy, G. P. (2015). Good Neighbors: Shared Challenges and Solutions Toward Increasing Value at Academic Medical Centers and Universities. Academic Medicine: Journal Of The Association Of American Medical Colleges.

Academic medical centers (AMCs) and universities are experiencing increasing pressure to enhance the value they offer at the same time that they are facing challenges related to outcomes, controlling costs, new competition, and government mandates. Yet, rarely do the leaders of these academic neighbors work cooperatively to enhance value. In this Perspective the author, a former university regional campus president with duties in an AMC as an academic physician, shares his insights into the shared challenges these academic neighbors face in improving the value of their services in complex environments. He describes the successes some AMCs have had in generating revenues from new clinical programs that reduce the overall cost of care for larger populations. He also describes how several universities have taken a comprehensive approach to reduce overhead and administrative costs. The author identifies six themes related to successful value improvement efforts and provides examples of successful strategies used by AMCs and their university neighbors to improve the overall value of their programs. He concludes by encouraging leaders of AMCs and universities to share information about their successes in value improvements with each other, to seek additional joint value enhancement efforts, and to market their value improvements to the public.

 

Faculty Publication: Thomas et al.

Thu, 08/06/2015 - 10:26pm -- kcrotty

Blog Teaser

Levine, M., Huang, M., Henderson, S. O., Carmelli, G., & Thomas, S. H. (2015). Aminocaproic Acid and Tranexamic Acid Fail to Reverse Dabigatran-Induced Coagulopathy. American Journal of Therapeutics, 1. doi: 10.1097/mjt.0000000000000216^

 

Faculty Publication: Thomas, Mumma, Satterwhite, Haas, Arthur, et al.

Thu, 08/06/2015 - 10:14pm -- kcrotty

Blog Teaser

Thomas, S. H., Mumma, S., Satterwhite, A., Haas, T., Arthur, A. O., Todd, K. H., . . . Pollack, C. V. (2015). Variation between physicians and mid-level providers in opioid treatment for musculoskeletal pain in the Emergency Department. Journal of Emergency Medicine. doi: 10.1016/j.jemermed.2015.05.036^

Background: Effective, appropriate, and safe opioid analgesia administration in the Emergency Department (ED) is a complex issue, with risks of both over- and underutilization of medications. ObjectiveTo assess for possible association between practitioner status (physician (MD) versus mid-level provider (MLP)) and use of opioids for in-ED treatment of musculoskeletal pain (MSP). MethodsThis was a secondary, hypothesis-generating analysis of a subset of subjects who had ED analgesia noted as part of entry into a prospective registry trial of outpatient analgesia. The study was conducted at 12 U.S. academic EDs, ten of which utilized MLPs. Patients were enrolled as a convenience sample from September 2012 through February 2014. Study patients were adults (>17) with acute MSP and eligibility for both non-steroidal anti-inflammatory drugs (NSAIDs) and opioids at ED discharge. The intervention of interest was whether patients received opioid therapy in the ED prior to discharge. ResultsMDs were significantly more likely to order opioids than MLPs for ED patients with MSP. The association between MD/MLP status and likelihood of treatment with opioids was similar in both classical logistic regression (OR 2.3, 95% CI 1.1-4.5, p = .019) and in propensity-adjusted modeling (OR 2.1, 95% CI 1.0-4.5, p = .049). ConclusionsIn preliminary analysis, MD/MLP status was significantly associated with likelihood of provider treatment of MSP with opioids. A follow-up study is warranted to confirm the results of this hypothesis-testing analysis and to inform efforts toward consistency in opioid therapy in the ED.


 

Faculty Publication: Fox, Gomez, Slater, et al.

Thu, 08/06/2015 - 10:06pm -- kcrotty

Blog Teaser

Fox, M. D., Budavich, R., Gelfand, S., Gomez, M. R., Munoz, R. T., Slater, J. What's in a Name? Conceptual Confusion About Death and Consent in Donation After Cardiac Determination of Death. (2015). American Journal of Bioethics, 15(8), 12-14. doi: 10.1080/15265161.2015.1045098^



    
 

Faculty Publication: Crane, O'Neal, Honey, & Kirkpatrick

Sun, 07/26/2015 - 3:24pm -- kcrotty

Blog Teaser

Crane, L. M., O'Neal, K. S., Honey, B. L., & Kirkpatrick, A. (2015). Effectiveness of a modified open airways curriculum. [Article]. Journal of Asthma, 52(5), 519-527. doi: 10.3109/02770903.2014.986739^

Objective: Open Airways for Schools is an asthma education program that has proven to be effective in decreasing the number of asthma attacks in children and increasing their confidence in self-management. It is taught to 8-11 year olds in six 40-min sessions. Due to financial and scheduling constraints, many schools have difficulty implementing the program. The Tulsa Health Department created a modified version of the program, which is taught in ten 20-min sessions over lunch. The same topics are covered in a different order and fewer activities are utilized. This study aimed to pilot the effectiveness of the modified program. Methods: In both versions, a pre-questionnaire is given to participating students on the first day of the program. At the end of the program, the same questionnaire is administered to assess knowledge gained. This is a retrospective review comparing preand post-questionnaire data from the two versions of the program. Descriptive statistics and t-tests were used to compare the results of the questionnaires from the modified program to results from the original program. Results: Twenty students completed the original curriculum and 45 completed the modified program. Both versions were found to improve children's knowledge of how to manage asthma triggers and symptoms, as well as to improve inhaler technique. Conclusions: The modified curriculum is effective at increasing asthma knowledge. Schools may use the modified program as an alternate delivery approach to reduce the scheduling burden and to allow more children to benefit from the educational program. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Asthma is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.


 

Faculty Publication: Honey, Gomez, Condren, et al.

Wed, 07/22/2015 - 3:28pm -- kcrotty

Blog Teaser

Honey, B. L., Bray, W. M., Gomez, M. R., & Condren, M. (2015). Frequency of Prescribing Errors by Medical Residents in Various Training Programs. Journal of Patient Safety, 11(2), 100-104. doi: 10.1097/pts.0000000000000048^

Objectives: Medication errors are hazardous and costly. Children are at increased risk for medication errors because of weight-based dosing, limited FDA indications, and human calculation errors. The aim of this study is to determine the frequency and type of resident prescribing errors in a pediatric clinic and further compare error rates of residents in different training programs. Methods: Resident prescription error data from a pediatric clinic was collected for 5 months. Upon detection of an error, residents were notified/ given feedback regarding the type of error, ways to remedy errors, and future prevention methods. Data were categorized based on medication involved, error type, and resident training program. Results: The review included 2941 prescriptions, with the overall resident prescribing error rate being 5.88%. The pediatric resident error rate was 4%. Family medicine, internal medicine, and medicine/ pediatrics had error rates of 11%, 8%, and 7%, respectively. The prescribing error rate showed a statistically significant difference with pediatrics compared with family medicine, internal medicine, and medicine/pediatrics (P < 0.0005, P = 0.013, and P = 0.03, respectively). The most common medication error type was overdose, followed by unclear quantity. Among the medication classes, topical agents and antimicrobials were among the top prescribed. Conclusions: Numerous types of medication errors occur in a pediatric clinic. Prescribing errors take place among all medical trainees; however, medication error rates in the pediatric population may vary among resident specialty. Identifying the cause of prescribing errors will allow institutions to create educational programs tailored for safe medication use in children as well as systemwide changes for error reduction.

 

Nir Evron's Projected Claims: A Multimedia Exhibit

Wed, 07/22/2015 - 12:39pm -- eargyrop

Blog Teaser

From June 29 - July 31, the Schusterman Library has featured Perspectives on International Child Welfare, a digital exhibition crafted by OU students in the School of Social Work. The exhibit examines the experiences and insights of students who participated in an exchange program that saw their return from Israel in May. The initiative is in partnership with the Haruv Institute, an organization established by the Schusterman Foundation in 2007, and one of Israel’s leading authorities on child abuse and neglect. The gallery offering highlights the importance of advancing child welfare initiatives in a climate of conflict, also bringing to light issues pertaining to social disparity between children in East and West Jerusalem.

Now, at the Philbrook Downtown, students and faculty can benefit from yet another perspective on the complexities of life in Israel as realized by up-and-coming Israeli artist Nir Evron, in his exhibit, Projected Claims. Evron’s work seeks to explore complex issues of history, culture, politics, religion, identity, and shifting borders through a diverse multimedia offering. Projected Claims—Evron’s first exhibition in the United States—explores Israel’s evolving landscape in a manner that seeks to confront romanticized notions of the Holy Land, as well as the dichotomy presented by the desire for change and the inability to successfully implement it. Included in the exhibition are two projected videos: In Virgin Land, “a mediation on the Israeli landscape and the claims made to the holy land throughout the centuries,” and Oriental Arch, “a study of a hotel in East Jerusalem that operates despite the lack of guests and activity.” Also featured is the world debut of Evron’s Threshold, a collection of doubly exposed black and white photographs that document the construction of a new Palestinian city in the West Bank region. The exhibit is ongoing until October 18, and OU-Tulsa students can visit for free with a valid student ID. Learn more at http://philbrook.org/explore/exhibitions/nir-evron

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Faculty Publication: Ivins et al.

Tue, 07/21/2015 - 4:00pm -- kcrotty

Blog Teaser

Peterson, L. E., Blackburn, B., Ivins, D., Mitchell, J., Matson, C., & Phillips, R. L., Jr. (2015). Do family physicians electronic health records support meaningful use? Healthcare (Amsterdam, Netherlands), 3(1), 38-42. doi: 10.1016/j.hjdsi.2014.11.002^

Background: Spurred by government incentives, the use of electronic health records (EHRs) in the United States has increased; however, whether these EHRs have the functionality necessary to meet meaningful use (MU) criteria remains unknown. Our objective was to characterize family physician access to MU functionality when using a MU-certified EHR.; Methods: Data were obtained from a convenience survey of family physicians accessing their American Board of Family Medicine online portfolio in 2011. A brief survey queried MU functionality. We used descriptive statistics to characterize the responses and bivariate statistics to test associations between MU and patient communication functions by presence of a MU-certified EHR.; Results: Out of 3855 respondents, 60% reported having an EHR that supports MU. Physicians with MU-certified EHRs were more likely than physicians without MU-certified EHRs to report patient registry activities (49.7% vs. 32.3%, p-value<0.01), tracking quality measures (74.1% vs. 56.4%, p-value<0.01), access to labs or consultation notes, and electronic prescribing; but electronic communication abilities were low regardless of EHR capabilities.; Conclusions: Family physicians with MU-certified EHRs are more likely to report MU functionality; however, a sizeable minority does not report MU functions.; Implications: Many family physicians with MU-certified EHRs may not successfully meet the successively stringent MU criteria and may face significant upgrade costs to do so.; Level Of Evidence: Cross sectional survey.


 

Faculty Publication: Yang, Cheng, et al.

Tue, 07/07/2015 - 3:45pm -- kcrotty

Blog Teaser

Yang, L., Son, J. B., Ma, J., Cheng, S., Hazle, J., Carter, B. W., & Lin, S. (2015). MO-F-CAMPUS-I-05: Quantitative ADC Measurement of Esophageal Cancer Before and After Chemoradiation. Medical Physics, 42(6), 3579-3579. doi: 10.1118/1.4925471^

Purpose: We investigated whether quantitative diffusion imaging can be used as an imaging biomarker for early prediction of treatment response of esophageal cancer.; Methods: Eight patients with esophageal cancer underwent a baseline and an interim MRI studies during chemoradiation on a 3T whole body MRI scanner with an 8-channel torso phased array coil. Each MRI study contained two axial diffusion-weighted imaging (DWI) series with a conventional DWI sequence and a reduced field-of-view DWI sequence (FOCUS) of varying b-values. ADC maps with two b-values were computed from conventional DWI images using a mono-exponential model. For each of DWI sequences, separate ADCall was computed by fitting the signal intensity of images with all the b-values to a single exponential model. For the FOCUS sequence, a bi-exponential model was used to extract perfusion and diffusion coefficients (ADCperf and ADCdiff) and their contributions to the signal decay. A board-certified radiologist contoured the tumor region and mean ADC values and standard deviations of tumor and muscle ROIs were recorded from different ADC maps.; Results: Our results showed that (1) the magnitude of ADCs from the same ROIs by the different analysis methods can be substantially different. (2) For a given method, the change between the baseline and interim muscle ADCs was relatively small (≤10%). In contrast, the change between the baseline and interim tumor ADCs was substantially larger, with the change in ADCdiff by FOCUS DWI showing the largest percentage change of 73.2%. (3) The range of the relative change of a specific parameter for different patients was also different.; Conclusion: Presently, we do not have the final pathological confirmation of the treatment response for all the patients. However, for a few patients whose surgical specimen is available, the quantitative ADC changes have been found to be useful as a potential predictor for treatment response.

 

Faculty Publication: Gandhapudi, Tan, Marino, Taylor, Pack, Van De Wiele, Teague, et al.

Mon, 07/06/2015 - 4:00pm -- kcrotty

Blog Teaser

Gandhapudi, S. K., Tan, C., Marino, J. H., Taylor, A. A., Pack, C. C., Gaikwad, J., Van De Wiele, J., Wren, J. D., Teague, T. K. (2015). IL-18 Acts in Synergy with IL-7 To Promote Ex Vivo Expansion of T Lymphoid Progenitor Cells. The Journal of Immunology, 194(8), 3820-3828. doi: 10.4049/jimmunol.1301542^
 
Although IL-18 has not previously been shown to promote T lymphopoiesis, results obtained via a novel data mining algorithm (global microarray meta-analysis) led us to explore a predicted role for this cytokine in T cell development. IL-18 is a member of the IL-1 cytokine family that has been extensively characterized as a mediator of inflammatory immune responses. To assess a potential role for IL-18 in T cell development, we sort-purified mouse bone marrow–derived common lymphoid progenitor cells, early thymic progenitors (ETPs), and double-negative 2 thymocytes and cultured these populations on OP9–Delta-like 4 stromal layers in the presence or absence of IL-18 and/or IL-7. After 1 wk of culture, IL-18 promoted proliferation and accelerated differentiation of ETPs to the double-negative 3 stage, similar in efficiency to IL-7. IL-18 showed synergy with IL-7 and enhanced proliferation of both the thymus-derived progenitor cells and the bone marrow–derived common lymphoid progenitor cells. The synergistic effect on the ETP population was further characterized and found to correlate with increased surface expression of c-Kit and IL-7 receptors on the IL-18–treated cells. In summary, we successfully validated the global microarray meta-analysis prediction that IL-18 affects T lymphopoiesis and demonstrated that IL-18 can positively impact bone marrow lymphopoiesis and T cell development, presumably via interaction with the c-Kit and IL-7 signaling axis.
 

 

Faculty Publication: Mallios et al.

Thu, 07/02/2015 - 2:48pm -- kcrotty

Blog Teaser

Mallios, A., Taubman, K., Claiborne, P., & Blebea, J. (2015). Subclavian Vein Stent Fracture and Venous Motion. Annals Of Vascular Surgery. doi: 10.1016/j.avsg.2015.04.064^

Primary subclavian vein stents are not recommended for venous thoracic outlet syndrome before surgical decompression by first rib resection due to a high risk of fracture because they are compressed between the clavicle and first rib. After rib removal, however, stent insertion has been advocated for venous re-stenosis and it is felt that stent fracture is unlikely to occur. We present a case suggesting that repetitive differential vein movement during respiration may be one of the causative factors for stent fractures occurring in this anatomic region.; Copyright © 2015 Elsevier Inc. All rights reserved.

 

Faculty Publication: Binz et al.

Sun, 06/28/2015 - 2:55pm -- kcrotty

Blog Teaser

Comparison of documentation and evidence-based medicine use for non--ST-segment elevation myocardial infarction among cardiology, teaching, and nonteaching teams. (2015). Baylor University Medical Center Proceedings, 28(3), 312-316.

 

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