The opioid epidemic continues to erode communities across Pennsylvania (PA). Federal and PA state programs developed grants to establish Hub and Spoke programs for the expansion of medications for opioid use disorders (MOUD). Employing the telementoring platform Project ECHO (Extension for Community Health Outcomes), Penn State Health engaged the other seven grant awardees in a Collaborative Health Systems (CHS) ECHO.
View Article and Find Full Text PDFBackground: Two previous reports from the same group concluded that the analytical reliability of Instrumentation Laboratory GEM4000 analyzers (GEM4K) deteriorated during a 24-hour period, based on results between samples from the same patient but collected at different times. Our routine blood gas Between-Laboratory Survey is done every 2 weeks using a freshly pooled heparinized blood sample taken to each analyzer location to verify comparability among our GEM4K and Radiometer ABL90 (Rad90) blood gas analyzers. Because another report found a few very large differences in glucose results between the GEM4K and central laboratory analyzers, we reviewed the glucose results on plasma from our Chemistry Between-Laboratory Surveys that includes comparisons between our central laboratory analyzers (Beckman DxC800; DxC800) and our GEM4K and Rad90 blood gas analyzers.
View Article and Find Full Text PDFBackground: Rotational thromboelastometry (ROTEM) can provide clinical information in 10-20 minutes for guiding administration of fibrinogen, platelets, and fresh frozen plasma products. While ROTEM testing is well established for cardiac and other surgeries, it is less characterized for use in postpartum hemorrhage (PPH) patients. We wanted to determine if the earlier-measured ROTEM parameters (α-angle and amplitude at 10 minutes [A10]) could replace the later parameters (amplitude at 20 minutes and maximum amplitude [maximum clot firmness {MCF}]) in all patient groups studied.
View Article and Find Full Text PDFBackground: Prescription opioid abuse has increased to epidemic proportions in the United States. Kentucky, along with other states, passed comprehensive legislation to monitor and curb opioid prescribing.
Objectives: This paper characterizes patients who presented to the emergency department (ED) after abusing prescription opioids and heroin prior to and after the passage of House Bill 1 (HB1) in April 2012.
This case report describes a unique long-term functional recovery process to promote successful community reintegration for a woman with Guillain-Barré syndrome (GBS), a rare autoimmune disease. Her main symptoms were very limited mobility and depressive symptoms due to the unknown cause of and cure for the illness. Holistic occupational strategies helped the client stabilize her emotional state, create a safe home environment, improve a communication method, increase physical activity, and promote social participation.
View Article and Find Full Text PDFContemp Clin Trials Commun
October 2015
Objective: Achieving patient recruitment goals are critical for the successful completion of a clinical trial. We designed and developed a web-based dashboard for assisting in the management of clinical trial screening and enrollment.
Materials And Methods: We use the dashboard to assist in the management of two observational studies of community-acquired pneumonia.
Introduction: Compliance with National Cholesterol Education Program Adult Treatment Panel III (NCEP) guidelines has been shown to significantly reduce incident cardiovascular events. We investigated physicians' compliance with NCEP guidelines to reduce cardiovascular disease (CVD) risk in a population infected with HIV.
Methods: We analyzed HIV Outpatient Study (HOPS) data, following eligible patients from January 1, 2002, or first HOPS visit thereafter to calculate 10-year cardiovascular risk (10yCVR), until September 30, 2009, death, or last office visit.
Cardiac dyspnea, especially if present only with exercise, is often confused with asthma and exercise-induced bronchospasm. Cardiac dyspnea or asthma is the consequence of pulmonary edema due to pulmonary venous hypertension and not due to asthmatic bronchoconstriction. In overt, acute congestive heart failure, the diagnosis may be readily made by history and physical examination and pertinent laboratory and imaging data.
View Article and Find Full Text PDFBackground: Traditional cardiovascular disease (CVD) risk factors, human immunodeficiency virus (HIV) infection, and antiretroviral (ARV) agents have been associated with CVD events in HIV-infected patients. We investigated the association of low CD4(+) T lymphocyte cell count with incident CVD in a cohort of outpatients treated in 10 HIV specialty clinics in the United States.
Methods: We studied patients who were under observation from 1 January 2002 (baseline), categorized them according to National Cholesterol Education Program guidelines into 10-year cardiovascular risk score (10-y CVR) groups , and observed them until CVD event, death, last HIV Outpatient Study contact, or 30 September 2009.
Background: Deletions of 19q have been associated with gliomas, especially oligodendrogliomas. In addition, cases with oligodendrogliomas with the 19q deletion have been observed to have a better survival compared with cases without the 19q deletion. The authors have previously described a 150-kilobase minimal deletion region in gliomas that maps to 19q13.
View Article and Find Full Text PDFAnn Pharmacother
February 2005
Background: Many pregnant women use dietary supplements during pregnancy; however, relatively scant information is available on the safety of these products. Consumers of dietary supplements often rely on employees of health food stores to provide recommendations.
Objective: To evaluate recommendations made by health food store employees in the Phoenix metropolitan area regarding treatment of nausea/vomiting and migraines during pregnancy.
Cardiovascular disease is a frequent cause of morbidity and mortality following renal transplantation. The percentage of deaths due to ischemic cardiovascular disease and cerebrovascular accidents nearly equals that caused by infection among patients receiving their first transplant, according to data from the European Dialysis and Transplant Association Registry. Hypercholesterolemia is a risk factor for cardiovascular disease frequently identified following renal transplantation, and diets low in fat and cholesterol have been suggested as treatment.
View Article and Find Full Text PDFThe purpose of this research is to examine some of the implicit standards that individuals may use when they rate themselves on personality dimensions. Specifically, we compared ratings based on instructions that specified normative, ipsative, or idiothetic criteria with ratings obtained when subjects used their own (implicit) standards. In a series of three studies, we found that each of the explicit ratings was highly similar to the implicit-standard ratings and that there were substantial individual differences in the relative similarity of each of the explicit ratings to the implicit ratings.
View Article and Find Full Text PDFHealth Care Strateg Manage
September 1987
As the number and complexity of stakeholders for health care organizations has increased, health care managers have become more aware of the ability of these groups to thwart or facilitate the implementation of strategic plans. Most stakeholder models have focused on identification of groups within the usual, global definition of affecting or being affected by an organization's actions. The authors argue that stakeholders management is critical to the implementation of strategic plans.
View Article and Find Full Text PDFFifteen patients with exertional angina underwent hemodynamic monitoring and measurement of cardiac output during a control treadmill exercise test. They were then randomized to receive sustained-release nitroglycerin, 13 mg (group I) or placebo (group II). Repeat exercise testing revealed that in group I, both maximal oxygen consumption and cardiac output increased significantly.
View Article and Find Full Text PDF