Increasing provider awareness of Lp(a) testing for patients at risk for cardiovascular disease: A comparative study.

Background: Lipoprotein(a) [Lp(a)] is a low-density lipoprotein variant with atherogenic, thrombogenic, and pro-inflammatory properties that may have numerous pathologic effects, including dyslipidemia. Screening for Lp(a) is clinically significant, due to its causal role in atherosclerotic cardiovascular disease (ASCVD). Among clinicians, however, there remains a general lack of both clinical awareness of Lp(a) and adequate tools to track Lp(a) testing in patients.

Automating and improving cardiovascular disease prediction using Machine learning and EMR data features from a regional healthcare system.

Background: The ACC/AHA Pooled Cohort Equations (PCE) Risk Calculator is widely used in the US for primary prevention of atherosclerotic cardiovascular disease (ASCVD), but may under- or over-estimate risk in some populations. We therefore designed an automated, population-specific ASCVD risk calculator using machine-learning (ML) methods and electronic medical record (EMR) data, and compared its predictive power with that of the PCE calculator.

Methods And Findings: We collected data from 101,110 unique EMRs of living patients from January 1, 2009 to April 30, 2020.

Improving Familial Hypercholesterolemia Diagnosis Using an EMR-based Hybrid Diagnostic Model.

Context: Familial hypercholesterolemia (FH) confers a greatly increased risk for premature cardiovascular disease, but remains very underdiagnosed and undertreated in primary care populations.

Objective: We assessed whether using a hybrid model consisting of 2 existing FH diagnostic criteria coupled with electronic medical record (EMR) data would accurately identify patients with FH in a Midwest US metropolitan healthcare system.

Methods: We conducted a retrospective, records-based, cross-sectional study using datasets from unique EMRs of living patients.

Lower-Intensity Statins Contributing to Gaps in Care for Patients With Primary Severe Hypercholesterolemia.

Background Although severe hypercholesterolemia confers a 5-fold increased long-term risk for coronary artery disease, treatment guidelines may not be fully implemented, leading to underdiagnosis and suboptimal treatment. To further understand the clinical features and gaps in treatment approaches, we analyzed electronic medical record data from a midwestern US multidisciplinary healthcare system, between 2009 and 2020. Methods and Results We retrospectively assessed the prevalence, clinical presentation, and treatment characteristics of individuals currently treated with statin therapy having a low-density lipoprotein cholesterol (LDL-C) value that is either (1) an maximum electronic medical record-documented LDL-C ≥190 mg/dL (group 1, n=7542) or (2) an pretreatment LDL-C ≥190 mg/dL (group 2, n=7710).

Prevalence and Characteristics of Patients With Primary Severe Hypercholesterolemia in a Multidisciplinary Healthcare System.

Severe hypercholesterolemia (SH) includes individuals with LDL-C ≥ 190 mg/dl, regardless of cause. These individuals have a fivefold increased long-term risk for coronary artery disease. Although systematic SH screening can trigger early treatment, current treatment guidelines may not be fully implemented or followed by patients.

Translating U-500R Randomized Clinical Trial Evidence to the Practice Setting: A Diabetes Educator/Expert Prescriber Team Approach.

Purpose The purpose of this article is to provide recommendations to the diabetes educator/expert prescriber team for the use of human regular U-500 insulin (U-500R) in patients with severely insulin-resistant type 2 diabetes, including its initiation and titration, by utilizing dosing charts and teaching materials translated from a recent U-500R clinical trial. Conclusions Clinically relevant recommendations and teaching materials for the optimal use and management of U-500R in clinical practice are provided based on the efficacy and safety results of and lessons learned from the U-500R clinical trial by Hood et al, current standards of practice, and the authors' clinical expertise. This trial was the first robustly powered, randomized, titration-to-target trial to compare twice-daily and three-times-daily U-500R dosing regimens.

PREDICTORS OF NONATTENDANCE AT AN ENDOCRINOLOGY OUTPATIENT CLINIC.

Objective: To identify predictors potentially contributing to patients' nonattendance or to same-day cancellation of scheduled appointments at an adult endocrinology office practice.

Methods: A retrospective, records-based, cross-sectional study was conducted using data from 9,305 electronic medical records of patients presenting at a U.S.

A systematic review of IT for diabetes self-management: are we there yet?

Background: Recent advances in information technology (IT) coupled with the increased ubiquitous nature of information technology (IT) present unique opportunities for improving diabetes self-management. The objective of this paper is to determine, in a systematic review, how IT has been used to improve self-management for adults with Type 1 and Type 2 diabetes.

Methods: The review covers articles extracted from relevant databases using search terms related information technology and diabetes self-management published after 1970 until August 2012.

Mobile applications for diabetes self-management: status and potential.

Background: Advancements in smartphone technology coupled with the proliferation of data connectivity has resulted in increased interest and unprecedented growth in mobile applications for diabetes self-management. The objective of this article is to determine, in a systematic review, whether diabetes applications have been helping patients with type 1 or type 2 diabetes self-manage their condition and to identify issues necessary for large-scale adoption of such interventions.

Methods: The review covers commercial applications available on the Apple App Store (as a representative of commercially available applications) and articles published in relevant databases covering a period from January 1995 to August 2012.

Obesity and type 2 diabetes mellitus in South Dakota: focused insight into prevalence, physiology and treatment.

Type 2 diabetes mellitus is one of the significant comorbidities of obesity. This review addresses the prevalence of obesity and diabetes mellitus nationally and in South Dakota. It elaborates on some of the mechanisms of association of obesity with diabetes mellitus, including effects related to adipokines, lipotoxicity, vitamin D deficiency and apolipoprotein C1.

Osteodystrophy in celiac disease: ultimate complications and possible treatment.

Hypovitaminosis D and its consequences are significant complications in the course of untreated celiac disease (CD). We report a case that illustrates the natural evolution of osteomalacia in an adult patient with untreated CD and his response to vitamin D supplementation. In patients with complicated CD and hypovitaminosis D, vitamin D-2 replacement in high enough doses is important to improving functional performance and for the treatment of osteomalacia.

Value of hemoglobin A1c in diagnosing diabetes mellitus within a chronic disease management system illustrated by the receiver operating characteristic curve.

Objective: To develop a receiver operating characteristic (ROC) curve of glycosylated hemoglobin (HbA1c) for diagnosing diabetes mellitus within a chronic disease management system.

Methods: A case-control study including medical records from January 1, 1997, to December 31, 2005, was conducted at the Sioux Falls Veterans Affairs Medical Center. Medical records for the case group (patients with diabetes) were selected based on 1 of 3 criteria: International Classification of Diseases, Ninth Revision, Clinical Modification or Current Procedural Terminology codes specific for type 1 and type 2 diabetes; patients' use of medications (oral hypoglycemic agents, antidiabetes agents, or insulin); or results from random blood or plasma glucose tests (at least 2 measurements of blood glucose > or = 200 mg/dL).

Obesity is associated with bronchial hyper-responsiveness in women.

The study's objective was to compare the bronchial hyper-responsiveness (BHR) between those with normal and increased weight and evaluate if the association was sex-specific. In this cross-sectional review of methacholine challenge test results of 1,141 adults for evaluation of respiratory symptoms, logistic regression analysis was conducted to adjust for covariates. When compared to normal weight, overweight or obese women showed a higher prevalence of symptomatic BHR with odds ratios of 1.

Case report: 66 year-old man with recurrent pneumonias and sinusitis.

A current myth is that Cystic Fibrosis (CF) is a disease of childhood. However, among adults with CF, 64% are between the ages of 18 and 29 years of age; 25% are between 30 and 39 years of age; 10% are between 40 and 49 years old; and 2% are 50 years of age. We report a case of a 66 year-old male with newly diagnosed cystic fibrosis after a history of recurrent pneumonias and sinusitis, with acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD).

Recurrent hypercalcemia due to ectopic production of parathyroid hormone-related protein and intact parathyroid hormone in a single patient with multiple malignancies.

Objective: To report a case of recurrent hypercalcemia due to ectopic production of parathyroid hormone (PTH) and parathyroid hormone-related protein (PTH-rP) from transitional cell carcinoma of the urinary bladder.

Methods: We present clinical, laboratory, and pathologic findings in a 73-year-old man with recurrent hypercalcemia. Results of serum calcium, PTH, PTH-rP and immunostaining of tumors for PTH and PTH-rP over 9 years are presented.

In vivo preservation of steroid specificity in CWR22 xenografts having a mutated androgen receptor.

Background: In vitro studies of CWR22 tumor cells lack steroid specificity. We sought to determine if CWR22 xenografts also lack steroid specificity.

Methods: We injected castrated nude mice with CWR22 tumor cells (6 x 10(6) cells) and implanted Alzet osmotic pumps that delivered approximately 1 mg steroid/kg body weight/day.