511 results match your criteria: "Roudebush Veterans Affairs Medical Center[Affiliation]"

Background: Digital health interventions are a promising method for delivering timely support to underresourced family caregivers. The uptake of digital health interventions among caregivers may be improved by engaging caregivers in participatory design (PD). In recent years, there has been a shift toward conducting PD remotely, which may enable participation by previously hard-to-reach groups.

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Pharmacogenetics promises to optimize treatment-related outcomes by informing optimal drug selection and dosing based on an individual's genotype in conjunction with other important clinical factors. Despite significant evidence of genetic associations with drug response, pharmacogenetic testing has not been widely implemented into clinical practice. Among the barriers to broad implementation are limited guidance for how to successfully integrate testing into clinical workflows and limited data on outcomes with pharmacogenetic implementation in clinical practice.

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Despite their beneficial actions as immunosuppressants, glucocorticoids (GC) have devastating effects on the musculoskeletal and cardiac systems, as long-term treated patients exhibit high incidence of falls, bone fractures, and cardiovascular events. Herein, we show that GC upregulate simultaneously in bone, skeletal muscle, and the heart the expression of E3 ubiquitin ligases (atrogenes), known to stimulate the proteasomal degradation of proteins. Activation of vitamin D receptor (VDR) signaling with the VDR ligands calcitriol or eldecalcitol prevented GC-induced atrogene upregulation in vivo and ex vivo in bone/muscle organ cultures and preserved tissue structure/mass and function of the 3 tissues in vivo.

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Background: Industrywide, primary care nurses' work is increasing in complexity and team orientation. Mobile health information technologies (HITs) designed to aid nurses with indirect care tasks, including charting, have had mixed success. Failed introductions of HIT may be explained by insufficient integration into nurses' work processes, owing to an incomplete or incorrect understanding of the underlying work systems.

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Purpose: The phase 3 Veterans Affairs Lung Cancer Surgery Or Stereotactic Radiotherapy study implemented centralized quality assurance (QA) to mitigate risks of protocol deviations. This report summarizes the quality and compliance of the first 100 participants treated with stereotactic body radiation therapy (SBRT) in this study.

Methods And Materials: A centralized QA program was developed to credential and monitor study sites to ensure standard-of-care lung SBRT treatments are delivered to participants.

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Article Synopsis
  • The study investigates the role of PPAR-gamma in skin inflammation and cancer using PPARγ-deficient mice, revealing significant changes in gene expression related to cancer and inflammation.
  • Single-cell sequencing highlighted increased inflammatory cell infiltration and alterations in fibroblast activity, linking PPARγ loss to heightened epithelial malignancy risks.
  • Overall, PPARγ and potentially PPARα appear to function as important tumor suppressors by inhibiting inflammation associated with actinic keratoses and cutaneous squamous cell carcinomas.
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Performance of bowel preparation quality scales in patients with Crohn's disease.

Aliment Pharmacol Ther

October 2024

Department of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada.

Article Synopsis
  • The study aimed to evaluate various instruments for assessing bowel preparation (BP) quality in patients with Crohn's disease, a condition where BP performance is not well understood.!
  • Five different scales were used to analyze BP quality in videos from 40 patients, focusing on reliability and validity through statistical methods.!
  • Results showed that most instruments demonstrated substantial reliability, with a negative correlation between BP quality and disease activity scores, indicating these tools are useful in clinical practice and research for Crohn's disease patients.!
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Telemedicine in Neuro-Ophthalmology Is Ready for Prime Time.

J Neuroophthalmol

September 2024

Department of Ophthalmology (KEL), Indiana University School of Medicine, Indianapolis, Indiana; Department of Ophthalmology and Visual Sciences (KEL), University of Louisville School of Medicine, Louisville, Kentucky; Ophthalmology Section (KEL), Surgery Service, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana; Neuro-Ophthalmology Section (KEL), Midwest Eye Institute, Carmel, Indiana; Circle City Neuro-Ophthalmology (KEL), Carmel, Indiana; Wilmer Eye Institute (ARC), Johns Hopkins University School of Medicine, Baltimore, Maryland; Blanton Eye Institute (AGL), Houston Methodist Hospital, Houston, Texas; and Department of Ophthalmology and Visual Sciences (GPVS), Washington University in St. Louis, St. Louis, Missouri.

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The progression of kidney disease varies among individuals, but a general methodology to quantify disease timelines is lacking. Particularly challenging is the task of determining the potential for recovery from acute kidney injury following various insults. Here, we report that quantitation of post-transcriptional adenosine-to-inosine (A-to-I) RNA editing offers a distinct genome-wide signature, enabling the delineation of disease trajectories in the kidney.

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Most cases of optic neuritis (ON) occur in women and in patients between the ages of 15 and 45 years, which represents a key demographic of individuals who seek health information using the internet. As clinical providers strive to ensure patients have accessible information to understand their condition, assessing the standard of online resources is essential. To assess the quality, content, accountability, and readability of online information for optic neuritis.

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Background: The Veterans Health Administration (VHA) is the largest integrated health care system in the US, providing care to more than 9 million enrolled veterans. In February 2019, the VHA identified key actionable steps to become a high reliability organization (HRO), transforming how employees think about patient safety and care quality. The VHA is also working toward becoming the largest age-friendly health system in the US to be recognized by the Institute for Healthcare Improvement for its commitment to providing care guided by the 4Ms (what matters, medication, mentation, and mobility), causing no harm, and aligning care with what matters to older veterans.

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Importance: Military members and veterans (hereafter, veterans) with posttraumatic stress disorder (PTSD) increasingly seek psychiatric service dogs as a complementary intervention, yet the effectiveness of service dogs is understudied.

Objective: To estimate the associations between psychiatric service dog partnership and self-reported and clinician-rated PTSD symptom severity, depression, anxiety, and psychosocial functioning after 3 months of intervention among veterans.

Design, Setting, And Participants: This nonrandomized controlled trial used standardized and validated assessment instruments completed by participants and administered by blinded clinicians.

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Lung squamous cell carcinoma (LUSC) is the second leading cause of lung cancer. Although characterized by high DNA mutational burdens and genomic complexity, the role of DNA repair in LUSC development is poorly understood. We sought to better understand the role of the DNA repair protein Xeroderma Pigmentosum Group C (XPC) in LUSC development.

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Racial disparities in staging, treatment, and mortality in non-small cell lung cancer.

Transl Lung Cancer Res

January 2024

Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

Background: Black race is associated with advanced stage at diagnosis and increased mortality in non-small cell lung cancer (NSCLC). Most studies focus on race alone, without accounting for social determinants of health (SDOH). We explored the hypothesis that racial disparities in stage at diagnosis and outcomes are associated with SDOH and influence treatment decisions by patients and providers.

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Introduction: Chronic kidney disease (CKD) negatively affects musculoskeletal health, leading to reduced mobility, and quality of life. In healthy populations, carnitine supplementation and aerobic exercise have been reported to improve musculoskeletal health. However, there are inconclusive results regarding their effectiveness and safety in CKD.

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Defining Preferred Esthetics of the Ideal Phallus via Crowdsource Survey.

Urology

April 2024

University of Southern California, Division of Plastic & Reconstructive Surgery, Los Angeles, CA; Department of Plastic & Reconstructive Surgery, Kaiser Permanente Medical Center, Los Angeles, CA. Electronic address:

Objective: To describe phalloplasty subunits and determine the preferred crowdsourced esthetics. Esthetic ideals are often used to guide reconstruction, and there has been an increase in the number of gender-affirming surgeries and reconstructive phalloplasties performed. However, there is a paucity of literature describing ideal phalloplasty esthetics.

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Improving understanding of behaviors that increase or reduce cancer risk for different Hispanic groups is a public health priority; such knowledge is sparse in new gateway immigration locations such as Indiana. The aims of this study were to: 1) describe cancer beliefs and cancer preventive/risk reduction behaviors (physical activity, tobacco, and alcohol use) among Hispanic adults; 2) examine differences in cancer beliefs and preventive behaviors by country/territory of birth, socioeconomic status, and area of residence (urban vs. rural); and 3) determine predictors of engagement in cancer prevention and risk reduction behaviors in this population.

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Learning from women veterans who navigate invisible injuries, caregiving, and reintegration challenges.

BMC Womens Health

December 2023

South Central MIRECC, Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA.

Article Synopsis
  • As more women join the military, their experiences during the transition to civilian life significantly impact their health and reintegration.
  • A study involving interviews with 16 post-911 women veterans revealed key challenges they face, such as establishing careers, accessing healthcare, and managing complex identities.
  • The findings indicate that women veterans often feel marginalized in healthcare compared to their male counterparts, highlighting crucial areas that the VA needs to address for better support during their transition.
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Article Synopsis
  • The progression of kidney disease differs for each individual, and existing methods to measure these timelines are insufficient, especially in assessing recovery from acute kidney injury.
  • Researchers discovered that A-to-I RNA editing provides a unique genome-wide signature that helps map kidney disease trajectories, using a mouse model to study its effects during inflammation.
  • Specifically, A-to-I editing of the gene AZIN1 plays a key role in kidney recovery by regulating polyamine biosynthesis and activating recovery mechanisms, suggesting that measuring AZIN1 editing could predict a person's recovery potential after inflammation.
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Renal reserve capacity may be compromised following recovery from acute kidney injury (AKI) and could be used to identify impaired renal function in the face of restored glomerular filtration rate (GFR) or plasma creatinine. To investigate the loss of hemodynamic renal reserve responses following recovery in a model of AKI, rats were subjected to left unilateral renal ischemia-reperfusion (I/R) injury and contralateral nephrectomy and allowed to recover for 5 wk. Some rats were treated 24 h post-I/R by hydrodynamic isotonic fluid delivery (AKI-HIFD) of saline through the renal vein, previously shown to improve recovery and inflammation relative to control rats that received saline through the vena cava (AKI-VC).

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Background: Radiation therapy can cause long-term dysphagia that seriously affects quality of life for survivors of head and neck cancer. This study evaluates a novel organ at risk, the contralateral pharyngeal constrictor muscles, to find out whether radiation dose to this structure predicts late swallowing function in patients with head and neck cancer.

Methods: The study included patients with head and neck cancer treated with radiation and concurrent systemic therapy at a single institution over 3 years.

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Accurate Documentation Contributes to Guideline-concordant Surveillance of Nonmuscle Invasive Bladder Cancer: A Multisite Department of Veterans Affairs Study.

Urology

November 2023

White River Junction VA Healthcare System, White River Junction, VT; Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth College, Lebanon, NH. Electronic address:

Objective: To determine if accurate documentation of bladder cancer risk was associated with a clinician surveillance recommendation that is concordant with AUA guidelines among patients with nonmuscle invasive bladder cancer (NMIBC).

Methods: We prospectively collected data from cystoscopy encounter notes from four Department of Veterans Affairs (VA) sites to ascertain whether they included accurate documentation of bladder cancer risk and a recommendation for a guideline-concordant surveillance interval. Accurate documentation was a clinician-recorded risk classification matching a gold standard assigned by the research team.

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Loss of Nmp4 enhances bone gain from sclerostin antibody administration.

Bone

December 2023

Department of Anatomy, Cell Biology, & Physiology, Indiana University School of Medicine (IUSM), Indianapolis, IN 46202, USA; Indiana Center for Musculoskeletal Health, IUSM, USA. Electronic address:

Severe osteoporosis is often treated with one of three Food and Drug Administration (FDA)-approved osteoanabolics. These drugs act by (1) parathyroid hormone (PTH) receptor stimulation using analogues to PTH (teriparatide) or PTH-related peptide (abaloparatide) or by (2) monoclonal antibody neutralization of sclerostin, an innate Wnt inhibitor (Scl-mAb, romosozumab-aqqg). The efficacies of both strategies wane over time.

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