<1. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26049532 AU - Ratwani RM AU - Fairbanks RJ AU - Hettinger AZ AU - Benda NC FA - Ratwani, Raj M FA - Fairbanks, Rollin J FA - Hettinger, A Zachary FA - Benda, Natalie C IN - Ratwani,Raj M. National Center for Human Factors in Healthcare, MedStar Health, Washington, DC, USA Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC, USA raj.ratwani@medicalhfe.org. Fairbanks,Rollin J. National Center for Human Factors in Healthcare, MedStar Health, Washington, DC, USA Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC, USA Department of Industrial and Systems Engineering, State University of New York at Buffalo, Buffalo, New York, USA. Hettinger,A Zachary. National Center for Human Factors in Healthcare, MedStar Health, Washington, DC, USA Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC, USA. Benda,Natalie C. National Center for Human Factors in Healthcare, MedStar Health, Washington, DC, USA Department of Industrial and Systems Engineering, State University of New York at Buffalo, Buffalo, New York, USA. TI - Electronic health record usability: analysis of the user-centered design processes of eleven electronic health record vendors. SO - Journal of the American Medical Informatics Association. 22(6):1179-82, 2015 Nov. AS - J Am Med Inform Assoc. 22(6):1179-82, 2015 Nov. NJ - Journal of the American Medical Informatics Association : JAMIA LM - Available online through MWHC library: 2003 - present, Available in print through MWHC library: 1999 - present AB - The usability of electronic health records (EHRs) continues to be a point of dissatisfaction for providers, despite certification requirements from the Office of the National Coordinator that require EHR vendors to employ a user-centered design (UCD) process. To better understand factors that contribute to poor usability, a research team visited 11 different EHR vendors in order to analyze their UCD processes and discover the specific challenges that vendors faced as they sought to integrate UCD with their EHR development. Our analysis demonstrates a diverse range of vendors' UCD practices that fall into 3 categories: well-developed UCD, basic UCD, and misconceptions of UCD. Specific challenges to practicing UCD include conducting contextually rich studies of clinical workflow, recruiting participants for usability studies, and having support from leadership within the vendor organization. The results of the study provide novel insights for how to improve usability practices of EHR vendors. Copyright © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com. IL - 1067-5027 DO - http://dx.doi.org/10.1093/jamia/ocv050 PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. LG - English <2. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25366980 AU - Zhang Z FA - Zhang, Zijun IN - Zhang,Zijun. Orthobiologic Laboratory, MedStar Union Memorial Hospital, Baltimore, Maryland. TI - Chondrons and the pericellular matrix of chondrocytes. SO - Tissue Engineering Part B-Reviews. 21(3):267-77, 2015 Jun. AS - Tissue Eng Part B Rev. 21(3):267-77, 2015 Jun. NJ - Tissue engineering. Part B, Reviews AB - In cartilage, chondrocytes are embedded within an abundant extracellular matrix (ECM). A typical chondron consists of a chondrocyte and the immediate surrounding pericellular matrix (PCM). The PCM has a patent structure, defined molecular composition, and unique physical properties that support the chondrocyte. Given this spatial position, the PCM is pivotal in mediating communication between chondrocytes and the ECM and, thus, plays a critical role in cartilage homeostasis. The biological function and mechanical properties of the PCM have been extensively studied, mostly in the form of chondrons. This review intends to summarize recent progress in chondron and chondrocyte PCM research, with emphasis on the re-establishment of the PCM by isolated chondrocytes or mesenchymal stem cells during chondrogenic differentiation, and the effects of the PCM on cartilage tissue formation. IL - 1937-3368 DO - http://dx.doi.org/10.1089/ten.TEB.2014.0286 PT - Journal Article PT - Research Support, Non-U.S. Gov't LG - English <3. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25807537 AU - Schultz M AU - Molligan J AU - Schon L AU - Zhang Z FA - Schultz, Melissa FA - Molligan, Jeremy FA - Schon, Lew FA - Zhang, Zijun IN - Schultz,Melissa. Center of Anatomical Science, Saint Louis University, St. Louis, Missouri, United States of America. Molligan,Jeremy. Orthobiologic Laboratory, Medstar Union Memorial Hospital, Baltimore, Maryland, United States of America. Schon,Lew. Orthobiologic Laboratory, Medstar Union Memorial Hospital, Baltimore, Maryland, United States of America. Zhang,Zijun. Orthobiologic Laboratory, Medstar Union Memorial Hospital, Baltimore, Maryland, United States of America. TI - Pathology of the calcified zone of articular cartilage in post-traumatic osteoarthritis in rat knees. SO - PLoS ONE [Electronic Resource]. 10(3):e0120949, 2015. AS - PLoS ONE. 10(3):e0120949, 2015. NJ - PloS one LM - Available online through MWHC library: 2006 - present AB - OBJECTIVES: This study aimed to investigate the pathology occurring at the calcified zone of articular cartilage (CZC) in the joints afflicted with post-traumatic osteoarthritis (PTOA). AB - METHODS: Rats underwent bilateral anterior cruciate ligament (ACL) transection and medial meniscectomy to induce PTOA. Sham surgery was performed on another five rats to serve as controls. The rats were euthanized after four weeks of surgery and tibial plateaus were dissected for histology. The pathology of PTOA, CZC area and the tidemark roughness at six pre-defined locations on the tibial plateaus were quantified by histomorphometry. AB - RESULTS: PTOA developed in the knees, generally more severe at the medial plateau than the lateral plateau, of rats in the experimental group. The CZC area was unchanged in the PTOA joints, but the topographic variations of CZC areas that presented in the control knees were reduced in the PTOA joints. The tidemark roughness decreased in areas of the medial plateau of PTOA joints and that was inversely correlated with the Mankin's score of PTOA pathology. AB - CONCLUSION: Reduced tidemark roughness and unchanged CZC area differentiate PTOA from primary osteoarthritis, which is generally believed to have the opposite pathology at CZC, and may contribute to the distinct disease progression of the two entities of arthropathy. IL - 1932-6203 DO - http://dx.doi.org/10.1371/journal.pone.0120949 PT - Journal Article PT - Research Support, Non-U.S. Gov't LG - English <4. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25807234 AU - Brar V AU - Gill S AU - Cardillo C AU - Tesauro M AU - Panza JA AU - Campia U FA - Brar, Vijaywant FA - Gill, Sartaj FA - Cardillo, Carmine FA - Tesauro, Manfredi FA - Panza, Julio A FA - Campia, Umberto IN - Brar,Vijaywant. MedStar Cardiovascular Research Network and MedStar Washington Hospital Center, Washington, District of Columbia, United States of America. Gill,Sartaj. Prince George's Hospital Center, Cheverly, Maryland, United States of America. Cardillo,Carmine. Internal Medicine, Catholic University, Rome, Italy. Tesauro,Manfredi. Systems Medicine, University of Tor Vergata, Rome, Italy. Panza,Julio A. Westchester Medical Center, Valhalla, New York, United States of America. Campia,Umberto. MedStar Cardiovascular Research Network and MedStar Washington Hospital Center, Washington, District of Columbia, United States of America. TI - Sex-specific effects of cardiovascular risk factors on endothelium-dependent dilation and endothelin activity in middle-aged women and men. SO - PLoS ONE [Electronic Resource]. 10(3):e0121810, 2015. AS - PLoS ONE. 10(3):e0121810, 2015. NJ - PloS one LM - Available online through MWHC library: 2006 - present AB - BACKGROUND: Healthy middle-aged postmenopausal women have higher endothelium-dependent dilation and lower vasoconstrictor activity of endothelin-1 than men. Whether these sex-specific differences extend to patients with cardiovascular risk factors has not been investigated. The current study aimed to determine whether, in patients with cardiovascular risk factors, sex-specific differences exist in endothelium-dependent dilation and endothelin-1 activity. AB - METHODS: Forearm blood flow responses were measured by strain-gauge plethysmography during the intra-arterial infusion of acetylcholine, sodium nitroprusside, and the selective endothelin type A receptor blocker BQ-123 in 50 women and 64 men with cardiovascular risk factors. AB - RESULTS: Acetylcholine and sodium nitroprusside induced a significant vasodilation in women and men alike (p < 0.01 for both). Also BQ-123 caused a significant vasodilation (p < 0.001) in both groups. The vasodilator response to acetylcholine was greater in women compared to men; however there were no differences in the response to sodium nitroprusside and BQ-123 (p = NS for both) between the two sex groups. AB - CONCLUSIONS: Middle-aged women with cardiovascular risk factors have significantly higher endothelium-dependent dilation than middle-aged men; however, vascular endothelin 1 activity is similar in the two groups. These findings suggest that the presence of cardiovascular risk factors is associated with sex-specific effects on endothelium-dependent dilation but not on endothelin 1 activity. Further study is needed to confirm our findings and to characterize the mechanisms underlying this sex-specific regulation of endothelial function. IL - 1932-6203 DO - http://dx.doi.org/10.1371/journal.pone.0121810 PT - Journal Article LG - English <5. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26864411 AU - Winstein CJ AU - Wolf SL AU - Dromerick AW AU - Lane CJ AU - Nelsen MA AU - Lewthwaite R AU - Cen SY AU - Azen SP AU - Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE) Investigative Team FA - Winstein, Carolee J FA - Wolf, Steven L FA - Dromerick, Alexander W FA - Lane, Christianne J FA - Nelsen, Monica A FA - Lewthwaite, Rebecca FA - Cen, Steven Yong FA - Azen, Stanley P FA - Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE) Investigative Team IN - Winstein,Carolee J. University of Southern California, Los Angeles. Wolf,Steven L. Emory University, Atlanta, Georgia. Dromerick,Alexander W. MedStar National Rehabilitation Hospital, Washington, DC. Lane,Christianne J. University of Southern California, Los Angeles. Nelsen,Monica A. University of Southern California, Los Angeles. Lewthwaite,Rebecca. University of Southern California, Los Angeles. Cen,Steven Yong. University of Southern California, Los Angeles. Azen,Stanley P. University of Southern California, Los Angeles. TI - Effect of a Task-Oriented Rehabilitation Program on Upper Extremity Recovery Following Motor Stroke: The ICARE Randomized Clinical Trial. SO - JAMA. 315(6):571-81, 2016 Feb 9. AS - JAMA. 315(6):571-81, 2016 Feb 9. NJ - JAMA LM - Available online from MWHC library: 1998 - present, Available in print through MWHC library: 1999 - present AB - IMPORTANCE: Clinical trials suggest that higher doses of task-oriented training are superior to current clinical practice for patients with stroke with upper extremity motor deficits. AB - OBJECTIVE: To compare the efficacy of a structured, task-oriented motor training program vs usual and customary occupational therapy (UCC) during stroke rehabilitation. AB - DESIGN, SETTING, AND PARTICIPANTS: Phase 3, pragmatic, single-blind randomized trial among 361 participants with moderate motor impairment recruited from 7 US hospitals over 44 months, treated in the outpatient setting from June 2009 to March 2014. AB - INTERVENTIONS: Structured, task-oriented upper extremity training (Accelerated Skill Acquisition Program [ASAP]; n=119); dose-equivalent occupational therapy (DEUCC; n=120); or monitoring-only occupational therapy (UCC; n=122). The DEUCC group was prescribed 30 one-hour sessions over 10 weeks; the UCC group was only monitored, without specification of dose. AB - MAIN OUTCOMES AND MEASURES: The primary outcome was 12-month change in log-transformed Wolf Motor Function Test time score (WMFT, consisting of a mean of 15 timed arm movements and hand dexterity tasks). Secondary outcomes were change in WMFT time score (minimal clinically important difference [MCID]=19 seconds) and proportion of patients improving >25 points on the Stroke Impact Scale (SIS) hand function score (MCID=17.8 points). AB - RESULTS: Among the 361 randomized patients (mean age, 60.7 years; 56% men; 42% African American; mean time since stroke onset, 46 days), 304 (84%) completed the 12-month primary outcome assessment; in intention-to-treat analysis, mean group change scores (log WMFT, baseline to 12 months) were, for the ASAP group, 2.2 to 1.4 (difference, 0.82); DEUCC group, 2.0 to 1.2 (difference, 0.84); and UCC group, 2.1 to 1.4 (difference, 0.75), with no significant between-group differences (ASAP vs DEUCC: 0.14; 95% CI, -0.05 to 0.33; P = .16; ASAP vs UCC: -0.01; 95% CI, -0.22 to 0.21; P = .94; and DEUCC vs UCC: -0.14; 95% CI, -0.32 to 0.05; P = .15). Secondary outcomes for the ASAP group were WMFT change score, -8.8 seconds, and improved SIS, 73%; DEUCC group, WMFT, -8.1 seconds, and SIS, 72%; and UCC group, WMFT, -7.2 seconds, and SIS, 69%, with no significant pairwise between-group differences (ASAP vs DEUCC: WMFT, 1.8 seconds; 95% CI, -0.8 to 4.5 seconds; P = .18; improved SIS, 1%; 95% CI, -12% to 13%; P = .54; ASAP vs UCC: WMFT, -0.6 seconds, 95% CI, -3.8 to 2.6 seconds; P = .72; improved SIS, 4%; 95% CI, -9% to 16%; P = .48; and DEUCC vs UCC: WMFT, -2.1 seconds; 95% CI, -4.5 to 0.3 seconds; P = .08; improved SIS, 3%; 95% CI, -9% to 15%; P = .22). A total of 168 serious adverse events occurred in 109 participants, resulting in 8 patients withdrawing from the study. AB - CONCLUSIONS AND RELEVANCE: Among patients with motor stroke and primarily moderate upper extremity impairment, use of a structured, task-oriented rehabilitation program did not significantly improve motor function or recovery beyond either an equivalent or a lower dose of UCC upper extremity rehabilitation. These findings do not support superiority of this program among patients with motor stroke and primarily moderate upper extremity impairment. AB - TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00871715. IL - 0098-7484 DO - http://dx.doi.org/10.1001/jama.2016.0276 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural LG - English <6. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26215327 AU - Burke LM AU - Bashir MR AU - Miller FH AU - Siegelman ES AU - Brown M AU - Alobaidy M AU - Jaffe TA AU - Hussain SM AU - Palmer SL AU - Garon BL AU - Oto A AU - Reinhold C AU - Ascher SM AU - Demulder DK AU - Thomas S AU - Best S AU - Borer J AU - Zhao K AU - Pinel-Giroux F AU - De Oliveira I AU - Resende D AU - Semelka RC FA - Burke, Lauren M B FA - Bashir, Mustafa R FA - Miller, Frank H FA - Siegelman, Evan S FA - Brown, Michele FA - Alobaidy, Mamdoh FA - Jaffe, Tracy A FA - Hussain, Shahid M FA - Palmer, Suzanne L FA - Garon, Bonnie L FA - Oto, Aytekin FA - Reinhold, Caroline FA - Ascher, Susan M FA - Demulder, Danielle K FA - Thomas, Stephen FA - Best, Shaun FA - Borer, James FA - Zhao, Ken FA - Pinel-Giroux, Fanny FA - De Oliveira, Isabela FA - Resende, Daniel FA - Semelka, Richard C IN - Burke,Lauren M B. Department of Radiology, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, NC. Electronic address: lauren_burke@med.unc.edu. Bashir,Mustafa R. Department of Radiology, Duke University Medical Center, Durham, NC. Miller,Frank H. Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL. Siegelman,Evan S. Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA. Brown,Michele. Department of Radiology, University of California, San Diego, School of Medicine, La Jolla, CA. Alobaidy,Mamdoh. Department of Radiology, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, NC. Jaffe,Tracy A. Department of Radiology, Duke University Medical Center, Durham, NC. Hussain,Shahid M. Department of Radiology, University of Nebraska Medical Center, Omaha, NE. Palmer,Suzanne L. Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA. Garon,Bonnie L. Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA. Oto,Aytekin. Department of Radiology, University of Chicago Medical Center, Chicago, IL. Reinhold,Caroline. Department of Radiology, Royal Victoria Hospital, McGill University Health Center, Montreal, QC, Canada. Ascher,Susan M. Department of Radiology, Medstar Georgetown University Hospital, Washington, DC. Demulder,Danielle K. Department of Radiology, Medstar Georgetown University Hospital, Washington, DC. Thomas,Stephen. Department of Radiology, University of Chicago Medical Center, Chicago, IL. Best,Shaun. Department of Radiology, University of California, San Diego, School of Medicine, La Jolla, CA. Borer,James. Department of Radiology, University of Nebraska Medical Center, Omaha, NE. Zhao,Ken. Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL. Pinel-Giroux,Fanny. Department of Radiology, Royal Victoria Hospital, McGill University Health Center, Montreal, QC, Canada. De Oliveira,Isabela. Department of Radiology, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, NC. Resende,Daniel. Department of Radiology, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, NC. Semelka,Richard C. Department of Radiology, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, NC. TI - Magnetic resonance imaging of acute appendicitis in pregnancy: a 5-year multiinstitutional study. SO - American Journal of Obstetrics & Gynecology. 213(5):693.e1-6, 2015 Nov. AS - Am J Obstet Gynecol. 213(5):693.e1-6, 2015 Nov. NJ - American journal of obstetrics and gynecology LM - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006 AB - OBJECTIVE: The purpose of this study was to determine the diagnostic performance of magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis during pregnancy in a multiinstitutional study. AB - STUDY DESIGN: In this multicenter retrospective study, the cases of pregnant women who underwent MRI evaluation of abdominal or pelvic pain and who had clinical suspicion of acute appendicitis between June 1, 2009, and July 31, 2014, were reviewed. All MRI examinations with positive findings for acute appendicitis were confirmed with surgical pathologic information. Sensitivity, specificity, negative predictive values, and positive predictive values were calculated. Receiver operating characteristic curves were generated, and area under the curve analysis was performed for each participating institution. AB - RESULTS: Of the cases that were evaluated, 9.3% (66/709) had MRI findings of acute appendicitis. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive values were 96.8%, 99.2%, 99.0%, 92.4%, and 99.7%, respectively. There was no statistically significant difference between centers that were included in the study (pair-wise probability values ranged from 0.12-0.99). AB - CONCLUSION: MRI is useful and reproducible in the diagnosis of suspected acute appendicitis during pregnancy.Copyright Published by Elsevier Inc. IL - 0002-9378 DO - http://dx.doi.org/10.1016/j.ajog.2015.07.026 PT - Journal Article PT - Multicenter Study LG - English <7. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25935783 AU - Meriwether KV AU - Rogers RG AU - Craig E AU - Peterson SD AU - Gutman RE AU - Iglesia CB FA - Meriwether, Kate V FA - Rogers, Rebecca G FA - Craig, Ellen FA - Peterson, Sean D FA - Gutman, Robert E FA - Iglesia, Cheryl B IN - Meriwether,Kate V. Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, NM. Electronic address: meriwet2@salud.unm.edu. Rogers,Rebecca G. Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, NM. Craig,Ellen. Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, NM. Peterson,Sean D. University of New Mexico School of Medicine, Albuquerque, NM. Gutman,Robert E. Departments of Obstetrics and Gynecology and Urology, MedStar Washington Hospital Center/Georgetown University, Washington, DC. Iglesia,Cheryl B. Departments of Obstetrics and Gynecology and Urology, MedStar Washington Hospital Center/Georgetown University, Washington, DC. TI - The effect of hydroxyquinoline-based gel on pessary-associated bacterial vaginosis: a multicenter randomized controlled trial. SO - American Journal of Obstetrics & Gynecology. 213(5):729.e1-9, 2015 Nov. AS - Am J Obstet Gynecol. 213(5):729.e1-9, 2015 Nov. NJ - American journal of obstetrics and gynecology LM - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006 AB - OBJECTIVE: Pessaries are important options for women with pelvic floor disorders, but many pessary users experience bacterial vaginosis (BV). The aim of this study was to evaluate the effect of TrimoSan gel (Milex Pessaries, Cooper Surgical, Trumbull, CT) on BV prevalence among pessary users. AB - STUDY DESIGN: Women presenting for a pessary fitting completed questionnaires on vaginal symptoms and hormone therapy use and underwent a BV BLUE test and slide collection for BV analysis by Nugent's criteria. Following pessary fitting, women were randomized to either standard pessary care with the use of TrimoSan placed vaginally twice weekly or to standard pessary care without TrimoSan gel. Women returned 2 weeks and 3 months later for a repeat slide collection for Gram stain, BV BLUE testing, and completion of questionnaires on vaginal symptoms and desire to continue the pessary. AB - RESULTS: There were 184 women randomized after successful fitting (92 to the TrimoSan group), and 147 (79%) presented for 3-month follow up. Mean age was 56 +/- 16 years; patients were mostly white (57%) or Hispanic (23%), and 36% were using hormone therapy. The groups did not differ in the prevalence of BV by Nugent's criteria at 2 weeks (20% TrimoSan vs 26% no gel, P = .46) or 3 months (24% TrimoSan vs 23% no gel, P = .82), nor did they differ in BV by BV BLUE testing at 2 weeks (0% TrimoSan vs 4% no gel, P = .12) or 3 months (3% TrimoSan vs 0% no gel, P = .15). The prevalence of at least one vaginal symptom did not differ between groups at 2 weeks (44% TrimoSan vs 45% no gel, P = .98) or 3 months (42% TrimoSan vs 32% no gel, P = .30). The TrimoSan group was equally likely to want to continue their pessary use compared with the standard care group at 2 weeks (90% vs 86%, P = .64) and 3 months (63% vs 60%, P = .76). AB - CONCLUSION: TrimoSan gel in the first 3 months of pessary use does not decrease the prevalence of BV or vaginal symptoms and does not alter the likelihood of a woman desiring to continue pessary use.Copyright © 2015 Elsevier Inc. All rights reserved. IL - 0002-9378 DO - http://dx.doi.org/10.1016/j.ajog.2015.04.032 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't LG - English <8. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26374766 AU - Schinzari F AU - Iantorno M AU - Campia U AU - Mores N AU - Rovella V AU - Tesauro M AU - Di Daniele N AU - Cardillo C AI - Campia, Umberto; ORCID: http://orcid.org/0000-0002-7894-3565, Cardillo, Carmine; ORCID: http://orcid.org/0000-0001-5182-3005 FA - Schinzari, Francesca FA - Iantorno, Micaela FA - Campia, Umberto FA - Mores, Nadia FA - Rovella, Valentina FA - Tesauro, Manfredi FA - Di Daniele, Nicola FA - Cardillo, Carmine IN - Schinzari,Francesca. Department of Internal Medicine, Catholic University Medical School, Rome, Italy; Iantorno,Micaela. Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland; Department of Medicine, Cardiology Division, Johns Hopkins Hospital, Baltimore, Maryland; Campia,Umberto. MedStar Cardiovascular Research Network, Washington, DC; Mores,Nadia. Department of Pharmacology, Catholic University Medical School, Rome, Italy; and. Rovella,Valentina. Department of Internal Medicine, University of Tor Vergata, Rome, Italy. Tesauro,Manfredi. Department of Internal Medicine, University of Tor Vergata, Rome, Italy. Di Daniele,Nicola. Department of Internal Medicine, University of Tor Vergata, Rome, Italy. Cardillo,Carmine. Department of Internal Medicine, Catholic University Medical School, Rome, Italy; carmine.cardillo@rm.unicatt.it. TI - Vasodilator responses and endothelin-dependent vasoconstriction in metabolically healthy obesity and the metabolic syndrome. SO - American Journal of Physiology - Endocrinology & Metabolism. 309(9):E787-92, 2015 Nov 1. AS - Am J Physiol Endocrinol Metab. 309(9):E787-92, 2015 Nov 1. NJ - American journal of physiology. Endocrinology and metabolism LM - Available online from MWHC library: 1997 - present (after 1 year) AB - Patients with metabolically healthy obesity (MHO) do not present the cluster of metabolic abnormalities that define the metabolic syndrome (MetS). Whether MHO is associated with lower impairment of vasoreactivity than the MetS is unknown. For this purpose, forearm blood flow (FBF) responses were measured by strain-gauge plethysmography during the intra-arterial infusion of acetylcholine (ACh), sodium nitroprusside (SNP), and/or the selective endothelin type A (ETA) receptor blocker BQ-123 in 119 obese individuals with MHO (n = 34) or with the MetS (n = 85) and in healthy lean controls (n = 56). ACh and SNP caused a significant vasodilation in both obese and lean participants (all P < 0.001). However, the response to both agents was significantly lower in the obese than in the control group (both P < 0.001). Among the obese participants, the reactivity to ACh was higher in MHO than in MetS patients, whereas the responsiveness to SNP was equally impaired in both groups (P = 0.45). Infusion of BQ-123 significantly increased FBF in obese patients (P < 0001), but not in the lean participants; hence, FBF following ETA receptor blockade was higher in both obese groups than in controls (both P < 0.001). FBF response to BQ-123 was significantly higher in patients with the MetS than in those with MHO (P = 0.007). In conclusion, patients with MHO have abnormal vascular reactivity, although their endothelial dysfunction is less pronounced than in patients with the MetS. These findings indicate that obesity is associated with vascular damage independent of those metabolic abnormalities underlying the MetS. Copyright © 2015 the American Physiological Society. IL - 0193-1849 DO - http://dx.doi.org/10.1152/ajpendo.00278.2015 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't LG - English <9. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26467392 AU - Lee AM AU - Fan KL AU - Willey SC AU - Pittman T FA - Lee, Arielle M FA - Fan, Kenneth L FA - Willey, Shawna C FA - Pittman, Troy IN - Lee,Arielle M. Georgetown University School of Medicine, Washington, District of Columbia. Fan,Kenneth L. Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia. Willey,Shawna C. Department of Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia. Pittman,Troy. Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia. TI - A new technique for secondary nipple biopsy in nipple sparing mastectomy. SO - Journal of Surgical Oncology. 112(5):465-7, 2015 Oct. AS - J Surg Oncol. 112(5):465-7, 2015 Oct. NJ - Journal of surgical oncology IL - 0022-4790 DO - http://dx.doi.org/10.1002/jso.24016 PT - Journal Article LG - English <10. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26345465 AU - El-Sabawi B AU - Sosin M AU - Carey JN AU - Nahabedian MY AU - Patel KM FA - El-Sabawi, Bassim FA - Sosin, Michael FA - Carey, Joseph N FA - Nahabedian, Maurice Y FA - Patel, Ketan M IN - El-Sabawi,Bassim. Division of Plastic and Reconstructive Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California. Sosin,Michael. Department of Surgery, Medstar Georgetown University Hospital, Washington, District of Columbia. Carey,Joseph N. Division of Plastic and Reconstructive Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California. Nahabedian,Maurice Y. Department of Plastic Surgery, Georgetown University, Washington, District of Columbia. Patel,Ketan M. Division of Plastic and Reconstructive Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California. TI - Breast reconstruction and adjuvant therapy: A systematic review of surgical outcomes. [Review] SO - Journal of Surgical Oncology. 112(5):458-64, 2015 Oct. AS - J Surg Oncol. 112(5):458-64, 2015 Oct. NJ - Journal of surgical oncology AB - BACKGROUND AND OBJECTIVES: The impact of adjuvant therapy on the surgical outcomes following breast reconstruction is poorly understood. The purpose of this systematic review was to evaluate surgical outcomes following autologous and prosthetic reconstruction in the setting of post-mastectomy radiation therapy (PMRT) and adjuvant chemotherapy. AB - METHODS: A systematic review of the English literature published from 2000 to 2015 in the Pubmed/MEDLINE database was performed to identify all manuscripts reporting outcome of breast reconstruction in patients receiving PMRT and/or adjuvant chemotherapy. AB - RESULTS: Sixty-two manuscripts met the criteria for inclusion. This included 56 manuscripts (5437 patients) evaluating patients treated with PMRT and 11 manuscripts (820 patients) evaluating patients treated with chemotherapy. Pooled analysis of the PMRT cohort revealed significantly higher weighted incidences of re-operation (P<0.0001), total complications (P<0.0001), and reconstructive failure (P<0.0001) in prosthetic reconstruction compared to autologous. There was little evidence to suggest that postoperative chemotherapy is associated with poorer overall outcomes. AB - CONCLUSIONS: PMRT was associated with an increased incidence of adverse events when compared to chemotherapy. There was little evidence to suggest that adverse events following breast reconstruction were related to adjuvant chemotherapy. Manipulating the method and timing of reconstruction may mitigate some of the undesirable outcomes associated with PMRT.Copyright © 2015 Wiley Periodicals, Inc. IL - 0022-4790 DO - http://dx.doi.org/10.1002/jso.24028 PT - Journal Article PT - Review LG - English <11. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25323459 AU - Duff SV AU - He J AU - Nelsen MA AU - Lane CJ AU - Rowe VT AU - Wolf SL AU - Dromerick AW AU - Winstein CJ FA - Duff, Susan V FA - He, Jiaxiu FA - Nelsen, Monica A FA - Lane, Christianne J FA - Rowe, Veronica T FA - Wolf, Steve L FA - Dromerick, Alexander W FA - Winstein, Carolee J IN - Duff,Susan V. Thomas Jefferson University, Philadelphia, PA, USA. He,Jiaxiu. Northwestern University, Chicago, IL, USA. Nelsen,Monica A. University of Southern California, Los Angeles, CA, USA. Lane,Christianne J. University of Southern California, Los Angeles, CA, USA. Rowe,Veronica T. University of Central Arkansas, Conway, AR, USA Texas Woman's University, Dallas, TX, USA. Wolf,Steve L. Emory School of Medicine, Atlanta, GA, USA. Dromerick,Alexander W. Georgetown University and MedStar National Rehabilitation Hospital, Washington, DC, USA. Winstein,Carolee J. University of Southern California, Los Angeles, CA, USA winstein@usc.edu. TI - Interrater reliability of the Wolf Motor Function Test-Functional Ability Scale: why it matters. SO - Neurorehabilitation & Neural Repair. 29(5):436-43, 2015 Jun. AS - Neurorehabil Neural Repair. 29(5):436-43, 2015 Jun. NJ - Neurorehabilitation and neural repair LM - Available online from MWHC library: 2006 - 2009, Available in print through MWHC library: 1999 - March 2006 AB - BACKGROUND: One important objective for clinical trialists in rehabilitation is determining efficacy of interventions to enhance motor behavior. In part, limitation in the precision of measurement presents a challenge. The few valid, low-cost observational tools available to assess motor behavior cannot escape the variability inherent in test administration and scoring. This is especially true when there are multiple evaluators and raters, as in the case of multisite randomized controlled trials (RCTs). One way to enhance reliability and reduce variability is to implement rigorous quality control (QC) procedures. AB - OBJECTIVE: This article describes a systematic QC process used to refine the administration and scoring procedures for the Wolf Motor Function Test (WMFT)-Functional Ability Scale (FAS). AB - METHODS: The QC process, a systematic focus-group collaboration, was developed and used for a phase III RCT, which enlisted multiple evaluators and an experienced WMFT-FAS rater panel. AB - RESULTS: After 3 staged refinements to the administration and scoring instructions, we achieved a sufficiently high interrater reliability (weighted kappa = 0.8). AB - CONCLUSIONS AND IMPLICATIONS: A systematic focus-group process was shown to be an effective method to improve reliability of observational assessment tools for motor behavior in neurorehabilitation. A reduction in noise-related variability in performance assessments will increase power and potentially lower the number needed to treat. Improved precision of measurement can lead to more cost-effective and efficient clinical trials. Finally, we suggest that improved precision in measures of motor behavior may provide more insight into recovery mechanisms than a single measure of movement time alone.Copyright © The Author(s) 2014. IL - 1545-9683 DO - http://dx.doi.org/10.1177/1545968314553030 PT - Journal Article PT - Research Support, N.I.H., Extramural LG - English