Atlanta Veteran Affairs Medical Center

Atlanta, GA, United States

Atlanta Veteran Affairs Medical Center

Atlanta, GA, United States
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Kabbani S.,Emory University | Jacob J.T.,Emory University | Gaynes R.P.,Emory University | Gaynes R.P.,Atlanta Veteran Affairs Medical Center | And 2 more authors.
American Journal of Infection Control | Year: 2016

Despite the recent focus on prevention of health care–associated infections, rates of Candida bloodstream infections in adults have remained unchanged until recently. We report a decline of Candida bloodstream infections, not explained by changes in broad-spectrum antibiotic use, but coinciding with infection control policies aimed at central venous catheter maintenance. © 2016 Association for Professionals in Infection Control and Epidemiology, Inc.

Maa A.Y.,Emory Eye Center | Maa A.Y.,Atlanta Veteran Affairs Medical Center | Evans C.,Emory University | Delaune W.R.,Atlanta Veteran Affairs Medical Center | And 4 more authors.
Telemedicine and e-Health | Year: 2014

Background: Telemedicine can improve access to care, especially for rural patients, and ophthalmology is a field that lends itself readily to telemedicine because interpretation of photographs is a routine part of diagnosing eye disease and patient care. We developed a novel tele-eye protocol based on diabetic teleretinal screening. We performed a feasibility study to see if our tele-eye program was comparable to the gold standard face-to-face eye exam. Materials and Methods: Fifty-two subjects underwent the tele-eye protocol and then received a face-to-face exam. A masked reader reviewed the tele-eye data remotely and developed an impression and plan for the patient. The provider assessments from the face-to-face exams and the tele-eye exams were compared. Sensitivity, specificity, and percentage agreement were calculated for the tele-eye protocol, focusing on the most common age-related eye diseases: cataract, macular degeneration, and glaucoma. The difference between the autorefraction and manifest eyeglass prescription was calculated. Results: The pilot study showed excellent percentage agreement between the screening protocol and the face-to-face exam. The percentage agreement for cataract was 100%, that for macular degeneration was 96%, and that for glaucoma suspect was 87%. The difference between the autorefraction's eyeglass prescription and the final manifest refraction was within American National Standards Institute for lens manufacturing guidelines. Conclusions: The initial data suggest that the tele-eye program is feasible to execute and appears fairly accurate when compared with the gold standard face-to-face eye exam. However, the study is significantly limited by the small sample size. This pilot provides justification of a much larger study of a similar design. © Copyright 2014, Mary Ann Liebert, Inc. 2014.

Rock E.E.,Indiana University – Purdue University Indianapolis | Steiner J.L.,Atlanta Veteran Affairs Medical Center | Rand K.L.,Indiana University – Purdue University Indianapolis | Bigatti S.M.,Indiana University
Supportive Care in Cancer | Year: 2014

Purpose: An estimated 10-40% of breast cancer (BC) patients report negative changes to their partnered relationships. Literature suggests that for these patients, marital satisfaction is related to depression and other quality of life factors which are associated with survivorship and treatment response. However, existing literature does not provide a clear explanation of the factors that strengthen vs. create strain in couples facing cancer. Given the benefits of a satisfying relationship to patient quality of life, it is important to better understand factors that put patients at greater risk for marital difficulties. This study examined the differential and combined roles of hope and optimism among BC patients and their partners on patient marital satisfaction. Method: Fifty-six breast cancer patient-partner dyads completed study questionnaires as part of a larger study. Regression analyses were used to examine the main and interaction effects of patient and partner hope and optimism on patient marital satisfaction. Results and conclusion: Higher patient and partner hope predicted greater patient marital satisfaction, whereas optimism did not. These results are divergent from the literature on optimism and well-being, which shows the importance of studying these two traits concurrently. Interaction effects suggest certain combinations of patient and partner hope and optimism are more beneficial than others for patient marital satisfaction and suggest a dyadic approach is important for investigation of well-being in breast cancer. © Springer-Verlag 2014.

Liu J.,Georgia Institute of Technology | Lau S.K.,Atlanta Veteran Affairs Medical Center | Varma V.A.,Atlanta Veteran Affairs Medical Center | Moffitt R.A.,Georgia Institute of Technology | And 12 more authors.
ACS Nano | Year: 2010

Tumor heterogeneity is one of the most important and challenging problems not only in studying the mechanisms of cancer development but also in developing therapeutics to eradicate cancer cells. Here we report the use of multiplexed quantum dots (QDs) and wavelength-resolved spectral imaging for molecular mapping of tumor heterogeneity on human prostate cancer tissue specimens. By using a panel of just four protein biomarkers (E-cadherin, high-molecular-weight cytokeratin, p63, and α-methylacyl CoA racemase), we show that structurally distinct prostate glands and single cancer cells can be detected and characterized within the complex microenvironments of radical prostatectomy and needle biopsy tissue specimens. The results reveal extensive tumor heterogeneity at the molecular, cellular, and architectural levels, allowing direct visualization of human prostate glands undergoing structural transitions from a double layer of basal and luminal cells to a single layer of malignant cells. For clinical diagnostic applications, multiplexed QD mapping provides correlated molecular and morphological information that is not available from traditional tissue staining and molecular profiling methods. © 2010 American Chemical Society.

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