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North Little Rock, AR, United States

Mooney L.A.,Baptist Health Medical Center | Franks A.M.,University of Arkansas for Medical Sciences
Journal of the American Pharmacists Association | Year: 2011

Objectives: To evaluate the effects of a community health screening and education intervention on knowledge of coronary heart disease (CHD) risk factors and participation in health-promoting behaviors. Design: Descriptive, exploratory, nonexperimental study. Setting: Little Rock, AR, from July 2007 to December 2007. Participants: 56 participants recruited from two community health screenings. Intervention: Prescreening written questionnaire to determine baseline knowledge of CHD risk factors. Participants underwent risk factor screening (lipid profile, blood glucose, body mass index [BMI], and blood pressure) and received tailored education. A postscreening telephone questionnaire was administered 4 to 8 weeks later. Main outcome measures: Participant knowledge of CHD risk factors and participation in health-promoting behaviors pre- and postscreening. Results: Of the 56 participants enrolled, 45 (80.4%) completed the postscreening telephone survey. Compared with prescreening responses, participants showed significantly greater postscreening knowledge of healthy values for CHD risk factors, including blood pressure (P = 0.02), fasting blood glucose (P = 0.03), fasting total cholesterol (P < 0.01), and BMI (P < 0.01). Following the screening, 20 (44.4%) participants had consulted their primary care provider and 31 (68.8%) made at least one healthy behavior change. Approximately one-half of participants reported changing eating habits, and 5 (11.1%) reported increased exercise. Conclusion: These results demonstrate that community-based health screening and education interventions can effectively promote public health knowledge and empower participants to engage in health-promoting behaviors. Source

Binkley P.F.,Ohio State University | Porterfield J.G.,University of Memphis | Porterfield L.M.,University of Memphis | Beau S.L.,Arkansas Heart Hospital | And 7 more authors.
Journal of Interventional Cardiac Electrophysiology | Year: 2012

Purpose: Pulmonary edema (PE) is associated with fluid accumulation in the lungs. Device-based impedance measurements have been used to detect fluid overload prior to hospitalization. However, studies have reported a high false positive rate (FPR). The objective of this study was to develop and test a new multivector impedance-based algorithm that reliably tracks PE clinical events. Methods: We enrolled patients with implanted CRT-Ds in 23 US centers within 2 weeks of device implant. Six-vector impedance data was collected automatically by the CRT-Ds every 30 min during emergency department visits/hospitalizations and every 2 h at all other times. Detection algorithms for cardiac resynchronization therapy defibrillator (CRT-D) and implantable cardiac defibrillator (ICD) devices were developed using those impedance vectors that would be available in corresponding devices and retrospectively evaluated. Results: There were 75 patients (69 % male), mean age 66±12 years, with a LVEF of 23±6 % and QRS of 149±25 ms. Twenty-one major clinical events occurred over 8.2±2.6 months of follow-up time. CRT-D vector combinations resulted in a sensitivity of 71.4 % (95 % confidence interval 47.8-88.7) and a FPR of 0.56 (0.30-0.94) false positives per patient-year (FPs/pt-yr); ICD vector combinations resulted in a sensitivity of 61.9 % (38.4-81.9) and a FPR of 0.63 (0.36-0.90) FPs/pt-yr. In comparison, the single-vector RVCoil-Can implementation of this algorithm resulted in a sensitivity of 57.1 % (34.0-78.2) and a FPR of 0.74 (0.44- 1.12) FPs/pt-yr. Conclusions: This multivector impedance algorithm was effective in tracking PE clinical events in this patient population. Additional studies are needed to prospectively evaluate the performance of this algorithm in a larger population. © Springer Science+Business Media, LLC 2012. Source

Beau S.,Arkansas Heart Hospital | Greer S.,Baptist Health Medical Center | Ellis C.R.,Vanderbilt Heart and Vascular Institute | Keeney J.,St. Jude Medical | And 3 more authors.
Journal of Interventional Cardiac Electrophysiology | Year: 2016

Background: Implantable cardioverter-defibrillators (ICD) provide treatment for life-threatening ventricular tachyarrhythmias. Failure of the pace/sense conductor of an ICD lead can cause noise on the sensing electrogram (EGM) that may be misinterpreted as ventricular activity, triggering inappropriate therapy. An algorithm based upon the confirmation of ventricular activity from a far-field EGM has been developed to reduce inappropriate therapies resulting from this type of lead failure, while ensuring that appropriate therapy is delivered. The objectives of this study were to evaluate the algorithm’s ability to discriminate lead noise from ventricular tachycardia/ventricular fibrillation (VT/VF) and to determine whether it inhibits inappropriate shocks without delaying appropriate shocks. Methods: The algorithm was prospectively tested using near- and far-field EGM recordings from patients in three conditions: normal sinus rhythm with sustained and non-sustained lead noise via manipulation of the ICD pocket or lead system, and VT/VF induced during defibrillation threshold testing. The recordings were played through a bench-top device running the algorithm with the diagnosis, time to diagnosis, and inhibition of therapy documented. Results: The algorithm detected noise and withheld inappropriate therapy in 231 of 238 recordings of sustained lead noise that would otherwise have been diagnosed as VT/VF (97.1 %). Non-sustained lead noise was correctly diagnosed in 47 of the 52 recordings (90.4 %). The device appropriately identified all 853 recordings of VT/VF (100 %), without an increase in the time to detection (0.01 ± 0.14 s). Conclusions: The SecureSenseTM algorithm correctly diagnosed sustained and non-sustained lead noise recordings without compromising detection of VT/VF. Use of the algorithm may reduce inappropriate shocks and alert clinicians to lead noise indicative of lead failure. © 2016, Springer Science+Business Media New York. Source

Register S.D.,Hyperbaric Physicians of Georgia Inc. | Register S.D.,Baptist Health Medical Center | Aaron M.E.,Emory University | Gelly H.B.,HyperbaRxs LLC
Undersea and Hyperbaric Medicine | Year: 2011

A history of optic neuritis has long been considered a relative contraindication to hyperbaric oxygen therapy [1,2]. However, the published medical literature regarding the use of hyperbaric oxygen therapy in patients with previous optic neuritis is very limited, and patients who might benefit from hyperbaric oxygen therapy may be denied its benefit without adequate consideration of the risk-benefit ratio. We present a case report of a patient with a history of optic neuritis who underwent comprehensive ophthalmologic evaluation before and after 40 treatments with hyperbaric oxygen therapy, with no detectable ophthalmologic deficit. Copyright © 2011 Undersea & Hyperbaric Medical Society, Inc. Source

Colaco R.J.,Proton Therapy | Hoppe B.S.,Proton Therapy | Flampouri S.,Proton Therapy | McKibben B.T.,Baptist Health Medical Center | And 8 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2015

Purpose: Study goals were to characterize gastrointestinal effects of proton therapy (PT) in a large cohort of patients treated for prostate cancer, identify factors associated with rectal bleeding (RB), and compare RB between patients receiving investigational protocols versus those in outcome-tracking protocols. Methods and Materials: A total of 1285 consecutive patients were treated with PT between August 2006 and May 2010. Potential pre-existing clinical and treatment-related risk factors for rectal toxicity were recorded. Common Terminology Criteria for Adverse Events version 3.0 was used to score toxicity. Results: Transient RB was the predominant grade 2 or higher (GR2+) toxicity after PT, accounting for 95% of gastrointestinal events. GR1 RB occurred in 217 patients (16.9%), GR2 RB in 187 patients (14.5%), and GR3 in 11 (0.9%) patients. There were no GR4 or GR5 events. Univariate analyses showed correlations between GR2+ RB and anticoagulation therapy (P=.008) and rectal and rectal wall dose-volume histogram (DVH) parameters (P<.001). On multivariate analysis, anticoagulation therapy (P=.0034), relative volume of rectum receiving 75 Gy (V75; P=.0102), and relative rectal wall V75 (P=.0017) were significant predictors for G2+ RB. Patients treated with investigational protocols had toxicity rates similar to those receiving outcome-tracking protocols. Conclusions: PT was associated with a low rate of GR2+ gastrointestinal toxicity, predominantly transient RB, which was highly correlated with anticoagulation and rectal DVH parameters. Techniques that limit rectal exposure should be used when possible. © 2015 Elsevier Inc. Source

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