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Dallas, TX, United States

DeFina L.F.,The Cooper Institute | Barlow C.E.,The Cooper Institute | Kerr A.,The Cooper Institute | Chakravorty R.,Texas Health Presbyterian Hospital | And 2 more authors.
Atherosclerosis | Year: 2015

Objective: To assess the effect of cardiorespiratory fitness on the association between the initiation of statin therapy and incident diabetes. Patients and methods: In a prospective observational study, we studied 6519 generally healthy men and 2334 women with two preventive health examinations from December 15, 1998 through December 18, 2013 which included measurement of fitness levels, statin therapy, risk factors for diabetes, and incident diabetes. Results: 93 cases of incident diabetes occurred during an average follow-up of 3.0 years. After multivariable adjustment, an increased odds of incident diabetes with statin use was observed in those patients with impaired fasting glucose at baseline (odds ratio [OR]: 2.15, [95% CI:1.26 to 3.67]), but not among individuals with normal glucose levels (OR:1.85, [95% CI: 0.76 to 4.52]). Cardiorespiratory fitness attenuated but did not eliminate the increased risk of incident diabetes with statin use. Conclusion: In a population of relatively healthy patients, statin use was not associated with incident diabetes in patients with normal fasting glucose at baseline. However, it was associated with incident diabetes in those patients with impaired fasting glucose at baseline, though this risk was substantially reduced by increasing fitness. In addition, increasing cardiorespiratory fitness was inversely associated with incident diabetes whether or not a patient was treated with a statin. © 2014 Elsevier Ireland Ltd. Source

Sueblinvong V.,Emory University | Johnson D.W.,University of Nebraska Medical Center | Weinstein G.L.,Texas Health Presbyterian Hospital | Connor M.J.,Emory University | And 8 more authors.
Critical Care Medicine | Year: 2015

Objective: This report describes three patients with Ebola virus disease who were treated in the United States and developed for severe critical illness and multiple organ failure secondary to Ebola virus infection. The patients received mechanical ventilation, renal replacement therapy, invasive monitoring, vasopressor support, and investigational therapies for Ebola virus disease. Data Sources: Patient medical records from three tertiary care centers (Emory University Hospital, University of Nebraska Medical Center, and Texas Health Presbyterian Dallas Hospital). Study Selection: Not applicable. Data Extraction: Not applicable. Data Synthesis: Not applicable. Conclusion: In the severe form, patients with Ebola virus disease may require life-sustaining therapy, including mechanical ventilation and renal replacement therapy. In conjunction with other reported cases, this series suggests that respiratory and renal failure may occur in severe Ebola virus disease, especially in patients burdened with high viral loads. Ebola virus disease complicated by multiple organ failure can be survivable with the application of advanced life support measures. This collective, multicenter experience is presented with the hope that it may inform future treatment of patients with Ebola virus disease requiring critical care treatment. Copyright © 2015 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Source

Ellenbogen P.H.,Texas Health Presbyterian Hospital
Journal of the American College of Radiology | Year: 2015

Imagine the world without the ACR. Imagine that Wilhelm Conrad Roentgen had died before November 8, 1895. Imagine that Albert Soiland, MD, had not founded the ACR in 1923. What would medicine look like now? The ACR is important in many ways: advocacy and economics, education, quality and safety, clinical research, publication, leadership, and diversity. The ACR is vital to patients, radiologists, and other physicians. The ACR is unique: No other organization or group of societies could fill the void. So instead of imagining a world without the ACR, imagine a better world - one in which patients always come first, and all imaging professionals are active members of the ACR. We are the lucky ones - we can change the world. © 2015 American College of Radiology. Source

Brooks V.,Texas Health Presbyterian Hospital
Urologic nursing | Year: 2011

Obstruction of the urethra can cause necrosis of the urethra. Without prompt intervention, this obstruction may lead to intrinsic renal failure. A unique nursing situation occurred with a patient's entrapped Foley catheter, requiring timely intervention. This case study reinforces that a nurse's ability to assess and describe clinical assessment findings to a physician via the telephone can be critical to patient outcomes. Source

Wilson M.,Texas Health Presbyterian Hospital | Wilson M.,Washington State University | Sleutel M.,Texas Health Arlington Memorial | Newcomb P.,Texas Health Harris Fort Worth | And 4 more authors.
Worldviews on Evidence-Based Nursing | Year: 2015

Background: Nurses have an essential role in implementing evidence-based practices (EBP) that contribute to high-quality outcomes. It remains unknown how healthcare facilities can increase nurse engagement in EBP. Purpose: To determine whether individual or organizational qualities could be identified that were related to registered nurses' (RNs') readiness for EBP as measured by their reported EBP barriers, ability, desire, and frequency of behaviors. Methods: A descriptive cross-sectional survey was used in which a convenience sample of 2,441 nurses within one United States healthcare system completed a modified version of the Information Literacy for Evidence-Based Nursing questionnaire. Descriptive statistics, t tests, one-way ANOVA, and regression modeling were used to analyze the data. Results: RNs employed by facilities designated by the American Nurses Credentialing Center (ANCC) as Magnet® or Pathway to Excellence® reported significantly fewer barriers to EBP than those RNs employed by non designated facilities. RNs in Magnet organizations had higher desire for EBP than Pathway to Excellence or non designated facilities. RNs educated at the baccalaureate level or higher reported significantly fewer barriers to EBP than nurses with less education; they also had higher EBP ability, desire, and frequency of behaviors. A predictive model found higher EBP readiness scores among RNs who participated in research, had specialty certifications, and engaged in a clinical career development program. Linking Evidence to Action: Education, research, and certification standards promoted by the Magnet program may provide a nursing workforce that is better prepared for EBP. Organizations should continue structural supports that increase professional development and research opportunities so nurses are empowered to practice at their full capacity. © 2015 Sigma Theta Tau International. Source

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