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Wilson M.,Texas Health Presbyterian Hospital | Wilson M.,Washington State University | Sleutel M.,Texas Health Arlington Memorial | Newcomb P.,Texas Health Specialty Hospitals | 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.


Guarascio A.J.,Duquesne University | Faust A.C.,Texas Health Presbyterian Hospital | Sheperd L.,Texas Health Presbyterian Hospital | O'Donnell L.A.,Duquesne University
Annals of Pharmacotherapy | Year: 2015

Ebola virus disease (EVD) poses significant clinical care implications for pharmacists. Emergency preparedness efforts should be undertaken to ensure vital response to EVD. Pharmacists should consider factors such as enhanced use of resources for front-line EVD patient care along with procurement of investigational medications. Appropriate and timely preparation, distribution, and administration of treatment for patients with EVD in the setting of substantial critical illness as well as infection control measures are essential. Aggressive supportive care and early, goal-directed therapy are cornerstones of therapy, whereas investigational treatments for EVD will likely play a larger, more well-defined role as future clinical trials are conducted. © The Author(s) 2014.


ST. LOUIS--(BUSINESS WIRE)--C N Diagnostics today reported results from its Phase 1 study testing ABBV-8E12 (Formerly C N-8E12) in patients with progressive supranuclear palsy (PSP). ABBV-8E12 is a humanized anti-tau monoclonal antibody currently under clinical investigation for the treatment of Alzheimer’s Disease and PSP, both progressive brain diseases currently lacking effective treatment options. Results from the first-in-human study were reported this morning as part of a Late-Breaking Oral Session at the Clinical Trials in Alzheimer’s Disease (CTAD) 2016 conference in San Diego, CA. Dr. Diana Kerwin, a key investigator to the study and Chief of Geriatrics as well as Director, Texas Alzheimer’s and Memory Disorders at the Texas Health Presbyterian Hospital, presented the results. The presentation was entitled: “Safety, Tolerability and Pharmacokinetics of ABBV-8E12: A Humanized Anti-tau Monoclonal Antibody, in a Phase 1, Single Ascending Dose, Placebo-controlled Study in Subjects with Progressive Supranuclear Palsy.” The study enrolled 30 subjects with PSP across 12 clinical sites throughout the United States. Patients were randomly assigned in a double-blinded manner to receive a one-time dose of either placebo or ABBV-8E12 at escalating doses up to 50 mg/kg. Subjects were followed out to 84 days post-dosing for safety, tolerability, and allergic reactions, as well as metabolism of the drug from the bloodstream. Study participants were, on average, 69 years of age, with 53% being males. Demographic characteristics of the patients were well balanced across the different dose groups. ABBV-8E12 was safe and well tolerated when administered intravenously in single doses of up to 50 mg/kg. No dose-limiting toxicities occurred, and adverse event frequency and severity did not vary by dose or when compared to placebo. Further, no allergic reactions occurred in any of the study participants. Metabolism and brain penetration levels of the drug were also consistent with what has previously been observed for other monoclonal antibodies. “We are extremely thankful to the patients and their family members who committed their time and energy to this study,” stated Dr. Joel Braunstein, CEO of C N Diagnostics. “The burden to patients in any Phase 1 trial is high, but the information we have gathered from this study is vitally important. This was one of the first human clinical studies to test the safety of tau passive immunotherapy in individuals with PSP. We can now use these results to design longer-term studies that will assess the therapeutic potential of ABBV-8E12 in clinical indications where misfolded tau appears to play an essential role in disease progression.” C N established a global therapeutic partnership with AbbVie, Inc during 2015. With AbbVie’s leadership, the companies will soon launch Phase 2 clinical testing of ABBV-8E12 in both Alzheimer’s Disease and PSP. C N Diagnostics, LLC (www.c2ndiagnostics.com) formed by scientific co-founders Drs. David Holtzman and Randall Bateman of Washington University School of Medicine in St. Louis, MO and LifeTech Research, a technology research and venture development firm (www.lifetechresearch.com). In March 2015, C N formed a global partnership with AbbVie to develop and commercialize a portfolio of anti-tau antibodies (including ABBV-8E12) for the treatment of Alzheimer’s Disease and other neurological disorders. In July 2015, C N and AbbVie announced FDA Orphan Drug Designation of ABBV-8E12 for the treatment of PSP. Beside its therapeutic development efforts, C N is commercializing a suite of biomarker tests to enable drug discovery, clinical drug development at lower risk and cost, and early detection of debilitating neurodegenerative disorders before symptom onset. The company's products include the SILK-Aβ®, SILK-ApoE™, SISAQ-Aβ™, and SISAQ-Tau™ Assays, which rely upon stable isotope labeling and mass spectrometry for the measurement of the kinetics, or in vivo metabolism, and quantitation of brain derived proteins. Beyond Alzheimer's Disease, products are in development to target Parkinson's Disease, Progressive Supranuclear Palsy, traumatic brain injury, schizophrenia and Amyotrophic Lateral Sclerosis, among other conditions. For additional information, please contact info@c2ndiagnostics.com or call 1-877-C2N-DIAG (1-877-226-3424).


Radford N.B.,Cooper Clinic | DeFina L.F.,The Cooper Institute | Barlow C.E.,The Cooper Institute | Kerr A.,The Cooper Institute | And 3 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.


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.


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.


Collins G.R.,University of Texas Southwestern Medical Center | Essary L.,University of Texas Southwestern Medical Center | Strauss J.,Texas Health Presbyterian Hospital | Hino P.,Texas Health Presbyterian Hospital | Cockerell C.J.,University of Texas Southwestern Medical Center
Journal of Cutaneous Pathology | Year: 2012

Chordomas represent rare malignant primary bone tumors most often occurring in the sacral area. These tumors uncommonly involve the skin and often follow a progressive course with multiple recurrences, metastases and eventual death. Reports of cutaneous metastases from chordoma are very rare. The immunohistochemical staining characteristics of these cutaneous metastases with comparison to the primary tumors are similarly rarely addressed in the literature. We report a rare case of incidentally discovered, small, solitary distant cutaneous metastasis of sacral chordoma that developed on the right upper back of a 44-year-old man with a history of multiple completely excised melanomas who had also been previously diagnosed with chordoma involving the sacrum 12 years earlier. We describe its pathologic features with comparison to the primary tumor and briefly review the literature. Immunohistochemically, the cutaneous metastasis and primary tumor both stained positively for pancytokeratin and vimentin, as expected. However, the cutaneous metastasis unexpectedly lacked S100 protein expression, whereas the primary tumor was S100 positive. This phenomenon has only been documented in one other case report. We demonstrate that late, incidentally discovered cutaneous metastasis with unexpected immunohistochemical staining features rarely occur and can present a diagnostic challenge. Copyright © 2012 John Wiley & Sons A/S.


Kelly P.P.,Texas Health Presbyterian Hospital
Clinical Journal of Oncology Nursing | Year: 2011

This article describes family history assessment for colorectal cancer in three outpatient gastroenterology units and examines gastroenterology unit nurses' knowledge and attitudes about family history assessments. Eighty-eight colonoscopy records were surveyed, and 16 RNs were interviewed. The medical record documentation was surveyed using a researcher-developed tool to identify type of cancer, age at disease onset, family relationship, and number of family members with cancer. Gastroenterology unit nurses were interviewed to assess knowledge and attitudes about family history assessment regarding colorectal cancer. Findings indicate that limited family history documentation was present in the medical record and that important age-at-disease-onset information was missing in 95% of patients with a family history of colorectal cancer and in 85% of patients with a family history of Lynch syndrome-associated cancers. No documentation was found in any charts about the number of affected relatives within the same family. Inconsistencies in family history documentation within the same medical record were noted, and family history information was found in multiple chart forms. Gastroenterology nurses rated family history as very important but gave a lower rating to personal knowledge about and resources for family history assessment. © 2011 Oncology Nursing Society.


Nina Pham, the nurse who was infected by the deadly Ebola virus after being part of the team that treated the first person diagnosed with it in the United States, has reached a settlement over the lawsuit that she filed against the Dallas hospital where she worked. Pham was infected with Ebola after treating Thomas Duncan, who contracted the virus in Liberia. He was admitted to the Texas Health Presbyterian Hospital in Dallas but succumbed to the virus two weeks later. Last year, Pham said that the lawsuit against Texas Health Resources, the parent company of the hospital, was due to the absence of proper safety equipment and resources needed to handle the Ebola case, with the hospital staff not receiving proper training and instructions on what they needed to do in the situation. Pham said that all the information that was given to her for protection when Duncan was taken in, before it was confirmed that he had Ebola, were what her manager simply searched for online and printed out. The lawsuit accused the hospital of negligence and deception in how it handled having Duncan as a patient and its lack of support for its workers. There was no amount specified for the damages being sought. Lawyers for Nina Pham announced that a settlement has been reached with Texas Health Resources over the lawsuit, with the terms of the deal remaining undisclosed. The hospital, however, still denies the claims made in the lawsuit. The lawsuit said Pham was "a casualty of a hospital system's failure to prepare for a known and impending medical crisis," as it described the chaotic situation that ensued at Texas Health Presbyterian Hospital once Duncan was diagnosed with Ebola. Nurses, who did not receive any formal training or guidance from supervisors were left to scramble for protective clothing that they could wear. Clear drop cloths were then taped to the ceiling and walls to put up a makeshift containment facility, with nurses needing to dispose hazardous waste themselves despite not being trained to do so. After the death of Duncan, Pham was told that she was safe from Ebola. She then spent time with her friends and family, but two days afterward, she started feeling sick. After a visit to a hospital, it was confirmed that she was infected with the virus. Fortunately, she was able to recover. The settlement with Texas Health Resources could finally be the end of a difficult chapter in Pham's life. However, the same could not be said for Sierra Leone, Guinea and Liberia, as the World Health Organization warned earlier in the year that the African countries are still under threat from the Ebola virus. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.


News Article | November 7, 2016
Site: www.businesswire.com

NASHVILLE, Tenn.--(BUSINESS WIRE)--Montecito Medical Real Estate, a premier owner of medical office buildings throughout the U.S., has entered into an agreement to acquire Rockwall Medical Plaza, a 20,007-square-foot medical office building and surgery center just east of Dallas, Texas. Strategically located on the campus of Texas Health Presbyterian Hospital and constructed last year, Rockwall Medical Plaza is anchored by an ambulatory surgery center joint-ventured by Texas Health Resources an

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