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Lopez-Jimenez C, Morrissey AM, Groth A, de la Puerta B, Lee KCL, Lamb CR. Use of CT sinography in 27 dogs and one cat. J Small Anim Pract 2021; 63:142-146. [PMID: 33939184 DOI: 10.1111/jsap.13339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/26/2021] [Accepted: 03/05/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To describe the clinical findings, imaging findings and outcome in patients in which CT sinography was performed, and assess to what degree this technique adds information about the extent of a tract or increases the accuracy of diagnosis of foreign bodies on CT. MATERIALS AND METHODS Retrospective review of medical records of 27 dogs and one cat with draining tracts that had CT sinography. Pre- and post-intravenous (IV) contrast CT series were compared with CT sinography in each patient. RESULTS Median duration of clinical signs before referral was 85 days (range 2 to 1478 days). The most common reported clinical signs were swelling (14/28, 50%) and regional pain (5/28, 18%). CT sinography revealed a more extensive tract than post-IV contrast CT in 21% cases. On post-IV contrast CT, 31% of foreign bodies were detected compared to 23% on CT sinography. All four foreign bodies detected by CT were observed in the non-contrast images. Surgery was performed after CT in 22 (79%) cases. Thirteen (46%) draining tracts resolved after surgery, three (11%) resolved without surgery, six (21%) persisted or recurred after surgery, and six (21%) were lost to follow-up. CLINICAL SIGNIFICANCE CT sinography provides limited additional information about the extent of draining tracts compared to pre- and post-IV contrast CT images and did not increase the number of foreign bodies identified.
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Affiliation(s)
- C Lopez-Jimenez
- North Downs Specialist Referrals, The Friesian Buildings 3 & 4, The Brewerstreet Dairy Business Park, Brewer Street, Bletchingley, RH1 4QP, UK
| | - A M Morrissey
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hatfield, Hertfordshire, AL9 7TA, UK
| | - A Groth
- North Downs Specialist Referrals, The Friesian Buildings 3 & 4, The Brewerstreet Dairy Business Park, Brewer Street, Bletchingley, RH1 4QP, UK
| | - B de la Puerta
- North Downs Specialist Referrals, The Friesian Buildings 3 & 4, The Brewerstreet Dairy Business Park, Brewer Street, Bletchingley, RH1 4QP, UK
| | - K C L Lee
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hatfield, Hertfordshire, AL9 7TA, UK
| | - C R Lamb
- North Downs Specialist Referrals, The Friesian Buildings 3 & 4, The Brewerstreet Dairy Business Park, Brewer Street, Bletchingley, RH1 4QP, UK
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Chen LY, Bigger JT, Hickey KT, Chen H, Lopez-Jimenez C, Banerji MA, Evans G, Fleg JL, Papademetriou V, Thomas A, Woo V, Seaquist ER, Soliman EZ. Effect of Intensive Blood Pressure Lowering on Incident Atrial Fibrillation and P-Wave Indices in the ACCORD Blood Pressure Trial. Am J Hypertens 2016; 29:1276-1282. [PMID: 26476086 DOI: 10.1093/ajh/hpv172] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 09/29/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There are no proven strategies to prevent atrial fibrillation (AF) in patients with type 2 diabetes (T2DM). We compared standard blood pressure (BP) lowering vs. intensive BP lowering in reducing incidence of AF or P-wave indices (PWI-ECG markers of left atrial abnormality that are considered intermediate phenotypes of AF) in patients with T2DM. METHODS We analyzed data from the ACCORD BP trial-a randomized controlled nonblinded trial (2001-2009) which randomized patients with T2DM and systolic BP (SBP) 130-180mm Hg on ≤3 antihypertensive medications aged 40-79 years with cardiovascular disease (CVD) or aged 55-79 years with subclinical CVD or ≥2 CVD risk factors to standard BP lowering (SBP <140mm Hg) vs. intensive BP lowering (SBP <120mm Hg). The primary outcome was a composite of incident AF and PWI. RESULTS Data from 3,087 participants (mean age, 62.2 years; women, 48.2%; non-White, 39.2%) were analyzed. During a mean follow-up of 4.4 years, the primary outcome occurred in 1,063 participants (incidence rate, 84.5 per 1,000 person-years in the standard-therapy group vs. 73.9 per 1,000 person-years in the intensive-therapy group). The adjusted hazard ratios (95% confidence intervals) of intensive-therapy group for the primary outcome and for incident PWI alone were 0.87 (0.77-0.98), P = 0.02 and 0.87 (0.76-0.98), P = 0.02, respectively. The effect of intensive therapy on the incidence of AF alone did not reach statistical significance. CONCLUSIONS In patients with T2DM, intensive BP lowering reduces the incidence of the composite outcome of AF and PWI, suggesting a potential benefit from stringent BP control in patients with T2DM. clinical trials registration Trial Number NCT00000620.
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Affiliation(s)
- Lin Y Chen
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - J Thomas Bigger
- Columbia University Department of Medicine, Division of Cardiology, New York, New York, USA
| | - Kathleen T Hickey
- Columbia University Department of Medicine, Division of Cardiology, New York, New York, USA
- Columbia University School of Nursing, New York, New York, USA
| | - Haiying Chen
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Carlos Lopez-Jimenez
- Columbia University Department of Medicine, Division of Cardiology, New York, New York, USA
| | | | - Gregory Evans
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jerome L Fleg
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Abraham Thomas
- Endocrinology, Diabetes, Bone and Mineral Disorders Division, Henry Ford Hospital, Detroit, Michigan, USA
| | - Vincent Woo
- Section of Endocrinology and Metabolism, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Elizabeth R Seaquist
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Division of Public Health Sciences, Winston-Salem, North Carolina, USA
- Department of Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Molina-Pinelo S, Meléndez R, Salinas A, Suarez R, Lopez-Jimenez C, Carnero A, Paz-Ares L, Ferrer I. 3041 Patient Derived Xenografts platform focused on developing effective anticancer agents for KRAS and FRFR1/4. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31684-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Boland MR, Rusanov A, So Y, Lopez-Jimenez C, Busacca L, Steinman RC, Bakken S, Bigger JT, Weng C. From expert-derived user needs to user-perceived ease of use and usefulness: a two-phase mixed-methods evaluation framework. J Biomed Inform 2014; 52:141-50. [PMID: 24333875 PMCID: PMC4055529 DOI: 10.1016/j.jbi.2013.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 11/04/2013] [Accepted: 12/06/2013] [Indexed: 11/16/2022]
Abstract
Underspecified user needs and frequent lack of a gold standard reference are typical barriers to technology evaluation. To address this problem, this paper presents a two-phase evaluation framework involving usability experts (phase 1) and end-users (phase 2). In phase 1, a cross-system functionality alignment between expert-derived user needs and system functions was performed to inform the choice of "the best available" comparison system to enable a cognitive walkthrough in phase 1 and a comparative effectiveness evaluation in phase 2. During phase 2, five quantitative and qualitative evaluation methods are mixed to assess usability: time-motion analysis, software log, questionnaires - System Usability Scale and the Unified Theory of Acceptance of Use of Technology, think-aloud protocols, and unstructured interviews. Each method contributes data for a unique measure (e.g., time motion analysis contributes task-completion-time; software log contributes action transition frequency). The measures are triangulated to yield complementary insights regarding user-perceived ease-of-use, functionality integration, anxiety during use, and workflow impact. To illustrate its use, we applied this framework in a formative evaluation of a software called Integrated Model for Patient Care and Clinical Trials (IMPACT). We conclude that this mixed-methods evaluation framework enables an integrated assessment of user needs satisfaction and user-perceived usefulness and usability of a novel design. This evaluation framework effectively bridges the gap between co-evolving user needs and technology designs during iterative prototyping and is particularly useful when it is difficult for users to articulate their needs for technology support due to the lack of a baseline.
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Affiliation(s)
- Mary Regina Boland
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Alexander Rusanov
- Department of Anesthesiology, Columbia University, New York, NY, USA
| | - Yat So
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Carlos Lopez-Jimenez
- Department of Medicine, Division of Cardiology, Columbia University, New York, NY, USA
| | - Linda Busacca
- The Clinical Trials Office, Columbia University, New York, NY, USA
| | - Richard C Steinman
- Department of Medicine, Division of Cardiology, Columbia University, New York, NY, USA; The Irving Institute for Clinical and Translational Research, Columbia University, New York, NY, USA
| | - Suzanne Bakken
- Department of Biomedical Informatics, Columbia University, New York, NY, USA; School of Nursing, Columbia University, New York, NY, USA; The Irving Institute for Clinical and Translational Research, Columbia University, New York, NY, USA
| | - J Thomas Bigger
- Department of Medicine, Division of Cardiology, Columbia University, New York, NY, USA; The Irving Institute for Clinical and Translational Research, Columbia University, New York, NY, USA
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University, New York, NY, USA; The Irving Institute for Clinical and Translational Research, Columbia University, New York, NY, USA.
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Weng C, Li Y, Berhe S, Boland MR, Gao J, Hruby GW, Steinman RC, Lopez-Jimenez C, Busacca L, Hripcsak G, Bakken S, Bigger JT. An Integrated Model for Patient Care and Clinical Trials (IMPACT) to support clinical research visit scheduling workflow for future learning health systems. J Biomed Inform 2013; 46:642-52. [PMID: 23684593 DOI: 10.1016/j.jbi.2013.05.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 04/06/2013] [Accepted: 05/01/2013] [Indexed: 11/29/2022]
Abstract
We describe a clinical research visit scheduling system that can potentially coordinate clinical research visits with patient care visits and increase efficiency at clinical sites where clinical and research activities occur simultaneously. Participatory Design methods were applied to support requirements engineering and to create this software called Integrated Model for Patient Care and Clinical Trials (IMPACT). Using a multi-user constraint satisfaction and resource optimization algorithm, IMPACT automatically synthesizes temporal availability of various research resources and recommends the optimal dates and times for pending research visits. We conducted scenario-based evaluations with 10 clinical research coordinators (CRCs) from diverse clinical research settings to assess the usefulness, feasibility, and user acceptance of IMPACT. We obtained qualitative feedback using semi-structured interviews with the CRCs. Most CRCs acknowledged the usefulness of IMPACT features. Support for collaboration within research teams and interoperability with electronic health records and clinical trial management systems were highly requested features. Overall, IMPACT received satisfactory user acceptance and proves to be potentially useful for a variety of clinical research settings. Our future work includes comparing the effectiveness of IMPACT with that of existing scheduling solutions on the market and conducting field tests to formally assess user adoption.
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Affiliation(s)
- Chunhua Weng
- Department of Biomedical Informatics, Columbia University, New York, NY 10032, USA.
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