Lankenau Medical Center

About: Lankenau Medical Center is a healthcare organization based out in Philadelphia, Pennsylvania, United States. It is known for research contribution in the topics: Atrial fibrillation & Medicine. The organization has 436 authors who have published 414 publications receiving 7095 citations. The organization is also known as: Lankenau Hospital.

Embolic and Other Adverse Outcomes in Symptomatic Versus Asymptomatic Patients With Atrial Fibrillation (from the ORBIT-AF Registry)

Abstract: Asymptomatic atrial fibrillation (AF) is being increasingly diagnosed via implantable devices, screening, and inpatient telemetry. Management of asymptomatic AF is controversial, in part, because the associated risks have not been well described. We examined the incidence of major adverse outcomes in patients with asymptomatic versus symptomatic AF using Outcomes Registry for Better Informed Treatment of Atrial Fibrillation, a nationwide US registry of AF patients. We compared stroke and/or non-central nervous system (CNS) embolism, major adverse cardiovascular and neurologic events, bleeding, and death in 9,319 asymptomatic (defined by European Heart Rhythm Association score = 1 or “no symptoms”) versus symptomatic patients. Overall, median (interquartile) age was 75 (67 to 82) years, 3,944 (42%) were women, and 38% versus 37% were asymptomatic based on physician versus patient-reported symptoms. Compared with those with symptoms, physician-defined asymptomatic patients were less likely to be woman (35%/47%) or be on an antiarrhythmic agent (22%/33%), but were more likely to have permanent and/or persistent AF (51%/40%). CHA2DS2-VASc scores did not vary by symptom status. After adjustment, risk of first stroke and/or non-CNS embolism (hazard ratio [HR] 0.85 [95% confidence interval {CI} 0.63 to 1.16], p = 0.32), major adverse cardiovascular and neurologic events (HR 0.88 [95% CI 0.76 to 1.03], p = 0.11), bleeding (HR 0.85 [95% CI 0.72 to 1.00], p = 0.05), and death (HR 0.99 [95% CI 0.87 to 1.13], p = 0.88) were similar in asymptomatic (European Heart Rhythm Association = 1) and symptomatic AF, respectively. Prospective, randomized studies are needed to further define associated adverse events and delineate optimal prophylactic therapies in patients with asymptomatic AF.

Prevalence of depressive symptoms and associated factors in an urban, ophthalmic population.

Abstract: Objective:To determine the prevalence of depressive symptoms in an adult ophthalmic patient population and to delineate correlates.Design:Cross-sectional study.Participants:Adult patients (⩾18 year...

Medical Student Volunteerism Addresses Patients' Social Needs: A Novel Approach to Patient-Centered Care.

Abstract: Background: Healthcare providers must be equipped to recognize and address patients9 psychosocial needs to improve overall health outcomes. To give future healthcare providers the tools and training necessary to identify and address psychosocial issues, Lankenau Medical Center in partnership with the Philadelphia College of Osteopathic Medicine designed the Medical Student Advocate (MSA) program. Methods: The MSA program places volunteer second-year osteopathic medical students in care coordination teams at Lankenau Medical Associates, a primary care practice serving a diverse patient population in the Philadelphia, PA, region. As active members of the team, MSAs are referred high-risk patients who have resource needs such as food, employment, child care, and transportation. MSAs work collaboratively with patients and the multidisciplinary team to address patients9 nonmedical needs. Results: From August 2013 to August 2015, 31 osteopathic medical students volunteered for the MSA program and served 369 patients with 720 identified needs. Faculty and participating medical students report that the MSA program provided an enhanced understanding of the holistic nature of patient care and a comprehensive view of patient needs. Conclusion: The MSA program provides students with a unique educational opportunity that encompasses early exposure to patient interaction, social determinants of health, population health, and interdisciplinary collaboration. Students develop skills to help them build patient relationships, understand the psychosocial factors shaping health outcomes, and engage with other healthcare professionals. This work in the preclinical years provides students with the knowledge to help them perform more effectively in the changing healthcare environment.

Recurrent right ventricular cardiac myxoma in a patient with Carney complex: a case report

Abstract: Carney complex is a multiple neoplasia syndrome involving cardiac, endocrine, neural and cutaneous tumors with a variety of pigmented skin lesions. It has an autosomal dominant mode of inheritance. Approximately 7% of cardiac myxomas are related to the Carney complex. Myxomas that occur as part of the Carney complex affect both sexes with equal frequency. Cardiac myxomas with Carney complex are reported mostly in the left side of the heart and are less common on the right side. As per our review, this is the first reported case of Carney complex with right ventricle cardiac myxoma. We present a rare case of recurrent cardiac myxoma in a patient later diagnosed to have Carney complex. A 46-year-old Caucasian man with a history of thyroid hyperplasia came to out-patient cardiology department with new onset atrial fibrillation. A transthoracic echocardiogram revealed a right ventricular mass attached to his interventricular septum, which was later seen on a transesophageal echocardiogram and cardiac magnetic resonance imaging. He underwent resection of the ventricular mass which on pathology revealed myxoma. He later developed skin lesions, pituitary adenoma and Sertoli cell tumor suggesting Carney complex. Two years later he developed a new mass within his right atrium which was later resected. Carney complex is a rare autosomal dominant disease with variable penetrance. Since it involves multiple organs, patients diagnosed with Carney complex should undergo serial endocrine workup, neural assessments, echocardiograms and testicular ultrasounds. Of the total number of cases of Carney complex, 65% are linked to PRKAR1A gene mutation. It is important for clinicians to be cognizant of a link between cardiac myxoma and Carney complex. The use of multi-imaging modalities allows better delineation of the mass before planned resection. Carney complex-related cardiac myxoma comprises 7% of all cardiac myxomas. Right ventricular cardiac myxomas are rare. This case report is the first to describe right ventricular myxoma with Carney complex.