Washington Hospital

About: Washington Hospital is a healthcare organization based out in Washington, Pennsylvania, United States. It is known for research contribution in the topics: Journal club & Population. The organization has 264 authors who have published 254 publications receiving 6114 citations.

Primary Results From the SmartDelay Determined AV Optimization: A Comparison to Other AV Delay Methods Used in Cardiac Resynchronization Therapy (SMART-AV) Trial A Randomized Trial Comparing Empirical, Echocardiography-Guided, and Algorithmic Atrioventricular Delay Programming in Cardiac Resynchronization Therapy

Abstract: BackgroundOne variable that may influence cardiac resynchronization therapy response is the programmed atrioventricular (AV) delay. The SmartDelay Determined AV Optimization: A Comparison to Other AV Delay Methods Used in Cardiac Resynchronization Therapy (SMART-AV) Trial prospectively randomized patients to a fixed empirical AV delay (120 milliseconds), echocardiographically optimized AV delay, or AV delay optimized with SmartDelay, an electrogram-based algorithm. Methods and ResultsA total of 1014 patients (68% men; mean age, 66±11 years; mean left ventricular ejection fraction, 25±7%) who met enrollment criteria received a cardiac resynchronization therapy defibrillator, and 980 patients were randomized in a 1:1:1 ratio. All patients were programmed (DDD-60 or DDDR-60) and evaluated after implantation and 3 and 6 months later. The primary end point was left ventricular end-systolic volume. Secondary end points included New York Heart Association class, quality-of-life score, 6-minute walk distance, lef...

Cognitive impairment associated with adjuvant therapy in breast cancer.

Abstract: The purpose of this study was to determine whether cognitive function changes over time in women with breast cancer who received adjuvant therapy as compared to women with breast cancer who received no adjuvant therapy. Three groups of women (n=46) were studied; groups 1 and 2 consisted of women with stage I or II breast cancer. Group 1 received chemotherapy and group 2 received chemotherapy plus tamoxifen. Group 3 consisted of women with ductal carcinoma in situ who received no chemotherapy or tamoxifen. Cognitive function was evaluated at three timepoints. Time 1 occurred after surgery and before chemotherapy initiation in groups 1 and 2. Time 1 for group 3 occurred post-surgery. Time 2 occurred within 1 week after the conclusion of chemotherapy for groups 1 and 2 and at a comparable time for group 3. Time 3 occurred 1 year after Time 2. Women who received chemotherapy plus tamoxifen exhibited deterioration on measures of visual memory and verbal working memory and reported more memory complaints. Women who received chemotherapy alone also exhibited deteriorations in verbal working memory. Conversely, cognitive function scores improved in women who received no therapy, indicating practice effects. In conclusion, adjuvant chemotherapy in women with breast cancer can be associated with deteriorations in memory and this may persist over time. The addition of tamoxifen may lead to more widespread memory deficits. Copyright © 2005 John Wiley & Sons, Ltd.

The Advanced Health and Disaster Aid Network: A Light-Weight Wireless Medical System for Triage

Abstract: Advances in semiconductor technology have resulted in the creation of miniature medical embedded systems that can wirelessly monitor the vital signs of patients. These lightweight medical systems can aid providers in large disasters who become overwhelmed with the large number of patients, limited resources, and insufficient information. In a mass casualty incident, small embedded medical systems facilitate patient care, resource allocation, and real-time communication in the advanced health and disaster aid network (AID-N). We present the design of electronic triage tags on lightweight, embedded systems with limited memory and computational power. These electronic triage tags use noninvasive, biomedical sensors (pulse oximeter, electrocardiogram, and blood pressure cuff) to continuously monitor the vital signs of a patient and deliver pertinent information to first responders. This electronic triage system facilitates the seamless collection and dissemination of data from the incident site to key members of the distributed emergency response community. The real-time collection of data through a mesh network in a mass casualty drill was shown to approximately triple the number of times patients that were triaged compared with the traditional paper triage system.