William Jennings Bryan Dorn VA Medical Center

About: William Jennings Bryan Dorn VA Medical Center is a healthcare organization based out in Columbia, South Carolina, United States. It is known for research contribution in the topics: Population & Medicine. The organization has 41 authors who have published 41 publications receiving 2091 citations. The organization is also known as: Dorn VAMC.

The Slipping Slipper Sign: A Poor Man's Test for Severe Diabetic Peripheral Neuropathy.

Abstract: BACKGROUND Neuropathic feet are at very high risk for infection and amputation. The slipping slipper sign (SSS) is elicited by a simple questionnaire test reported to detect the presence of severe diabetic peripheral neuropathy. This test can be administered by non-medical staff. In this study, subjects with and without the SSS were evaluated by nerve conduction studies (NCS) and ultrasound measurements of the right sural nerve diameters as well as with traditional scoring systems for peripheral and autonomic neuropathy. OBJECTIVE To demonstrate that the Slipping Slipper Sign can be used as an index of severe diabetic peripheral neuropathyMethod:This was a prospective cross sectional study in which 74 patients with diabetes (38 positive and 36 negative for SSS) underwent ultrasonography and NCS of the right sural nerve by an examiner blinded to SSS status. Findings were evaluated against demography, clinical history, anthropometry as well as traditional clinical and autonomic neuropathic scores. RESULTS Patients without the SSS [median (IQR) = 10.0 years (4.0-20.3)] had a significantly shorter duration of diabetes compared with those with the SSS [median (IQR) = 15.0 years (8.5-25.0)], p = 0.028. The frequencies of retinopathy (36.8% vs 2.8%, p < 0.05) and cerebrovascular accidents (18.4% vs 13.9 %, p < 0.05) were higher among those with SSS compared with those without. Differences in nerve conduction characteristics were markedly significant. The amplitude of the sural sensory nerve action potential (SNAP) was ([median (IQR)] 0 microvolts vs 4.0 microvolts (0.0-10.8) p < 0.002) between those with and without SSS, respectively whilst none of patients with SSS had a recordable SNAP vs 78% without a SSS. Similarly, maximal thickness of the right sural nerve at the ankle 3.0 mm (2.3-3.4) vs 3.5 mm (3.0-3.9), and leg 3.4 mm (2.7-3.8) vs 3.9 mm (3.3-4.2) was reduced, p < 0.01 in patients with the SSS compared with those with a negative SSS. CONCLUSION The SSS identifies feet with objective neurophysiological and imaging characteristics of severe neuropathy.

We three kings and Christmas trees: pharmacotherapy from presents and diseases from decorations.

Abstract: The Medical Journal of Australia ISSN: 0025729X 3/17 December 2007 187 11/12 701-702 ©The Medical Journal of Australia 2007 www.mja.com.au Christmas offerings ancient kinds of Christmas gifts turn out to have mo applications, while, not so positively, some moder cause a fair degree of morbidity. Here, solely t amuse and pique curiosity, not exhaustive review, we explore the pharmacology of th mas gifts, as well as the potential benefits and haz modern Christmas decorations. e ma so W seldom identify the holiday season with medical tters, but perhaps we have been remiss in not doing . Many holiday customs have medical significance — some positive, some negative. Christmas and the following 2 weeks host the highest cardiac and non-cardiac mortality of the major holidays, but few people seem to dread the approach of December as a threat to their physical health. On the positive side, some dern medical n decorations

Impact of a pharmacy‐cardiology collaborative management program during initiation of antiarrhythmic drugs

Abstract: Antiarrhythmic drugs (AADs) are commonly used for management of atrial fibrillation and other cardiac arrhythmias. However, the use of AADs in clinical practice is challenging due to the risk of serious adverse drug events associated with these medications. Adherence to recommended monitoring parameters may improve safety in these agents. The primary objective of this study was to determine the effectiveness of a pharmacy‐cardiology collaborative approach to AAD management.

Effect of intensive blood pressure on the progression of non-diabetic chronic kidney disease at varying degrees of proteinuria.

Abstract: The ideal blood pressure (BP) target for renoprotection is uncertain in patients with non-diabetic chronic kidney disease (CKD), especially considering the influence exerted by pre-existing proteinuria In this pooled analysis of landmark trials, we coalesced individual data from 5001 such subjects randomized to intensive versus standard BP targets We employed multivariable regression to evaluate the relationship between follow-up systolic blood pressure (SBP) and diastolic blood pressure (DBP) on CKD progression (defined as glomerular filtration rate decline by 50% or end-stage renal disease), focusing on the potential for effect modification by baseline proteinuria or albuminuria The median follow-up was 32 years We found that SBP rather than DBP was the primary predictor of renal outcomes The optimal SBP target was 110–129 mm Hg We observed a strong interaction between SBP and proteinuria such that lower SBP ranges were significantly linked with progressively lower CKD risk in grade A3 albuminuria or ≥05–1 g/day proteinuria (relative to SBP 110–119 mm Hg, the adjusted HR for SBP 120–129 mm Hg, 130–139 mm Hg, and 140–149 mm Hg was 15, 23, and 33, respectively; all p 005), while in grade A1 albuminuria or proteinuria 01) We conclude that in non-diabetic CKD, stricter BP targets