Soluble ICAM-1 and soluble HLA class 1 as indicators of immune activation in liver allograft recipients *1. Transplantation Immunobiology Laboratory, Department of Transplantation, California Pacific Medical Center, San Francisco, CA

Background Long-term weakness and disability are common after an intensive care unit (ICU) stay. Usual care in the ICU prevents most patients from receiving preventative early mobilization. Objective The study objective was to describe a quality improvement project established by a physical therapist at the University of California San Francisco Medical Center from 2009 to 2011. The goal of the program was to reduce patients' ICU length of stay by increasing the number of patients in the ICU receiving physical therapy and decreasing the time from ICU admission to physical therapy initiation. Design This study was a 9-month retrospective analysis of a quality improvement project. Methods An interprofessional ICU Early Mobilization Group established and promoted guidelines for mobilizing patients in the ICU. A physical therapist was dedicated to a 16-bed medical-surgical ICU to provide physical therapy to selected patients within 48 hours of ICU admission. Patients receiving early physical therapy intervention in the ICU in 2010 were compared with patients receiving physical therapy under usual care practice in the same ICU in 2009. Results From 2009 to 2010, the number of patients receiving physical therapy in the ICU increased from 179 to 294. The median times (interquartile ranges) from ICU admission to physical therapy evaluation were 3 days (9 days) in 2009 and 1 day (2 days) in 2010. The ICU length of stay decreased by 2 days, on average, and the percentage of ambulatory patients discharged to home increased from 55% to 77%. Limitations This study relied upon the retrospective analysis of data from 6 collectors, and the intervention lacked physical therapy coverage for 7 days per week. Conclusions The improvements in outcomes demonstrated the value and feasibility of a physical therapist–led early mobilization program.

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SUMMIT (Serially Unified Multicenter Multiple Sclerosis Investigation): creating a repository of deeply phenotyped contemporary multiple sclerosis cohorts

Multiple Sclerosis Journal ◽

10.1177/1352458517726657 ◽

2017 ◽

Vol 24 (11) ◽

pp. 1485-1498 ◽

Cited By ~ 10

Author(s):

Riley Bove ◽

Tanuja Chitnis ◽

Bruce AC Cree ◽

Mar Tintoré ◽

Yvonne Naegelin ◽

...

Keyword(s):

Multiple Sclerosis ◽

San Francisco ◽

Medical Center ◽

Clinically Isolated Syndrome ◽

American University ◽

American University Of Beirut ◽

Longitudinal Investigation ◽

American Academic

Background: There is a pressing need for robust longitudinal cohort studies in the modern treatment era of multiple sclerosis. Objective: Build a multiple sclerosis (MS) cohort repository to capture the variability of disability accumulation, as well as provide the depth of characterization (clinical, radiologic, genetic, biospecimens) required to adequately model and ultimately predict a patient’s course. Methods: Serially Unified Multicenter Multiple Sclerosis Investigation (SUMMIT) is an international multi-center, prospectively enrolled cohort with over a decade of comprehensive follow-up on more than 1000 patients from two large North American academic MS Centers (Brigham and Women’s Hospital (Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women’s Hospital (CLIMB; BWH)) and University of California, San Francisco (Expression/genomics, Proteomics, Imaging, and Clinical (EPIC))). It is bringing online more than 2500 patients from additional international MS Centers (Basel (Universitätsspital Basel (UHB)), VU University Medical Center MS Center Amsterdam (MSCA), Multiple Sclerosis Center of Catalonia-Vall d’Hebron Hospital (Barcelona clinically isolated syndrome (CIS) cohort), and American University of Beirut Medical Center (AUBMC-Multiple Sclerosis Interdisciplinary Research (AMIR)). Results and conclusion: We provide evidence for harmonization of two of the initial cohorts in terms of the characterization of demographics, disease, and treatment-related variables; demonstrate several proof-of-principle analyses examining genetic and radiologic predictors of disease progression; and discuss the steps involved in expanding SUMMIT into a repository accessible to the broader scientific community.

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Managing the Patient With Pulmonary Arterial Hypertension and Methamphetamine Use: A Practical Perspective for the Clinician

Advances in Pulmonary Hypertension ◽

10.21693/1933-088x-17.2.55 ◽

2018 ◽

Vol 17 (2) ◽

pp. 55-62 ◽

Cited By ~ 1

Author(s):

Nimaljeet Tarango ◽

Andrea Gergay Baird

Keyword(s):

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

San Francisco ◽

Medical Center ◽

The United States ◽

Methamphetamine Abuse ◽

Methamphetamine Use ◽

Personal Experiences ◽

History Of ◽

Pulmonary Arterial

Pulmonary arterial hypertension (PAH) is a serious, chronic, progressive cardiopulmonary disease. PAH is associated with several concomitant conditions, as well as drugs and toxins.12 Methamphetamine abuse is likely associated with the development of PAH.3 Methamphetamine abuse is epidemic in the United States and abroad, with rates of new users escalating since 2012. There are over 100,000 new users annually as young as 12 years old. Treating a patient with a history of methamphetamine abuse poses many challenges for a clinician, including nonadherence, therapeutic treatment selection, complex psychosocial issues, and relapse or continued drug abuse. Patients with methamphetamine-associated PAH (Meth-APAH) have higher mortality rates when compared to idiopathic PAH.3 Having a better understanding of the complexities of addiction and working with a multidisciplinary team that includes a social worker to provide care and counseling to these patients can improve their trajectory. In this article, we will offer insight and background into methamphetamine abuse and addiction, as well as discuss a practical approach for clinicians in treating a patient with Meth-APAH, based on the literature, as well as our personal experiences at University of California, San Francisco Medical Center.

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NEWS AND ANNOUNCEMENTS

PEDIATRICS ◽

10.1542/peds.49.1.155 ◽

1972 ◽

Vol 49 (1) ◽

pp. 155-159

Keyword(s):

San Francisco ◽

Reading Disabilities ◽

Medical Center ◽

Perinatal Care ◽

Guest Speaker ◽

Obstetrics And Gynecology ◽

Information Contact ◽

Good Samaritan ◽

Good Samaritan Hospital ◽

Hilton Hotel

Symposium on Reading Disabilities in Children: The Eye Section of the California Medical Association will sponsor an interdisciplinary symposium on "Reading Disabilities in Children," at the San Francisco Hilton Hotel, on Sunday, February 13, 1972. Dr. Arthur Keeney of Philadelphia is the invited guest speaker. The panel will comprise representatives of ophthalmology, pediatrics, child psychiatry, and education. For information contact Rush M. Blodget, Jr., M.D., Redding Ophthalmology Group, 1950 Court Street, Redding, California 96001. Obstetrics-Pediatrics Symposium : The Department of Obstetrics and Gynecology of Good Samaritan Hospital, in cooperation with the same Department of Saint Joseph's Hospital and Medical Center, both of Phoenix, will present a symposium, "Newer Concepts in Delivery of Obstetrical and Perinatal Care," February 25-26, 1972.

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