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  1. AU="Mims, Catherine"
  2. AU="Abbasi, Ardeshir"
  3. AU="Gailey, Samantha" AU="Gailey, Samantha"
  4. AU="Yano, Shuya"
  5. AU="Balaur, Eugeniu"
  6. AU="Ağaçfidan, Ali"
  7. AU="Perkins, James A."
  8. AU="Arkoun, Brahim"

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  1. Artikel ; Online: A challenging case of granulomatosis with polyangiitis with cardiac involvement: a rare case report.

    Shelton, Anthony / Parikh, Suparshva / Mims, Catherine / Quintero-Del-Rio, Ana

    AME case reports

    2022  Band 7, Seite(n) 8

    Abstract: Background: Granulomatosis with polyangiitis (GPA), a systemic antineutrophil cytoplasmic antibody (ANCA) associated vasculitis, is characterized by inflammation of the small arteries, arterioles, and capillaries classically manifesting with ... ...

    Abstract Background: Granulomatosis with polyangiitis (GPA), a systemic antineutrophil cytoplasmic antibody (ANCA) associated vasculitis, is characterized by inflammation of the small arteries, arterioles, and capillaries classically manifesting with glomerulonephritis and necrotizing granulomatous lesions of the upper and lower respiratory tract. With an incidence of approximately 12 cases per one million individuals per year it is an uncommon diagnosis that typically presents as frequent pulmonary and sinus infections; however, if left without definitive treatment progresses to more severe manifestations specifically hemoptysis and hematuria.
    Case description: This case report highlights a 15-year-old woman who had both classic and non-classic findings making the diagnosis challenging. Specifically, her age of presentation, improvement with anti-microbials, and coronary dilation were not classic. Additionally, her lab work was negative for the cytoplasmic subset antineutrophil cytoplasmic autoantibody (c-ANCA), but positive for serum anti-proteinase 3 antineutrophil cytoplasmic antibody (PR3-ANCA) which further delayed the ultimate diagnosis as this is typically c-ANCA positive.
    Conclusions: Other systemic vasculitides, such as mucocutaneous lymph node disease, are associated with cardiac pathology necessitating further medical management and follow-up to prevent increased morbidity and mortality. Knowing this, we conclude that further evaluation for cardiac pathology would be prudent as part of the initial workup of patients with a diagnosis of GPA. Included is a brief review of available literature on GPA to emphasize the typical presentation, lab findings, and importance of early diagnosis.
    Sprache Englisch
    Erscheinungsdatum 2022-11-21
    Erscheinungsland China
    Dokumenttyp Case Reports
    ISSN 2523-1995
    ISSN (online) 2523-1995
    DOI 10.21037/acr-22-29
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Design and implementation of a decision aid for juvenile idiopathic arthritis medication choices.

    Brinkman, William B / Lipstein, Ellen A / Taylor, Janalee / Schoettker, Pamela J / Naylor, Katherine / Jones, Karla / Vora, Sheetal S / Mims, Catherine C / Roth-Wojcicki, Elizabeth / Gottlieb, Beth / Griffin, Nancy / Lannon, Carole / Morgan, Esi

    Pediatric rheumatology online journal

    2017  Band 15, Heft 1, Seite(n) 48

    Abstract: Background: Randomized trials have demonstrated the efficacy of patient decision aids to facilitate shared decision making in clinical situations with multiple medically reasonable options for treatment. However, little is known about how best to ... ...

    Abstract Background: Randomized trials have demonstrated the efficacy of patient decision aids to facilitate shared decision making in clinical situations with multiple medically reasonable options for treatment. However, little is known about how best to implement these tools into routine clinical practice. In addition, reliable implementation of decision aids has been elusive and spread within pediatrics has been slow. We sought to develop and reliably implement a decision aid for treatment of children with juvenile idiopathic arthritis.
    Methods: To design our decision aid, we partnered with patient, parent, and clinician stakeholders from the Pediatric Rheumatology Care and Outcomes Improvement Network. Six sites volunteered to use quality improvement methods to implement the decision aid. Four of these sites collected parent surveys following visits to assess outcomes. Parents reported on clinician use of the decision aid and the amount of shared decision making and uncertainty they experienced. We used chi-square tests to compare eligible visits with and without use of the decision aid on the experience of shared decision making and uncertainty.
    Results: After 18 rounds of testing and revision, stakeholders approved the decision aid design for regular use. Qualitative feedback from end-users was positive. During the implementation project, the decision aid was used in 35% of visits where starting or switching medication was discussed. Clinicians used the decision aid as intended in 68% of these visits. The vast majority of parents reported high levels of shared decision making following visits with (64/76 = 84%) and without (80/95 = 84%) use of the decision aid (p = 1). Similarly, the vast majority of parents reported no uncertainty following visits with (74/76 = 97%) and without (91/95 = 96%) use of the decision aid (p = 0.58).
    Conclusions: Although user acceptability of the decision aid was high, reliable implementation in routine clinical care proved challenging. Our parsimonious approach to outcome assessment failed to detect a difference between visits with and without use of our aid. Innovative approaches are needed to facilitate use of decision aids and the assessment of outcomes.
    Mesh-Begriff(e) Arthritis, Juvenile/drug therapy ; Arthritis, Juvenile/epidemiology ; Arthritis, Juvenile/psychology ; Canada ; Decision Making ; Decision Making, Computer-Assisted ; Decision Support Techniques ; Evidence-Based Medicine/methods ; Female ; Humans ; Male ; Medication Therapy Management/organization & administration ; Medication Therapy Management/standards ; Needs Assessment ; Parents/psychology ; Pediatrics/methods ; Reproducibility of Results ; Rheumatology/methods ; United States
    Sprache Englisch
    Erscheinungsdatum 2017-06-05
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 2279468-2
    ISSN 1546-0096 ; 1546-0096
    ISSN (online) 1546-0096
    ISSN 1546-0096
    DOI 10.1186/s12969-017-0177-x
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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