Category Archives: Blogging

Southwest Health System, UMMC announce health care affiliation

Published on Tuesday, October 29, 2019

By: Ruth Cummins, [email protected]

A new affiliation between Southwest Health System in McComb and the University of Mississippi Medical Center in Jackson will strengthen and expand health care services in McComb and southwest Mississippi.

The affiliation brings the advanced health care offerings of Mississippi’s only academic medical center to Southwest Mississippi Regional Medical Center, a 165-bed, progressive hospital with a medical staff of nearly 100 physicians representing 12 medical specialties.

The working relationship allows 1,200-employee Southwest Health System to enhance its strong medical staff, expand its health care services and improve access to treatment through UMMC’s medical outreach. The agreement allows UMMC and Southwest to explore future research and education opportunities.

Expanded access to state-of-the-art care will enable more McComb-area residents to stay home for treatment, said Kevin Cook, chief executive officer of the UMMC Health System.

Portrait of Kevin Cook
Cook

“As health care resources continue to shrink, collaboration among providers is essential,” Cook said. “We are excited about our affiliation with SMRMC and look forward to working with the hospital and community to ensure that region’s health needs are addressed for many years to come.”

Portrait of Norman Price
Price

“For several months, our board, medical staff and administrative team have worked together on this affiliation process,” said Norman M. Price, Southwest Health System chief executive officer. “Our goal was to find the best fit for not only our hospital and employees, but also for our patients and our community.

“We feel this affiliation with UMMC meets our present as well as our future expectations.”

In addition to Southwest Mississippi Regional Medical Center, Southwest Health System encompasses 12 specialty clinics near the hospital including the Cardiovascular Institute of Mississippi, Mississippi Cancer Institute, Norman M. Price Ambulatory Surgery Center, St. Luke Home Health & Hospice, Digestive Diseases Center, Southwest Center for Rehabilitation, and Southwest Regional Women’s Center Maternity Suites.

The system also includes three family practice clinics, two in McComb and one in Lawrence County, and the nonprofit Lawrence County Hospital, a 25-bed critical access hospital in Monticello.

Portrait of Dr. Kevin Richardson
Richardson

“This partnership will enable us to provide exceptional care to the patients and families that we serve throughout our community,” said Dr. Kevin Richardson, Southwest Mississippi Regional Medical Center chief medical officer.

The affiliation with Southwest Mississippi Regional Medical Center is one of many collaborative business relationships UMMC has, in a variety of formats, with hospitals and other health care entities in Mississippi and other states.

Portrait of Dr. Charles O'Mara
O’Mara

“This affiliation with Southwest Mississippi Regional Medical Center allows UMMC to broaden and strengthen our continued efforts to collaborate with health systems across the state and the region, for the ultimate benefit of the patients we all serve,” said Dr. Charles O’Mara, associate vice chancellor for clinical affairs.

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Benzodiazepine Withdrawal: Potentially Fatal, Commonly MissedFollowing benzodiazepine cessation, withdrawal symptoms may begin within 24 hours or take up to two weeks to develop

Wolters Kluwer Health

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Comparing Potentially Inappropriate Prescribing Tools and Their Association With Patient Outcomes


OBJECTIVE

To assess the agreement of several different measures of potentially inappropriate prescribing (PIP) in older people and compare their relationship with patient‐reported outcomes.

DESIGN

Prospective cohort study including participants in The Irish Longitudinal Study on Ageing (TILDA).

SETTING

Waves 1 and 2 of TILDA, a nationally representative aging cohort study.

PARTICIPANTS

A total of 1753 community‐dwelling TILDA participants with linked administrative pharmacy claims data on medications.

MEASUREMENTS

Potentially inappropriate medications were assessed using the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) v1, American Geriatrics Society (AGS) Beers Criteria® 2012, and relevant Assessing Care of Vulnerable Elders (ACOVE) v3 indicators. Potential prescribing omissions were assessed using the Screening Tool to Alert Doctors to the Right Treatment (START) v1 and ACOVE v3 indicators. Their agreement was assessed via κ statistics, and multivariate regression was used to assess relationships with emergency department visits, general practitioner (GP) visits, quality of life, and functional decline (increased assistance needed for activities of daily living).

RESULTS

There was slight agreement between STOPP and AGS Beers Criteria® (κ = 0.20) and ACOVE indicators (κ = 0.15), while agreement between AGS Beers Criteria® and ACOVE indicators was fair (κ = 0.31). Agreement was fair between START and ACOVE indicators (κ = 0.34). All measures of inappropriate medications were significantly associated with increased GP visits. Only exposure to two or more START indicators was associated with reduced quality of life (adjusted mean difference = −1.12; 95% confidence interval [CI] = −1.92 to −0.33), and only two or more AGS Beers Criteria® were associated with functional decline (adjusted odds ratio = 2.11; 95% CI = 1.37‐3.28). For omissions, both measures were associated with functional decline, but only ACOVE indicators were associated with increased GP visits.

CONCLUSION

Prevalence of PIP and relationships with outcomes can differ substantially between tools with little agreement. Choice of PIP measure for research or practice should be considered in light of the circumstances and requirements in each case.

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A kidney transplant wait can take years – but just months with a live donor

Published on Thursday, October 31, 2019

By: Ruth Cummins, [email protected]

Krystal Richmond thought she’d been cleared to donate a kidney to her husband, whose end-stage renal disease was confirmed when he decided on a whim to get it checked.

The Louisiana resident was shell-shocked when her physician in Shreveport said tests showed her healthy kidneys had an unusually large number of vessels.

“He said, ‘We can’t take you here,’” Richmond said. “I went from hero to zero.”

But as it turned out, the loss of her super powers was temporary.

As she and her husband Matt drove back to their home in rural Wisner, La., Richmond looked out of the window, trying to hide her tears. “We thought God had answered our prayers, but now there’s a roadblock,” the 33-year-old remembered of that fall day in 2018.

Dr. Franco Cabeza Rivera, left, chats with Matt Richmond during a follow-up appointment to Richmond's June 20 kidney transplant. Also pictured are Richmond's wife, Krystal, who donated the kidney, and their son Morgan, 4.

Dr. Franco Cabeza Rivera, left, chats with Matt Richmond during a follow-up appointment to Richmond’s June 20 kidney transplant. Also pictured are Richmond’s wife, Krystal, who donated the kidney, and their son Morgan, 4.

Not 30 minutes later, her cell phone rang. It was one of her doctor’s staff. “She said she had called the University of Mississippi Medical Center, and that I’d see them at 8 in the morning,” Richmond said. “That no turned into a yes.”

They sat down with Dr. Mark Earl, associate professor of transplant surgery, whose specialty is abdominal organ transplant. “Dr. Earl … He’s confident,” Richmond said. “He said, ‘Not a problem for me. We’ve got this.’”

Matt Richmond’s surgery through University Transplant took place June 20. Today, the couple who between them have four children has returned to a life free of fatigue and home dialysis for Matt, a pipeline supervisor, and constant worry for Krystal, a former teacher.

Because of Krystal’s generosity, Matt didn’t have to wait long for a kidney. The average wait time is three to five years at most centers, stretching to seven years in some areas of the country, the National Kidney Foundation says. One of every 20 people waiting for a kidney die each year.

Their journey underscores the urgent need for more live organ donors. As of September 2019, 114,000 children and adults in the United States were on a transplant waiting list, the vast majority – including about 1,000 Mississippians – needing a kidney.

Recipients of a living donor kidney usually lead longer, healthier lives compared to those who receive a kidney from someone who has died. In 2018, there were a total 17,553 donors nationwide, with 10,722 being deceased and 6,831 of them living donors, statistics show.

Portrait of Dr. Felicitas Koller
Koller

“If we’re going to make an impact on kidney disease in Mississippi, we’re going to have to use more living donors,” said Dr. Felicitas Koller, assistant professor of transplant surgery who specializes in abdominal organ transplant. She transplanted Krystal’s kidney after Earl removed it.

University Transplant is taking steps to increase the number of potential live donors by offering education for those exploring donation. Live webinars are set for 7 p.m. Nov. 12 and 7 p.m. Dec. 10; participants can attend the classes at the Mississippi Organ Recovery Agency, 4400 Lakeland Drive in Flowood, or take part via a computer or mobile device.

University Transplant surgeons and the Medical Center’s living door team will discuss what it means to be a live donor, and what to expect throughout the evaluation process, surgery and recovery.

Anyone with two healthy kidneys can potentially be a live donor, and both the donor and recipient generally can do just fine with one healthy kidney. Most surgeries are laparoscopic, as opposed to the previous practice of removing a donor kidney via a large incision that can cause a longer recovery period. A donor usually spends one to three days in the hospital.

“Living donated kidneys tend to be uncomplicated,” said Dr. Franco Cabeza Rivera, assistant professor of nephrology. “These kidneys are working until the very last minute, and as soon as we place them in the recipient, they begin working again.”

About 800 people in end-stage or advanced kidney disease are waitlisted for a transplant at UMMC. Anyone over 18 and in good physical and mental condition can be considered as a donor, Cabeza Rivera said.

Being the right blood type for a match is only one part of live donor screening, Koller and Cabeza Rivera said. It’s an exhaustive process involving an assessment of any present or past diseases. “The team that does the screening includes a patient donor advocate who makes sure nothing is done inappropriately,” he said. “It’s a group decision.”

Down time after surgery is usually shorter with laparoscopic surgery, Koller said. “If you work a day job, maybe two weeks, and if your job involves significant labor, about four to six weeks.”

The recipient’s insurance typically pays for the donor’s medical workup and surgery, Koller said. “It saves the insurance company money, because it’s cheaper than keeping the recipient on dialysis.”

Richmond is one of nine live kidney donors at the Medical Center through mid-fall of this year.  That’s the maximum previously transplanted annually, so by year’s end, a new record should be set, Cabeza Rivera said. As of Oct. 28, a total 110 kidneys overall had been transplanted at UMMC this year.

“Our real goal should be two live kidneys a month, or 15-20 percent of our total kidney donations,” he said.

Matt Richmond, 43, has coped with major heart issues his entire life and was diagnosed with a kidney disease in his early 20s, before he and Krystal met. Both of his brothers died early from heart disease.

In late spring 2018, Matt mentioned to Krystal that he hadn’t had his kidneys checked in a while. They crossed that bridge at his heart appointment that summer. It’s time, his doctor told him, for dialysis.

Krystal-Richmond_Transplant-Donor_07.jpg

Richmond spoke to caregivers attending the UMMC Transplant Symposium.

“We thought out of the hundreds of people we knew, family and church family and work friends, there’d be somebody who would donate,” Krystal said.

“There were some people who wanted to, but that didn’t mean they were able,” she said. “My mom wanted to, but she smokes. I never thought I would be a match, but they told me I was compatible.”

Mississippi’s health demographics hinder live donations. “Obesity is the big problem, and with that come other conditions, like diabetes and hypertension,” Cabeza Rivera said. “A lot of what I see is patients whose relatives have the same health problems, or are going in that direction.”

If she hadn’t been a match, Krystal said, she would have wanted to donate a kidney to someone other than Matt. She would have taken part in a kidney “chain” or swap that benefits two recipients. The way it works: a live donor who isn’t a match for his intended recipient is paired with another live donor who isn’t a match for his intended recipient – but the two are matches for each other’s intended recipients.

Koller encourages those considering donation to attend one of the educational sessions. “Take some time to think about it, and ask questions before you come to a decision,” she said.

Before his surgery, “I was pretty sick,” Matt said. “I didn’t realize how sick I was until I got better.”

“It hurt,” Krystal said of her own surgery. “But you get over it, and it’s worth it.”

To take part in UMMC’s transplant education classes at 7 p.m. Nov. 12 and 7 p.m. Dec. 10, come to the Mississippi Organ Recovery Agency, 4400 Lakeland Drive in Flowood. Or, call in from a mobile device at 1-415-655-0001 or go to umc.webex.com. The access code for both is 809 535 021.

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Reasonable Doubt: Once and for All, Stop Ordering Stress Tests

Wolters Kluwer Health

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Black Nursing Home Residents More Likely to Watch Advance Care Planning Video


BACKGROUND/OBJECTIVES

This study aims to identify resident characteristics associated with being offered and subsequently shown an advance care planning (ACP) video in the Pragmatic Trial of Video Education in Nursing Homes (PROVEN) and if differences are driven by within‐ and/or between‐facility differences.

DESIGN

Cross‐sectional study, from March 1, 2016, to May 31, 2018.

SETTING

A total of 119 PROVEN intervention nursing homes (NHs).

PARTICIPANTS

A total of 43 303 new NH admissions.

MEASUREMENTS

Data came from the Minimum Data Set and an electronic record documenting whether a video was offered and shown to residents. We conduct both naïve logistic regression models and hierarchical logistic models, controlling for NH fixed effects, to examine the overall differences in offer and show rate by resident characteristics.

RESULTS

In naïve regression models, compared to white residents, black residents are 7.8 percentage point (pp) (95% confidence interval [CI] = −9.1 to −6.5 pp) less likely to be offered the video. These differences decrease to 1.3 pp (95% CI = −2.61 to −0.02 pp) when accounting for NH fixed effects. In fully adjusted models, black residents compared to white residents were 2.1 pp more likely to watch the video contingent on being offered (95% CI = 0.4‐3.7 pp). Residents with cognitive impairment were less likely to be offered and shown the video.

CONCLUSIONS

After controlling for NH fixed effects, there were smaller racial differences in being offered the video, but once offered, black residents were more likely to watch the video. This suggests that black residents are receptive to this type of ACP intervention but need to be given an opportunity to be exposed.

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Research excellence awards mark faculty, staff achievements

Published on Monday, October 28, 2019

By: Karen Bascom, [email protected]

The University of Mississippi Medical Center held its annual Excellence in Research Awards Oct. 25 in the Norman C. Nelson Student Union.

Hosted by the Office of Research, the ceremony recognizes faculty members for their achievements in gaining outside funding. The award levels – platinum, gold, silver and bronze – are based on the cumulative amount of extramural funding received by the investigator for their original research over their career at UMMC.

The 18 medallion recipients, including two platinum, five gold, nine silver and two bronze contributed to UMMC’s 302 grants and awards for fiscal year 2019.

Dr. Richard Summers, associate vice chancellor for research, said the event is one of his favorite days of the Medical Center year. He noted the diversity of the recipients, representing 14 departments and three schools. He also noted that UMMC brought in nearly $75 million in FY 2019, more than 60 percent of which came from federal agencies ranging from the National Institutes of Health to the National Endowment for the Humanities.

“This is a reflection of the robustness of our research mission across the university,” Summers said.

Addressing the researchers in attendance, Summers added, “Your hard work has accomplished this, not the Office of Research. We are just your cheerleaders and facilitators, and we are very excited about the direction our mission is going.”

Platinum Medallion – $5 million total

Dr. Susan Buttross, professor of pediatrics-child development

Buttross, medical director of the Center for Advancement of Youth, is the principal investigator of the Child Health and Development Project, which seeks to measurably improve health and development outcomes for young children through screenings and interventions in child care centers, doctors’ offices and other locations.

Dr. Deborah Konkle-Parker, professor of medicine-infectious diseases

Konkle-Parker served as PI for the UMMC cohort of the Women’s Interagency HIV Study and serves in the same capacity for the study’s successor, the MACS/WIHS Combined Cohort Study. She is also the PI for a substance abuse treatment program called Helping HAND (Helping to Advance in New Directions).

Gold Medallion – $1 million total

Dr. Fan Fan, assistant professor of pharmacology and toxicology

Dr. Bernadette Grayson, associate professor of neurobiology and anatomical sciences

Dr. Michael Hall, associate professor of medicine-cardiology

Dr. Bradley Walters, assistant professor of neurobiology and anatomical sciences

Dr. Licy Yanes Cardozo, associate professor of cell and molecular biology

 

Gold Award recipients Dr. Fan Fan, Dr. Licy Yanes Cardozo, Dr. Bernadette Grayson and Dr. Michael Hall. Not pictured: Dr. Bradley Walters

Gold Award recipients include, from left starting second from left, Dr. Fan Fan, Dr. Licy Yanes Cardozo, Dr. Bernadette Grayson and Dr. Michael Hall.

Silver Medallion – $500,000 total

Dr. Denise Cornelius, assistant professor of emergency medicine

Dr. Charlotte Hobbs, associate professor of pediatrics-infectious diseases

Dr. Sally Huskinson, assistant professor of psychiatry and human behavior

Dr. Michael Roach, associate professor of biomedical materials science

Dr. Joshua Speed, assistant professor of physiology and biophysics

Dr. Frank Spradley, assistant professor of surgery

Dr. Kedra Wallace, associate professor of obstetrics and gynecology

Dr. Junming Wang, professor of pathology

Dr. Keli Xu, assistant professor of neurobiology and anatomical sciences

Silver medallion recipients Dr. Sally Huskinson, Dr. Michael Roach, Dr. Joshua Speed, Dr. Charlotte Hobbs, Dr. Denise Cornelius, Dr. Keli Xu, Dr. Kendra Wallace and Dr. Frank Spradley. Not pictured: Dr. Junming Wang.

Silver medallion recipients include, from left starting second from left, Dr. Sally Huskinson, Dr. Michael Roach, Dr. Joshua Speed, Dr. Charlotte Hobbs, Dr. Denise Cornelius, Dr. Keli Xu, Dr. Kendra Wallace and Dr. Frank Spradley.

Bronze Medallion – $250,000 total

Dr. Seth Lirette, assistant professor of data science

Dr. Zhen Wang, assistant professor of physiology and biophysics

Bronze Award recipients Dr. Zhen Wang and Dr. Seth Lirette.
Bronze Award recipients include Dr. Zhen Wang, second from left, and Dr. Seth Lirette, second from right.

Discovery Awards

Early Career Investigator

Dr. Denise Cornelius, assistant professor of emergency medicine

Early Career Investigator Dr. Denise Cornelius

Dr. Denise Cornelius receives the Early Career Investigator Award.

 

Meritorious Research Service – Faculty

Dr. Vani Vijayakumar, professor of radiology

Meritorious Research Service-Faculty award recipient Dr. Vani Vijayakumar

Dr. Vani Vijayakumar receives the Faculty Meritorious Research Service Award.

Meritorious Research Service – Staff

Ashley Johnson, scientist III in pharmacology and toxicology

Gloria Minniefield, accounting manager for the Office of Research and Sponsored Programs, Post-Award

Meritorious Research Service-Staff award recipients Ashley Johnson and Gloria Minniefield

Ashley Johnson, left, and Gloria Minniefield each receive the Staff Meritorious Research Service Award.

Outstanding Achievement in Clinical Research

Dr. Shou-Ching Tang, professor of medicine, director of clinical and translation research, Cancer Center and Research Institute 

Outstanding Achievement in Clinical Research award winner Dr. Shou-Ching Tang

Dr. Shou-Ching Tang receives the Outstanding Achievement in Clinical Research Award.

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What Lies Beneath: In Praise of Skin

Wolters Kluwer Health

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UMMC, C Spire collaborate on new health app

Published on Thursday, October 24, 2019

By: Ruth Cummins, [email protected]

A new C Spire mobile telehealth app is allowing anyone located in Mississippi to receive non-emergency urgent care from University of Mississippi Medical Center providers.

The free app, C Spire Health, connects users face-to-face with providers through UMMC’s Center for Telehealth. It’s designed to improve access to quick and reliable care for a number of routine ailments, especially for those living in the state’s rural corners and other underserved areas.

The app is the product of more than two years of development by C Spire in collaboration with the Center for Telehealth. Those using it don’t have to be C Spire customers. The app can be downloaded from the Google Play and Apple App stores to any smartphone that runs either an Android or iOS operating system.

“As an innovative technology leader that gets our inspiration from customers, we are excited about giving the state’s consumers more choices to better manage their health care with simple, easy and convenient solutions,” said Hu Meena, president and CEO of C Spire, a Mississippi-based diversified telecommunications and technology services company.

Kevin Cook, chief executive officer of the UMMC Health System, explains the need for telehealth for those who live in areas with few health care options.

Kevin Cook, CEO of the UMMC Health System, explains the need for telehealth for those who live in areas with few health care options.

“We see this as a step forward for Mississippi,” said Kevin Cook, chief executive officer for UMMC’s Health System. “We’re proud to be a partner with them and to provide high quality health care when you need it and where you need it.”

UMMC is one of only two Telehealth Centers of Excellence nationwide and has led industry efforts in Mississippi for broader application of telemedicine.

Currently, UMMC clinicians are providing services through the app, but as the program grows, the goal is to include other physicians and nurse practitioners from around the state.

The cost for a visit is $59, payable online by credit card when scheduling an appointment through the app. It’s an attractive alternative for those with limited or no health insurance, and studies show is significantly less expensive than a visit to a traditional urgent care clinic or emergency room.

C Spire Health isn’t intended to replace a user’s primary care physician, but instead to treat common, non-emergency medical conditions. Patients can make an appointment after downloading the app and creating an account. Visit hours are Monday-Friday 7 a.m.-9 p.m. and Saturday 8 a.m.-5 p.m.

Representatives of C Spire, the University of Mississippi Medical Center and the Mississippi Telehealth and Rural Health Associations gather to unveil the new C Spire He

Representatives of C Spire, UMMC and the Mississippi Telehealth and Rural Health Associations unveil the health app.

On the initial visit, a clinician will ask the patient questions about his medical history. The information is stored securely. The clinician will evaluate the patient’s condition verbally through audio or video consultation. In most cases, the clinician can reach a diagnosis and recommend a treatment plan without additional testing.

The provider also can call in prescriptions to the patient’s preferred pharmacy and refer patients to specialists if needed. The app will send patients a summary of their visit at the end of their appointment.

UMMC 2 You, a similar telehealth urgent care program, is offered by the Medical Center to state employees who are covered by the state’s insurance plan. Several corporations also take part In UMMC 2 You. Users can download the UMMC 2 You app onto a computer, tablet or smartphone and create an account. State employees covered by the base plan pay $49 per visit and are eligible for a $10 copay after meeting their annual deductible; those covered by the select plan pay $10 per visit, which is not subject to their annual deductible. Costs to corporate customers vary by insurance provider.

The C Spire Health app debuts at a time when hospitals and doctors are looking for new, creative ways to combat physician shortages. At the same time, there are growing consumer preferences for more convenient access and treatment for minor health issues and conditions, said Ryan Kelly, executive director of the Mississippi Telehealth and Rural Health Associations.

Meena said technology innovation in health care is a key part of the C Spire Tech Movement, a companywide effort begun in 2017 designed to help move the region forward through improvements in broadband access and workforce development. 

To learn more or to download and use the C Spire Health app, go to www.cspirehealth.com.To learn more about the UMMC Center for Telehealth, go to www.umc.edu/Healthcare/Telehealth

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